An In Vitro model to study bone metastasis.

Isolated osteoblastoma of the cuboid bone: A case report and review of the literature

Osteoblastoma is a relatively rare, benign, bone-forming tumor, commonly observed in the second and third decades of life. Spine and the long tubular bones are the most common sites of involvement. Osteoblastoma is infrequently seen in other sites, including the bones of hand and foot. A rare case of a 35-year-old man that presented an osteoblastoma of the cuboid bone is reported. The patient was treated with surgical resection and grafting. After the intervention, the patient recovered with no clinical and radiological evidence of recurrence after one year of follow-up. Several cases of osteoblastoma-like variant of osteosarcoma of the cuboid have been previously reported, but, to our know…

Lesioni traumatiche delle parti molli

Scoliosi e Sindrome di Rett

Indications and limits of the Fixator TGF "Gex-Fix" in fractures of the proximal end of the humerus

Polinucleotidi vs acido ialuronico nelle in filtrazioni ecoguidate dell'anca artrosica. Risultati preliminari

Le biopsie mini invasive nei tumori ossei e delle parti molli: aspetti gestionali e considerazioni cliniche

Non previsto

What’s the resolutive surgery for Pseudo-Ainhum in vohwinkel syndrome? A case report and review of the literature

Vohwinkel Syndrome, also known as Keratoderma Hereditarium Mutilans, is an extremely rare dominant autosomal keratosis. It typically presents with “starfish” keratoses on the knuckles, palmoplantar keratoderma (PPK), hearing impairment and mutilating digital constriction bands (pseudoainhum) that cause strangulation, often leading to autoamputation of the affected digit. Both medical and surgical treatment haven’t shown to date consistent results, in the treatment of pseudoainhum. In this study we present the case of a woman with Vohwinkel syndrome who showed constriction bands causing ischemic changes of the 5th digit of the right hand for which she was treated with surgery. We also presen…

The incidence of hip, forearm, humeral, ankle, and vertebral fragility fractures in Italy: results from a 3-year multicenter study

Introduction: We aimed to assess the incidence and hospitalization rate of hip and "minor" fragility fractures in the Italian population.Methods: We carried out a 3-year survey at 10 major Italian emergency departments to evaluate the hospitalization rate of hip, forearm, humeral, ankle, and vertebral fragility fractures in people 45 years or older between 2004 and 2006, both men and women. These data were compared with those recorded in the national hospitalizations database (SDO) to assess the overall incidence of fragility fractures occurring at hip and other sites, including also those events not resulting in hospital admissions.Results: We observed 29,017 fractures across 3 years, with…

La riabilitazione dei bambini e degli adulti con paralisi cerebrali ( Traduzione)

Sindrome di Volkmann e le retrazioni ischemiche

LUSSAZIONE DISSOCIATA DEL SEMILUNARE E DELLE OSSA DEL CARPO: CASE REPORT

L'artrosi precoce nello sport

Three single loops enhance the biomechanical behavior of the transtibial pull-out technique for posterior meniscal root repair

Purpose: To investigate the effect of applying an additional suture to enhance the biomechanical behavior of the suture–meniscus construct used during the transtibial pull- out repair technique. Methods: A total of 20 fresh-frozen porcine tibiae with intact medial menisci were used. In one half of all speci- mens (N = 10), two non-absorbable sutures were passed directly over the meniscal root from the tibia side of the meniscus to the femoral side (2SS). In other ten specimens, three sutures were passed over the meniscal root (3SS). All specimens were subjected to cyclic loading followed by load-to-failure testing. Displacement of the construct was recorded at 100, 500, and 1000 cycles. Fur…

Self-inflicted long bone fractures for insurance fraud.

Self-inflicted fractures simulating traffic accident represent a new social fraud opportunity for criminality. Recognising scams through an increase of awareness of existence of self-inflicted arm fractures for insurance fraud could help community health workers to report these injuries to the competent authorities. In this article, authors have recognised an unusual but consistent pattern of upper and lower limb fractures whose incidence does not coincide in numerical terms with what is reported in literature. The aim of the present study is to describe fracture patterns observed over the past 2 years. Further, authors describe clinical presentations of these fractures and attempt to defin…

Il morbo di Kienbock: esperienza di trattamento con sostituto osseo e PRP

Results of closed subtalar dislocations.

Background The subtalar dislocation (SD) of the foot is an uncommon injury characterized by a simultaneous dislocation of talocalcaneal and talonavicular joints without involvement of the tibiotalar and calcaneocuboid joints. Purposes The purpose of this study was to evaluate the clinical and radiological outcome in a consecutive series of close SD. Methods We retrospectively evaluated a case series of patients who presented a close SD. Thirteen patients were selected for this study. There were 9 patients with a medial SD, 3 patients with a lateral dislocation and 1 patient with a posterior subtalar dislocation. Results The most frequent symptoms observed in our study included transient mil…

Femoral neck’s fracture in Fahr’s Syndrome: case report

Fahr's syndrome, also known as "Bilateral Striopallidodentate Calcinosis" (BSPDC) primitive, is a rare neurological disease characterized by the presence of idiopathic, bilateral, symmetrical and abnormal deposition of calcium in areas of the brain that control movements including the basal ganglia, dentate nuclei of the cerebellum, nuclei of thalamus and semi-oval center. We describe a case of a 76-year-old male patient underwent reduction and fixation of a subtrochanteric fracture with intramedullary nail. During post-operative rehabilitation therapists's patient management was difficult due to obvious extrapyramidal symptoms characterized by dysarthria, rigidity, bradykinesia, postural i…

ARTHRITIS AND CROHN'S DISEASE: OUR EXPERIENCE

Introduction: Crohn's disease (CD) is a form of inflammatory bowel disease, which may affect any part of the gastrointestinal tract from mouth to anus, causing a wide variety of symptoms. The arthritis is counted as the worst side effect of CD. The orthopaedic manifestations of CD are: peripheral arthritis, spondylitis, sacroiliitis. Material and Method: The authors evaluated the orthopedic clinical manifestation in Sicilian group of forty-five patients with Crohn's disease. Every patients are analyzed with clinical exams, laboratory data, radiographic exams. In addition, all patients were screened for the presence of the antigen HLA B27. Result: Arthritis occurred in 8 patients (17,7 %). P…

Fratture sottocapitate nel giovane adulto G.IO.T., 2006, 32.( Supp. 1.) S165-169.

