During the period 2004–2009, 35 children were admitted to the emergency department,(24 males:11 females), aged 3–14 years old,(MEAN 8,45 years), with supracondylar humeral fractures (33 extension type and 2 flexion type). All fractures were closed and result of sports injuries or games and were treated with closed reduction under general anesthesia and percutaneous k-w fixation.

The postoperative follow-up lasted from 6 months to 4 years. The Bauman’s angle was evaluated postoperatively on the operated and normal elbow and was 76, 6 ±1° and 74, 7 ±0, 6°. According to Flynn’s criteria the functional outcome was excellent in 29 cases. In 6 cases where the Bauman’s angle was greater than 10–15° there has been observed varus deformity (4 cases), valgus deformity (1 case), and flexion deficit (1 case).

The percutaneous k-w fixation and preservation of Bauman’s angle with carrying angle too, on supracondylar humeral fractures on children is a safe solution to avoid future complications.

To estimate the outcomes after posterior dynamic stabilization in situ with Dynesys (Zimmer Spine, Minneapolis, MN) for treatment of symptomatic spinal stenosis and degenerative spondylolisthesis in long-term follow-up.

28 patients(mean age 73 years old) with symptomatic spinal stenosis and spondylolisthesis underwent inter-laminar decompression and stabilization with Dynesys. Patients were evaluated clinically and radiologically after a follow-up from 6 months to 4 years.

Pain on VAS and walking distance improved significantly at less than 2 years and remained unchanged at 4 years follow-up. Radiographically, spondylolisthesis did not progress and the motion segments remained stable. 2 patients showed screw-loosening at 1 year follow-up and underwent revision. Overall, patient satisfaction remained high as 93% and would undergo the same procedure again.

In elderly patients with spinal stenosis and degenerative spondylolisthesis, decompression and dynamic stabilization lead to excellent clinical and radiologic results. It maintains enough stability to prevent progression of spondylolisthesis. Because no bone grafting is necessary, donor site morbidity, which is one of the main drawbacks of fusion is eliminated

Background: Mobile-bearing knee designs represent an alternative to conventional fixed-bearing TKA designs. We present the results of a prospective, long-term clinical follow-up study of the Rotaglide (Corin UK) rotating – translating platform total knee design.

Methods: Between October 1990 and December 1998, 326 primary consecutive knee replacements were performed in 260 patients (223 women and 37 men). The average age of the patients at the time of the index procedure was 66.84 years (range 20–82 years). Osteoarthritis was the etiologic factor in 297 knees (91.10%) and rheumatoid arthritis in 25 knees (7.66%). Twenty knees (6.13%) had previous operations (including 16 osteotomies). Both femoral and tibial components were cemented in all knees and the patellae were resurfaced in 199 knees (61.04%). The polyethylene (GUR 1050) mobile inlay was at that time sterilized by Gamma irradiation (2.5 Mrad), packed and stored in air permeable ‘paper bag’. Patients were evaluated at three and six months post operatively and yearly thereafter with use of the KSS. In addition, a radiographic analysis of the tibial, femoral, and patellar components was carried out at each interval and at the last assessment. Twenty four knees (7.36%) were excluded from the study out of which ten knees (3.07%) of eight patients who had died and fourteen knees (4.29%) of ten patients who were lost to follow up. Thus 302 knees (92.64%) were assessed clinically and radiologically in 242 patients. Average follow-up 12.13 years (range 9 to 17).

Results: Pre-operative KSS Knee score 30 (range, 22 to 56) and KSS function score 39 (range, 32 to 58) improved to 88 (range, 62 to 96) and 85 (range, 56–95) respectively. Knee alignment was achieved in 279 out of 302 knees (92.38%). Knee stability was achieved in 292 knees (96.68%). Knee flexion was improved from an average of 92 degrees pre-op to an average of 113 degrees post-operatively. Zonal radiographic analysis revealed fourteen (4.63%) instances of radiolucent lines, ten of which measured < 1 mm in width. None of these lines were deemed to be progressive. Four of the remaining knees with a radiolucent line > 2 mm followed-up carefully and three of them eventually were revised. There were twenty four (7.36%) failures that resulted in revision surgery. In seventeen (5.21%) of them the findings were those of worn out or broken polyethylene with no sings of metal wear or component loosening and therefore only polyethylene exchange was carried out. The other seven knees (2.15%) were totally revised. Kaplan-Meier survivorship using revision of polyethylene mechanical failure as the end point was 94.76%. Overall survivorship of the implant at seventeen years was 92.64%.

Conclusions: This mobile-bearing, total knee prosthesis was associated with a good survival rate and demonstrated clinical efficacy during the 9 to 17 years follow-up interval.

Introduction. This prospective cohort study aimed at the assessment of the incidence of indolent SH among otherwise ‘healthy’ and symptoms’ free postmenopausal women suffering from primary KOA.

Methods. During a period of 23 months (November 2004 – Sepetember 2006), two hundred and forty-two postmenopausal women suffering from primary KOA were enrolled. None of them had suffered any osteoporotic fracture, received any anti-osteoporosis treatment or suffered from any disease interfering with their bone mass/quality. The serum levels of Intact-Parathyroid Hormone (I-PTH), Calcium and Phosphorus were evaluated and Creatinine Clearance was calculated. The latter was performed in order to determine a possible relation between the patients’ renal function and the I-PTH level.

Results. The patients’ mean age was 70,20 years (range: 49–81). The years that had passed since their menopause ranged from 7 to 31 (mean of 18,7 years). The patients were divided into three groups according to their age: Group A (n=41) age < 64 years, Group B (n=140) age 65–74 years and Group C (n=61) age > 75. The overall incidence of SY in all three groups was 35,95% (87 out of 242 patients). Group C patients were most likely to suffer from SY (25 out of 61 patients or 40,98%). The I-PTH values of Group A patients were normal in 27 out of 41 patients (68,85%) and of Group B in 92 out of 140 patients (65,71%). One group B patient suffered from Primary Hyperparathyroidism. No statistically significant relation between the patient’s renal function and the I-PTH level was found.

Discussion/Conclusion. SH appears to be a ‘silent’ epidemic among elderly postmenopausal women. According to our results, women 75 years-old and older are most likely to suffer from SY. One of the main reasons for that seems to be the insufficient calcium and/or vitamin D intake. It is our belief that anti-osteoporosis diagnosis and treatment modalities should be focused on this group of patients.

Aim: Although several surgical procedures have been proposed for advancedstage Kienböck’s disease, it still remains a difficult therapeutic problem. This study documents the clinical, radiographic and MRI outcomes of ten patients, who underwent lateral closing wedge osteotomy of the distal radius by the same surgeon, after MRI confirmation of advanced Kienböck’s disease. Methods: Ten patients (6 men and 4 women) with a mean age of 28,7 years (range 21–66) were included in this study. Seven had Lichtman stage III-B and three stage IV disease. The lateral closing wedge osteotomy was performed at the distal metaphysis of the radius through a palmar approach and was fixed with a 3,5mm titanium T-plate. The average follow up period was 52 months (range 36–60 months). Results: Substantial pain relief, increase in grip strength and range of wrist flexion and extension were achieved. Clinical results were excellent in two patients, good in five, fair in two patients and poor in one patient according to Nakamura’s postoperative scoring system. Gadolinium enhanced MRI at the latest follow up revealed signs of revascularization of the lunate in 6 cases. Conclusions: Lateral closing osteotomy decreases radial inclination and pressure at the radiolunate joint, thus improving lunate coverage. It is a reliable extra-articular procedure for advanced Kienbock’s disease that provides pain relief while there is evidence that it may improve lunate vascularization.