Confidential enquiry into avoidable vehicle accident deaths in the province of Modena, Italy.

The authors describe the methods and results of a kind of study confidential enquiries into avoidable deaths very rarely performed in the Mediterranean area. After assessing some quali/ quantitative evaluation criteria, an independent expert panel investigated the quality of each step in emergency health care. Information was collected by clinical and forensic reports (clinical method). Of 102 cases, 4 were avoidable deaths and 18 probably avoidable. These results, which are comparable with other similar ones found in Italy (autoptic method) and abroad, have been useful in highlighting some health care errors: in particular, in on-site care and in emergency department diagnosis and treatment. Other avoidable factors emerging were the inappropriateness of transporting severe trauma cases to a small hospital lacking proper equipment and trained staff, and the importance of staff training in first emergency care of severe trauma on ambulance. This situation had been highlighted previously and led to implementation of trauma centres. The methods implemented turned out to be quite statistically reproducible and have been used in local health care planning, especially in the rearrangement of ambulance deployment and emergency staff training.

[Osteotomy in the prosthetic substitution of severe axial deviation of the knee]. / Le resezioni ossee nella sostituzione protesica delle gravi deviazioni assiali del ginocchio.

Arthroplasty can be a successful treatment for arthritis even in cases of severe axial deviation of the knee. Since significant bone loss is often present in these cases, the technique and extent of the resection is very important. In this paper we review our series and compare it with solutions proposed by other authors, focusing our attention on the techniques of resection and replacement of lost bone employed in order to achieve optimal axial alignment and anchoring of the prosthetic components.