Shoulder replacement in the treatment of pluri-fragmentary and displaced fractures of the proximal humerus: our experience

Osteoartropatie infiammatorie e infettive

Hyperbaric oxygen therapy in the prevention of complications of opens fractures (nonunions, osteomyelitis)

Results of isolated posterolateral corner reconstruction

Abstract Background Isolated posterolateral corner (PLC) tears are relatively rare events. Various surgical techniques to treat posterolateral knee instability have been described; because surgical results are linked to cruciate reconstructions it has been difficult to date to define whether one surgical procedure has better prognosis than another. The goal of this study is to determine the clinical outcome of PLC reconstruction following fibular-based technique. Materials and methods We retrospectively evaluated a case series of patients who received isolated PLC reconstruction between March 2005 and January 2007. Ten patients were surgically treated for isolated injuries and were availabl…

Tecniche di infiltrazione articolare dei tessuti molli (Traduzione.)

Le sinostosi

Lussazione abituale del nervo ulnare al gomito: proposta di nuova tecnica chirurgica

Avoiding tunnel collisions between fibular collateral ligament and ACL posterolateral bundle reconstruction

A new method to evaluate the influence of the glenosphere positioning on stability and range of motion of a reverse shoulder prosthesis

Abstract Purpose Shoulder instability and reduced range of motion are two common complications of a total reverse shoulder arthroplasty. In this work, a new approach is proposed to estimate how the glenoid component positioning can influence the stability and the range of motion of a reverse shoulder prosthesis. Materials and methods A standard reverse shoulder prosthesis has been analysed. To perform virtual simulation of the shoulder-prosthesis assembly, all the components of the prosthesis have been acquired via a 3D laser scanner and the solid models of the shoulder bones have been reconstructed through CT images. Loads on the shoulder joint have been estimated using anatomical models d…

A case of bilateral luxatio erecta

AbstractLuxatio erecta is an uncommon form of glenohumeral dislocation. Cases of bilateral inferior shoulder dislocation (luxatio erecta) are very rare, and only ten cases have been described in literature. We describe a case of a woman with bilateral luxatio erecta of the shoulders treated with close reduction, immobilization and rehabilitation. The patient had fallen downstairs while clinging to both lateral banisters.

IL TRATTAMENTO CONSERVATIVO DELLE FRATTURE VERTEBRALI TORACOLOMBARI DELL'ANZIANO

Fractures of the proximal extremity of the femur: current diagnostic and therapeutic classification overview.

Optimal positioning of the humeral component in the reverse shoulder prosthesis.

Total reverse shoulder arthroplasty is becoming more and more the standard therapeutic practice for glenohumeral arthropathy with massive lesions of the rotator cuff. The biomechanical principle of this prosthesis is represented by the reversion of the normal anatomy of the shoulder joint. This non-anatomical prosthesis leads to a medialization of the rotation centre of the glenohumeral joint and also to a distalization of the humeral head. All that causes a deltoid tension increasing so allowing a larger abduction of the arm. Main complications of the reverse shoulder prosthesis are due to the joint instability, the scapular notching and the wear of the polyethylene insert. The main goal o…

Indications and limitations of the fixator TGF “Gex-Fix” in proximal end humeral fractures

Abstract The incidence of fractures of the humerus has increased exponentially in recent years. The most used classifications for humerus fracture are morphological (Neer), biological (AO/ASIF) and descriptive (Hertel). The types of surgical treatment for humerus fracture include prosthetic replacement and synthesis using different devices, including the Tension Guide Fixator (TGF), Gex-Fix. External fixation for displaced proximal humeral fractures avoids dissection and soft tissue stripping and has been reported by some authors to be associated with higher union rates, a lower incidence of avascular necrosis, less scarring of the scapulohumeral interface, and faster rehabilitation compare…

Influence of sutures configuration on the strength of tendon-patch joints for rotator cuff tears treatment

Abstract Purpose Massive rotator cuff tears are common in the aging population. The incidence of failed rotator cuff repairs is still quite high, especially in the treatment of full-thickness tears or revision repairs. In this context, natural and synthetic meshes can be used as augmentation scaffolds or as devices to close the gap between a retracted tendon and the bone. The purpose of this work is to evaluate the ultimate tensile strength of different tendon-patch joints in order to consider their use in the treatment of massive cuff tears. Materials and methods Porcine tendons and a synthetic low-density polypropylene mesh have been used. A preliminary study on the tensile strength of te…

Il trattamento delle lesioni midollari (Traduzione)

Il gomito del tennista: aspetti clinici ed approccio chirurgico

Anatomy of the cervical spine

The vertebral column, or spine, consisting of a coordinated series of 33-34 vertebrae separated from each other by intervertebral disks, is divided in five segments or sections: cervical, dorsal, lumbar, sacral and coccygeal [1-7]. Not available

Current status and prospects conservative stem prostheses in hip-replacement surgery

FIBRONECTIN (FN) AND UROTHELIAL DAMAGE SECONDARY TO ADJUVANT INTRAVESICAL THERAPY

Introduction and Objectives: Intravesical chemotherapy has been proven effective in preventing recurrence of low-risk non-muscle invasive bladder cancer (NMIBC). BCG is recognised as the best conservative treatment for intermediate and high risk NMIBC. Maintenance for at least one year is required to ameliorate the efficacy of adjuvant therapy. Discomfort and toxicity often cause interruption of adjuvant therapy, BCG particularly. Almost 50% of the patients undergoing BCG does not complete one year. A biomarker of urothelium damage would be helpful for timely detection of toxicity in order to ameliorate patient’s tolerance and compliance. The aim of the present study was to evaluate the gen…

Ultrasound-guided viscosupplementation in glenohumeral microinstability in sports athletes

SINERGISMO TRA VISCOSUPPLEMENTAZIONE ED ESERCIZIO TERAPEUTICO NELLA COXARTROSI

Case report: laser Nd:YAG e rieducazione funzionale nella sindrome del piriforme

La sindrome del piriforme è caratterizzata da una lombalgia con interessamento del gluteo e con possibile irradiazione all'arto inferiore; può essere definita come una patologia dovuta ad intrappolamento, compressione o irritazione del nervo sciatico a livello del muscolo piriforme con o senza deficit neurologici. In questo studio è stata valutata l'efficacia della sinergia terapeutica tra laser Neodimio:YAG e rieducazione funzionale nella riduzione del dolore e nel miglioramento dell'indipendenza funzionale in una paziente affetta da sindrome del piriforme.

