83 results on '"Liuzza F."'
Search Results
2. Treatment of distal femur fractures with VA-LCP condylar plate: A single trauma centre experience
- Author
-
Campana, V., Ciolli, G., Cazzato, G., Giovannetti De Sanctis, E., Vitiello, C., Leone, A., Liuzza, F., and Maccauro, G.
- Published
- 2020
- Full Text
- View/download PDF
Catalog
3. Preliminary data on the neurophysiological evaluation of male sexual dysfunction in patients with pelvic ring fractures: a multicenter retrospective study.
- Author
-
ROVERE, G., FUSCO, A., SMAKAJ, A., DE MAURO, D., DE VITIS, R., PADUA, L., MECCARIELLO, L., FIDANZA, A., ERASMO, R., PERESSON, M., NOIA, G., MACCAGNANO, G., MACCAURO, G., and LIUZZA, F.
- Abstract
OBJECTIVE: Traumatic pelvic ring fractures include several comorbidities due to the close anatomical relationship between the skeletal system, pelvic organs, and neurovascular structures. In this retrospective multicenter study, we evaluated patients complaining of sexual dysfunction following pelvic ring fractures, assessed through different neuro-physiological examinations. PATIENTS AND METHODS: Patients were enrolled one year after the injury according to their reported ASEX scores and evaluated on the basis of the Tile's type of pelvic fracture. Lower limb and sacral somatosensory evoked potentials, pelvic floor electromyography, bulbocavernosus reflex and pelvic floor motor evoked potentials were recorded, according to the neurophysiological indications. RESULTS: A total of 14 male patients (mean age 50.4; 8 subjects Tile-type B and 6 Tile-type C) were enrolled. The ages between the Tile B group and the Tile C group of patients were not significantly different (p=0.187), while the ASEX scores were significantly different (p=0.014). In 57% of patients (n=8), no alterations in nerve conduction and/or pelvic floor neuromuscular responses were found. In 6 patients, electromyographic signs of denervation were revealed (2 patients), and alterations of the sacral efferent nerve component were detected in 4 patients. CONCLUSIONS: Sexual dysfunctions after a traumatic pelvic ring fracture are more common in Tile-type B. Our preliminary data did not reveal a significant association with neurogenic aetiology. Other causes could explain the complaining impairments. [ABSTRACT FROM AUTHOR] more...
- Published
- 2023
4. Robotic-assisted unicompartimental knee arthroplasty performed with Navio system: a systematic review.
- Author
-
ARE, L., DE MAURO, D., ROVERE, G., FRESTA, L., TARTARONE, M., ILLUMINATI, A., SMAKAJ, A., MACCAURO, G., and LIUZZA, F.
- Abstract
OBJECTIVE: Robotic-assisted arthroplasty is a relatively modern concept, quickly arising in its use. The aim of this systematic review is to assess, according to the existing literature, which are the functional and clinical outcomes and component positioning and implant survivorship of unicompartmental knee arthroplasty surgery performed using an image-free hand-held robotic system. Moreover, we analyzed whether there are significant differences and advantages compared to conventional surgery. MATERIALS AND METHODS: A systematic review has been performed on studies published between 2004 and 2021, on the electronic library databases, according to the Preferred Reporting Items of Systematic Reviews and Meta-analysis (PRISMA) statement. The inclusion criteria were all studies described as unicompartmental knee arthroplasty performed with the Navio robotic system. RESULTS: Fifteen studies were included, and 1,262 unicondylar knee arthroplasties were analyzed. These studies showed a satisfactory recovery of joint function, with a good range of motion (extension <5° and flexion which ranged from 105° to 130.3°) in patients of the NAVIO group. The revision rate was <2% while the infection rate <1%; no postoperative transfusion was needed in all UKA implanted. CONCLUSIONS: The use of a robotic tool for unicompartmental knee arthroplasty (UKA) could lead to a better implant positioning and joint alignment than conventional surgery. There is still limited evidence to support that the use of this robot in unicompartmental knee arthroplasty is a greater survivorship than other systems or conventional techniques; therefore, a longterm follow-up is needed. [ABSTRACT FROM AUTHOR] more...
- Published
- 2023
5. Elastofibroma dorsi: 8 case reports and a literature review
- Author
-
Muratori, F., Esposito, M., Rosa, F., Liuzza, F., Magarelli, N., Rossi, B., Folath, H. M., Pacelli, F., and Maccauro, G.
- Published
- 2008
- Full Text
- View/download PDF
6. A particular solution in the treatment of primitive neoplasms of the distal third of the tibia. Presentation of a clinical case and review of the literature
- Author
-
Maccauro, G., Liuzza, F., Muratori, F., Gosheger, G., Salgarello, M., and Logroscino, C. A.
- Published
- 2006
- Full Text
- View/download PDF
7. Long proximal femoral nail for the treatment of femoral metastases: a report of 27 cases
- Author
-
Maccauro, G., Muratori, F., Liuzza, F., Sgambato, A., Leone, A., Cianfoni, A., Rosa, M. A., and Gosheger, G.
- Published
- 2005
- Full Text
- View/download PDF
8. Lung carcinoma metastasis to the soft tissues: presentation of two cases and review of the literature
- Author
-
Maccauro, G., Liuzza, F., Muratori, F., and Gosheger, G.
- Published
- 2005
- Full Text
- View/download PDF
9. A very rare localization of metastatic lung carcinoma to the interosseous membrane
- Author
-
Maccauro, G., Liuzza, F., Muratori, F., Falcone, G., and Gosegher, G.
- Published
- 2003
- Full Text
- View/download PDF
10. Treatment options for proximal periprosthetic femoral fractures in Total Hip Arthroplasty: a single center experience.
- Author
-
MARINO, S., GIULIANI, A., DE MAURO, D., ROVERE, G., SMAKAJ, A., SASSARA, G. M., ARE, L., MACCAURO, G., and LIUZZA, F.
- Abstract
OBJECTIVE: Proximal periprosthetic femoral fractures (PPFFs) are gradually increasing and surgical management is often associated with high risk of complications, due to elderly population and associated comorbidities. PATIENTS AND METHODS: We retrospectively assessed 39 patients at least at 2-years follow-up. We identified two study groups, similar for demographic data. Group A included patients surgically treated without involving prosthetic implants, whereas Group B included patients in which an implant revision was performed. RESULTS: Data were recorded from January 2017 to February 2020, and 39 patients were included: 30 females (76.9%) and 9 males (23.1%), with a confirmed diagnosis of periprosthetic fracture of the proximal femur. 23 (58.9%) patients were treated with Open Reduction and Internal Fixation (ORIF), 12 (30.7%) with revision surgery and 4 (10.3%) were treated by modular megaprosthesis. CONCLUSIONS: The treatment options considered in the study, revision arthroplasty and internal fixation had shown no significant differences as a matter of clinical outcomes and post-operative complications. [ABSTRACT FROM AUTHOR] more...
- Published
- 2022
11. Medial gastrocnemius flap for the treatment of infected knee prostheses.
- Author
-
ROVERE, G., SMAKAJ, A., DE MAURO, D., MARINO, S., VITIELLO, R., MESCHINI, C., ZIRANU, A., LIUZZA, F., MACCAURO, G., and PATAIA, E.
- Abstract
OBJECTIVE: Muscular flaps may represent a valid treatment option for prosthetic infection after knee arthroplasty. PATIENTS AND METHODS: We present the results of 20 consecutive patients treated with the use of medial gastrocnemius flap for the management of different types of injuries or integumentary defects after total knee arthroplasty. Tissue necrosis or dehiscence occurred within 1 and 2 months after arthroplasty. The mean follow-up was 23.4 (12-60) months. Clinical outcome was evaluated according to the infection control rate and post-operative Knee Society Score (KSS). RESULTS: Prosthesis salvage and complete restoration of skin coverage were achieved in all patients. Functional assessment was performed using the KSS score. The final knee KSS score was classified as excellent (score: 80-100) in 0 patients, good (score: 70-79) in 17 patients, fair (score: 60-69) in 2 patients, and poor (score: 60) in 1 patient. Residual Extension Deficit: 0-20°; Very Satisfactory in 17 patients. 30-70° Satisfactory in 2 patients, 80-90° Unsatisfactory in 1 patient. Patients who successfully underwent flap treatment experienced a much greater increase in both components of the KSS score. CONCLUSIONS: The results highlight the effectiveness of medial gastrocnemius muscular flap for the treatment of prosthetic knee infection, in terms of function, limb salvage, cost-effectiveness and post-surgery quality of life. Further larger studies may consolidate these findings. [ABSTRACT FROM AUTHOR] more...
- Published
- 2022
12. A very rare localization of metastatic lung carcinoma to the interosseous membrane
- Author
-
Maccauro, G., Liuzza, F., Muratori, F., Falcone, G., and Gosheger, G.
- Published
- 2004
- Full Text
- View/download PDF
13. Elastofibroma dorsi: 8 case reports and a literature review.
- Author
-
F. Muratori, M. Esposito, F. Rosa, F. Liuzza, N. Magarelli, B. Rossi, H. Folath, F. Pacelli, G. Maccauro, Muratori, F, Esposito, M, Rosa, F, Liuzza, F, Magarelli, N, Rossi, B, Folath, H M, Pacelli, F, and Maccauro, G more...
- Subjects
CONNECTIVE tissue tumors ,PATIENTS ,TISSUES ,SURGICAL excision ,OPERATIVE surgery - Abstract
A series of 8 cases of elastofibroma is reported, and the clinical, pathological and imaging features and different therapeutic modalities are reviewed. On this basis, we suggest an algorithm for the diagnosis and treatment of elastofibroma. Briefly, marginal excision is the treatment of choice in symptomatic patients, while followup appears to be a good solution in asymptomatic ones. [ABSTRACT FROM AUTHOR] more...
- Published
- 2008
- Full Text
- View/download PDF
14. Floating knee: A new prognostic classification.
- Author
-
Meccariello L, Pica R, Erasmo R, Ronga M, Ippolito F, Vicenti G, Maccagnano G, Coviello M, Liuzza F, Rollo G, Carrozzo M, Rovere G, Rinonapoli G, Matera L, Bruno G, Scialpi L, Grubor P, Bove F, and Caiaffa V more...
