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Microplastics (MPs) are ubiquitous pollutants that have also been detected in the aquatic ecosystems at high concentrations. The use of shellfish as bioindicators is widespread for assessing and monitoring the environmental quality in both freshwater and marine environments. On this path, biomarkers represent an effective tool in monitoring programs. This minireview would broaden the existing knowledge on biomarkers of MPs in the Mediterranean mussel Mytilus galloprovincialis. This species was selected as it is widely distributed across the Mediterranean Sea and used as a bioindicator to monitor the presence of MPs in the marine environment. The literature search returned only 11 studies, mainly related to oxidative stress biomarkers. Although certain biomarkers were explored to estimate the effects of MPs on M. galloprovincialis, a battery of standardized and validated biomarkers as well as the inclusion of new ones are needed in future studies to obtain more comparable and robust findings across the Mediterranean Sea.

The aim of biomechanics applied to implantology is to determine the deformative and tensional states by solving the equilibrium equations within the mandibular bone and the osseointegrated implant to ensure its stability and improve the success rate. The finite element method is a powerful numerical technique that uses computing power to derive approximate solutions for the analysis of components with very complex geometry, loads, materials, and especially the biomechanical problems analysis, which is challenging to find in vivo or in vitro. This study performs a complete FEA survey on 3 implants Cono-in with 3 different diameters 3.4 mm, 4.5 mm, and 5.2 mm with abutments inclined to 15° and evaluates the tensions that are generated in the system as a result of the application of chewing loads. In this study, the extent of the stresses developed in the peri-crestal zone of the implants with the variation of the occlusal overstress acting on them was also evaluated. Autodesk Inventor Nastran Software was used to perform this type of localized finite element analysis; With this type of analysis, it was possible to analyze the peri-crestal area of the implant more precisely through a more accurate reconstruction of the mesh element, which allowed us to solve the FEA solution mathematically. The results showed how the application of the inclined load with respect to the vertical load on a larger diameter system leads to an increase in stress.

Environmental diagnostics are commonly used to identify anthropogenic influences in various environmental settings. However, the use of a single survey technique is limiting and leads to an incomplete and often inaccurate picture of reality. In this study, three real cases analyzing impacts on marine ecosystems have been presented to prove how the integration of different diagnostic techniques can be very beneficial to better understand the phenomena that occur as well as the impacts and associated damages. Studies combining classical diagnostics based on the determination of contaminant levels by chemical analysis, ecotoxicological tests and stress biomarkers with diagnostics by Field Emission Scanning Electron Microscopy-FESEM and X-ray diffraction-XRD microscopy are reported. Findings suggest that the embedding of chemical analyses, ecotoxicology and microchemical FESEM and XRD analyses allow us to hit the mark and give precise and effective responses in environmental management.

In open regions of the Ross Sea, the role of the microbial community in the turnover of organic matter has scarcely been investigated; indeed, very little is known on how microbial distribution and functional diversity respond to environmental conditions and hydrographic structures. During the austral summer of 2017, two pelagic areas of the Ross Sea [the Drygalski Ice Tongue and the nearby Terra Nova Bay polynya (A area), and the continental Shelf Break area near Cape Adare (C area)] were studied at selected depths [surface, Deep Chlorophyll Maximum (DCM), Circumpolar Deep Water (CDW), deep waters]. Trophic properties [nutrient concentrations, particulate (POC), dissolved organic carbon (DOC) and its optically significant fraction (CDOM) were measured, together with the main hydrological variables. Microbial community abundance [total prokaryotes, living, dead, and actively respiring fraction, high- and low nucleic acid cells (HNA and LNA), pico- and nano-eukaryotes, culturable heterotrophic bacteria], composition, and metabolism (as whole community and as isolated bacteria) were also assessed. Through a multidisciplinary dataset, this study highlighted the variable response of microbial abundance, diversity, and metabolism of the microbial community to the changing local environmental conditions of the Ross Sea. Different forces, such as organic matter inputs (mostly of detrital nature) released from the Drygalski glacier in the A area, and a coastal-to-offshore gradient in the C area, coexisted within this extreme ecosystem. This resulted in a significant spatial segregation of the edaphic parameters, and of the microbial community distribution and metabolic activity patterns.