Nostra esperienza nella coxartosi: Trattamento riabilitativo integrato alla viscosupplementazione

Diagnostic therapeutic flow-charts. for low-back pain patient: the Italian clinical guidelines Eura Medicophis, 2005 ; 41: 243-260

SISTEMIC MANIFESTATIONS IN CROHN DISEASE: OUR EXPERIENCE

Arthritis and Crohm's disease has a close link and are frequently associated with aspecific and specific dermatitis. The arthritis is counted as the worst side effect of Crohn's disease. The greatest part of chronic inflammatory bowel disease induce with dermatologic disease, tha are sometimes the first clinical manifestation. In this article the authors desrcibe their clinical observation about orthopaedic, dermatologic and gastroenteric manifestations.

Mid-term results of isolated posterolateral corner reconstruction

Isolated posterolateral corner (PLC) tears are relatively rare events. Various surgical techniques to treat posterolateral knee instability have been described; because surgical results are very much linked to cruciate reconstructions to date it is difficult to define whether one surgical procedure has better prognosis than another. The goal of this study is to determine the clinical outcome of PLC reconstruction following fibular-based technique. MATERIALS AND METHODS: We retrospectively evaluated a case series of patients who had received isolated PLC reconstruction between March 2005 and January 2007. 12 patients were surgically treated for isolated injuries and 10 patients were availabl…

Le fratture dello scafoide carpale

Sono descritte le generalità e le metodiche di diagnosi e trattamento delle fratture dello scafoide carpale

Biomechanical comparison between the modified rolling-hitch and the modified finger-trap suture techniques

Purpose: The purpose of this study was to characterize the biomechanical effect of two grasping suture techniques used during ligament reconstruction: the modified rolling-hitch (MRH) and the modified finger-trap (MFT). Methods: Flexor profundus tendons were harvested from fresh pig hind-leg trotters. Each specimen was mounted on an electro-mechanic universal testing machine (Instron 3367). In half of all tendons (15 specimens), the suture was passed around the tendon following the MRH knot (Group 1). In the remaining half of all tendons (15 specimens), the suture was passed over a distance of 30 mm according to the MFT suture technique (Group 2). As per standard intra-operative technique, …

Complicanze delle fatture dello scafoide carpale

Le fratture dello scafoide carpale sono relativamente rare e avvengono soprattutto nei giovani in seguito a traumi ad alta energia. Per via della sua particolare conformazione anatomica e per la sua vascolarizzazione, è importante un’attenta valutazione del tipo di frattura per individuare il più corret- to approccio terapeutico, al ne di prevenire le non rare complicanze quali: ritardo di consolidazione, viziosa consolidazione e pseudoartrosi. Diverse sono le classi cazioni delle fratture e delle pseudoartrosi proposte da vari autori, le quali convergono sull’importanza della valutazione della stabilità dei frammenti. Le fratture di scafoide stabili bene ciano in genere di un trattamento i…

Le fratture dell’estremo distale di radio nel paziente over 80

Le fratture del radio distale sono tra i più comuni traumi trattati dagli ortopedici rappresentando quasi un sesto delle fratture osservate al pronto soccorso e il 75% di tutte le fratture dell’arto superiore e sono seconde solo alle fratture di femore nella popolazione anziana. L’età di distribuzione di questo tipo di frattura è tipicamente bimodale con picchi nei giovani e negli anziani al di sopra dei 65 anni d’età. Nel primo caso il meccanismo traumatico è in genere un trauma ad alta energia come un incidente stradale, mentre nel secondo caso è in genere un trauma a bassa energia come una caduta. Sono stati proposti diversi sistemi classificativi per queste fratture. La classica classif…

Update nella diagnosi delle lesioni posterolaterali del ginocchio

Nell’ultimo decennio sono stati fatti grossi passi in avanti nella chirurgia ricostruttiva legamentosa del ginocchio. La ricerca dei fattori che possono condurre al fallimento della ricostruzione del legamento crociato anteriore (LCA) ha aperto la strada allo studio di diverse strutture anatomiche come quelle posterolaterali, rimaste nella penombra per troppo tempo. Nonostante l’estrema variabilità delle strutture anatomiche posterolaterali, studi di dissezione anatomica hanno permesso di osservare come il legamento collaterale laterale (LCL), il popliteo ed il legamento popliteo-fibulare (LPF) risultino essere quasi costantemente presenti. Sono state inoltre chiarite le specifiche funzioni…

Fattori di crescita tissutali nelle lesioni ossee tumorali e simil-tumorali Riv. Chir. Mano 43, 524-25 7, 2006

Trattamento delle deformità complesse degli arti con fissatore esterno esapodalico TL-HEX: analisi dell’osteogenesi per distrazione e risultati clinici

Non previsto

Lesioni ostetriche della spalla

Bilateral ruptures of the extensor mechanism of the knee: A systematic review

Abstract Introduction We conduct a systematic and qualitative review of the current literature to evaluate studies that described bilateral ruptures of the extensor mechanism of the knee. Methods A comprehensive literature search was performed to evaluate all studies included in the literature until September 2016. Results Fourteen studies with a total of 44 patients met the inclusion criteria. There were 14 patients with CRF (61%), 6 patients were affected by diabetes mellitus (14%) while other 6 patients were obese patients (14%). Conclusion CRF represents the most frequent comorbidity in patients with bilateral quadriceps/patellar tendon ruptures.

