Two compression rods to treat unstable lesions of the pelvic ring.

The authors report 7 cases involving the surgical treatment of unstable pelvic ring fractures (Malgaigne type) using two compression bars, as described by Tile. The method was used only in cases where x-ray examination and CT scan revealed that the posterior branch of the fracture was located at the very medial aspect of the sacrum (fracture through the sacral foramina or even medial to the sacral foramina), and therefore could not be stabilized by using other devices.

Ketoprofen lysine salt inhibits disuse-induced osteopenia in a new non-traumatic immobilization model in the rat.

Immobilization and the consequent unloading can cause osteopenia both in humans and in animals due to an increased bone resorption and a parallel reduction in bone formation. Non-steroidal anti-inflammatory drugs (NSAIDs), and in particular the aryl propionic acids, are described to prevent bone loss by inhibiting the cyclo-oxygenase activity. In this study we evaluated the role of a classical aryl propionic acid, ketoprofen lysine salt (KLS), in a new model of disuse-induced osteoporosis in the rat. Tail immobilization evoked a time-dependent bone loss in the caudal vertebral bodies, measured densitometrically as a reduction of bone mineral density (BMD) and content (BMC). KLS was administered once daily for 10 days by subcutaneous route at 0.5 mg kg-1, a dose lower than that effective to elicit an anti-inflammatory response. In these conditions, KLS completely abolished BMD and BMC decrease observed in the caudal vertebrae after 10-day immobilization, without affecting bone mass in normal (non-immobilized) rats. These results suggest that KLS can exert, besides to its anti-inflammatory effect, an anti-resorptive activity on bone that could be useful in the prevention of disuse-induced osteopenia.

Surgical treatment of pubic pain refractory to conservative treatment.

After some considerations on the biomechanical nature of pubic pain, the authors present a series of 17 leading athletes (14 professional football players, 1 marathon runner, 1 weight-lifter and 1 French boxer), complaining of this disorder for at least one year and refractory to conservative treatment, surgically treated with the Nesovic technique and evaluated after an average follow-up period of two years (18-30 months).

[The average thickness of trabecular osteons in the iliac crest in normal subjects]. / Lo spessore medio dell'osteone trabecolare nella cresta iliaca in soggetti normali.

The mean wall thickness (MWT), measured by the Kragstrup technique, and the trabecular bone volume (TBV), have been measured in 50 transiliac undecalcified bone biopsies performed in 50 subjects who died suddenly (traffic accident, carbon monoxide, poisoning). Diseases affecting the skeleton were excluded in the autopsies. Our values for MWT were similar to those found in previously published studies except those of Kragstrup's group, in which values are higher. As our measuring technique was that of Kragstrup, these results could be explained either by a difference in staining methods (Solocromo cyanine R and Goldner method respectively) or by the differences in populations considered (French and Danish respectively). Our study confirmed a significant decrease in MWT and TBV with age and a positive correlation between MWT, TBV and age.

Evidence for a toxic effect of aluminum on osteoblasts: a histomorphometric study in hemodialysis patients with aplastic bone disease.

To evaluate the potential role of aluminum (Al) in a subset of dialysis patients with aplastic bone disease, we have studied tetracycline-labeled bone biopsies of 32 patients (22 males and 10 females, 45-73 years) on maintenance hemodialysis. Selection criteria included normal resorption surfaces (RS) and osteoid thickness. Eleven patients (Group I) had no stainable bone Al (Al-; 61.7 +/- 7.2 years) and 21 (Group II) had stainable bone Al (Al+; 57.7 +/- 6.8 years). Serum Al was normal to slightly elevated in Group I, but significantly higher in Group II (p less than 0.01). Al surfaces (AlS), undetectable in Group I, were 67.8 +/- 17.9% in Group II. Bone Al content (BAC) was much lower in Group I than in Group II (14.8 +/- 3.7 vs. 113.8 +/- 100.2 micrograms/g, p less than 0.01), but higher in Group I than in controls (p less than 0.05). Extensive thin osteoid seams were present in Group II. AlS was correlated with OS (r = 0.56, p less than 0.001) and OV (r = 0.48, p less than 0.01). Labeled surfaces were decreased in both groups. Labeled osteoid surfaces (TLS/OS) were below 2 SD of the mean control values in 96% of patients and calcification rate (CR) was depressed below 0.20 micros/day in 44% of patients. Bone formation rate (BFR) was strikingly depressed, values being below one SD of the mean control value in 92-100% of patients at both levels and below 2 SD of the mean in 82% of patients at BMU levels. Mineralization lag time (OMP) was markedly prolonged above 2 SD of controls in 89% of patients.(ABSTRACT TRUNCATED AT 250 WORDS)