Introduction and purpose: The aim of this study is to determine whether a porous tantallium implant is effective in the treatment of femoral head osteonecrosis (ON) in its early stages.

Materials and methods: Between December 2002 and March 2006, 20 tantalum-on-rod screws were implanted in 15 patients with femoral head ON. A retrospective study was performed to analyze distribution by sample age, sex and etiology, stage of ON according to the Ficat and Arlet classification and the Shimuzu et al classification as modified by Lieberman et al. The result obtained was quantified according to subjective clinical evolution, ON evolution as determined by x-rays and the subsequent need for total hip replacement.

Results: Good results were obtained, with clinical remission and absence of necrosis progression in 60% of ON cases. Conversion to total hip replacement was necessary in 35% of hips. Mean follow-up was 16.4 months.

Conclusions: The treatment of ON with porous tantallium implants is quick and simple. It is important to use an accurate technique with implantation at the appropriate level and limit this surgery to the initial stages of the disease. To obtain more significant results it is necessary to study more cases and carry out a longer follow-up.

Introduction: There are protocols on the management of polytrauma in obstetric patients. However, there is little information about osteo-articular injuries sustained in these patients. The object of this study is to review the management of these patients and to suggest a guideline.

Material and method: Inclusion criteria: Pregnant patients treated during the last 6 years, treated as inpatients in our center during pregnancy due to osteo-articular injuries.

Variables studied: Gestational age, mechanism of injury, fracture type, management, termination of pregnancy and sequelae.

Results: We treated 13 patients with 21 fractures in our center, with an incidenc of 2,13 fractures/10.000 births. The mechanism of injury was low degree trauma in 6 cases (60% 3rd trimester) and high-degree in 7 (83% 1st and 2nd trimester). There was a predominance of lower extremity fractures, especially tibia and fibula (7 cases) and pelvis (3 cases).

Gestational age was 1st trimester (3 cases), 2nd trimester (5 cases), 3rd trimester (5 cases). 10 women were treated surgically, 8 before finishing gestation. Gestation ended as and induced abortion (3 cases, 1 due to fetal death and 2 due to teratogenic risk), and birth (10 cases, all alive, 50% eutocic). Only 3 babies needed type II or type III neonatal reanimation.

CONCLUSIONS: Pregnant women can get injured by low-energy trauma, especially during the third trimester. Pregnancy does not necessarily compromise surgical management of fractures. We review diagnostic and therapeutic management strategies for these patients.