Il trattamento chirurgico con vite cannulata e PRP della pseudoartrosi dello scafoide carpale

Nonunion is an important complication of carpal navicular fractures. The aim of this study is to report the medium term results of a reconstruction technique with cannulated screw combined with Platelet Rich Plasma (PRP) in Herbert fractures C (late consolidation), D1 (fibrous union without deformity) and D2 (pseudarthrosis with initial deformity).

Patient Specific Instrumentation for Total Knee Arthroplasty: a Literature Review

During the past decade, total knee arthroplasty (TKA) has been markedly increased. Recently, patient-specific custom cutting guides have been commercially introduced in order to achieve an accurate component alignment during TKA. In fact, these cutting blocks are specific to a patient’s knee anatomy and should help the surgeons to perform bone cuts, reducing the complexity of conventional alignment and sizing tools. Nevertheless, there are critical arguments against patient-specific cutting guides for routine use, such as poor evidence and higher costs. Additionally, there are still no mild and long-term results available that describe the clinical outcomes following patient-specific instru…

Role of low-field magnetic resonance imaging in the detection of floating meniscus sign as consequence of sport-related trauma

Aim. To assess the role of magnetic resonance (MR) imaging performed with a low-field scanner in the detection of floating meniscus sign as a consequence of sports-related trauma. Methods. Retrospective review of 2436 MR knee examinations executed, in 18 months, using a low-field scanner of 0.2T, was performed by three musculoskeletal radiologists of varying experience. Diagnostic criteria to define the presence of a complete floating meniscus were as codified in the literature, lithe thickness of the fluid signal band between the meniscus and tibial plateau was comprised in the range >= 3 mm and <= 5 mm the floating meniscus was defined as partial. Patients with the sign were called to lea…

The treatment of wrist fractures with Epibloc System

BACKGROUND Fractures of the distal extremity of the radius are the most common bone lesions of the superior extremity of the body, representing 17% of the fractures treated in First Aid facilities. The restoration of anatomical relationships in the radiocarpal joint is considered to be a prerequisite for good functional recovery. There are numerous methods of treatment of these fractures. The Epibloc system is a percutaneous endomedullary synthesis alternative to the plaster cast in wrist fracture treatment. MATERIALS AND METHODS The authors describe their experience with 81 fractures (63 type A2-3 fractures and 18 type C1) of the wrist treated with the Epibloc System (ES). The results were…

Il Fast Track nelle fratture di femore può davvero favorire risultati clinici migliori?

Le attuali linee guida raccomandano di effettuare il trattamento chirurgico di stabilizzazione o sosti- tuzione protesica entro 24-48 ore dall’accesso ospedaliero, al ne di migliorare il risultato funziona- le, ridurre il rischio di mortalità, la degenza ospedaliera e le complicazioni post-operatorie. Tuttavia, la mancanza di studi randomizzati rappresenta un importantissimo limite scienti co dal momento che ad oggi la migliore evidenza scienti ca sul timing chirurgico nelle fratture di collo femore si basa esclusivamente su studi prospettici e retrospettivi. In questo articolo, viene descritto il percorso ospedaliero per il trattamento delle fratture del collo del femore nel paziente anzia…

Polinucleotides versus ialuronic acid in ecoguided hip infiltration: preliminary results

Surgical time for graft preparation using different suture techniques

Background: The purpose of the present study was to compare the operative time for graft prepa- ration using different techniques for graft sutur- ing. Material and methods: Flexor profundus tendons were harvested from fresh pig hind-leg trotters. Three different suture techniques were investigat- ed: the Krackow stitch (K), the Whipstitch (W), and the Modified Finger-Trap suture (MFT). Ten- dons were sutured starting at 10 mm from the dis- tal free end of the tendon. The suture configura- tions of the Krackow stitch and Whipstitch were completed with five suture throws. According to the MFT technique, the suture was wrapped five times around the tendon over a distance of 30 mm. The time re…

Nonunion of the carpal navicular: surgical treatment and PRP

Non-metallic implant for patellar fracture fixation: A systematic review

Abstract Introduction Despite good clinical outcome proposals, there has been relatively little published regarding the use of non-metallic implant for patellar fracture fixation. The purpose of the study was to perform a systematic literature review to summarize and evaluate the clinical studies that described techniques for treating patella fractures using non-metallic implants. Methods A comprehensive literature search was systematically performed to evaluate all studies included in the literature until November 2015. The following search terms were used: patellar fracture, patella suture, patella absorbable, patella screw, patella cerclage. Two investigators independently reviewed all a…

A proteomic cluster for osteotropic breast cancer cells

Effect of suturing the femoral portion of a four-strand graft during an ACL reconstruction

Purpose A suture passed along the part of the graft that will be inserted into the femoral tunnel is widely used by surgeons, because it could prevent the graft sliding on the femoral fixation device during pulling from the tibial side. The aim of this study was to evaluate the biomechanical effects of suturing the intratunnel femoral part of the graft during an anterior cruciate ligament (ACL) reconstruction. Methods Bovine digital extensor tendons and tibias were harvested from 20 fresh-frozen mature bovine knees ranging in age from 18 to 24 months. Quadruple-strand bovine tendons were passed through the tibial tunnel and secured distally with a bioabsorbable interference screw. In one ha…

L’algodistrofia post-traumatica

Non disponibile

How to avoid collision between PCL and MCL femoral tunnels during a simultaneous reconstruction.

PURPOSE: The purpose of the present study was to assess the risk of femoral tunnel collisions between the medial collateral ligament (MCL) and the posterior cruciate ligament (PCL) tunnels during a simultaneous PCL and MCL reconstruction. METHODS: Fourth generation medium and large synthetic femur bones were used. On each femur, a MCL tunnel and a PCL tunnel were reamed. The MCL tunnel was drilled at 0°, 20° and 40° of axial and coronal angulations. The PCL femoral tunnel was reamed to simulate two different tunnel directions that could be obtained through an inside-out and outside-in technique. Tunnels were filled with epoxy resin augmented with BaSO4, and a multidetector CT examination of…

TERAPIA INFILTRATIVA INTRA-ARTICOLARE ASSOCIATA A MESALAZINA E PROBIOTICI NEL TRATTAMENTO DELL'ARTRITE NEL PAZIENTE CON MALATTIA INFIAMMATORIA CRONICA INTESTINALE (IBD)

L'artrite secondaria a malattia infiammatoria cronica intestinale può essere presente parecchi anni prima della diagnosi oppure manifestarsi come una vera complicanza.