Transitional water ecosystems are targeted by the European Union (EU) Water Framework Directive (WFD, CE 2000/60) monitoring programs in coastal zones. Concerning sediments, activities performed for the WFD focus on a few variables concerning the biochemical composition of organic matter. Our research reports the effects of oxygen availability on the biochemical composition of organic matter in sediments to highlight levels of targeted variables in time and, according to the depth of sediment layer, both under oxygenated and anoxic conditions in a mesocosm study on sediment cores. Results provide evidence that tested factors of interest (i.e., disturbance type, oxygenic versus anoxic conditions, persistence time of disturbance, 0&ndash, 14 days, penetration through sedimentary layers, 0&ndash, 10 cm depth) are able to significantly affect the biochemical composition of organic matter in sediments. Large part of the variables considered in this study (total organic carbon (TOC), total phosphorous (TP), total sulphur (TS), Fe, carbohydrates (CHO), total proteins (PRT), biopolymeric carbon (BPC), chlorophyll-a (Chl-a) are significantly affected and correlated to the oxygenation levels and could be good early indicators of important changes of environmental conditions. Monitoring activities performed under WFD guidelines and management strategies of Mediterranean coastal lagoon ecosystems shall include the biochemical composition of organic matter in sediment to provide an exhaustive picture of such dynamic ecosystems.

The occurrence of the protozoan parasites Toxoplasma gondii and Cyclospora cayetanensis was molecularly investigated in the hemolymph, gills, stomach, hepatopancreas and gonads of the eleven invasive Atlantic blue crab Callinectes sapidus from the Lesina Lagoon (Mediterranean Sea). Out of 11 blue crabs, 6 (54.5%) and 4 (36.4%) were found positive to T. gondii and C. cayetanenis, respectively; parasites were found only in the six females analysed, while the remaining five males resulted negative. Moreover, out of 55 tissues samples, 7 (12.7%) and 8 (14.5%) were positive to T. gondii and C. cayetanensis, respectively with hemolymph and gills being the most infected tissues. This is the first report of the presence of protozoan pathogens in wild crab species collected from a Mediterranean lagoon. The present results may provide a baseline reference on microbial infection in the species for invaded Mediterranean waters, and on the potential health risks related with its consumption if eaten raw.

This study investigates how multiple forcing factors such as rivers, surface marine circulation and winds affect hydrology and biogeochemical processes in the Gulf of Manfredonia and the seas around the Gargano peninsula, in the south-western Adriatic Sea. The study adopted an integrated approach, using in situ and remote sensing data, as well as the output of current models. The data reveal variability in the area's hydrography induced by local freshwater sources, the Western Adriatic Current (WAC) flowing from the north along the Italian coast, and the current patterns under different wind regimes. Specifically, exchange with offshore waters in the gulf induces variability in salinity and biogeochemical content, even within the same season, i.e. winter, in our case. This strong dependence on physical and biogeochemical factors makes the Manfredonia-Gargano ecosystem vulnerable to climate change, which could compromise its important role as a nursery area for the Adriatic Sea.

Changes in environmental stressors inevitably lead to an increasing need for innovative and more flexible monitoring tools. The aim of this work has been the characterization of the motility pattern of the cryopreserved sea bream semen after exposure to a dumpsite leachate sample, for the identification of the best representative parameters to be used as endpoints in an ecotoxicological bioassay. Sperm motility has been evaluated either by visual and by computer-assisted analysis; parameters concerning motility on activation and those describing it in the times after activation (duration parameters) have been assessed, discerning them in terms of sensitivity, reliability and methodology of assessment by means of multivariate analyses. The EC50 values of the evaluated endpoints ranged between 2.3 and 4.5 ml/L, except for the total motile percentage (aTM, 7.0 ml/L), which proved to be the less sensitive among all the tested parameters. According to the multivariate analyses, a difference in sensitivity among "activation" endpoints in respect of "duration" ones can be inferred; on the contrary, endpoints seem to be equally informative either describing total motile sperm or the rapid sub-population, as well as the assessment methodology seems to be not discriminating. In conclusion, the CRYO-Ecotest is a multi-endpoint bioassay that can be considered a promising innovative ecotoxicological tool, characterized by a high plasticity, as its endpoints can be easy tailored each time according to the different needs of the environmental quality assessment programs. (C) 2015 Elsevier Inc. All rights reserved.

