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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.

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 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.

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.

Three cases of demoplastic fibroma of bone are presented. Thirty six cases already reported in the world literature are reviewed, making the present total thirty nine cases. The extreme rarity of the tumor is emphasised, and its clinical, radiographic, morphological and pathological aspects discussed. Though the absence of metastases or histologically abnormal cells attest to its benign nature it has a definite tendency to local recurrence. Differential diagnosis and treatment are discussed.

The authors present a case of intraosseus lipoma seen at the Orthopaedic Clinic of the University of Bari, bringing the total in the world literature to thirty cases. The tumour is a benign primary neoplasm of bone, made up of mature adipose tissue containing atrophic bone trabeculae. This affection is a definite entity quite distinct from parosteal lipomas arising in periosteum, fasciae and muscles which only affect the bone secondarily by compression or direct invasion. Emphasizing the extreme rarity of the tumour, the authors discuss its clinical, radiological, anatomical and pathological features. The differential diagnosis is with certain dysplasic and neoplastic lesions of bone such as: bone cyst, non-ossifying fibroma, aneurismal cyst, monostotic fibrous dysplasia, and solitary myeloma. Complete removal is followed by cure.

This work compares the results of 2 different techniques of anterior cruciate reconstruction performed by 2 surgeons with the same rehabilitation program and same criteria of results evaluation. Forty-five patients were operated on using semitendinous tendon autograft, (average followup, 8 years 4 months), and 30 patients using bone patellar tendon bone autograft (average followup, 7 years 5 months). Functional results were evaluated using the Lysholm and Tegner rating systems, and clinical laxity or stability were evaluated using the Lachmann and Jerk tests. Articular stability and function were significantly better in the patients operated on using bone patellar tendon bone autograft.