Le infezioni in chirurgia della mano

La preartrosi nella attività sportiva

TRATTAMENTO INCRUENTO

Complex pluri-fragmentary fractures of the distal humerus: our experience with double-plate

Il trattamento chirurgico delle malattie reumatiche delle grandi articolazioni

Posterior subtalar dislocation.

A subtalar dislocation of the foot is an uncommon injury, and cases of posterior subtalar dislocation are even rarer. This injury is characterized by a simultaneous dislocation of talocalcaneal and talonavicular joints while tibiotalar and calcaneocuboid articulations remain intact. Subtalar dislocation is commonly accompanied by fractures of the malleoli, talus, or fifth metatarsal and by a rotational component of the subtalar joint. Subtalar dislocation can occur in any direction and produces significant deformity. This article presents a case of pure posterior subtalar dislocation in an 80-year-old man who presented with pain and deformity in his left ankle following a motorcycle acciden…

Valutazione delle lesioni focali del tendine del sovraspinato con elastosonografia: confronto con ecografia B-mode e risonanza magnetica: esperienza personale.

Obiettivo. Scopo dello studio era valutare l’elasticità del tendine del sovraspinato nella spalla sintomatica di pazienti con sospetto clinico di rottura unilaterale della cuffia dei rotatori, e comparare i reperti riscontrati con quelli dell’ecografia convenzionale (ultrasound, US) e della risonanza magnetica (RM). Metodi. Nel periodo compreso tra gennaio e dicembre 2009 sono state esaminate da un radiologo entrambe le spalle di 58 pazienti (età media: 46 anni; range 32-58 anni) sia con modulo elastosonografico in real-time che in B-mode tramite uno stesso ecografo (EUB - Hitachi 7500), usando una sonda lineare a elevata frequenza (13 MHz). L’elasticità delle fibre tendinee del sovraspinat…

Comments to the paper "do we really need new medical information about the Turin Shroud?".

Abstract Following the interesting arguments raised in a recent letter to the editor, about a paper recently published in this journal, the authors are happy to take a cue from them to clarify some facts that have not been sufficiently treated for space. After a description of the methods used, arguments regarding a blunt trauma on the right shoulder with consequent dislocation, the position of the hands on the pubis with brachial plexus injury, and the wrist nailing that caused retracted thumbs are discussed in detail.

Il trattamento nelle fratture di polso: i punti principali oggi

MRI evaluation to predict tendon size for knee ligament reconstruction.

Background The aim of this study is to evaluate a possible correlation between specific anthropometric parameters and sizes of knee tendons commonly used for ACL reconstruction. We hypothesized that specific clinical and radiological knee measurements could be better tendon sizes predictors than age, gender, height and weight. Materials and methods 100 consecutive patients were enrolled and 77 patients met the inclusion criteria of the study. All patients underwent a MRI of the knee with a 1.5 T super conducting MR System. For each patient, anthropometric data such as gender, height, weight, body mass index (BMI) and knee circumference were recorded. Specific MRI knee measurements were perf…

Sinergismo tra viscosupplementazione ed esercizio fisico nella coxartrosi

Progettazione di un chiodo endomidollare tibiale

Anterior dislocation in a total knee arthroplasty: A case report and literature review.

Dislocations of a total knee arthroplasty (TKA) are an uncommon injury and only few cases of anterior dislocations have been reported. We report a rare case of anterior dislocation of a 10-year-old posterior stabilized total knee arthroplasty in a 74-year-old woman. The patient was successfully treated by close reduction of the dislocation followed by immobilization in full extension with a long leg cast. Because of a high risk of neurovascular complications, a high index of suspicion for vascular injury must be maintained. For this reason, a proper diagnosis is required and immediate reduction is recommended.

A ten-year follow-up of the Reflection cementless acetabular component.

We reviewed the long-term results at ten to 12 years of 118 total hip replacements in 109 patients using a second-generation hemispherical cementless acetabular component (Reflection) designed to address the problem of backside wear. Five patients (five hips) died and six patients (seven hips) were lost to follow-up. The remaining 98 patients (106 hips) had a mean age of 62.9 years (34.0 to 86.2) A rate of revision for aseptic loosening of 0.9%, and predictable results were found with respect to radiological evidence of fixation, lack of pain, walking ability, range of movement and function. One component was revised for aseptic loosening, and of the 101 hips (95.2%) that did not have a rev…

The current state of the art of angle-stable volar plating in the treatment of distal epiphisis fractures

Emergent and delayed hybrid external fixation management of tibial pilon fractures: A multicentric retrospective analysis of 80 patients

Objective: To report our experience with the hybrid external fixator in emergency. Methods: We assessed 80 cases of pilon fracture treated with the external fixator during the period of January 2009 and December 2016:55 men (69%) and 30 women (33%) with a mean age of 40 years (range between 16 and 70). About 45 occurred as isolated trauma, 35 instead were politrauma. Each patient underwent standard radiographic examination and a CT examination. There were 28 open fractures (35%), (Gustilo type 1, 2 and 3) while closed fractures showed soft tissue involvement of various grade (2-3 Tscherne classification). In all cases, the external fixation, sometimes associated with other reduction and syn…

L'impiego del TGF (Jex Fix) nelle fratture dell'estremo prossimale dell'omero

Achilles tendon rupture: percutaneous repairing

FRATTURE DA STRESS: VALUTAZIONI EZIOPATOGENETICHE E MODALITA' DI PREVENZIONE

Wound drainages in total hip arthroplasty: to use or not to use? Review of the literature on current practice.