Xanthones represent a class of naturally occurring compounds with valuable and promising reported pharmacological activities. One of the main disadvantages in the use of such products is related to the difficulties in their chemical synthesis. In this Letter a new and improved method for the chemical synthesis of xanthones is described. The title compounds have been synthesized in good yields under microwave irradiation from substituted 2-hydroxybenzoic acids and phenols in the presence of Yb(OTf)3 hydrate as the catalyst.

Integrated classification maps were produced by combining sediment grain-size and hydrological data (water renewal time, WRT) from two Mediterranean lagoons, Lesina (LL) and Varano (LV), Italy. The geophysical characteristics of the two basins, derived from detailed bathymetric charts, are quite distinct: ∼30% of LL (mean depth ∼1 m) but only 3% of LV (mean depth ∼3 m) is shallower than 1 m. The sediments of both lagoons are mainly composed of mud (∼80%). A detailed multivariate analysis of grain-size data by EntropyMax classified the lagoon beds of LL and LV into five sedimentary facies. WRT data, computed by a hydrodynamic model, indicated different hydrological conditions in the two lagoons: LL showed a sharp west–east gradient, with a basin-wide average of ∼190 days, whilst LV showed a fairly uniform distribution and a higher basin-wide average (∼260 days). The distribution of sedimentary facies and water renewal times were combined in a composite map representing the distribution of environmental patterns. The approach outlined in this study can be used to improve zonation schemes by providing a hydromorphological perspective on transitional and coastal environments., This is the accepted version/post-print of the article Molinaroli, E.; Sarretta, A.; Ferrarin, C.; Masiero, E.; Specchiulli, A.; Guerzoni, S. Sediment grain size and hydrodynamics in mediterranean coastal lagoons: Integrated classification of abiotic parameters. Journal of Earth System Science 2014, 123, 1097-1114. Available online: https://doi.org/10.1007/s12040-014-0445-9

The effects on the microtidal lagoon of Lesina of runoff and the discharge of water and material from agricultural activities were investigated combining chemical analyses of pollutants [11 metals and 16 priority polycyclic aromatic compounds (PAHs)], determination of organic matter and grain size, and performance of innovative ecotoxicological tests. For metals, enrichment factors >3 for arsenic, nickel, and copper (Cu) were observed in the eastern zone of the lagoon, which is affected by nearby urban activities with discharge of water and domestic waste and by agricultural input with waters rich in fertilizers. Cu was correlated with no other metal, and its high concentrations (≤77 µg g(-1)) may result from the use of Cu-based fungicides in vineyards. Total PAHs (2,230 ± 3,150 ng g(-1)) displayed a wide range of concentrations with hot spots near freshwater inputs from the part of the catchment area exploited for wheat crops. Pyrolitic contamination also emerged, with higher-mass PAH congeners, such as asphalt, bitumen or coal, usually present in higher fractions as the dominant components. Ecotoxicological evaluations recorded moderate to high toxicity levels; the innovative MOT test bioassay showed good discriminatory ability because it identified a lagoon area whose inputs mainly depend on agricultural activities and which is impacted by metals rather than PAHs. Floods during periods of heavy rain and the discharge of water and material from agricultural activities may impact vulnerable systems, such as the lagoon of Lesina, where the presence of hot spots with remarkably high pollution values was observed.