- Subjects
- Humans, Prognosis, Retrospective Studies, Male, Female, Adult, Middle Aged, Reproducibility of Results, Aged, Young Adult, Tibial Fractures classification, Tibial Fractures surgery, Femoral Fractures classification, Femoral Fractures surgery
- Abstract
Introduction: Usually ipsilateral fractures of the femur and tibia are not compatible with good results and require surgery. The unsatisfactory results are more likely due to complex patterns of fractures, compromised soft tissue, associated ligament injuries, and concomitant vital organ injuries. There are many classifications to describe this type of fracture but none of them is a prognostic classification. The aim of this study is to validate our classification according to prognostic terms., Methods: This retrospective study encloses patients accepted with a diagnosis of floating knee between January 1st 2014 and December 31th 2020. A total of 372 patients met the inclusion criteria, but only 168 patients were selected for the final review. We have reclassified the 168 patients into three classifications: according to our alphanumeric; according to the Fraser classification; according to Letts and Ran. Our classification is divided into 5 macro categories in increasing order of severity, and considering fracture site, and exposure status. The Tau B Kendall and Cohen's Kappa was used to statistically evaluate the prognostic value, reliability and reproducibility of our classification versus Fraser Classification, Letts and Ran Classification in the prognosis of these injuries., Results: The statistical results showed that classifiying patient into macro category and sub-category it is possible to have a prognostic correlation with functional results. Noteworthy, floating knee is a complex injury with poor results., Conclusion: The floating knee is not only the bone lesion but is above all the lesion of the soft tissues and the extensor apparatus that allow the correct functionality of the knee. These lesions do not always have favorable outcome, with respect to the nonseverity of the lesion as in Fraser's classification. Furthermore, on average these patients are subjected to an average of 6 surgical interventions; in some cases we have assisted to 23 surgical procedures. This study proved that this new classification system is prognostic, reliable and reproducible., Competing Interests: Declaration of competing interest All authors disclose any financial and personal relationships with other people or organizations that could inappropriately influence (bias) their work. Examples of potential conflicts of interest include employment, consultancies, stock ownership, honoraria, paid expert testimony, patent applications/registrations, and grants or other funding., (Copyright © 2024 Elsevier Ltd. All rights reserved.) more...
- Published
- 2024
- Full Text
- View/download PDF
15. Treatment options for unstable posterior pelvic ring lesions: A multicenter retrospective cohort study of the Italian Society for the Traumatology of the Pelvis.
- Author
-
De Mauro D, Aprato A, Bove F, Mezzadri U, Giorgi PD, Casiraghi A, Galante C, Erasmo R, Santolini F, Formica M, Smakaj A, Rovere G, Ceccarelli M, Fidanza A, Faugno L, Balagna A, Fabbro M, Are L, Moretti F, Marino S, Maccauro G, Massè A, and Liuzza F more...
- Subjects
- Humans, Retrospective Studies, Female, Male, Adult, Middle Aged, Treatment Outcome, Italy, Radiography, Pelvic Bones injuries, Pelvic Bones surgery, Pelvic Bones diagnostic imaging, Fracture Fixation, Internal methods, Fractures, Bone surgery, Fractures, Bone diagnostic imaging, Quality of Life, Bone Screws
- Abstract
Purpose: Posterior pelvic ring lesions are a common finding in patients with pelvic trauma, representing a challenging condition for trauma surgeons. Surgical options are different and there is not yet evidence about the best option. Aim of the study are: (i) to compare Lumbopelvic fixation (LPF) and ilio-sacral screw fixation (ISS) regarding clinical and radiological outcome in unstable posterior pelvic ring injuries, both as whole population and single similar fracture types according to Tile classification (C1vsC1, C2vsC2, C3vsC3); (ii) to analyze clinical outcomes and complications in lumbopelvic fixation group, comparing open and closed reduction technique., Methods: A retrospective multicenter study was performed. Data of the patients were collected. Inclusion criteria were: (i) unstable posterior ring lesions Tile C type, (ii) surgically treated either through ISS (Group A) or LPF (Group B), (iii) minimum follow-up 12 months. Radiological evaluation was made through plain radiographs in Antero-posterior (AP), inlet and outlet views. Last clinical evaluation at 12 months was assessed through Majeed Score, and quality of life (QoL) through SF-12., Results: Group A was represented by 76 patients, and Group B by 42. Group B had better result in Majeed score for non-workers (average 60.1 ± 21.6 vs 65.0 ± 15.6, p = 0.016*). Comparing only C3-type lesions, Group A showed a higher rate of implants breakage (p = 0.032*). Other differences had p > 0.05. Comparing patients underwent open (ORIF) or closed (CRIF) reduction in Group B, CRIF group had shorter hospitalization (47.2 vs 23.4 days, p = 0.020*), an earlier full weight-bearing recovery (4.1 vs 2.6 months, p = 0.035*) and a better Majeed score in workers patients (70.3 vs 82.8, p = 0.019*). Better results for CRIF group were also recorded in quality of life (QoL), both in mental (45.1 vs 55.2, p = 0.040*) and physical outcome (31.9 vs 50.7, p < 0.001*)., Conclusion: ISS and LPF represent both good choices in posterior pelvic ring lesions, however some significant differences were noted. LPF seems to be preferable if the patient did not work before the trauma, due to better clinical outcome. In Tile C3 lesions, LPF have lower breakage rates. If LPF is chosen, CRIF provides better clinical outcomes, QoL and lower hospitalization., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier Ltd.) more...
- Published
- 2024
- Full Text
- View/download PDF
16. Evaluating Treatment Outcomes for Pelvic Insufficiency Fractures: A Systematic Review.
- Author
-
Sassara GM, Smakaj A, De Mauro D, Righini R, Arnone A, Rovere G, El Ezzo O, Farsetti P, Tarantino U, and Liuzza F
- Abstract
Background : Pelvic insufficiency fractures (PIF) are typical in geriatric populations with reduced bone quality, most commonly in elderly postmenopausal women. These fractures are usually caused by low-energy forces over the bones during ordinary life and cause disabling pain. Treatment options range from conservative to operative. The aim of this study is to assess the outcomes of treatments for pelvic insufficiency fractures, determining optimal approaches between surgical intervention and conservative management. Methods : This literature review systematically examines articles focusing on patients with PIF, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, and using PubMed, Medline, and the Cochrane Library database. We took into account only full-text articles in indexed journals with available English abstracts, considering data about patient demographics, surgery, and outcomes. Results: After screening 128 articles, this study reviewed 20 manuscripts involving 1499 patients, mostly elderly females and focusing on sacrum fractures. Common treatments included conservative methods and sacroplasty, with a few complications reported. Osteoporosis was the prevalent comorbidity, and the survival rate post-treatment was high at 92.3%. Mobility outcomes varied, with some patients experiencing significant autonomy loss. The average follow-up period was over 17 months. Conclusions : This study found a cautious approach to surgery (timing of three weeks), which is reserved only for specific patterns, and it leads to increased autonomy and a lower risk of mortality. Due to the lack of pre- and postoperative scores as well as conflicting results, it is imperative to undertake further studies and research to be able to compare the alternative treatments efficiently. more...
- Published
- 2024
- Full Text
- View/download PDF
17. Fragility Fractures in End-Stage Chronic Kidney Disease (CKD) Population: Patient-Related and CKD-Related Factor Analysis-A Single-Center Experience.
- Author
-
De Mauro D, De Luca G, Marino S, Smakaj A, Rovere G, Liuzza F, Covino M, Fulignati P, Grandaliano G, and El Ezzo O
- Abstract
Background: Chronic kidney disease (CKD) stands as a prevalent global health concern, and mineral and bone disease are among the most impactful consequences. A severe complication arising from mineral and bone disease is the occurrence of fragility fractures, which disproportionately affect individuals with CKD compared to the general population. The prevalence of these fractures impacts both survival rates and quality of life. The aims of this study are analyzing and identifying (i) patient-related risk factors and (ii) CKD-related risk factors to contribute to the development of preventive measures for fragility fractures for this population. Methods: A retrospective, single-center observational study was conducted, encompassing patient data from the years 2021 to 2023. Registry data were recorded, including patient-related and CKD-related data. Patients were interviewed about traumatological history, and their answers were recorded. Logistic regression analysis was employed to investigate the association between independent variables and dependent variables. Results: Eighty-four patients, with a mean age of 64.3 ± 15.2 years and a male percentage of 58.3%, were included in this study. Among them, 19.5% exhibited smoking habits. The mean Charlson Comorbidity Index was 3.06 ± 1.21. All patients were diagnosed with end-stage chronic kidney disease, with mean durations of 208 months from the diagnosis and 84.5 months from the beginning of dialysis. The logistic regression analysis, adjusted for age, sex, and CCI, revealed that smoking habits play a significant role as a risk factor for fragility fractures in lower limbs ( p: 0.011 *). The incidence of fragility fractures increases directly proportionally to the time since diagnosis ( p -value: 0.021 *) and the beginning of dialysis treatment ( p -value: 0.001 *). Conclusions: Among patient-related factors, smoking habits seem to significantly affect lower-limb fracture rates ( p < 0.05), whereas among CKD-related factors, time since CKD diagnosis and time since the beginning of dialysis treatment are directly related to higher risks of fragility fractures. No relevant correlations emerged in the studied treatments, except for a reduction in proximal femur fracture occurrence when patients underwent a combined treatment of a calcimimetic and a vitamin D analog. more...
- Published
- 2024
- Full Text
- View/download PDF
18. Triangular osteosynthesis and lumbopelvic fixation as a valid surgical treatment in posterior pelvic ring lesions: a systematic review.
- Author
-
Rovere G, De Mauro D, Smakaj A, Sassara G, De Vitis R, Farsetti P, Camarda L, Maccauro G, and Liuzza F
- Abstract
Objective: Unstable fractures of the sacrum often occur in patients with pelvic fractures and represent a real challenge for the orthopedic surgeon. Triangular osteosynthesis (TOS) and lumbopelvic fixation (LP) may represent a valid management option for the treatment of this condition. We present a systematic literature review about lumbopelvic fixation and triangular fixation as treatment option for unstable sacral fractures, to assess clinical and radiological outcomes after surgery and to evaluate appropriate indications and impact on the natural history of sacral fractures., Methods: The review is reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. 50 articles out of 108 titles, were considered eligible for the full-text analysis. Finally, 16 studies that met inclusion criteria were included in this review., Results: Overall, 212 patients (87 males, 58 females) with sacral fractures treated with TOS triangular fixation or LP lumbopelvic fixation were collected. The mean age was 37.6 years. Mean follow-up reported in all studies was 24.14 months., Conclusion: The results presented by the different authors, highlight the effectiveness of TOS triangular fixation and LP lumbopelvic fixation for the treatment of unstable sacral fractures associated with other pelvic fractures, in terms of function, stability, cost-effectiveness, and quality of life postoperatively., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (© 2024 Rovere, De Mauro, Smakaj, Sassara, De Vitis, Farsetti, Camarda, Maccauro and Liuzza.) more...