Aim of this study is to analyze data reported in literature concerning the efficacy of using wound low-vacuum suction drainages in orthopedic surgery after total hip arthroplasty. We analyzed studies concerning the use of drainages in prosthetic hip replacement surgery, performing our research through Pubmed, Cochrane database and Google Scholar, and selecting the ones evaluating the following parameters: bleeding, the need for blood transfusions, number or reinforcement of post-operative medications, length of hospitalization, functional results, periprosthetic and surgical wound infection, post-operative hematoma. Our review did not show any demonstrated advantage from the use of wound dr…

Gli innesti acetabolari ed i sostituti dell’osso nelle revisioni acetabolari Supplemento GIOT Vol. 30 ,S 94-S98 ,2004.

Do we really need new medical information about the Turin Shroud?

Abstract Image processing of the Turin Shroud (TS) shows that the Man represented in it has undergone an under glenoidal dislocation of the humerus on the right side and lowering of the shoulder, and has a flattened hand and enophthalmos; conditions that have not been described before, despite several studies on the subject. These injuries indicate that the Man suffered a violent blunt trauma to the neck, chest and shoulder from behind, causing neuromuscular damage and lesions of the entire brachial plexus. The posture of the left claw-hand is indicative of an injury of the lower brachial plexus, as is the crossing of the hands on the pubis, not above the pubis as it would normally be, and …

Le Fratture di Rotula

Patellar fractures are relatively uncommon, accounting for approximately 1% of all fractures. Non-operative treatment represents the best choice for undisplaced patellar fractures. However, surgery becomes necessary when fractures are displaced by more than 2 mm, and may include open reduction and internal fixation. Accurate reduction and rigid fixation are required in order to allow early knee mobilization and to obtain a better clinical outcome. Several techniques have been described for patellar fracture fixation, such as tension band wiring, interfragmentary screw fixation, and the combination of screw fixation and cerclage. In this article up-to-date diagnosis, classification and treat…

Le infezioni tubercolari dell’apparato locomotore

Gli AA dopo aver presentato i dati epidemiologici più importanti della TBC osteoarticolare, si soffermano sulla fisiopatologia, il quadro clinico e radiografico delle localizzazioni più frequenti sottolineando i segni clinici e radiografici tipici di queste lesioni e l’importanza della RM, specie se eseguita con mezzo di contrasto, nella diagnosi precoce della malattia. Vengono inoltre presi in considerazione gli aspetti evolutivi della malattia sia prima che dopo l’introduzione dei farmaci antitubercolari, la terapia medica ed il trattamento incruento e chirurgico delle varie forme. Gli AA concludono che la TBC è una malattia purtroppo sempre di attualità contrariamente a quanto si pensava…

MRI evaluation of spine abnormalities in the supine position and under physiological load in athletes with a dedicated MR scanner

Purpose of our study was to evaluate the behavior of the lumbar spine of young athletes in the supine and standing position, taking into account all postural changes that the spine undergoes during physiological load, any alterations and any discrepancies in the detection of pathology between the two positions. Between August 2008 and October 2009, we evaluated 40 sportsman (20 men and 20 women) with symptoms of lumbar pain. All subjects underwent MRI with a dedicated scanner of 0.25 Tesla (G-Scan, Esaote Biomedica, Genoa, Italy) either in the conventional supine position, either in the weight-bearing position. Spin echo T1w and fast spin echo T2w images were acquired with a dedicated recei…

GASTRO-ESOPHAGEAL REFLUX MANIFESTATIONS IN THE TREATMENT OF OSTEOARTHRITIS WITH NON STEROIDAL ANTI-INFLAMMATORY DRUGS

Augmentation of tibial plateau fractures with an injectable bone substitute: CERAMENT™. Three year follow-up from a prospective study

Background: Reduction of tibial plateau fractures and maintain a level of well aligned congruent joint is key to a satisfactory clinical outcome and is important for the return to pre-trauma level of activity. Stable internal fixation support early mobility and weight bearing. The augmentation with bone graft substitute is often required to support the fixation to mantain reduction. For these reasons there has been development of novel bone graft substitutes for trauma applications and in particular synthetic materials based on calcium phosphates and/or apatite combined with calcium sulfates. Injectable bone substitutes can optimize the filling of irregular bone defects. The purpose of this…

Core Curriculum - Ortopedia e Traumatologia

How was the Turin Shroud Man crucified?

As the literature is not exhaustive with reference to the way the Turin Shroud (TS) Man was crucified, and it is not easy to draw significant information from only a "photograph" of a man on a linen sheet, this study tries to add some detail on this issue based on both image processing of high resolution photos of the TS and on experimental tests on arms and legs of human cadavers. With regard to the TS Man hands, a first hypothesis states that the left hand of the TS Man was nailed twice at two different anatomical sites: the midcarpal joint medially to the pisiform between the lunate/pyramidal and capitate/uncinate bones (Destot's space) and the radiocarpal joint between the radio, lunate…

PHENOTYPIC PROFILING OF OSTEOTROPIC BREAST CANCER CELLS

One of the preferred locations of metastases from breast cancer is the bone tissue. On the other hand, it should be recalled that mammary tumors with equal clinical diagnosis have a different course, and also different metastatic progression. Therefore, it would be helpful to have appropriate markers of osteotropism to test on the surgical cancer tissues, in order to predict the possible propensity of the breast cancer to generate bone metastases and to adequate the therapeutic plan. We previously reported1,2 on the setting-up of an in vitro model for the study of the osteotropic propensity of breast cancer cells and the influences exerted by the bone microenvironment on the cancer cells ph…

Infiltrazioni intra-articolari ecoguidate di acido ialuronico (Hyalubrix) nel trattamento di pazienti con grave osteoatrosi d'anca: dati clinici e valutazioni preliminari

L'osteoartrosi dell'anca (AO), nei casi indirizzabili al trattamento chirurgico è solitamente curata con terapie mediche sistemiche. la viscosupplementazione si propone come opzione terapeutica. il presente studio ha mostrato efficacia nel trattamento di pazienti con OA d'anca di grado alto.