Abra segmentum is a common and frequently abundant species in the Mediterranean coastal lagoons, playing a dominant role, both in numbers and biomass, in the infauna of these habitats and is an important food for a variety of species. 2 - The main objective of this work is to describe the renewal time of Abra segmentum in Lesina lagoon. The insurgence of hydrogen sulphide which exterminated the benthic macrofauna in an area of Lesina lagoon during July 2008 allowed us to accurately observe the re-colonization time of this bivalve. In order to achieve this aim, the population structure and spatial distribution of A. segmentum before and after the dystrophic crisis were investigated in the entire Lesina lagoon and, in detail, in the area affected by the crisis. 3 - 51 sampling units were collected in Lesina lagoon in May and October 2008, allowing to compare the situation before and after the dystrophic crisis. The length-frequency distribution showed the existence of two size groups in both May and October 2008. The individuals were counted, their individual length measured and their total wet biomass weighed. 4 - The total number of individuals decreased after the crisis in the entire lagoon, but this drop was strongly observed in the perturbed area. The length-frequency distribution showed the existence of two size groups in both May and October 2008. After dystrophic crisis, the two size groups were clearly separated and juveniles group (2-5 mm) was located in the area interested by dystrophic event. 5 - The results obtained in this study highlight the rapidity of re-colonisation of A. segmentum after the strong disturbance caused by the insurgence of dystrophic crisis. The dynamics of the population was particularly clear when considering the area affected by the dystrophic crisis. In May the population was structured as in the rest of the lagoon, but in October there was a marked difference. The insurgence of a dystrophic crisis in Lesina lagoon allowed to clearly observe the resilience of A. segmentum to environmental stress, confirming it as an r strategy species.

There has been a worldwide increase in the number of Marine Protected Areas and marine reserves over the last decade. In these areas, the protection measures adopted are related to specific management goals; nevertheless, actual knowledge of the effectiveness of the restrictions is far from exhaustive. This article aims to contribute to knowledge of the environmental quality of the marine reserves in the Tuscan Archipelago (Mediterranean central area) which is composed of seven islands at different levels of protection. A monitoring programme spanning multiple years was performed on water and sediment samples to finalise a definition of the trophic levels and the response of microbiological indicators (total heterotrophic bacteria, Actynomyces, hydrocarbon-degrading bacteria) to persistent organic pollutants (polychlorinated biphenyls, 1,1-bis-(4-chlorophenyl)-2,2-dichloroethene, hexachlorobenzene and polybrominated diphenyl ethers) was assessed. The results showed that these reserves were generally of good quality. A clear fingerprint produced by human activities along the coast and significant differences relating to the level of protection were observed. There exists the need to also consider basin dynamics when planning the protection management strategies adopted for marine reserves.

We examined the clinical and radiographic results of 93 patients affected by knee arthritis or osteonecrosis subjected to unilateral cementless mobile-bearing total knee arthroplasty with the LCS prothesis (Depuy/Johnson & Johnson). The mean follow-up was 9.5 years (range, 7–12 years). Clinical evaluation was performed using the Knee Society rating system, while radiographic evaluation was done according to the Knee Society roentgenographic system. At the latest follow-up, the mean knee score was 87 points: the functional score improved from 40 to 90. Radiolucent lines were small and not progressive. The implant survival at 12 years was 88%. Six knees (7%) required revision for implant-related problems. We conclude that the mobile-bearing prosthesis is a successful device even at long-term follow-up.

Xanthones represent a class of naturally occurring compounds with valuable and promising reported pharmacological activities. One of the main disadvantages in the use of such products is related to the difficulties in their chemical synthesis. In this Letter a new and improved method for the chemical synthesis of xanthones is described. The title compounds have been synthesized in good yields under microwave irradiation from substituted 2-hydroxybenzoic acids and phenols in the presence of Yb(OTf)3 hydrate as the catalyst.

