Introduction: Tibial plateau fractures are usually challanging although they are not really common. In fact this type of lesion represent about 1,5% of all fractures, and mostly they interest young patients.

The classification system commonly used the Muller and Schatzker ones those relate grade to treatment ad outcome.

Aim of study: It was to evaluated mid term results of tibial plateau fracture treated using hybrid external fixation performed (with k-wires and pins and transfixing pins) and minimally invasive osteosynthesis.

Material and Methods: In the last five years there were treated 39 patients in our hospital using external fixation and minimal invasive osteosynthesis, 35 of those were evaluated in radiographs and functional outcome. The mean follow-up was 2,5 years.

Results: Our study showed good results and a poor complication rate related to the applied technique. The clinical outcome overall was 86% good, while the evaluation of function was good in 77% of cases revised. The radiographs were satisfactory in 91% of cases.

Conclusions: It is authors’ opinion that the quality of results are related to early motion of the knee, while bad results are often due to scar and to mechanism of injury (high energy trauma, floating knee). External fixation has shown to give good results with low complications.

Recently it has been increasing the interest of theorthopaedic surgeon about those tools o devices to optimize the results of the replacement surgery. In fact in the last few years the incidence of operations executed in order to treat patients affected by osteoarthritis of the hip with THR is increased, and so the need ness of giving back more long-lived implants.

For this reason new navigation systems, based CT have been developed, which, during surgey, can make the positioning hip and knee prosthesis easier. A pool of international workers (surgeon, engineers, etc.) has developed recently an articular navigation system based on surgery reliefs, using tools gauged and provided with visible markers detected by a computerized system which uses infrared cameras.

For this reason new navigation systems, based CT have been developed, which, during surgey, can make the positioning hip and knee prosthesis easier. A pool of international workers (surgeon, engineers, etc.) has developed recently an articular navigation system based on surgery reliefs, using tools gauged and provided with visible markers detected by a computerized system which uses infrared cameras.

In fact it is not based on CT images of thehip, but on direct data (kept during the operation) analysis, and for this reason the procedure should be more accurate.

Introduction: the prevalence of diabetics in the old population, and the enhancement of medications actually cause an enormous augmentation of the incidence of diabetic foot. Aim: aim of the study is to report authors’ experience about the transmetatarsal amputation. Patients were enrolled according to skin conditions, arteriography and life expectation. However, based on personal experiance arteriography has not been one of the main criteria in selecting the level of amputation. Methods: Since jenuary 1997 up to december 2002 thertyfour patients were treated. 26 were male, 8 females, the mean age was 69 years. The total amount of transmetatarsal amputation has been 36 surgical procedures. Those were performed after a peripheral anesthesia, the surgeon always avoided the use of torniquette. A short leg cast was made in order to let the wound heal and to avoid equinus deformity untill the weightbearing gait was allowed. Results: At a mean follow-up of 48 months 28 patients were able to walk using one or without crutches, two patients needed two crutches full time, four patients underwent to a further procedure of resection at a more proximal level. Conclusion: the outcome showed to be dependent by many variables, however middle term results are encouraging, patients can walk and attend again their own daily activities fairly soon. Although it is well understood that the long term result will be worst, we suggest to try whenever it is possible to perform a transmetatarsal amputation expecially in old people who can not easily ricover from a leg resection.