- Published
- 2024
- Full Text
- View/download PDF
19. Treatment of Scaphoid Non-Unions with Custom-Made 3D-Printed Titanium Partial and Total Scaphoid Prostheses and Scaphoid Interosseous Ligament Reconstruction.
- Author
-
Cioffi A, Rovere G, Bosco F, Sinno E, Stramazzo L, Liuzza F, Ziranu A, Romeo M, Vigni GE, Galvano N, Maccauro G, Farsetti P, Rossello MI, and Camarda L
- Abstract
Purpose: Treatment of scaphoid fracture sequelae is still an unsolved problem in hand surgery. Custom-made 3D-printed titanium partial and total scaphoid prosthesis and scaphoid interosseous ligament reconstruction (SLIL) are performed in cases of non-union and isolated aseptic necrosis of the proximal scaphoid pole and when it is impossible to save the scaphoid bone, respectively. This study aims to evaluate the clinical, functional and radiographic results after these two prosthesis implantations., Methods: Between January 2019 and July 2020, nine partial and ten total scaphoid prostheses were implanted using custom-made 3D-printed titanium implants. Evaluation criteria included carpal height ratio (CHR), radioscaphoid angle, wrist extension and flexion, radial deviation and ulnar deviation of the wrist, grip strength and pinch strength, Visual Analogue Scale (VAS), the Disabilities of Arm, Shoulder, and Hand (DASH) score, and the Patient-Rated Wrist Evaluation (PRWE)., Results: Clinical, functional, and radiographic improvements were found in all outcomes analyzed for both patient groups. The VAS pain scale obtained the most remarkable improvement at the one-year follow-up. The results of the DASH scores and the PRWE were good, with a great rate of patient satisfaction at the end of the follow-up. SLIL reconstruction also provided excellent stability and prevented a mid-carpal bone collapse in the short- and medium-term follow-up., Conclusions: A custom-made 3D-printed titanium partial or total scaphoid prosthesis is a viable solution for patients with scaphoid non-union and necrosis or complete scaphoid destruction in whom previous conservative or surgical treatment has failed. more...
- Published
- 2023
- Full Text
- View/download PDF
20. Tenoplasty in suspension with or without tendon interposition: A prospective randomized study in the treatment of advanced thumb carpometacarpal arthritis.
- Author
-
Fidanza A, Rovere G, Colafarina O, Chiarolanza F, Fulchignoni C, Smakaj A, Liuzza F, Farsetti P, and Logroscino G
- Abstract
Introduction: The aim of this prospective and randomized study is to analyze and compare the outcomes of two surgical techniques for trapeziometacarpal joint osteoarthritis (Eaton-Littler grade III and IV)., Materials and Methods: 52 consecutive patients underwent surgical intervention by two different surgical techniques and checked for subjective outcomes (DASH, NPRS), objective outcomes (ROM, opposition test, grinding test, pulp pinch, hand grip) and radiographic outcomes. Surgical time was calculated., Results: 26 patients underwent suspension arthroplasty using abductor pollicis longus tendon interposition (Ceruso procedure) and 26 patients underwent arthroplasty using suspension tenoplasty of the flexor radialis carpi (Altissimi procedure). Both techniques were performed by a single surgeon and showed good and satisfactory results, with best outcome reported in Altissimi procedure regarding DASH and ROM (p = 0.011 and p = 0.012, respectively), with reduced surgical time (about 6 min less, p = 0.03). The proximal shift between scaphoid and the base of first metacarpal did not influence the final results of the cases treated., Conclusion: This study provides evidence that trapeziectomy in combination with both tendon suspension arthroplasty and tendon interposition are two surgical procedures useful to solve advanced basal joint arthritis. Patients who underwent suspension tenoplasty without tendon interposition seemed to be generally more satisfied with significantly better symptomatic and functional outcomes., (© 2023 The Authors.) more...
- Published
- 2023
- Full Text
- View/download PDF
21. Consensus for management of sacral fractures: from the diagnosis to the treatment, with a focus on the role of decompression in sacral fractures.
- Author
-
Aprato A, Branca Vergano L, Casiraghi A, Liuzza F, Mezzadri U, Balagna A, Prandoni L, Rohayem M, Sacchi L, Smakaj A, Arduini M, Are A, Battiato C, Berlusconi M, Bove F, Cattaneo S, Cavanna M, Chiodini F, Commessatti M, Addevico F, Erasmo R, Ferreli A, Galante C, Giorgi PD, Lamponi F, Moghnie A, Oransky M, Panella A, Pascarella R, Santolini F, Schiro GR, Stella M, Zoccola K, and Massé A more...
- Subjects
- Humans, Consensus, Traction, Fractures, Bone surgery, Sacrum injuries, Sacrum surgery, Decompression, Surgical, Fracture Fixation
- Abstract
Background: There is no evidence in the current literature about the best treatment option in sacral fracture with or without neurological impairment., Materials and Methods: The Italian Pelvic Trauma Association (A.I.P.) decided to organize a consensus to define the best treatment for traumatic and insufficiency fractures according to neurological impairment., Results: Consensus has been reached for the following statements: When complete neurological examination cannot be performed, pelvic X-rays, CT scan, hip and pelvis MRI, lumbosacral MRI, and lower extremities evoked potentials are useful. Lower extremities EMG should not be used in an acute setting; a patient with cauda equina syndrome associated with a sacral fracture represents an absolute indication for sacral reduction and the correct timing for reduction is "as early as possible". An isolated and incomplete radicular neurological deficit of the lower limbs does not represent an indication for laminectomy after reduction in the case of a displaced sacral fracture in a high-energy trauma, while a worsening and progressive radicular neurological deficit represents an indication. In the case of a displaced sacral fracture and neurological deficit with imaging showing no evidence of nerve root compression, a laminectomy after reduction is not indicated. In a patient who was not initially investigated from a neurological point of view, if a clinical investigation conducted after 72 h identifies a neurological deficit in the presence of a displaced sacral fracture with nerve compression on MRI, a laminectomy after reduction may be indicated. In the case of an indication to perform a sacral decompression, a first attempt with closed reduction through external manoeuvres is not mandatory. Transcondylar traction does not represent a valid method for performing a closed decompression. Following a sacral decompression, a sacral fixation (e.g. sacroiliac screw, triangular osteosynthesis, lumbopelvic fixation) should be performed. An isolated and complete radicular neurological deficit of the lower limbs represents an indication for laminectomy after reduction in the case of a displaced sacral fracture in a low-energy trauma associated with imaging suggestive of root compression. An isolated and incomplete radicular neurological deficit of the lower limbs does not represent an absolute indication. A worsening and progressive radicular neurological deficit of the lower limbs represents an indication for laminectomy after reduction in the case of a displaced sacral fracture in a low-energy trauma associated with imaging suggestive of root compression. In the case of a displaced sacral fracture and neurological deficit in a low-energy trauma, sacral decompression followed by surgical fixation is indicated., Conclusions: This consensus collects expert opinion about this topic and may guide the surgeon in choosing the best treatment for these patients., Level of Evidence: IV., Trial Registration: not applicable (consensus paper)., (© 2023. Societa Italiana di Ortopedia e Traumatologia (Italian Society of Orthopaedics and Traumatology SIOT).) more...
- Published
- 2023
- Full Text
- View/download PDF
22. Positioning accuracy and facet joints violation after percutaneous pedicle screws placement with robot-assisted versus fluoroscopy-guided technique: Systematic review and meta-analysis.
- Author
-
Perna A, Velluto C, Smakaj A, Tamburrelli F, Borruto MI, Santagada DA, Gorgoglione FL, Liuzza F, and Proietti L
- Abstract
Introduction: Minimally invasive spine surgery became the gold standard for the treatment of many spinal diseases. Only a few comparative studies were performed regarding the superiority of robotic-assisted (RA) surgery over fluoroscopic guidance (FG) surgery during percutaneous pedicle screws placement. Therefore, the aim of the present study was to conduct a systematic literature review and meta-analysis to evaluate the accuracy and potential advantages of RA compared with FG., Material and Methods: This study is a systematic literature review conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. The review questions were formulated following the PICO scheme. Measured outcomes were presented using Forest plots. Heterogeneity among the included studies was assessed using the χ
2 test, and the I2 statistic was utilized to estimate the proportion of total variation among the studies. A value exceeding 50% was considered indicative of substantial heterogeneity., Results: Seven studies that met inclusion criteria were finally included in this meta-analysis. These seven studies include: 447 patients, 228 patients (931 screws) treated with robotic guide, and 219 patients (767 pedicle screws) using fluoroscopic guide, with a mean age of 55.2. The percentages of clinically acceptable screws were 94.3% in the robot-assisted group and 89% in the fluoroscopic guided group. The percentages of non-acceptable screws were 5.7% in the robot-assisted group and 11% in the fluoroscopic-guided group., Discussion: Significant differences were observed between the two groups in terms of radiographic and clinical outcomes, with the robotic-assisted pedicle screw group exhibiting longer operative times. Robot technology serves as a valuable tool for assisting surgeons in challenging scenarios such as anatomical variants or patients with spinal deformities, ensuring accurate screw placement., Conclusion: The accuracy of pedicle screw placement with robotic technology is higher than with FG. In fact, the robotic approach allows significantly lower complication rates, fewer cases of violation of the proximal articular facet, less intraoperative exposure to radiation, even if it requires longer surgical times than the FG technique., Competing Interests: There are no conflicts of interest., (© 2023 Published by Scientific Scholar on behalf of Journal of Neurosciences in Rural Practice.) more...- Published
- 2023
- Full Text
- View/download PDF
23. Outcomes at 2 years follow-up of sacral fractures associated with unstable vertical pelvic ring injuries in obese patients: a multicentric retrospective study.
