The treatment of epiphysiolysis of the upper femoral epiphysis.

This paper is based on our experience and follow-up of 100 cases of epiphysiolysis of the upper femoral epiphysis (and 105 hips) treated over a period of 19 years at the Toscano Institute of Orthopaedics. It stresses the fact that in the early stage this condition is easily and permanently curable by the simple and innocuous operation of epiphysiodesis. On the contrary, if it is not recognised early, or if having been recognised, is inadequately treated at this stage, the displacement gradually increases, and whatever the subsequent treatment, future incapacity is inevitable which will affect the whole life of the patient. The logical deduction from this is that at the first manifestation of symptoms and radiographic signs, even in the incipient pre-slipping stage, no time should be lost in carrying out an epiphysiodesis. This is simple and safe if done early; difficult and uncertain if done late.

The treatment of epiphysiolysis of the hip. Further thoughts based on recent instructive cases.

As an addendum to an earlier paper on the treatment of epiphysiolysis of the hip, the author presents four recent cases that demonstrate the importance both of early diagnosis and, more especially, of immediate operative treatment. This consists of reduction (if possible, as in the acute variety), epiphysiodesis and immediate mobilization. Otherwise, "late diagnosis", "inadequate treatment", or a combination of both condemns the hip joints of these young patients to permanent damage. Yet, by strict adherence to the programme of treatment suggested, it is possible to salvage the great majority of these hips.

Articular synovial microchondromatosis.

Under the general heading of articular osteochondromatosis, there is particular interest in those cases where the synovial change generates small cartilaginous bodies. These exhibit little or no calcification and are found both in the articular cavity and within the synovial tissue. This suggests a pathogenesis in which the disease evolves from a micronodular form into a macronodular chondromatosis of various sizes. These considerations also raise the possibility of regression of the process in its microchondromatosic form towards normalization of the synovial membrane.

Axial deviations of the knee with secondary arthrosis. Correction by high osteotomy of the tibia and fibula.

The authors describe a surgical technique for high tibio-fibular osteotomy used eighty seven times to correct varus or valgus deviations causing arthrosis of the knee. Osteotomy of the tibia is carried out above the tibial tuberosity. Fixation is by two nails with a compression device. This allows immediate movement of the knee, thereby preventing stiffness. After forty five days the osteotomy is usually consolidated. Of the complications, only the neuro-muscular type is of importance and the possible causes of this are discussed. The overall results are good and the technique described has proved to be effective in the treatment of mechanical arthrosis of the knee.

[Extrusive therapy and periodontal alignment. Considerations and indications. 2]. / Terapia estrusiva ed allineamento parodontale. Considerazioni ed indicazioni - Nota II.

The Authors report some clinical cases treated with orthodontic forced eruption, periodontal surgery and prosthetic rehabilitation. The theoretic first part of this work was published on Dental Cadmos no. 9/87.

Pachydermoperiostosis and acro-osteolysis.

The authors present a case of pachydermoperiostosis (digital hippocratism, periostosis, pachydermia) associated with acro-osteolysis. This is the first association of this type described in Italy, and it is only recently that foreign authors have reported the presence of acro-osteolysis in patients affected with pachydermoperiostosis. The results obtained from studies of the micro and macro circulation in pachydermoperiostosis are reported.