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The aim of this study is to retrospectively compare clinical and radiographic outcomes of patients treated with non-lateralizing reverse shoulder arthroplasty (RSA) and with humeral lateralizing RSA after proximal humerus fracture (PHF). In total, 32 patients (8 men and 24 women), with a mean age of 77.4 (67–92), have been reevaluated (follow-up of 14.3 months) and divided into Grammont group (G-group—16 patients, 2 men and 14 women, mean age 82.3) and lateralizing group (L-group—16 patients, 4 men and 12 women, mean age 72.5). The dominant side was affected in 21 patients. Pain, Constant–Murley score (CMS), range of motion accurately measured with inertial sensors (SHoWlder, NCSLab®) and complications. Anatomic tuberosity healing, signs of loosening or mobilization of the implants and scapular notching (according to Sirveaux classification) have been measured on standard X-ray series (antero-posterior view in neutral, external and internal rotation; axillary view; outlet view). Similar CMS was recorded between the two groups (G-group: 61/100; L-group: 64/100). G-group had higher forward flexion (128° vs. 112°) and abduction (126° vs. 114°), L-group had higher external rotation in abduction (35° vs. 41°); similar internal rotation (sacrum) and rotation with elbow in adduction were measured (12° vs. 19°). No statistically significant differences emerged. Anatomic healing of the tuberosity was higher in G-group (87.5% vs. 50%); low-grade scapular notching was higher in L-group (18.25% grade 1–2 vs. 0). Anatomic healed tuberosity guaranteed highly statistically significant improved functional outcomes. No revisions of the implant were performed. RSA can be considered a valid solution for the treatment of PHF in elderly low-demanding population. Cuff conditions should be investigated before surgery for the indication of the adequate model.

The etiopathogenesis of reflex sympathetic dystrophy is still undefined, and diagnosis and treatment are difficult. It is the purpose of this study to propose precise diagnostic and therapeutic criteria for post-traumatic reflex sympathetic dystrophy of the ankle and foot. Diagnosis is pre-eminently clinical. Clinical progression of the disease occurs in three stages: acute, dystrophic, chronic. Radiographic examination cannot be used to classify the stage of the syndrome. Bone scan with Tc 99M methylendiphosphonate aids diagnosis, and helps establish the prognosis of the disease. Clinical symptoms and instrumental tests (x-ray, bone scan, CT scan, MRI) are discussed in relation to differential diagnosis with other pathologies of the ankle and foot. Furthermore, the effective use of drugs, physiokinesitherapy, and hyperbaric oxygen therapy is discussed. The authors present a study of 32 patients, paying close attention to early clinical signs of the disease. X-ray examination and bone scan were routinely carried out in established diagnostic protocols.

It is the purpose of this study to analyze the data found in the literature and to compare our experience with that of other traumatology centers. A series of patients observed between 1985 and 1996 were reviewed. Nine out of 12 patients with sequelae related to dislocation of the knee were re-evaluated. Based on an analysis of the results, obtained by using the International Knee Documentation Committee (IKDC) form, it was concluded that the patients treated surgically are better overall. It is possible only rarely to obtain satisfactory recovery in work and/or sports activity, as the lesion is severe and even when treated it leaves functional and/or structural sequelae of varying importance.

Conventional radiography, ultrasound, Magnetic Resonance (MR), Arthrography Computed Tomography (Arthro-CT) and Arthrography Magnetic Resonance (Arthro-MR) are available for diagnosis of rotator cuff tears. Our purpose is to assess the specificity and sensitivity of these examinations and if they could give to the surgeon all the informations to select the more accurate treatment. We have evaluated retrospectively the images of 68 patients, 43 male and 25 female (average age 51 years), which then have been surgically treated for rotator cuff pathology. On the basis of our findings, we think that conventional radiography and ultrasound are excellent in a first evaluation. MR images, particularly in the coronal and sagittal oblique planes, are able to demonstrate partial or complete rotator cuff tears. The use of intra-articular contrast medium (arthro-CT, arthro-MR) should be reserved for partial lesions on specific cases.

The Authors relate their experience in 14 cases of prosthesis revision using a long stem implant by H. Wagner, performed in 12 cases with transfemoral approach. Notwithstanding the aggressive procedure, that consists of splitting the proximal extremity of the femur for a length of 16 cm to 25 cm, to perform the complete removal of the first implant and of all the cement, after a 2 year check-up, the Authors observed: the complete mechanical stability of the new implant, the rapid process of ossification replacing the surgical fractures and bone loss.