- Author
-
Liuzza F, Smakaj A, Rovere G, De Mauro D, Rollo G, Erasmo R, Fidanza A, Gruobor P, and Meccariello L
- Subjects
- Humans, Retrospective Studies, Follow-Up Studies, Quality of Life, Fracture Fixation, Internal, Treatment Outcome, Spinal Fractures complications, Spinal Fractures surgery, Fractures, Bone complications, Fractures, Bone surgery
- Abstract
Background and Aim: Sacral fractures with concomitant unstable pelvic ring injuries are severe conditions which occur in patients involved in high-energy trauma. When operative treatment is required, high surgical experience on the field is mandatory, especially in a sub-polpulation of obese patients which have increased risk of complications. The aim of this multicentric retroscpective study was to describe and analyze clinical and radiological outcomes of sacral vertical fractures in obese patients with a minimum of 2 years follow-up. Methods: A total of 121 pelvic fractures admitted to Emergency Departments of three II level trauma centres from April 2015 to April 2021 were retrospectively reviewed. Demographics, injury mechanism, surgical data and complications were collected. The quality of life and the pelvic function were respectively measured by SF-12 questionnaires, Denis Work Scale and Majeed Score. The inter-rater agreement between the clinical scores and the Denis Work Scale was assessed. Results: A total of 19 patients were included in the study. The average follow up was 41.16 months. The average BMI was 38.63 and the mean abdominal circumference was 128.10 cm. The average Majeed and SF-12 scores were respectively 66.47 and 74.32. Five patients were able to return to their previous employment. The post traumatic life's quality and related dysfunctions are influenced by the high BMI. Conclusions: Faster recovery and early weight-bearing should be persued in order to minimize complications, expecially in obese patients. In these sample of patients, "triangular osteosynthesis" was the best treatment choice for sacral vertical fractures. more...
- Published
- 2023
- Full Text
- View/download PDF
24. Correlation between traumatic pelvic ring injuries and sexual dysfunctions: a multicentric retrospective study.
- Author
-
Rovere G, Smakaj A, Perna A, De Mauro D, Are L, Meccariello L, Fidanza A, Erasmo R, Falez F, Maccauro G, and Liuzza F
- Subjects
- Humans, Male, Female, Adult, Middle Aged, Retrospective Studies, Pelvis, Sexual Behavior, Sexual Dysfunction, Physiological epidemiology, Sexual Dysfunction, Physiological etiology, Pelvic Bones injuries, Fractures, Bone complications, Fractures, Bone surgery
- Abstract
Purpose: Among the functional impairments associated with pelvic ring injuries (PRI), sexual dysfunction (SD) is a common clinical issue. The aim of this study is to investigate correlations between traumatic PRI, genitourinary, and sexual dysfunctions, for a proper multidisciplinary treatment., Methods: We performed an observational, multicentric study, from January 2020 to 2022. We conducted a follow-up after surgery at three, six, 12, and 24 months by measuring the Female Sexual Functioning Index (FSFI), the International Index of Erectile Function (IIEF), the Arizona Sexual Experience Scale (ASEX), the Majeed Score, and the SF-12. Descriptive statistics was conducted on T-test, Whelc's test, and one-way ANOVA which were performed when appropriate., Results: A total of 76 patients (mean age 42.17 ± 15 years) were included in the study and allocated into three groups (A, B, and C). Tile A group revealed good sexual outcomes, similar to that of healthy patients. Tile B group demonstrated worsen SD than the previous group. In Tile C group, there was a longer average duration of the orthopaedic surgery when compared to group B. However, in terms of SDs, statistical significance could not be demonstrated between groups C and B., Conclusions: We observed a progressive spontaneous recovery of sexual function, corresponding to each PRI group. Moreover, men classified as B2 had milder SDs than B1 male patients., (© 2023. The Author(s).) more...
- Published
- 2023
- Full Text
- View/download PDF
25. Surgical treatment of carpometacarpal thumb arthritis with trapeziectomy and intra-tendon (FCR) suspension with one-loop APL: comparative cohort study.
- Author
-
Passiatore M, Taccardo G, Cilli V, Rovere G, Liuzza F, Pannuto L, and De Vitis R
- Subjects
- Humans, Retrospective Studies, Thumb, Cohort Studies, Tendons surgery, Arthroplasty adverse effects, Arthroplasty methods, Arthritis, Carpometacarpal Joints surgery
- Abstract
Background: One of the current choices of treatment for Trapeziometacarpal (TMC) joint arthritis is trapeziectomy with ligament reconstruction and tendon interposition arthroplasty. The Ceruso's technique consists of complete trapezial excision and abductor pollicis longus (APL) tendon suspension. The APL tendon is tied to the flexor carpi radialis (FCR) tendon with two loops, one around it and one inside, and then used as interposition tissue. The purpose of the present study was to compare two different techniques of a trapeziectomy with ligament reconstruction and tendon interposition arthroplasty using the Abductor Pollicis Longus (APL) tendon, which is only Once Looped Around (OLA) versus Once Looped Inside (OLI) the Flexor Carpi Radialis (FCR) tendon., Methods: A single-center, retrospective study (Level of evidence: III) has been conducted on sixty-seven patients older than 55 years (33 OLI, 35 OLA), assessing clinical outcomes for at least 2 years of post-surgery follow-up. The outcomes were to assess and compare surgical outcomes comparing the two groups, in terms of subjective and objective evaluation for both groups at the last follow-up (primary outcome), and at the intermediate follow-ups (three and six months). Complications were also assessed., Results: The authors found an improvement in pain, range of motion, and function, with equivalent results for both techniques. No subsidence was observed. FCR tendinitis was significantly reduced with OLI, as well as the need of post-operative physiotherapy., Conclusions: The one-loop technique allows for reduced surgical exposure, providing excellent suspension and clinical outcomes. Intra FCR loop should be preferred to improve post-surgical recovery., Level of Evidence: Level III study. This is a retrospective cohort study (written according to STROBE guidelines)., (© 2023. The Author(s).) more...
- Published
- 2023
- Full Text
- View/download PDF
26. Development of the Italian fractures registry (RIFra): A call for action to improve quality and safety.
- Author
-
Vicenti G, Bizzoca D, Pascarella R, Delprete F, Chiodini F, Daghino W, Casiraghi A, Maccauro G, Liuzza F, Boero E, Belluati A, Pari C, Berlusconi M, Randelli F, Bove F, Sabbetta E, Carrozzo M, Solarino G, and Moretti B more...
- Subjects
- Humans, Italy epidemiology, Europe, Registries, Quality of Life, Fractures, Bone
- Abstract
In recent years, there has been an increasing interest in the development of arthroplasty registries, therefore, in our country, the Italian Arthroplasty Registry (RIAP), was issued by the National Law No. 221/2012. In the last decade, however, some European countries -namely Sweden, Denmark, Norway, and Germany (in development)- have introduced another nationwide orthopaedic registry than arthroplasty registers: the fracture registry. The development of this new tool aims to improve quality and safety in fracture management, thus trying to provide a better postoperative quality of life in trauma patients. Based on these findings, the AO-Trauma Italy Council encouraged the development of a national fracture registry in Italy. The present study aims to (1) provide an overview of the fracture registries in Europe and (2) to develop, for the first time, a pilot Italian Fracture Registry (RIFra). Thirteen AO-Trauma Italy members, chairmen of Level-I orthopaedic and trauma centres, diffused throughout Italy, were involved in the RIFra project. The RIFra form, developed between November 2019 and March 2020, consists of 5 main sections, namely: epidemiologic data, previous surgical procedure (if any), patient and fracture features, surgical procedure, surgical implant details. This study constitutes the first step to start, in future years, the bureaucratic procedure leading to the final establishment of a RIAP-like fracture registry in Italy., Competing Interests: Declaration of Competing Interest None, (Copyright © 2020 Elsevier Ltd. All rights reserved.) more...
- Published
- 2023
- Full Text
- View/download PDF
27. Spring Plates as a Valid Additional Fixation in Comminuted Posterior Wall Acetabular Fractures: A Retrospective Multicenter Study.
- Author
-
De Mauro D, Rovere G, Are L, Smakaj A, Aprato A, Mezzadri U, Bove F, Casiraghi A, Marino S, Ciolli G, Cerciello S, Maccagnano G, Noia G, Massè A, Maccauro G, and Liuzza F
- Abstract
Background: The posterior wall fracture is the most frequent pattern of acetabular fractures. Many techniques of fixation have been described in the literature and involve plates, screws, or a combination of both. This study aims to investigate the clinical and radiological outcomes of spring plates in the treatment of comminuted posterior wall acetabular fractures. (2) Methods: A retrospective multicenter (four level I trauma centers) observational study was performed. Patients with a comminuted posterior wall acetabular fracture treated with a spring plate (DePuy Synthes, West Chester, PA) were included. Diagnosis was made according to the Judet and Letournel classification. Diagnosis was confirmed with plain radiographs in an antero-posterior view and Judet views, iliac and obturator oblique views, and thin-slice CT with multiplanar reconstructions. (3) Results: Forty-six patients (34 males and 12 females) with a mean age of 51.7 years (range 19-73) were included. The most common mechanism of injury was motor vehicle accident (34 cases). In all cases, spring plates were placed under an overlapping reconstruction plate. The mean follow-up was 33.4 months (range 24-48). The mean period without weight-bearing was 4.9 weeks (range 4-7), and full weight-bearing was allowed at an average of 8.2 weeks (range 7-11) after surgery. (4) Conclusions: According to the present data, spring plates can be considered a viable additional fixation of the posterior wall acetabular fractures. more...
- Published
- 2023
- Full Text
- View/download PDF
28. Outcomes of acetabular fractures treated with acute fix and replace versus open reduction and internal fixation in elderly population: a multicentric retrospective study.