The Lago di Varano is situated on the north side of the Gargano National Park (southeast Italy) and covers a surface area of about 65 km(2). It communicates with the Adriatic Sea through two artificial canals (Foce Capoiale and Foce Varano) located at the two ends of a long and narrow coastal dune. This work presents preliminary results of four seasonal surveys (1999-2000) carried out to measure chemical and physical parameters of the water column (temperature, salinity, dissolved oxygen and pH) and to analyse a number of biogeochemical characteristics of surface sediments (organic matter, total phosphorus, total nitrogen and total Hg, As, Pb, Cd, Cr, Cu and Ni content). Water analysis indicated poor exchange between the coastal pond and the open sea, limited to autumn and winter. Surface sediments were rich in organic matter, whose distribution was influenced by chemical-physical and hydrodynamic variations in the water column. At the sediment level, the highest values of Cd were found in the central zone of the basin, while the highest Cr values were measured in the central and southeastern areas. With the exception of Cd and Pb, the metal content did not indicate anthropogenic pollution, in particular when compared with the Venice Lagoon and the Central Adriatic Sea.

A new classification is proposed for post-reduction necrosis of the femoral epiphysis based on retrospective analysis of 54 cases with a mean follow-up of 15 years. Necrosis can be divided under two main headings:A) partial, involving only the epiphysisB) total, involving the metaphyseal cartilage.Four total forms have been identified:B1: eventually resulting in coxa valgaB2: eventually resulting in a short stubby neck, oval head and coxa magnaB3: eventually resulting in coxa vara and severe acetabular dysplasiaB4: eventually resulting in hypoplasia of the whole hip joint.This classification system comprises all the aspects of necrosis, while at the same time providing guidelines for treatment and long-term planning.

In CHD (Congenital Hip Dislocation), the elements which determine the degree and quality of acetabular growth are not clear. This has caused a great deal of controversy on the capability of development of the cotyloid cavity, hence on the indications to reconstructive surgical treatment. In order to study the behavior of che cotyloid cavity, two groups of patients were taken into consideration: normal subjects and subjects with CHD. In normal subjects the median value of the Hingelreiner angle was 19°–4'± 1° (normal limit), at 1 year old. The acetabular index decreases rapidly until becoming stable at adult values at the age of 8-10 years of age. The distinctive characteristics of the hip with spontaneous recovery from cotyloid dysplasia could be defined as follows: a) the higher critical value on average is reached after 24 months of treatment; b) once the borderline is reached, the dislocated hip evolves in the same way as the healthy hip; c) the earlier treatment is started, the sooner correction of the H angle is obtained; d) the cotyloid cavity continues to develop even after 5 years from reduction. In CHD with terminal residual dysplasia, an initial correction of the H angle is followed by a sudden interruption in acetabular development, which remains inadequate and will never reach normal values. These data allow not only the definition of the acetabular growth potential, but also the establishment of more precise indications for reconstructive surgical treatment.

Good results have been reported after both primary repair and conservative management of grade III ankle sprains. This prospective study found no advantage of operative treatment compared to taping; no significant differences were found between the groups with regard to objective or subjective stability, functional scores, or the overall result.

In this first, introductory study we established the parameters with which to develop an in-depth study of the mechanical interpretation of roentgenographic images of osteoarthritic hips. Our choice of parameters, and in fact our whole approach, parted from the theories of morphobiomechanics advanced by Pauwels and by Bombelli

The aim of this study was to define the characteristics of the diseased hip through a series of roentgenographic parameters measured on X-rays taken from a group of patients suffering from primary osteoarthritis. The arthritic hips were divided into three groups: superolateral OA, concentric OA, and medial OA. In light of the anatomo-roentgenographic characteristics this study proposes a new classification of osteoarthritis based on the direction of migration of the femoral head. Analysis of the data has highlighted the extreme polymorphism which characterizes the course and evolution of osteoarthritis and the serious modifications brought about in the hip-joint region. The clinical impression at the conclusion of this study is of a direct correlation between primary alterations of parameters of the hip and development of osteoarthritis.

The aim of this study was to establish the point at which a hip is at risk of developing osteoarthritis and the percentage of hips which run such a risk. 253 hips of 164 adults (average age 43) suffering from pathologies not involving the coxofemoral joint were examined. The most important data were: The WBS presented a greater obliquity than the medio-normal; the S. S. surface was narrower; all parameters presented considerable standard deviation. A hip was considered “at risk” when at least two parameters were outside the “normal” limits established in our previous study.

