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  • Author: Pietro Ruggieri x
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Daniel Kotrych, Andrea Angelini, Andrzej Bohatyrewicz, and Pietro Ruggieri

  • Satisfactory results in terms of functional and oncological outcomes can be obtained in sacral and pelvic malignant bone tumors.

  • Preoperative planning, adequate imaging, and a multidisciplinary approach are needed.

  • 3D-printed prostheses have to fulfill several requirements: (i) mechanical stability, (ii) biocompatibility, (iii) implantability, and (iv) diagnostic compatibility.

  • In this review, we highlight current standards in the use of 3D-printed technology for sacropelvic reconstruction.

Andrea Angelini, Nicolò Mosele, Elisa Pagliarini, and Pietro Ruggieri

  • Patients with Gorham–Stout disease (GSD) present progressive destruction and resorption of bone.

  • Typical bone-related symptoms include swelling, pain and functional impairment in the region involved.

  • The three aspects of GSD etiopathology are osteoclasts, angiogenesis/lymphangiogenesis and osteoblast function.

  • Multi-targeted pharmacological approach includes innovative options and represent milestones of treatment, sometimes associated with radiotherapy.

  • Surgery is mainly used to treat complications: pathologic/impending fractures, spinal instability or deformities and chylothorax.

  • In this narrative review, we highlight current standards in diagnosis, clinical management and therapeutic strategies.

Elisa Pala, Alberto Procura, Giulia Trovarelli, Antonio Berizzi, and Pietro Ruggieri


  • The aim of this study is to compare titanium vs carbon fiber intramedullary (IM) nailing in terms of response to radiotherapy, local control of the disease, time of surgery, fluoroscopy exposure, and complications.


  • From 2015 to 2021, 52 impending or pathologic fractures were treated with IM nailing in 47 patients: 18 males and 29 females with a mean age of 73. Titanium nails were used in 27 cases: femur (17 cases), humerus (8 cases), and tibia (2 cases). Carbon fiber nails were used in 25 cases: femur (17 cases), humerus (7 cases), and tibia (1 case).


  • At a mean follow-up of 8.4 months, most patients died from the disease (63.4%). Fracture healing without osteolysis progression was present in 52% of titanium nailing at a mean time of 6 months and in 53% of carbon fiber nails at a mean time of 4.6 months. No statistically significant difference has been shown in terms of healing (P = 0.5), intraoperative fluoroscopy (P = 0.7), and time of surgery in femoral nailing (P = 0.6), while a significantly lower surgical time for carbon fiber humeral nailing (P  = 0.01) was found. Two breakages of carbon fiber femoral nails were observed, and both were treated with revision with modular tumor megaprosthesis.


  • Our results suggest that surgical time and fluoroscopy exposure are not longer for carbon fiber nails compared to titanium ones. Healing seems to be faster in carbon fiber nails. Further clinical studies are needed to clarify the long-term outcomes of these implants.