- Author
-
Smakaj A, Rovere G, Scoscina D, De Mauro D, Erasmo R, Battiato C, Maccauro G, and Liuzza F
- Subjects
- Acetabulum injuries, Acetabulum surgery, Aged, Fracture Fixation, Internal adverse effects, Fracture Fixation, Internal methods, Humans, Retrospective Studies, Treatment Outcome, Arthroplasty, Replacement, Hip adverse effects, Fractures, Bone etiology, Fractures, Bone surgery, Hip Fractures etiology, Hip Fractures surgery, Spinal Fractures surgery
- Abstract
Purpose: The optimal operative treatment for displaced acetabular fractures in elderly population is still object of debate. Acute fix and replace procedure, the so called "combined hip procedure" (CHP), was introduced because of the poor results of the open reduction and internal fixation (ORIF) alone. The aim of the study is to compare clinical outcomes of CHP and ORIF alone for the treatment of acetabular fractures in elderly patients., Methods: This is the largest multicentric retrospective analytical study, with a case-control design on the issue. Hospital records and clinical notes were reviewed to collect demographic, peri-operative, and clinical data., Results: A total of 45 patients met the inclusion criteria: 24 patients entered the CHP group whereas 21 entered the ORIF control group. The mean age was 69.5 + - 1.12 years in the ORIF group and 73.4 + - 1.84 in the control group. The most frequent traumatic mechanism was the fall from same level in both groups (37.5% CHP; 42.9% ORIF). Operating time was significantly lower in the CHP group compared to the ORIF group (207 + - 11.0 ORIF; 175 + - 9.16 CHP; p < 0.05). Moreover, full weight-bearing was allowed significantly earlier in the CHP group compared to ORIF alone (37.3 + - 1.59 ORIF; 32.5 + - 1.69 CHP; p < 0.05). Among the clinician-completed scores, the HHS at three months was higher in the CHP group (66.3 + - 1.83 ORIF;73.6 + - 2.09 CHP; p < 0.05). All the other clinical outcomes were similar in both study groups., Conclusion: CHP is desirable treatment option in elderly patients with acetabular fracture when there are poor expected outcomes in terms of joint survival with ORIF alone., (© 2022. The Author(s).) more...
- Published
- 2022
- Full Text
- View/download PDF
29. Interprosthetic and interimplant femoral fractures: is bone strut allograft augmentation with ORIF a validity alternative solution in elderly?
- Author
-
Pica G, Liuzza F, Ronga M, Meccariello L, Mauro D, Smakaj A, De Cruto E, and Rollo G
- Abstract
Background: Nowadays orthopedic surgeons have a new challenge to treat the interimplants fractures. Although fixation strategies exist for periprosthetic hip and knee fractures, there is no standard of care regarding the more complex interprosthetic and interimplants fractures., Objective: The aim of our study is targeting the focus on the bone strut grafting to avoid the metal hardware failure and to achieve the bone healing in these injuries., Methods: A prospective case note review of all interprosthetic or interimplants femoral fractures admitted to our trauma center. There were 11 patients (2 males and 9 females) with a mean age over 85 years old. We treated all the patients by ORIF and medial graft strut allograft to reduce the main complication leading to re-operations and morbidity or mortality is the nonunion or delayed union. The criteria to evaluate the patients during the follow-up were: the survival and complication after the surgery; the objective quality of life measured by Activities of Daily Living Score (ADL). The bone healing was measured by X-rays control as the alignment was measured by radiographic UNION SCORE, and postoperative complications., Results: All the patients reduced their ADL. In the most of cases we had a good x-rays reduction. We had not: No nonunion or Not delayed union. All patients died within 2 years from the surgery but not due by surgical complications., Conclusions: According us, the purpose of this surgery is to limit comorbidities and early mortality not to improve optimal restoration of lower limb function., Competing Interests: All authors disclose any financial and personal relationships with other people or organizations that could inappropriately influence (bias) their work. Examples of potential conflicts of interest include employment, consultancies, stock ownership, honoraria, paid expert testimony, patent applications/registrations and grants or other funding. more...
- Published
- 2022
- Full Text
- View/download PDF
30. Revision Surgery Using Retrograde Nail versus Replating in Nonunion Distal Femur Fracture Treated with Plate.
- Author
-
Ziranu A, Noia G, Cipolloni V, Coviello M, Maccagnano G, Liuzza F, Maccauro G, Nasto LA, and Pola E
- Abstract
Articular distal femur fractures represent 4% to 6% of femur fractures. Locking compression plates (LCPs) are the main treatment option. Nevertheless, a reoperation rate of 12.9% has been reported; nonunion is reported at 4.8%, delayed union at 1.6%, and malunion at 0.6%. Treatment of nonunions can be challenging as no unanimous consensus regarding the best surgical technique has been reached. The aim of this study was to evaluate and compare two types of revision surgery as treatment of LCP-treated articular distal femoral fracture nonunion: retrograde nail or replating. A retrospective cohort study of patients admitted from January 2015 to February 2017 for nonunion of AO/OTA 33C2 fractures previously treated with a lateral LCP was conducted. Patients were treated either with intramedullary nailing (Group A) or with replating (Group B). One independent observer performed clinically and radiographically followed up at 1, 3, 6, 9, 12, 24, and 36 months after surgery. The nonunion scoring system (NUSS) was used. Nine patients were included in our study. The mean follow-up was 2 years. Five patients were treated with intramedullary nailing and four with replating. The NUSS score was 24.2 ± 6.8 in the nailing group and 37.3 ± 3 in the replating group ( P =0.03). In the nailing group, radiographic consolidation was obtained in all cases. In the replating group, nonunion was found in 3 patients and failure of osteosynthesis in one patient. Therefore, four patients (Group B) underwent implant removal and retrograde femoral nailing, obtaining radiological healing. The union time was 7.6 months in the nailing group. Retrograde intramedullary nailing can be used as an effective treatment of aseptic AO-33C distal femoral nonunion following primary locking plating., Competing Interests: The authors declare that there are no conflicts of interest regarding the publication of this article., (Copyright © 2022 Antonio Ziranu et al.) more...
- Published
- 2022
- Full Text
- View/download PDF
31. Use of muscular flaps for the treatment of knee prosthetic joint infection: A systematic review.
- Author
-
Rovere G, Smakaj A, Calori S, Barbaliscia M, Ziranu A, Pataia E, Maccauro G, De Mauro D, and Liuzza F
- Abstract
Deep periprosthetic infection after total knee arthroplasty is a serious and challenging complication for the orthopedic surgeon. Muscular flaps may represent a valid treatment option for the treatment of this condition. We present a systematic literature review about the use of muscular flaps for the treatment of knee prosthetic joint infection. The review is reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. 70 articles, out of 589 titles, were considered eligible for the full-text analysis. Finally, 27 studies that met inclusion criteria were included in this review. Overall, 345 patients (139 males, 206 females) suffering from TKA infection treated with muscular flaps were collected. The mean age was 57.3 years. Mean follow-up, reported in all studies, was 30.1 months. The results presented by the different authors, highlight the effectiveness of muscular flaps for the treatment of periprosthetic infection, in terms of function, limb salvage, prevention of recurrences, cost-effectiveness, and quality of life postoperatively. Muscle flaps provide an excellent management option for patients with persistent infection after total knee arthroplasty., Competing Interests: The authors declare no potential conflict of interest more...
- Published
- 2022
- Full Text
- View/download PDF
32. Clinical Application of Adipose Derived Stem Cells for the Treatment of Aseptic Non-Unions: Current Stage and Future Perspectives-Systematic Review.
- Author
-
Smakaj A, De Mauro D, Rovere G, Pietramala S, Maccauro G, Parolini O, Lattanzi W, and Liuzza F
- Subjects
- Adipocytes, Cell- and Tissue-Based Therapy, Humans, Regenerative Medicine, Adipose Tissue, Mesenchymal Stem Cells
- Abstract
Fracture non-union is a challenging orthopaedic issue and a socio-economic global burden. Several biological therapies have been introduced to improve traditional surgical approaches. Among these, the latest research has been focusing on adipose tissue as a powerful source of mesenchymal stromal cells, namely, adipose-derived stem cells (ADSCs). ADSC are commonly isolated from the stromal vascular fraction (SVF) of liposuctioned hypodermal adipose tissue, and their applications have been widely investigated in many fields, including non-union fractures among musculoskeletal disorders. This review aims at providing a comprehensive update of the literature on clinical application of ADSCs for the treatment of non-unions in humans. The study was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Only three articles met our inclusion criteria, with a total of 12 cases analyzed for demographics and harvesting, potential manufacturing and implantation of ADSCs. The review of the literature suggests that adipose derived cell therapy can represent a promising alternative in bone regenerative medicine for the enhancement of non-unions and bone defects. The low number of manuscripts reporting ADSC-based therapies for long bone fracture healing suggests some critical issues that are discussed in this review. Nevertheless, further investigations on human ADSC therapies are needed to improve the knowledge on their translational potential and to possibly achieve a consensus on their use for such applications. more...
- Published
- 2022
- Full Text
- View/download PDF
33. The value of megaprostheses in non-oncological fractures in elderly patients: A short-term results.
- Author
-
Vitiello R, Ziranu A, Oliva MS, Meluzio MC, Cauteruccio M, Maccauro G, Liuzza F, and Saccomanno MF
- Subjects
- Aged, Aged, 80 and over, Female, Femur surgery, Humans, Male, Reoperation, Retrospective Studies, Treatment Outcome, Arthroplasty, Replacement, Hip adverse effects, Femoral Fractures diagnostic imaging, Femoral Fractures etiology, Femoral Fractures surgery, Knee Prosthesis, Periprosthetic Fractures diagnostic imaging, Periprosthetic Fractures etiology, Periprosthetic Fractures surgery
- Abstract
Introduction: The management of both hip and distal femur fractures as well as periprosthetic fractures can be challenging for orthopaedic surgeons. The use of megaprosthetic implants could provide substantial advantages in elderly population affected by complex fractures. The aim of the study was to evaluate the effectiveness of megaprosthetic implants for treating hip and distal femur fractures as well as periprosthetic fractures in elderly., Material and Methods: From January 1st 2015 to December 31st 2019, patients treated for proximal or distal femoral fractures with severe bone loss or failure of previous surgery were retrospectively reviewed. Patients were divided into two group based on diagnosis: proximal femur fractures (group A) and distal femur fractures (group B). Subsequently, patients underwent hip (group A) or knee (group B) megaprosthesis. Self-assessed questionnaires were administered to all patients pre and postoperatively. Primary outcome was the Activity Daily Living. Secondary outcomes were: Instrumental Activity Daily Living, Short Form-12, Oxford knee or hip score, complications. Charlson score, Harris classification for hip or Anderson Orthopaedic Research Institute score and complication were recorded. All patients underwent a radiological follow up to rule out implant loosening and mobilization. Pre and postoperative functional score comparisons in each group were undertaken. Significance was set p ≤ 0.05., Results: Twelve patients were finally included in the study. There were 6 male and 6 females, the mean age was 72,9 years old (± 7,4); the mean BMI was 29,8 points (± 4.5). The mean follow-up was 2.9 years (± 1.4). No differences could be found between pre and postoperative evaluation in each group. No aseptic loosening, dislocation, mobilization or radiolucency were recorded during the follow-up. In group A, two surgical site infections (2/6 patients) and one pneumonia (1/6 patients) were recorded. In group B, two surgical site infections occurred (2/6 patients). All patients were treated by antimicrobial oral therapy with complete regression., Conclusion: The use of hip and knee megaprosthetic implants in traumatology is a safe and viable option in elderly patients., Competing Interests: Declaration of Competing Interest None, (Copyright © 2021. Published by Elsevier Ltd.) more...
