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Massive bone allograft after tumor resection has been used for over 20 years. Many factors negatively influence the healing of the junction between the allograft and the host bone, resulting in a low healing rate and lengthy time to union. This study evaluated whether pulsing electromagnetic field stimulation could be advantageously used in these patients. A double blind prospective randomized study was designed. Eighty three host graft junctions in 47 patients were considered. The overall host graft junction healing rate was the same (67%) in both control and active stimulated patients. Although not statistically significant, a positive effect of pulsing electromagnetic fields was observed for those host graft junctions with a cortico-cortical contact between allograft and host bone. When adjuvant postoperative chemotherapy was not employed, a definite effect of pulsing electromagnetic field stimulation was observed: the healing time decreased from 9.4 months in the control group to 6.7 months in the active stimulated group (p0.001). This effect would have been lost if chemotherapy was employed. There was also no advantage in supplement with iliac crest autografts at the host graft junction site if chemotherapy was used. Factors that significantly influenced the host graft junction healing rate were: chemotherapy; type of allograft host bone contact; quality of host graft junction; and, in intercalary allografts, use of the osteosynthesis device. No difference was observed between control and active groups for patient survival or number of local or distal tumor recurrences.

A multicentric study was conducted by the European Musculoskeletal Oncology Society on 113 cases of resection for tumors of the major long bones and reconstruction with massive allografts, as intercalary diaphyseal or for arthrodesis. The follow-up was at least 12 months. There was a 14% incidence of infection, with a higher frequency (18.5%) in intercalary grafts as compared to arthrodeses (7%). Fracture of the graft occurred in 15.5% of the cases with a prevalence in the humerus (28.5%) as compared to the tibia (21.4%) and femur (14.7%). Fracture constantly occurred after osteosynthesis with screws, in 16% of the cases after osteosynthesis with a plate, and in 12.5% of the cases after osteosynthesis with an intramedullary nail. It was observed in 32% of the grafts preserved at -30 degrees, in 17% of those irradiated, and in 7% and 7.6% of those preserved at -180 degrees and -80 degrees, respectively. Delayed union and non-union was observed in 57% of the cases: 63% in intercalary grafts, 48% in arthrodeses. Final results after treatment of complications were excellent and good in 63% of the entire series. The results should, however, be evaluated after 3 years, as during this period of time important transformation phenomena of the graft occur. Complications are observed in 75% of the cases, but they may be reduced if planning is correct and surgery is accurate. Each complication may be dealt with and resolved without high risks for preservation of the limb.

Neurological affections responsible for secondary arthropathic pathology are: tabes, syringomyelia, diabetes mellitus, congenital insensitivity to pain syndrome, alcoholism, leprosy. Each of the affections shows predilection for specific joints: syringomyelia the shoulder, tabes the hip and knee, diabetes mellitus the foot, congenital insensitivity to pain the lower limb, alcoholism the shoulder and knee. The authors discuss two cases of hip arthropathy in previous dorsal myelic fractures.

We report the discovery of the optical and near-infrared counterparts to GRB 001011. The GRB 001011 error box determined by Beppo-SAX was simultaneously imaged in the near-infrared by the 3.58-m New Technology Telescope and in the optical by the 1.54-m Danish Telescope ~8 hr after the gamma-ray event. Here we implement the colour-colour discrimination technique proposed by Rhoads (2001) and extend it using near-IR data as well. We present the results provided by an automatic colour-colour discrimination pipe-line developed to discern the different populations of objects present in the GRB 001011 error box. Our software revealed three candidates based on single-epoch images. Second-epoch observations carried out ~3.2 days after the burst revealed that the most likely candidate had faded, thus identifying it with the counterpart to the GRB. In deep R-band images obtained 7 months after the burst a faint (R=25.38+/-0.25) elongated object, presumably the host galaxy of GRB 001011, was detected at the position of the afterglow. The GRB 001011 afterglow is the first discovered with the assistance of colour-colour diagram techniques. We discuss the advantages of using this method and its application to error boxes determined by future missions., Comment: Accepted for publication in Astronomy and Astrophysics, 13 pages, 16 figures