Aims: i) To describe the anatomy of the peroneal nerve on a tridimensional fashion, and ii) to identify an external anatomic landmark to deþne the trajectory of the nerve and its branches at the level of the proximal tibia. Material and Methods: 21 cadavers were dissected. The peroneal nerve was identiþed and followed as its branches entered the muscles of the anterior compartment of the leg. Results: The trajectory of the common peroneal nerve, and its branches was best described as a section of a circumference centered at the Gerdyñs tubercle with an average radius of 45 mm (range 41 to 49mm). In this circumference, the distance between the Gerdyñs tubercle and the common peroneal nerve at the level of the head of the þbula was equidistant to the distance between the tubercle and the most distal portion of the tibialis anterior branch of the peroneal nerve. Discussion and conclusion: Several anatomic studies describe the location of the peroneal nerve only in two dimensions and in relation to the head of the þbula. By relating the position of the peroneal nerve to the Gerdyñs tubercle, a circumferential safe zone can be easily deþned and marked preoperatively and may help avoid complications in procedures such as þbular osteotomies, high tibial osteotomies, external þxation wire placement, þxation of tibial plateau fractures, interlocking of tibial nails, and transtibial traction pin insertion.

Aims: The purpose of this study was to quantify the amount of cell viability and cartilaginous damage present in non-reparable human osteoarticular fragments removed at the time of acetabular fracture surgery. Material and Methods: The cases of 6 patients with comminuted fractures of the acetabulum were prospectively analyzed. Average age was 39 years, and none of them had evidence of preexisting hip pathology. Loose small osteoarticular fragments that were not reparable were microscopically analyzed to assess in-situ cell viability. Observations were divided into (i) depth of chondrocyte death from the articular surface, and (ii) structural matrix damage and cell death under regular histology. The depth of cell death was classiþed as mild between 1 and 15%, moderate from 15 to 30%, severe from 31 to 60% and total from 61 to 100%. Results: Five of the patients were classiþed as having only mild amount of chondrocyte death and one specimen had a moderate amount of chondrocyte death. The articular surface damage was mainly located on the superþcial zone of the cartilage. Discussion and conclusion: Most of the chondrocytes on small osteochondral fragments removed from displaced intraarticular acetabular fractures were still viable after having received a substantial amount of trauma.

Aims: The objectives of this study are to determine the feasibility of the endoscopic þxation of the anterior pelvis. Material and Methods: Twenty adult cadavers were studied. A þve hole plate was introduced and þxed by balloon and C02 dilatation of the space of Retzius. After plating, the cadavers were dissected to analyze plate and screw position, and presence of damage on the surrounding tissues related to the procedure. Results: Plate and screws were seen to be in good position in all cases. No damage to vital structures was identiþed. Case Report: 33 y/o male sustained an open book external rotation AO/OTA type 61-B3.1 pelvic fracture. EFAP was performed successfully. Postoperative x rays showed good reduction and implants position. Discussion and conclusion: Open approaches to the anterior pelvis are not free of complications. Endoscopy allows clear visualization of the space of Retzius and it is a valuable aid for pelvis fracture þxation. Extraperitoneal endoscopy of the anterior pelvis is a safe and commonly performed surgical procedure. This paper shows that plate and screws þxation of the symphysis pubis can also be performed using this minimally invasive approach.

Aims: The objectives of this study were i) to deþne the impact of osteomyelitis in the patientñs quality of life, and ii) to grade this impact in order to revert this social deterioration on an early fashion. Material and Methods: Thirty six patients with a diagnosis of chronic osteomyelitis and still under treatment were retrospectively reviewed and they were asked to completed a questionnaire. The main questions were: 1) evidence of long-term complications 2) length of treatment 3) number of surgeries 4) number and type of antibiotic treatments 5) employment or education changes during the disease 6) health insurance coverage changes during the disease 7) marital status changes over the course of the disease 8) need to spend savings to pay for treatment 9) new onset depression 10) new addictions.

The patients were graded from I to III according to the results of the questionnaire. Results: The patients were classiþed as Grade I if they were still employed and did not undergo any major social losses. Grade II if they are unemployed, without insurance but with an intact family core, and Grade III if the had also lost their family support. Discussion and conclusion: All efforts should be directed to keep the patient on a Grade I. Progression of the patient to a Grade II or III should be avoided. Failure to recognize the early impact of the disease may cause an inevitable progression in the grade of social impairment. The greatest challenge in the treatment of osteomyelitis is to prevent the social deterioration that accompanies and is the hallmark of this disease by an effective early surgical and clinical intervention.