Management of Distal Radius Fractures in the Elderly Patients

Distal radius fractures are one of the most common injuries treated by the orthopedic surgeons representing almost 1/6 of the fractures that are treated in the emergency departments and the 75% of all fractures of the upper limb and are second only to hip fractures in elderly population. The age distribution of this kind of injury is typically bimodal with peaks in the young patients (6-25) and in the elderly patients older than 65. In the first case the mechanism of injury is usually a high energy trauma, such as a car accident, whilst in the second one is usually a low energy trauma like a domestic fall. Various classification systems have been proposed for these fractures. The classic ep…

Can Clinical and Surgical Parameters Be Combined to Predict How Long It Will Take a Tibia Fracture to Heal? A Prospective Multicentre Observational Study: The FRACTING Study

Background. Healing of tibia fractures occurs over a wide time range of months, with a number of risk factors contributing to prolonged healing. In this prospective, multicentre, observational study, we investigated the capability of FRACTING (tibia FRACTure prediction healING days) score, calculated soon after tibia fracture treatment, to predict healing time.Methods. The study included 363 patients. Information on patient health, fracture morphology, and surgical treatment adopted were combined to calculate the FRACTING score. Fractures were considered healed when the patient was able to fully weight-bear without pain.Results. 319 fractures (88%) healed within 12 months from treatment. Fo…

Trattamento con PRP (platelet rich plasma) nelle tendinopatie dell'arto inferiore. Nostra esperienza.

Diagnostic therapeutic flow-charts for low-back pain patient : the Italian clinical guidelines

Proximal Tibiofibular Joint Reconstruction With Autogenous Semitendinosus Tendon Graft

Isolated and chronic anterolateral instability of the proximal tibiofibular joint (TFJ) is an uncommon condition, generally linked to an unrecognized or unhealed dislocation of the TFJ. Clinically, abnormal anterior movement of the head of the fibula is detected. In acute injuries conservative management should be preferred, whereas surgical treatment have been advocated in patients with chronic TFJ instability. Authors describe a new surgical reconstruction technique for chronic instability of the proximal TFJ using an autogenous semitendinosus tendon. The graft is passed through fibular and tibia tunnels and fixed with 2 interference screws. The tibial tunnel is reamed from the posterolat…

Electromagnetic distal targeting system does not reduce the overall operative time of the intramedullary nailing for humeral shaft fractures

Abstract Introduction We aimed to evaluate the efficacy of the use of the electromagnetic distal targeting system in treating humeral shaft fracture. Methods Patients were divided in: Group 1) patients that received a distal locking screw placement following the free-hand technique; Group 2) patients in which the distal locking screw was performed using the SURESHOT device. Results No differences were noted comparing Group 1 (freehand) [71,9 range 40–135 min] to Group 2 (SURESHOT)[70, range 25–125 min]. Conclusion The use of the EM distal targeting system doesn't reduce the overall operative time of the humeral shaft fracture fixation using IMN.

Fractures of the humeral head: our expertise in anatomical reconstruction

Femoro-acetabular impingement. Classification, diagnosis and treatment.

Introduction: The femoro-acetabular impingement (FAI) is the result of a number of congenital or acquired pathologies of the hip and it has as main pathogenetic element an abnormal contact between the two joint components (acetabulum and proximal femoral epiphysis). Mainly male young adults, often athletes, are affected because of the repetition of gestures responsible for the conflict in these subjects. Classification: FAI has specific clinical and radiological characteristics and it can be classified into three types: 1. CAM type (femoral). 2. PINCER type (acetabular). 3. CAM-PINCER mixed-type. Diagnosis: It is based on medical hystory (young and active patients, diseases or previous hip …

FiberWire tension band for patellar fractures.

Background Symptomatic hardware represents the most frequent complication reported following surgical treatment of patellar fracture. For this reason, some authors suggested using nonabsorbable sutures to fix the fracture with various techniques. The aim of this study was to evaluate clinical and radiological results of patients treated following a modified Pyriford technique using a FiberWire suture (Arthrex, Naples, FL, USA). Materials and methods We retrospectively evaluated a case series of  seventeen patients with displaced patellar fractures treated by open reduction and internal fixation with a modified tension band using FiberWire sutures. Clinical and radiological outcome were eval…

COMPARSA DI COMPLICANZE GASTRO-INTESTINALI NELL'UTILIZZO DI ANTI-INFIAMMATORI NELLE MALATTIE DEGENERATIVE CRONICHE DELLE ARTICOLAZIONI

Prassi di chirurgia della coxa manus

Management of anemia: blood loss in orthopaedic surgery

Major ortopaedic surgery and high energy trauma are often responsible of acute bleeding. Long bones and pelvis fractures are correlated with increased blood loss. The final consequence of a major bleeding is hypovolemic shock. The reduced oxygen tension of tissue could be responsible of heart attack, arrythmia, ictus, multi organ deficiency. For these reasons, it is important to immediately recognize and correct all potential bleeding in order to avoid complications. In orthopaedics the elective treatments in the managenment of hypovolemia are different. Blood banks and allogenic blood components have had an important impact on operative treatment and health care worldwide. erythropoietin h…

Greater Trochanteric Pain Syndrome: What is the Meaning?

Greater trochanteric pain syndrome (GTPS) is a common cause of lower extremity pain. This is frequently attributed to trochanteric bursitis and distension of the subgluteal bursae. Patients are suffering from pain radiating to the posterolateral aspect of the thigh, paraesthesiae in the legs, and tenderness over the iliotibial tract. Often the symptoms are mild, with the patient treating himself successfully through activity modification and other conservative measures. including relative rest, ice, compression, elevation, anti-inflammatory medication and treatment modalities such as ultrasound and electrical stimulation, combined with a structured rehabilitation program. Patients whose sym…

Differential diagnosis of vascular necrosis of the femoral head (AVN) and transient hip osteoporosis (THO): role of MRI

Surgery for femoroacetabular impingement in early degenerative stage

Patologie da stress della volta plantare

Dupuytren contracture in diabetic hand

Dupuytren's disease (DD) is a fibroproliferative disorder of unknown origin causing palmar nodules and flexion contracture of the digits. About 5% of individuals with DD are diabetic, with an increased prevalence that is proportional to the duration of the diabetes. The association with diabetes mellitus is well recorded, with a reported prevalence of between 3% and 32%. This review considers the evidence behind the association between DD and diabetes mellitus, considering the pathogenesis, clinical manifestations and therapies that can be found in the literature.