- Published
- 2022
- Full Text
- View/download PDF
34. Anterior intrapelvic approach and suprapectineal quadrilateral surface plate for acetabular fractures with anterior involvement: a retrospective study of 34 patients.
- Author
-
Ciolli G, De Mauro D, Rovere G, Smakaj A, Marino S, Are L, El Ezzo O, and Liuzza F
- Subjects
- Acetabulum diagnostic imaging, Acetabulum surgery, Bone Plates, Fracture Fixation, Internal adverse effects, Humans, Middle Aged, Retrospective Studies, Treatment Outcome, Fractures, Bone diagnostic imaging, Fractures, Bone epidemiology, Fractures, Bone surgery, Hip Fractures
- Abstract
Background: The purpose of the study is to evaluate the use of the suprapectineal quadrilateral surface (QLS) plates associated with the anterior intrapelvic approach (AIP) to the acetabulum in the surgical treatment of acetabular fractures with anterior involvement., Methods: We did a retrospective study of patients surgically treated with QLS plates and AIP for acetabular fractures with the involvement of the anterior column, between February 2018 and February 2020, in our Hospital. The following data were recorded: mechanism of injury, the pattern of fracture, presence of other associated injuries, the time before performing the surgery, surgical approach, position on operating table, time of surgery, intraoperative bleeding, hospitalization time, intraoperative and postoperative complications. Follow-ups were performed at 1, 3, 6, 12 months, then annually. The clinical-functional outcome was assessed with the Merle d'Aubigne Postel score (MAP) modified by Matta; while the radiological outcome with the Matta Radiological Scoring System (MRSS). A Chi-square test was utilized to examine associations between parametric variables., Results: We included 34 patients, mean age 62.1, with an average follow-up of 20.7 months. The most frequent traumatic mechanism was road trauma. There were 15 isolated anterior columns and 19 associated patterns. There were 5 cases of associated visceral injuries, and 10 cases of other associated skeletal fractures. All patients were in the supine position. The surgical approach used was the AIP in all cases, with the addition of the first window of the ilioinguinal approach in 16 cases and of the Kocher-Langenbeck approach in 2 cases. The average time before performing the surgery was 8.5 days. The mean time of the surgery and the mean length of stay after surgery were 227.9 min and 8.2 days, respectively. There weren't cases of intra-operative complications, while there were postoperative complications in 5 patients. The MRSS was judged anatomical in 26 cases, imperfect in 7 cases and poor in 1 case. The average MAP value was 15.2. We observed a significant relationship between the radiological outcome and the clinical outcome (p < 0.05)., Conclusions: The QLS plates in association with the AIP approach represent an effective treatment strategy for the treatment of acetabular fractures with anterior involvement., (© 2021. The Author(s).) more...
- Published
- 2021
- Full Text
- View/download PDF
35. Gibson approach and surgical hip dislocation according to Ganz in the treatment of femoral head fractures.
- Author
-
De Mauro D, Rovere G, Smakaj A, Marino S, Ciolli G, Perna A, Battiato C, El Ezzo O, and Liuzza F
- Subjects
- Acetabulum, Femur Head, Fracture Fixation, Internal adverse effects, Humans, Retrospective Studies, Treatment Outcome, Femoral Fractures, Hip Dislocation, Hip Fractures diagnostic imaging, Hip Fractures surgery
- Abstract
Background: The purpose of the study is to evaluate clinical and radiological outcomes in those patients with femoral head fracture, treated with open reduction and internal fixation through Gibson approach and Ganz flip trochanter osteotomy. The treatment of Pipkin fractures is very challenging, especially for small trauma centers, because of the unusual fracture patterns and high-level surgical skills required., Case Presentation: Between 2017 and 2020, nine cases of Pipkin fractures came to the Emergency Department at the Trauma Center of our Hospital in Rome. Inclusion criteria were the diagnosis of femoral head fracture, the open reduction and internal fixation as surgical choice and at least 24 months follow-up. Patients older than 65 years and those treated through total hip replacement or combined hip procedure (CHP) were excluded. Thus, five patients were included in our case series. The clinical outcome was evaluated according to Western Ontario and McMaster Universities Arthritis Index, Vail Hip score, modified Harris Hip score and Merle D'Aubignè Postel score. Radiographic assessment was scored according to Epstein-Thompson classification and heterotopic ossification was assessed through Brooker classification. The mean follow-up was 24 months (range 12-24). Average modified Harris Hip score was 92.1 points (range 75.9-100), and the average Vail score was 81.8 (range 55-95). WOMAC score was assessed in three different subscales, pain (A), stiffness (B) and physical condition (C), with the following results: 1.4 A (range 0-7), 1.2 B (range 0-6) and 6.4 C (range 0-22). Merle d'Aubignè Postel score resulted excellent for four patients and good for one patient. According to Epstein-Thompson score of the radiological outcome, four patients showed a good result and one a fair result. No mechanical or infective complications occurred in the five patients., Conclusions: Gibson's approach and surgical hip dislocation through Ganz trochanteric flip osteotomy allow a good exposure of the femoral head and acetabulum, giving us the possibility to perform an anatomical reduction of the fracture. In our case series, satisfactory clinical and radiological short-term results were obtained without significant complications., (© 2021. The Author(s).) more...
- Published
- 2021
- Full Text
- View/download PDF
36. Newer generation straight humeral nails allow faster bone healing and better functional outcome at mid-term.
- Author
-
Mocini F, Rovere G, De Mauro D, De Sanctis EG, Smakaj A, Maccauro G, and Liuzza F
- Subjects
- Adolescent, Adult, Aged, Aged, 80 and over, Fracture Fixation, Intramedullary, Humans, Humeral Fractures diagnostic imaging, Humeral Fractures surgery, Humerus, Middle Aged, Nails, Shoulder Fractures, Treatment Outcome, Young Adult, Bone Nails
- Abstract
Purpose: Although proximal and diaphyseal humerus fractures are frequent, the optimal management remains controversial. Antegrade nailing prevents further damage to the soft tissues and to the vascularization, but it has been associated with postoperative shoulder pain and dysfunction. During the latest years a straight nail design was developed to minimize these problems., Methods: A total of 243 patients who had undergone surgery for antegrade intramedullary humeral nailing between January 2013 and July 2018 in A. Gemelli Trauma Center were divided into two groups according to the nail design used: straight nail group (S-group) and curvilinear nail group (C-group). Clinical data were collected using assessment forms (SF12-v2, Quick-DASH, ASES and Constant-Murley). Radiographic bone healing was assessed with RUST score at 30, 90 and 180 days after surgery., Results: The S-group was made up of 128 patients with a mean age of 59 ± 19 (range 18-97) and a mean follow-up of 46 ± 9 months. The C-group was made up of 115 patients with a mean age of 53 ± 16 (range 18-88) and a mean follow-up of 51 ± 8 months. The S-group had a mental component summary (MCS) score of 54.3 ± 7.7 and a physical component summary (PCS) score of 46 ± 10.2, the C-group had a MCS score of 50.9 ± 8.4 and a PCS score of 44.1 ± 7.4. Quick-DASH and ASES were respectively 18.8 ± 4.3 and 78.6 ± 8.2 in the S-group, 28.3 ± 11.6 and 72.1 ± 13.5 in the C-group with statistical significance. Constant-Murley score was 73.9 ± 9.1 in the S-group (76% of the contralateral healthy side) and 69.4 ± 10.4 in the C-group (73% of the contralateral healthy side). The radiographic union score in the S-group was 4.1 ± 0.3 at 30 days after surgery, 7 ± 0.8 at 90 days and 10 ± 1.2 at 180 days, while in the C-group it was 4.2 ± 0.4 at 30 days, 6.4 ± 0.7 at 90 days and 9 ± 0.9 at 180 days., Conclusion: Newer generation straight nails allow a faster bone healing and better functional outcome at mid-term follow up. Level of evidence III., (© 2021. The Author(s).) more...
- Published
- 2021
- Full Text
- View/download PDF
37. Epidemiology and aetiology of male and female sexual dysfunctions related to pelvic ring injuries: a systematic review.
- Author
-
Rovere G, Perna A, Meccariello L, De Mauro D, Smimmo A, Proietti L, Falez F, Maccauro G, and Liuzza F
- Subjects
- Causality, Female, Humans, Incidence, Lumbosacral Plexus, Male, Retrospective Studies, Fractures, Bone complications, Fractures, Bone epidemiology, Pelvic Bones
- Abstract
Introduction: Pelvic ring injuries, frequently caused by high energy trauma, are associated with high rates of morbidity and mortality (5-33%), often due to significant blood loss and disruption of the lumbosacral plexus, genitourinary system, and gastrointestinal system. The aim of the present study is to perform a systematic literature review on male and female sexual dysfunctions related to traumatic lesions of the pelvic ring., Methods: Scopus, Cochrane Library MEDLINE via PubMed, and Embase were searched using the keywords: "Pelvic fracture," "Pelvic Ring Fracture," "Pelvic Ring Trauma," "Pelvic Ring injury," "Sexual dysfunction," "Erectile dysfunction," "dyspareunia," and their MeSH terms in any possible combination. The following questions were formulated according to the PICO (population (P), intervention (I), comparison (C), and outcome (O)) scheme: Do patients suffering from pelvic fracture (P) report worse clinical outcomes (C), in terms of sexual function (O), when urological injury occurs (I)? Is the sexual function (O) influenced by the type of fracture (I)?, Results: After screening 268 articles by title and abstract, 77 were considered eligible for the full-text analysis. Finally 17 studies that met inclusion criteria were included in the review. Overall, 1364 patients (902 males and 462 females, M/F ratio: 1.9) suffering from pelvic fractures were collected., Discussion: Pelvic fractures represent challenging entities, often concomitant with systemic injuries and subsequent morbidity. Anatomical consideration, etiology, correlation between sexual dysfunction and genitourinary lesions, or pelvic fracture type were investigated., Conclusion: There are evidences in the literature that the gravity and frequency of SD are related with the pelvic ring fracture type. In fact, patients with APC, VS (according Young-Burgess), or C (according Tile) fracture pattern reported higher incidence and gravity of SD. Only a week association could be found between GUI and incidence and gravity of SD, and relationship between surgical treatment and SD. Electrophysiological tests should be routinely used in patient suffering from SD after pelvic ring injuries., (© 2021. The Author(s).) more...
