The first world war drives rehabilitation toward the modern concepts of disability and participation.

The First World War produced a huge number of disabled soldiers. During the war, surgeons realized that it was not enough to merely treat the limbs of the wounded soldiers; it was also necessary to train them to use their remaining abilities to their greatest capacity. Governments at the same time realized that such a high number of veterans created a financial burden, by entitling disabled veterans to full healthcare, raising the issues of social welfare. Both in the US and Europe, programs of rehabilitation were instituted, providing injured soldiers with long-term medical care and vocational training aimed at restituting soldier's independence for a speedy return to work. In Italy at the Istituto Ortopedico Rizzoli, one of the most renowned Hospitals for the treatment of orthopedic deformities, Putti set up a technologically advanced Orthopedic Workshop, and a Rehabilitation House. The so called "reconstruction programs" addressed all aspects of rehabilitation (including physiotherapy, curative workshops and vocational therapy), seeing disability in terms of function. The experience gained in the treatment of war victims markedly enriched rehabilitation techniques, but overall the First World War helped engender the concept of rehabilitative programs to assist disabled veterans reintegrate in the workplace, thus laying the foundations of the modern concept of participation at a social level. In the centenary of Italy's entry into the First World War, it is worth underlining just how much hindsight affords us a new perspective on Physical Medicine and Rehabilitation. It reminds us that rehabilitation is not merely the role of medicine, but forms part of a multifaceted approach involving societal roles and expectations, regardless of the psychological and physical impairments suffered by the individuals concerned.

Fractures in myopathies.

The paper reports the results obtained in a study on the frequency of fractures in patients affected with Duchenne Muscular Dystrophy and Spinal Muscular Atrophy, types II and type III; the patients were observed between 1974 and 1988 at the muscle clinic of the Rizzoli Orthopaedic Institute. Out of a total of 238 cases, 36 (15.1%) reported one or more fractures during the follow-up period. For each fracture, age, functional capacity, the particular circumstances in which fractures occurred, site and type of fracture, medical treatment and consequences were all considered. A protocol for fracture prevention in neuromuscular patients is proposed, and suitable methods of treatment suggested.