The electromigration performance of the Al-1 per cent Si/TiN/Ti metal scheme is investigated both for contacts and for stripes and compared with the results for the standard Al-1 per cent Si metallization. Statistical extrapolations at the operating conditions for a device have been performed to calculate the useful life of contacts and stripes. The results indicate that the most severe limitation to the interconnection reliability is given by the contacts without the diffusion barrier layer.

With the aim of defining the roentgenographic characteristics of a “normal” hip - meaning an articulation able to fully respond to static and dynamic stress without wear, we examined 60 hips of people over 70 years old from a population of Southern Italy. The parameters considered were: width of WBS, inclination of WBS, height of Gothic Arch, width of Gothic Arch, angle of aperture of Gothic Arch, a angle of Gothic Arch, diameter of femoral head, CE angle of Wiberg, neck-shaft angle, offset, angle of aperture of spherichal sector (SS), surface area of SS, volume of SS, radius of the spherical bowl, height of the spherical bowl, distance from the “tear drop” image of the fundus acetabuli. The main findings are: a) the WBS is horizontal; b) the gothic arch is orthogonal to the WBS; c) the spherical sector presents wide individual oscillations; d) the female hip has specific characteristics, being mainly smaller.

The retrospective study concerns use of the AO method for the treatment of 75 ankle fractures between 1990 and 1995. After a mean follow-up of 5 years and 7 months the Cedell criteria were used for a subjective evaluation of results. Good results were obtained in 53 out of 75 patients submitted to surgery (70%), with a significant difference between uni-malleolar fractures and bi- and tri-malleolar fractures. Dorsal flexion measured an average of 24 degrees (80% of the healthy contralateral side), plantar flexion 36 degrees (90% of the healthy side). The presence of a fracture-dislocation considerably worsens prognosis because of the cartilaginous damage produced. The risk of poor results increases considerably when reduction of fracture is insufficient or absent. Post-traumatic arthrosis constitutes a common complication (25%) and it particularly affects females aged between 45 and 65 years, as a result of the presence of post-menopausal osteoporosis. Accurate reduction, fracture stabilization, sex and age constitute essential elements for satisfactory final results.

The authors report results obtained using production machines in a test program that started in the first quarter of 1989. Chemical and physical evaluation of different kinds of commercial water-soluble solder creams and fluxes was first performed. Three products were selected and subjected to test in order to qualify their application in the professional field for wave soldering and reflow processes, and they were compared to the standard CFC (chlorofluorocarbon) cleaning procedure. Ionic contamination and THB (temperature-humidity-bias) tests were performed on ad hoc designed PWAs (printed wiring assemblies). It was found that acceptable cleanliness is obtained with water-soluble products provided that the washing machine has suitable spray pressure, nozzle angles, and drying section. Reliability tests on components are in progress to evaluate the possible detrimental effects of residual contaminants when moisture is present. Preliminary results of this step are given. >

A total of 15 patients affected with Perthes' disease that occurred during adolescent were followed-up in order to study progression of the disease, and to identify the "risk factors" capable of influencing the future of the lesion. Age of onset was on the average 11 years (10-13 years), age at follow-up was 38 years (20-56 years). On diagnosis, 2 hips were classified as Catterall group II, 8 as group III, 6 as group IV. Treatment was conservative in 11 patients and surgical in 4 (valgus osteostomy). A total of 88% of the hips healed with deformity to a greater or lesser degree of the femoral epiphysis (Stulberg III-IV and V). The most significant prognostic factors that emerged from the present study were the early closing of growth plate (femoral and triradiate), disorders in growth of the proximal femur, acetabular roof insufficiency, and changes in the acetabulum.

It is the first time that a case of simultaneous and bilateral avulsion of the iliac spines is described in the international orthopaedic literature. The X-ray diagnosis was made by means of traditional techniques and tridimensional CT.

