Lateral tibial plateau fractures are articular fractures that can have a severe prognosis involving a joint biomechanically and functionally very important.

Osteosynthesis is very often required as the articular surface must be accurately restored.

In many cases rigid devices were implanted, often sacrificing lateral meniscus and leading to osteoarthritic changes in the following years.

In the recent years new diagnostic tools as TC and MRI and the growing role of arthroscopy have allowed a more precise diagnosis and the possible use of less invasive devices.

Considering all fractures classified as B3 according AO (or type 2 by Schatzker), we considered 10 cases treated with Barr screw and 8 cases treated with K-wires positioned as a shelf after reduction and bone grafting.

All patients underwent an accelerated rehabilitation protocol with immediate mobilization and full weight bearing within 10 weeks.

At the follow-up at 24 months, both the groups showed very good and comparable clinical, radiographical and functional results.

We can conclude that after an accurate preoperative planning also the use of less invasive devices allow a quick recovery of range of motion without compromising the stability of osteosynthesis and the morphology of knee joint.

Aims: The purpose of our review is to evaluate results of surgical treatment in bone metastases and to relate the surgical indications to these results. Methods: 297 patients operated between 1980 and 1998 were reviewed. Main age of the patients was 60.9 (18–86). The involved bones were femur (169cases), humerus (77), spine (33), tibia (8), pelvis (4), cubitus (2)others (4). The primary tumours (of 215 reviewed diagnosis) were breast (80cases), lung (31), myeloma (21), kidney (18), intestine (8), thyroid (7), prostate (6), uterus (6), pharynx (4), sarcoma (4), bladder (2), liver (2), others (4), well differentiated unknown origin (14), undifferentiated (8). The operations performed were nailing (86cases), interlocked-nailing (59), prosthesis (58), spinal osteosynthesis (34), plating+cement (25) nailing+cement (17), resection (10), resection+cement (6), amputation (2). Minimal conditions for surgery were life expectancy of at least 60 days, possibility of a solid implant and acceptable blood parameters (wbc> 2,000, plt> 30,000). Most of the patients underwent postoperative radiotherapy. Results: The Karnofsky index at sixty days showed a mean improvement of 30pts% using nails and prosthesis, and 10pts% with plating+cement (performed in patients in better general conditions). After surgery, all of the patients reached a score over 70pts% and in every case pain was sensibly reduced. There were 3 perioperative deaths (1%) and 10 major complications (3.4%). Conclusions: An operation performed after an accurate planning leads to an improvement in the quality of life and self-sufþciency of these patients, thereby reducing the cost of care. The choice of technique must allow to obtain a quick result (no bone grafting) and a fast functional improvement, considering the limited life expectancy of the patients.