- Published
- 2021
- Full Text
- View/download PDF
38. Quality of Life and Clinical Evaluation of Calcaneoplasty with a Balloon System for Calcaneal Fracture at 5 Years of Follow-Up.
- Author
-
Maccagnano G, Noia G, Cassano GD, Sarni AL, Quitadamo R, Stigliani C, Liuzza F, Vitiello R, and Pesce V
- Abstract
Calcaneal fractures are a challenging clinical problem. Management of this type of injury remains controversial, especially in the context of intra-articular fractures. Surgical treatment with open reduction and internal synthesis (ORIF) is considered the standard treatment for CF, but it is associated with many complications. Several minimally invasive techniques such as balloon-assisted reduction, pin fixation, and tricalcium phosphate augmentation have been proposed to avoid the frequent and recurrent postoperative problems related to these fractures. We retrospectively examined 20 patients (mean age was 54.5), all undergoing minimally invasive calcaneoplasty surgery at our Department of Orthopaedics and Traumatology between 2012 and 2016. X-ray and CT scan were performed preoperatively and at 5 years of follow-up (57.9 ± 6 months). The American Orthopaedic Foot and Ankle Society (AOFAS) score was used for clinical examination, and the Short-Form (36) Health Survey (SF-36) score and Visual Analogue Scale (VAS) were used to assess the Health-Related Quality of Life (HRQoL). All 20 patients were available at the final follow-up. The mean AOFAS score was 82.25/100. The VAS results attest an overall average of 2.7/10 (0-9). The average of the parameters "Physical Health" and "Mental Health" was, respectively, 81.25 and 83.55. In terms of postoperative complications, we observed no cases of superficial or deep infections. Clinical response after balloon-assisted reduction, pin fixation, and tricalcium phosphate augmentation has shown a comparable or better outcome according to the AOFAS and VAS score. Quality-of-life scores, obtained according to the SF-36 questionnaire, are considered high. From both a clinical and quality-of-life point of view, our study highlights that there is not gender distinction. Further comparative studies with a higher number of patients are needed which assess the quality of life in the various techniques used to treat calcaneal fractures., Competing Interests: All authors have no conflicts of interest to declare., (Copyright © 2021 Giuseppe Maccagnano et al.) more...
- Published
- 2021
- Full Text
- View/download PDF
39. Corrigendum to '3D - Navigated percutaneous screw fixation of pelvic ring injuries - a pilot study' [Injury 51S3 (2020) S28 - S33].
- Author
-
Florio M, Capasso L, Olivi A, Vitiello C, Leone A, and Liuzza F
- Published
- 2021
- Full Text
- View/download PDF
40. Radiographic and functional outcome of complex acetabular fractures: implications of open reduction in spinopelvic balance, gait and quality of life.
- Author
-
Muzii VF, Rollo G, Rocca G, Erasmo R, Falzarano G, Liuzza F, Bisaccia M, Pica G, Franzese R, and Meccariello L
- Subjects
- Fracture Fixation, Internal, Gait, Humans, Lumbar Vertebrae, Pelvis diagnostic imaging, Retrospective Studies, Hip Fractures, Quality of Life
- Abstract
Aim To investigate the effects of surgical reduction of complex acetabular fractures on spine balance, postural stability and quality of life. Methods Twenty-six patients with acetabular fractures surgically treated by open reduction and internal fixation were divided into two groups according to the amount of reduction. Group A consisted of 18 patients with satisfactory reduction (≤2 mm), and group B of eight patients with incomplete reduction (>2 mm). Functional outcome was measured with Harris Hip Score (HHS), Oswestry Disability Index (ODI), and Short Form (12) Health Survey (SF12). Radiological parameters were assessed with standing whole spine, pelvis and hip X-rays, including pelvic incidence (PI), pelvic tilt (PT), sacral slope (SS), and sagittal vertical axis (SVA). Follow-up intervals were 1, 3, 6 and 12 months and annually thereafter. Gait analysis and baropodometry were performed after 24 months of operation. Results Mean HHS, ODI, and SF-12 was improved during the first postoperative year in both groups. After two years average scores kept improving for group A, but worsened for group B. Mean PI, PT, and SS increased in both groups during the first postoperative year, with further increase after two years only in group B. After two years, 16 (89%) patients in group A and four (50%) in group B had a balanced spine (SVA <50 mm). Gait analysis and baropodometry showed greater imbalance and overload for group B compared to group A. Conclusion In the long term, incomplete reduction of associated acetabular fractures may lead to poor outcome because of secondary spinopelvic imbalance, with posture and gait impairment., (Copyright© by the Medical Assotiation of Zenica-Doboj Canton.) more...
- Published
- 2021
- Full Text
- View/download PDF
41. Single use instruments for total knee arthroplasty.
- Author
-
Romeo M, Rovere G, Stramazzo L, Liuzza F, Meccariello L, Maccauro G, and Camarda L
- Subjects
- Humans, Knee Joint surgery, Treatment Outcome, Arthroplasty, Replacement, Knee, Osteoarthritis, Knee surgery
- Abstract
Aim Total knee arthroplasty represents a procedure that is successfully performed to relieve functional limitation and pain in advanced stages of osteoarthritis. In the next 20 years the number of these procedures will be increased about four times. Patient specific instrumentation (PSI) has been introduced in the past years. The aim of this study was to evaluate whether SUI are more useful in clinical, organizational and economic terms. Methods A database search about single use instrumentation (SUI) was conducted on PubMed and Google Scholar for the period 2010-2020 using the following key "total knee replacement", "total knee arthroplasty", "single use instruments", and "disposable instruments". The results of the selected studies were classified according to clinical, economic and organizational criteria. Results The main advantage of SUI has been reported to reduce costs, timely turnover of operating rooms, maximizing the operating room utilization and patient throughput, improving the number of outpatient total joint replacements. No difference has been found other than with regard to conventional instruments in terms of clinical outcome such as hip-knee-ankle angle and other radiographic parameters, Oxford Knee Score, while a decreased infection rate has been demonstrated. Regarding the economic aspect, a reduction of direct and indirect reduction of costs has been shown for the cost of instruments reprocessing, tray sterilization, 90-day infection rate. Conclusion The SUI can be an alternative to conventional instruments, but there are still few studies in the literature regarding clinical outcomes., (Copyright© by the Medical Assotiation of Zenica-Doboj Canton.) more...
- Published
- 2021
- Full Text
- View/download PDF
42. A new prognostic pelvic injury outcome score.
- Author
-
Meccariello L, Razzano C, De Dominicis C, Herrera-Molpeceres JA, Liuzza F, Erasmo R, Rocca G, Bisaccia M, Pagliarulo E, Cirfeda P, Gómez Garrido D, and Rollo G
- Subjects
- Adolescent, Adult, Aged, Female, Humans, Injury Severity Score, Male, Middle Aged, Prognosis, Reproducibility of Results, Treatment Outcome, Young Adult, Fractures, Bone, Pelvic Bones
- Abstract
Aim To propose a new prognostic classification system for pelvic injuries based on a new detailed and all-encompassing evaluation of the injury pelvic outcome score and to check the prognostic value of this classification and evaluate its reliability and reproducibility. Methods From January 2017 to June 2020 from 156 pelvic fractures treated at our hospitals, 98 patients with pelvic fractures were recruited according to inclusion and exclusion criteria. All patients compiled three scores (New Score System, Majeed Score, SF-12) sessions two times during the hospital stay to evaluate the endpoint before the trauma and two years after the trauma. All patients carried out three tests independently. The evaluation of three scores included a pelvic and general complication after the surgery, the times needed to compile three score system. For reliability of the new score systems we evaluated the inter-observer or intraobserver agreement, the prediction strength of each score, and a prognostic value. Results A total of 98 patients were enrolled (74 were males and 24 females) with mean age of 43.6 (±18.6) (range 16-75) years. Tau B Kendall value was 0.827 for the new score system, 0.673 for the Majeed score, 0.746 for SF-12, there was p<0.05 for the new score system. Conclusion The new score system is prognostic, reliable, reproducible and can become a useful instrument to adequately correlate the long-term outcomes of pelvic injury fractures. Also, it provides a better evaluation of pain, work, sexual possibilities and satisfaction, balance-sitting-walking and psychological status., (Copyright© by the Medical Assotiation of Zenica-Doboj Canton.) more...
- Published
- 2021
- Full Text
- View/download PDF
43. Navigated percutaneous screw fixation of the pelvis with O-arm 2: two years' experience.
- Author
-
Ciolli G, Caviglia D, Vitiello C, Lucchesi S, Pinelli C, De Mauro D, Smakaj A, Rovere G, Meccariello L, Camarda L, Maccauro G, and Liuzza F
- Subjects
- Bone Screws, Fracture Fixation, Internal, Humans, Pelvis diagnostic imaging, Retrospective Studies, Sacrum, Tomography, X-Ray Computed, Imaging, Three-Dimensional, Surgery, Computer-Assisted
- Abstract
Aim To evaluate the case series of the patients operated with percutaneous fixation by the navigation system based on 3D fluoroscopic images, to assess the precision of a surgical implant and functional outcome of patients. Methods A retrospective study of pelvic ring fractures in a 2-year period included those treated with the use of the O-Arm 2 in combination with the Stealth Station 8. Pelvic fractures were classified according to the Tile and the Young-Burgess classification. All patients were examined before surgery, with X-rays and CT scans, and three days after surgery with additional CT scan. The positioning of the screws was evaluated according to the Smith score, the outcome with the SF-36. Results Among 24 patients 18 were with B and six with C type fracture according to Tile, while eight were with APC, 10 LC, and six with VS type according to Young-Burgess classification. All patients were treated in the supine position, except two. A total of 41 iliosacral or transsacral screws and five anterior pelvic ring screws were implanted. The medium surgical time per screw was 41 minutes. There was a perfect correspondence of screw scores value from post-operative CT and intraoperative fluoroscopy. The mean screw score value was 0.92. There were no cases of poor positioning. The median follow-up was 17.5 months. The patients were satisfied with their health condition on SF-36. Conclusion The use of the O-arm guarantees great precision in the positioning of the screws and reduced surgical times with excellent clinical results in patients., (Copyright© by the Medical Assotiation of Zenica-Doboj Canton.) more...
