The Official Journal of EuroPCR and the European Association of Percutaneous Cardiovascular Interventions (EAPCI)

The aim of this study was to compare the results achieved in two groups of 40 patients, treated for uncomplicated midclavicular fractures. Group 1 (mean age, 37.2 years) underwent nonoperative treatment with a figure-of-8 bandage, whereas group 2 (mean age, 30.2 years) underwent open reduction and intramedullary fixation with a 2.5-mm threaded pin. The groups were similar with respect to fracture type. A high rate of complications occurred in group 2, including eight superficial infections, three refractures, two delayed unions with pin breakage, and two nonunions. Return to daily activities was undertaken after an average of 16.7 days from trauma in group 1, and after 40.7 days in group 2 (p = 0.00). Also, return to heavy and sport activities was more rapid for patients treated conservatively: 2.6 months versus 3.2 months (p = 0.014). At follow-up, which averaged 63.7 months, clinical evaluation according to the Constant rating scale did not show significant differences between the two groups. The absolute score averaged 84.8 in group 1 and 82.9 in group 2, whereas the mean relative scores were 94.9% and 95%, respectively. Thirty patients of each group were completely satisfied with the treatment received. The most common cause of dissatisfaction was represented by the unaesthetic appearance of the clavicle, because of subcutaneous bone prominence or dystrophic surgical scars. According to our experience, we conclude that nonoperative treatment appears more advantageous than open intramedullary fixation for the management of most midclavicular fractures.

The aim of the present study was to investigate the differences between types of sport (i.e., closed vs. open skills sport) on inhibitory control and motor fitness in children. Forty-nine children were allocated into three groups based on their sports participation, which comprised an open skill sport group, a closed skill sport group, and a sedentary group. Participants were tested on cognitive performance (inhibitory control by the Flanker task) and motor fitness (reaction time, speed, agility, power, balance). Open skill sport group appeared to display higher inhibitory control (response time and accuracy of incongruent condition of the Flanker task) and motor fitness performance (reaction time, speed, agility, power) than sedentary group, whereas its superiority over closed skill sport group was found only in speed and agility. Moreover, closed skill sport group had only a better reaction time than sedentary group. Our data supports the framework according to which cognitive demands in complex motor actions may contribute to explain the beneficial effects of exercise on inhibitory control. This might suggest that the complexity of the environment (typical in open skill sports) in which sport training is performed plays a key role for both cognitive and motor development in children.

Background: Dislocation is one of the most common complications of total hip arthroplasty with a reported dislocation rate of 3.2%. Despite increased experience with hip replacement, the overall rate has not yet changed. The aim of this paper is to review the most recent literature published on this topic and indexed in Medline, in order to clarify the main risk factors, and to standardize a treatment protocol of such an important complication of prosthetic surgery. Materials and Methods: Medline database was searched using key words: "hip dislocation", "hip instability" from 1980-2007. Studies were eligible for review and included if they met the following criteria: (1) publication in English, (2) clinical trials (3) review papers. Results: The risk of first-time dislocation as a function of time after the surgery is not well understood. Most, but not all, series have demonstrated that the risk of dislocation is highest during the first few months after hip arthroplasty; however, first-time late dislocation can also occur many years after the procedure. Several risk factors were described, including the surgical approach, the diameter of the head, impingement, component malposition, insufficient abductor musculature. In addition, there are also many treatment options, such as long-term bracing after closed reduction, component reorientation, capsulorraphy, trochanteric advancement, increasing offset, exchange of the modular head and the polyethylene liner, insertion of constrained liner. Conclusion: Preventing hip dislocation is obviously the best strategy. Surgeons must take into account patient and surgical risk factors. For patients at high risk for dislocation the surgeon should accurately restore leg length and femoral offset; the use of larger femoral heads, posterior transosseous repair of the capsulotendinous envelope if posterior approach is chosen or the use of a lateral approach should be considered. Proper patient education and postoperative care are very important.