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Introduction

In this retrospective study we have analyzed a consecutive series of patients affected by isolated radial head Mason III fractures and treated with bone resection or prosthesis.

Patients and methods

This study includes 24 patients affected by fractures mentioned above and treated between July 2009 and November 2015.15 patients (average age 48 y.o.) have been treated with prosthesis. The remaining 9 (average age 573) have been treated with a capitellectomy instead.From a clinical point of view, we have evaluated the patients according to main performance indicators such as range of motion, pain, instability and Mayo Elbow Performance Score as parameters.

Results

We have found similar results in both group, with an average MEPS value of 95 in the prosthesis group and 966 in the radial head resection group.The range of motion was similar too: between 1,3° and 1203° in the first group and between 4,4° and 120° in the second one. No significant complication has detected in any patient.

Discussion

According to most recent literature, it is not precisely defined how to treat isolated Mason III fractures, contrary to what is defined in more complex pattern, in which prosthesis are now evaluated as the best indication.Due to radial head limited contribution to elbow stability, in absence of other bony or ligamentous lesions both capitellectomy and prosthesis can be good treatment in this kind of fracture.

Conclusion

According to our experience and to the most recent literature, we recommend prosthesis in patient younger than 50 y.o., high demanding or manual worker, while in other cases we think that radial head resection can be the treatment of choice.  相似文献   
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Adolescent smoking is a major public health problem. While the socioeconomic status (SES) of the neighbourhood and that of the family are known to play a role in smoking onset and progression, it is not clear whether it modifies the association between parental influences and adolescent behaviour. The purpose of this study is to investigate family correlates of adolescent smoking experimentation and to explore the modifying role of socioeconomic context and European geographical area in a sample of European adolescents. This is a secondary analysis of the baseline survey of the European Drug Addiction Prevention (EU-Dap) trial which took place in seven European countries and involved 7079 students. School SES was used as indicator of socioeconomic context. European countries were aggregated in two geographical areas: North-Central and South. The associations between parental, family factors, and adolescents smoking experimentation were analysed through multilevel mixed-effect logistic regression models, stratified by school SES and European geographical area. Parental smoking, permissiveness towards tobacco, family conflicts, problematic relationships, low connectedness, and low parental control were significantly associated with adolescent smoking experimentation. Paternal smoking was a stronger correlate of adolescent smoking in low SES schools, while maternal smoking in high SES schools. Parental permissiveness was a stronger correlate in low SES schools. Family conflicts and low parental control were correlates only in low SES schools. The associations did not substantially differ between European geographical areas, with the exception of parental smoking that was a stronger correlate in the North, and parental control that was a correlate only in the South of Europe. To reduce inequalities in tobacco-related outcomes, prevention efforts in low socioeconomic contexts appear to be a public health priority. Parental smoking, permissiveness, family relationships, and connectedness should be addressed in preventive programs.

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Respiratory complications are common in the patient with muscular dystrophy. The periodic clinical and instrumental respiratory evaluation is extremely important. Despite the presence in the literature of updated guidelines, patient associations often report lack of knowledge of these pathologies, particularly in peripheral hospitals. The purpose of this work, inspired by the Italian Muscular Dystrophy Association (UILDM) is to improve management of respiratory problems necessary for the management of these patients complex. To this end, the main items that the specialist can meet in the follow-up of these pathologies have been analyzed and discussed, among which the respiratory basal evaluation, the criteria of adaptation to non-invasive ventilation, management of bronchial secretions, situations of respiratory emergency, indications for tracheostomy and the subject of advance directives of treatment (DAT).Key words: respiratory failure, muscular dystrophy, cough efficacy, spirometry, polygraphy, non-invasive ventilation, arterial blood gases, cough machine, invasive ventilation, tracheostomy, mechanical ventilation  相似文献   
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