RHEUMATIC PATHOLOGIES IN SUBJECTS WITH INFLAMMATORY BOWEL DISEASE

Inflammatory Bowel Disease (IBD) are commonly associated with rheumatic diseases of the joints. Sixty-five patients are selected during a 5-year study period. All Patients were analyzed with clinical, laboratory and radiographic exams. 38 patients had ulcerative colitis (mean age 42.1 years range:19-75) and 27 patients had Crohn's disease (CD) (mean age 37.2 years, range: 17-64 years). Arthritis occurred in 11 patients (17%): 7 with UC (18.4%) and 4 CD (14.8%). The mean age of patients with arthritis was 35 and mean disease duration of pain and limitation symptoms was 28 months. In 9 patients, arthritis appeared after the onset of bowel symptoms with mean duration of 20 months in UC and 24 …

La sindrome da conflitto ischio-femorale: valutazione diagnostica con RM

Le localizzazioni extravertebrali della tubercolosi osteoarticolare

Esito delle fratture di polso. Concetti generali

EFFICACIA NELLA PRATICA CLINICA DI UN SUPPLEMENTO A BASE DI GLUCOSAMINA SOLFATO(GS), CONDROITINA SOLFATO (CS), COLLAGENE IDROLIZZATO DI TIPO B, ACIDO IALURONICO IDROLIZZATO E L-CARNITINA IN SOGGETTI CON OSTEOARTROSI DEL GINOCCHIO

Aim: Osteoarthritis (OA) is a degeneration of articular cartilage. four components of the cartilage structure, glucosamine, chondroitin collagen type II and hyaluronic acid are available in a food supplements. It has been claimed that they reduce the pain of OA and help rebuild cartilage in patients with early OA. Methods: A multicentre, randomized, double-blind ascorbic acid controlled study was carried out in patients with osteoarthritis of the knee. The purpose of the study was to evaluate the effectiveness of a food supplement sachet containing glucosamine sulfate (500 mg), chondroitin sulfate (400 mg), hydrolyzed collagen tipe II and hyaluronic acid mixture (300 mg), L-carnitine fumara…

Gli innesti acetabolari ed i sostituti dell’osso nelle revisioni acetabolari

LE FRATTURE ACUTE DELLO SCAFOIDE CARPALE: METODI ATTUALI DI TRATTAMENTO. UNA METANALISI

The effectiveness of eco-guided infiltrations with high molecular weight associated with administration of oral chondroprotective supplements in osteoarthritis of the hip

Osteoarthritis does not mean a degenerative articular process only but a pathologic expression of wear, inflammation and immunological imbalance of the joints. Our study has the aim to demonstrate the effectiveness of eco-guidate infiltrations with high molecular weight associated with administration of oral chondroprotective supplements (glucosamine solfate, chondroitin sulphate, hydrolyzed collagen type II, hyaluronic acid and L carnitine fumarate) in comparison with the only treatment with ecoguided infiltrations with hyaluronic acid in patients suffering from primary osteoarthiritis of the hip.

UN NUOVO APPROCCIO ECOGRAFICO NELLA DIAGNOSTICA DELLA PATOLOGIA TENDINEA DEL GOMITO

A rare case of peri-implant distal radius fracture☆

A peri-implant fracture near the volar plate of distal radius represent a very rare injury. The main factor of this lesion is high energy trauma on the wrist. We report a case of a 61-year-old woman with a peri-implant fracture located just proximally to the plate and a fracture of the ulnar head that occurred after a simple fall. The patient was surgically treated by plate and screws removal. The fracture was fixed using a longer volar plate for the radial fracture and a plate for the head ulnar fracture. Different factors such as osteoporosis, BMI and screw position could influence the fracture pattern. However, considering growing use of plates for distal radius fracture fixation, the fr…

ULTRASOUND-GUIDED PERCUTANEOUS TREATMENT OF MUSCLE HEMATOMAS IN ATHLETES

Muscle lesions, a frequent event in sport, often cause hematomas. In fact, both in the traumatic direct injuries, as in American football, and in the traumatic indirect ones, as in strength sports, lesions interesting leg's Muscles Cause intra- and extramuscular hematomas. A diagnosis in a short time, allow LIS to evaluate the lesion rank and plan a surgery approach. Authors present high resolution Ultrasound (HRSU) as a new diagnostic method for this kind of lesion. It allows us to confirm clinic diagnosis, define the lesion's areas and follow-up. Moreover, HRSU has all important role in therapy, promoting in real time the blood's aspiration from lesion's area. Three phases after trauma, d…

Genetic, clinical and radiographic signs in knee osteoarthritis susceptibility

Abstract INTRODUCTION: Osteoarthritis (OA) is considered to be a multifactorial and polygenic disease and diagnosis is mainly clinical and radiological. Correlation between radiographic data and clinical status has been reported. However, very few studies, especially in Caucasian people, describe the association between the Kellgren and Lawrence OA grading scale (KL) and genetic alterations to better understand OA etiopathogenesis and susceptibility. In order to update the knee OA grading, in this study we assessed the associations between KL grade, clinical features such as American Knee Society Score (AKSS), age, and polymorphisms in the principal osteoarthritis susceptibility (OS) genes …

Medical news from scientific analysis of the Turin Shroud

This paper synthetizes a series of works recently published in reference to medical studies regarding both the physical conditions of the Man who was wrapped in the Turin Shroud (TS) and the tortures to which this Man was subjected. An event that influenced the rapid course of the Passion and the cause of death of the TS Man was the fall under the weight of the cross. This Man shows, on the right side, shoulder lowering, flat hand and henophthalmos, revealing a violent blunt trauma, from behind, to neck, chest and shoulder, with the entire brachial plexus injury and muscular damage to the neck bottom with the head bent forward and turned to the left, on the cross, as he had a stiff neck. Mo…

Fractures of the patella today: use of absorbable cerclage