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Introduction: Distal femoral shaft fractures are characterized by increasing incidence and complexity and are still considered a challenging problem (high morbidity and mortality). No consensus on best surgical option has been achieved., Aim: This study aims is to investigate radiographic, mineral bone densitometry and clinical outcomes of locking retrograde intramedullary (LRN) nailing and anatomical locking plate to surgically treat distal femoral shaft fractures in young adults based on the hypothesis that there is no statistical difference among the two surgical options in terms of results (radiographic, bone densitometry and outcomes assessment)., Methods: Retrospective study: 30 patients divided into 2 groups (Group 1 LRN, Group 2 Nailing). Average age was 42.67±18.32 for Group 1 and 42.84 ±18.32 for Group 2 (range of age 18-65 for both groups). Gender Ratio (male: female) was 2.75 (11:4) for both Group 1 and 2. AO Classification, NUSS and RUSH score, VAS, Dexa scans, plain radiographs were used. Evaluation endpoint: 12 months after surgery (mean follow up 16.24)., Results: No statistical difference in terms of surgery time, transfusions, wound healing. Similar results with regard to average time of bone healing, RUSH scores, VAS, regression between RUSH and VAS, average correlation clinical-radiographic results and patients outcomes. Only one patient of each group had reduction of mineral bone densitometry values., Conclusion: No statistical difference about the use of LNR or Nailing for treatment of distal femur shaft fractures in terms of radiographic, bone densitometry and outcomes has been found accordingly to our results. Good subjective and objective results are provided by both techniques. The choice among the two techniques must be based on surgeons' experience, indications and subjective patients' aspects. The absence of relevant similar data in the published literature does not allow definitive validation (or rejection) of our hypothesis. A more powered study with bigger cohort is needed for definitive validation.

Introduction: The SNAC wrist (Scaphoid nonunion advanced collapse) is one of the complications following scaphoid fractures treated conservatively and one of the causes of wrist arthritis that the hand surgeon has to face most frequently. In these cases surgical management is usually warranted., Materials and Methods: In the set time frame of 6 years we treated 15 SNAC wrist cases. On average patients underwent surgery five years after the trauma. All patients were treated via dorsal incision with partial carpal arthrodesis and total scaphoidectomy, associated with denervation of the posterior interosseous nerves. A plaster cast was applied to all patients for 3 weeks postoperatively. In the preoperative stage, X-rays of the healthy contralateral limb were taken for the measurement of the normal radiocarpal joint space. Clinical and radiographic follow-ups were conducted at 1,3, 6 and 12 months from the trauma; then every 12 months. Criteria for the evaluation of patients: visual analog pain scale (VAS), average time of radiographic fusion of wrist bones, Active Range of Wrist Motion (WAROM), subjective Mayo Wrist Score (MWS) and The Short Form ( 36) Health Survey (SF-36), return to the main tasks and complications. The evaluation endpoint was set at 60 months. Average time of surgery: 48.3 minutes. Average time of arthrodesis consolidation: 67.8 days. The VAS and WAROM showed a gradual improvement in seriated controls, returning to values almost identical to pre-trauma at a 5-year follow-up. By this time, the MWS and SF-36 scores were similar to pre-trauma. On average, the return to pre-injury daily activities occurred in 12.5 months after surgery. There were no complications., Conclusions: The partial carpal arthrodesis is a safe and effective procedure for the treatment of SNAC wrist cases. Our results show a progressive and significant improvement in ROM, VAS and great satisfaction from the patient.