- Published
- 2021
- Full Text
- View/download PDF
44. Supra-inguinal fascia iliaca compartment block for postoperative analgesia after Acetabular fracture surgery.
- Author
-
Vergari A, Frassanito L, Tamburello E, Nestorini R, Sala FD, Lais G, Ciolli G, and Liuzza F
- Subjects
- Fascia, Humans, Analgesia, Hip Fractures surgery, Nerve Block
- Abstract
Competing Interests: Declaration of Competing Interest No author has conflict of interest to declare.
- Published
- 2020
- Full Text
- View/download PDF
45. COVID-19 pandemic: management of patients affected by SARS-CoV-2 in Rome COVID Hospital 2 Trauma Centre and safety of our surgical team.
- Author
-
De Mauro D, Rovere G, Smimmo A, Meschini C, Mocini F, Maccauro G, Falez F, Liuzza F, and Ziranu A
- Subjects
- Hospitals, Humans, Pandemics prevention & control, Patient Care Team, Rome, SARS-CoV-2, Trauma Centers, COVID-19
- Abstract
Background: SARS-CoV-2 pandemic left a deep mark in the health systems around the globe, leading to an important change in the way we intend the access to the healthcare and its fruition. Hospitals faced something unexpected, and they underwent a deep change and so did orthopaedic activity., Materials and Methods: In "A. Gemelli" University hospital new protocols were adopted for the safe management of patients affected by SARS-CoV-2. Among these patients, six had to be treated also for orthopaedic problems. The management of these patients, from the admission in the Emergency Room (E.R). to the operating room (O.R.), followed the protocols we developed for the coronavirus crisis., Results: Four among the six patients underwent surgical treatments. Two of them showed a change of their clinical status, due to a worsening of COVID-19 symptoms, so the surgical option was postponed. All of them were admitted to the Infectious Diseases Unit, rather than the Orthopaedic and Traumatology Unit, in order to provide the best measures to prevent the spread of the contagion and to ensure the best treatment for COVID-19. No O.R. staff was infected by SARS-CoV-2., Conclusions: More studies are needed to provide a higher statistical significance to the safety measures taken in order to contrast the spread of SARS-CoV-2 in the Surgical Room. Orthopaedic surgeons are more exposed to the contagion due to the particular tools set they use. A more sensible and specific quick test for novel Coronavirus is particularly needed, due to the lack of sensitivity of the serological rapid test. more...
- Published
- 2020
- Full Text
- View/download PDF
46. 3D - Navigated percutaneous screw fixation of pelvic ring injuries - a pilot study.
- Author
-
Florio M, Capasso L, Olivi A, Vitiello C, Leone A, and Liuzza F
- Subjects
- Bone Screws, Fluoroscopy, Fracture Fixation, Internal, Humans, Imaging, Three-Dimensional, Pilot Projects, Quality of Life, Tomography, X-Ray Computed, Fractures, Bone diagnostic imaging, Fractures, Bone surgery, Pelvic Bones diagnostic imaging, Pelvic Bones surgery, Surgery, Computer-Assisted
- Abstract
Introduction: Screw fixation of pelvic ring fractures is a common, but demanding procedure and navigation techniques were introduced to increase the precision of screw placement. The purpose of this case series is to demonstrate a lower screw malposition rate using percutaneous fixation of pelvic ring fractures and sacroiliac dislocations guided by navigation system based on 3D-fluoroscopic images compared to traditional imaging techniques and to evaluate the functional outcomes of this innovative procedure., Patient and Methods: 10 cases of disrupted pelvic ring lesions treated in our hospital from February 2018 to December 2018 were included for closed reduction and percutaneous screw fixation of using with O-Arm and the acquisition by the Navigator. Preoperative assessment was performed on the patients by means of X Ray imaging and CT scan. Routine CT was carried out on third postoperative day to evaluate screw placement. Measures of radiation exposure were extracted directly from reports provided by system. Quality of life was evaluated by SF 36-questionnaire 6 months after surgery., Results: 12 iliosacral- and 2 ramus pubic-screws were inserted. In post-operative CT-scans the screw position was assessed and graded using the score described by Smith. No wound infection or iatrogenic neurovascular damage were observed. No re-operations were performed. The exposure to radiation is, for the patient, slightly greater than that resulting from the use of traditional fluoroscopic systems, while it is naught for the surgical team, which at the time of image acquisition is located outside the room., Discussion and Conclusion: The execution of an intraoperative 3D-fluoroscopic scan can on its own suffice as a post-operative control examination since its accuracy is similar to that of the post-operative CT. The use of a navigated 3d fluoroscopy exposes the patient to an amount of radiation slightly greater than that of traditional fluoroscopy, but the dose is lower than a CT examination. For the operating team, exposure to radiation is naught. 3D-fluoroscopic navigation is a safe tool providing high accuracy of percutaneous screw placement for pelvic ring fractures. Finally, despite the small cohort of patients studied, the excellent results obtained regarding the patients' quality of life and the absence of complications allow us to look positively at the future of this technique, which needs further studies and improvement., (Copyright © 2020. Published by Elsevier Ltd.) more...
- Published
- 2020
- Full Text
- View/download PDF
47. Cemented versus cementless megaprosthesis in proximal femur metastatic disease: A systematic review.
- Author
-
Oliva MS, Vitiello R, Cauteruccio M, Pesare E, Rovere G, Meschini C, Liuzza F, Maccauro G, and Ziranu A
- Abstract
The proximal femur is the long bone most commonly affected by metastatic disease. There are many treatment options, such as hip megaprostheses. A topic still widely debated in literature is the use of cemented or uncemented megaprostheses in this kind of patients. The purpose of this review is to examine both these surgical options to understand which of them should be preferred in metastatic patients. Twelve articles were finally included in the review. Eight authors used cemented mega - prostheses, two cementless megaprostheses and two authors used both techniques. Better functional outcomes and lower infection rates were found in cementless mega - prostheses. More studies have to be performed to choose the better technique and improve patients' quality of life., Competing Interests: Conflict of interest: the authors declare no potential conflict of interest., (©Copyright: the Author(s).) more...
- Published
- 2020
- Full Text
- View/download PDF
48. Foot metastasis: Current knowledge.
- Author
-
Greco T, Cianni L, De Mauro D, Dughiero G, Bocchi MB, Cazzato G, Ragonesi G, Liuzza F, Maccauro G, and Perisano C
- Abstract
Foot metastasis are rare and often overlooked due to non-specifical symptoms. This often leads to misdiagnosis delaying the right diagnosis. Metastatic disease of the foot is rare. Foot pain and swelling may be the presenting symptom of an occult malignancy. If metastatic disease is not kept in the differential diagnosis of foot pain, diagnosis and treatment will be delayed. The purpose of this study was to analyze articles presenting cases of foot metastasis to provide a more accurate incidence of symptomatic foot acrometastasis as well as to review the clinical course and outcomes. Studies were searched on PubMed/Medline from the inception to February 2020. All studies included in the review presented foot metastasis either with or without a known primary tumor. Most of the articles were case reports, to which we added two case reports of foot acrometastasis produced by our Institute. Forty-three studies with a total of 45 patients were included in this review. The literature published mostly concerning case reports about old patients (average age: 63,2), in a late phase of their disease. Lung cancer appeared to be the most common primary tumor, followed by endometrial and breast cancer. In the 36% of the cases foot metastasis were found when the primary site was still unknown. Calcaneus and metatarsal bones were the most common bones involved. Surgical solution is rare, the chosen treatments are often of palliative care. Prognosis was often poor, death occurred within 2 years since the discovery of foot metastasis in about 50% of cases., Competing Interests: Conflict of interest: the authors declare no potential conflict of interest., (©Copyright: the Author(s).) more...
- Published
- 2020
- Full Text
- View/download PDF
49. Efficacy of postoperative drainage in total knee arthroplasty: Review of the literature.
- Author
-
Basilico M, Vitiello R, Liuzza F, Minutillo F, Ruberto P, Matrangolo MR, Palmacci O, Maccauro G, and Malerba G
- Abstract
Postoperative drainage after total knee arthroplasty (TKA) is an established routine procedure for orthopedic surgeries, and is considered a useful practice in postoperative, but the use of drainage is controversial. Our study aims to clarify this aspect of knee prosthetic surgery. A systematic review of the literature was performed in the electronic databases to investigate the risks and the benefits of wound drainage in total knee arthroplasty: 30 articles were included in our review for eligibility. After the analysis of the literature performed, we found no significant advantages related with the use of wound drain following total knee replacement (TKR) in terms of pain, transfusion rate, blood loss, swelling, postoperative range of motion, wound complications, deep infection and hospital stay, while no drainage means a significant cost saving compared to drainage use. Thus, the use of drainage after TKA cannot be justified on the basis of the results of this study., Competing Interests: Conflict of interest: the authors declare no potential conflict of interest., (©Copyright: the Author(s).) more...
- Published
- 2020
- Full Text
- View/download PDF
50. The stiff elbow: Current concepts.
- Author
-
Masci G, Cazzato G, Milano G, Ciolli G, Malerba G, Perisano C, Greco T, Osvaldo P, Maccauro G, and Liuzza F
- Abstract
Elbow stiffness is defined as any loss of movement that is greater than 30° in extension and less than 120° in flexion. Causes of elbow stiffness can be classified as traumatic or atraumatic and as congenital or acquired. Any alteration affecting the stability elements of the elbow can lead to a reduction in the arc of movement. The classification is based on the specific structures involved (Kay's classification), anatomical location (Morrey's classification), or on the degree of severity of rigidity (Vidal's classification). Diagnosis is the result of a combination of medical history, physical examination (evaluating both active and passive movements), and imaging. The loss of soft tissue elasticity could be the result of bleeding, edema, granulation tissue formation, and fibrosis. Preventive measures include immobilization in extension, use of post-surgical drain, elastic compression bandage and continuous passive motion. Conservative treatment is used when elbow stiffness has been present for less than six months and consists of the use of serial casts, static or dynamic splints, CPM, physical therapy, manipulations and functional re-education. If conservative treatment fails or is not indicated, surgery is performed. Extrinsic rigidity cases are usually managed with an open or arthroscopic release, while those that are due to intrinsic causes can be managed with arthroplasties. The elbow is a joint that is particularly prone to developing stiffness due to its anatomical and biomechanical complexity, therefore the treatment of this pathology represents a challenge for the physiotherapist and the surgeon alike., Competing Interests: Conflict of interest: The authors declare no potential conflict of interest., (©Copyright: the Author(s).) more...
- Published
- 2020
- Full Text
- View/download PDF
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.