Long-term follow-up (5 years and 7 months) was obtained for the results of core decompression in 18 patients (20 hips) affected with ischemic necrosis of the femoral head at Ficat stages I and IIA. Two methods were used to diagnose osteonecrosis: bone scan, and MRI. Progression of the disease was monitored by annual MRI. The persistence of pain, progression of the disease in the Ficat scale, the use of total arthroplasty, were considered to be signs of failure. Core decompression was favorable in 16 hips, there was progression of the disease in 4. Good results were observed in 90% of the stage I necroses and in 70 of the stage IIA necroses. The results of the present study suggest bone reaming as the treatment of choice in initial stages of necrosis. Thus, the need for arthroplasty in young patients is delayed.

A case of isolated dorsal dislocation of the fifth carpometacarpal joint treated conservatively is reported. The mechanism is thought to be a force hitting the head of the fifth metacarpal in a dorso-palmar direction, along the longitudinal axis of the metacarpal. Both clinical and radiological results 1 year after injury are satisfactory.

It is the purpose of this study to compare the prognostic value of the Herring classification (lateral pillar) with that of the Catterall classification. The material is constituted by 45 patients affected with Perthes' disease and reviewed an average of 24 years after onset. At follow-up the hips were divided into three classes based on joint congruency as suggested by Stulberg. The Catterall classification demonstrated overall a better predictive value for the Herring system. Instead, the most satisfactory reproducibility seems to be that of Herring: 80% as compared to 42% for the Catterall classification.

Meyer's femoral cephalic dysplasia (FCD) is a rare affection that is often confused with Perthes' disease from which it differs in terms of both treatment and prognosis. A constant feature is the absence of the nucleus of ossification that does not occur until 15-18 months of age; at times there are multiple nuclei of ossification, so that the epiphysis has a "morulated" aspect. Fusion of the various centers of ossification occurs at about 5 years of age. The epiphysis does not collapse and it preserves its density and its structure. Differential diagnosis involves Perthes' disease and other pathologies such as multiple dysplasia epiphysealis, hypothyroidism, dyschondroplasia.

The authors analyze the biomechanics of the dislocated hip in preparation to total hip replacement. Using the Pauwels criteria as a starting point, the authors observe the pathologic modification of this equilibrium when the hip is congenitally dislocated. Finally, applying these criteria to the acetabular component positioned in both the neoacetabulum and the true or paleoacetabulum, the authors show that the latter is biomechanically more advantageous.

We reviewed 36 patients who had undergone reconstructive surgery of the ligaments of the lateral compartment of the ankle between 1981 and 1986. The follow-up period averaged 6 years (range, 3-9 years). Ligamentous lesion was diagnosed by clinical examination and contact thermography. Eighty-six percent of the subjects reviewed achieved a good result, resuming sports activity and regaining full joint stability. Reports in the literature are conflicting: good results have been achieved by both conservative treatment and reconstructive surgery. We are convinced that surgery offers young athletes a better chance of regaining joint stability because it is the only treatment that promotes anatomical healing of the ligaments without lengthening or loss of strength. Contact thermography is an important means of diagnosis because of its few limitations and low cost.

Fifty-three patients treated between 1979 and 1986 with high tibial osteotomy for varus osteoarthritic knee are evaluated. The average follow-up was 6 years and 8 months (range 3-10 years). All of the osteotomies were stabilized using Weber's method. The purpose of the operation was to realign the mechanical axes with overcorrection of 3 degrees. Results were good in 71% of the patients, and 85% claimed to be satisfied with the operation. The preoperative varus, 9.5 degrees on average, was corrected to 2-degree valgus; the deformity was exactly corrected in 59% of the cases, undercorrected in 9%, and overcorrected in 32%. The corrections slowly deteriorated over time. The correlation between the results and the stage of the arthritis, the degree of deformity, and the alignment of the mechanical axes showed that the best results were obtained in monocompartmental lesions with a varus deformity of less than 10 degrees and in osteotomies resulting in an average postoperative mechanical axis of 184.5 degrees. Weber's method has undeniable advantages over other methods, such as stable internal fixation, rapid healing, early restoration of articular function and resumption of weight-bearing.