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Ortolani A, Lana D, Martucci A, Pesce F, Stallone S, Milani L, Urso R, Melucci G, Tigani D. Correlation between cephalic screw positioning of Standard Gamma 3 Nail for intertrochanteric fractures and cut-out incidence. SICOT J 2024; 10:9. [PMID: 38415767 PMCID: PMC10901073 DOI: 10.1051/sicotj/2024006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 01/27/2024] [Indexed: 02/29/2024] Open
Abstract
INTRODUCTION Lateral fractures of proximal femur are the most frequent fractures in elderly people. Internal fixation using medullary nails is the gold standard of treatment (Gamma 3 nail is the most implanted device) due to reduced incidence of complications than other devices. We report our experience in treating this kind of fractures with Gamma 3 nail, between January 2015 and December 2021. METHODS We performed a retrospective cohort study of patients treated in our orthopaedic department; level of clinical care is III: 559 patients (431 females and 128 males, with an average age of 85.3 years) with lateral femoral neck fracture. All patients were surgically treated with Gamma 3 standard nail (SGN). We evaluated preliminary X-rays to classify fractures, according to AO-OTA classification and post-operative X-ray to verify cephalic screw position site, according to areas described by Cleveland in 1959: we measured tip-to-apex distance (TAD) and tip-to-apex calcar referred distance (CalTAD). Finally Chang reduction quality criteria (CRQC) for fracture reduction of trochanteric fractures were determined using preoperative or postoperative Antero-Posterior (AP) and lateral radiographs in a Picture Archiving and Communication System (PACS). Incidence of cut-out was evaluated in relation with these parameters. Patients were divided into 2 groups: first group had cephalic screw in optimal positions (5-8-9), the other group had cephalic screw in other positions. RESULTS In 328 patients (58.7%) screw was in positions 5-8-9, in 231 patients (41.2%) screw was in not-optimal position. Median TAD was 19.1 ± 7.0 mm (range = 0.0-50.5); in 463 patients (82.8%) TAD was ≤ 25 mm. Median CalTAD was 21.4 ± 4.7 mm (range = 5.7-39.2); in 105 patients (79.4%) CalTAD was ≤ 25 mm. Cut-out was observed in 8 cases (1.43%). Multivariate analysis showed a significant correlation (p < 0,05) between incidence of cut-out and fracture type 31A2 and with TAD values >25 mm. Cephalic screw position did not influence incidence of cut-out. DISCUSSION In order to obtain fracture healing with a low risk of failure, in particular cut-out, it is necessary to obtain good reduction of fracture and optimal lag screw position in order to achieve a TAD inferior to 25 mm.
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Affiliation(s)
- Alessandro Ortolani
- Department of Trauma and Orthopaedic Surgery, Maggiore Hospital, Largo Nigrisoli 2, 40133 Bologna, Italy
| | - Debora Lana
- Department of Trauma and Orthopaedic Surgery, Maggiore Hospital, Largo Nigrisoli 2, 40133 Bologna, Italy
| | - Antonio Martucci
- Department of Trauma and Orthopaedic Surgery, Maggiore Hospital, Largo Nigrisoli 2, 40133 Bologna, Italy
| | - Francesco Pesce
- Division of Renal Medicine, "Ospedale Isola Tiberina - Gemelli Isola", Via di Ponte Quattro capi, 39, 00186 Rome, Italy
| | - Stefano Stallone
- Department of Trauma and Orthopaedic Surgery, Maggiore Hospital, Largo Nigrisoli 2, 40133 Bologna, Italy
| | - Lorenzo Milani
- Department of Trauma and Orthopaedic Surgery, Maggiore Hospital, Largo Nigrisoli 2, 40133 Bologna, Italy
| | - Roberto Urso
- Department of Trauma and Orthopaedic Surgery, Maggiore Hospital, Largo Nigrisoli 2, 40133 Bologna, Italy
| | - Giuseppe Melucci
- Department of Trauma and Orthopaedic Surgery, Maggiore Hospital, Largo Nigrisoli 2, 40133 Bologna, Italy
| | - Domenico Tigani
- Department of Trauma and Orthopaedic Surgery, Maggiore Hospital, Largo Nigrisoli 2, 40133 Bologna, Italy
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Di Gennaro GL, Trisolino G, Stallone S, Ramella M, Rocca G, Gallone G. Guided Growth Technique for Epiphysiodesis and Hemiepiphysiodesis: Safety and Performance Evaluation. Children (Basel) 2023; 11:49. [PMID: 38255362 PMCID: PMC10814807 DOI: 10.3390/children11010049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 12/27/2023] [Accepted: 12/28/2023] [Indexed: 01/24/2024]
Abstract
BACKGROUND Guided-growth modulation is a first-line treatment widely adopted to correct lower-limb angular deformities and limb-length discrepancies (LLD) in the paediatric population. METHODS We conducted a retrospective study to evaluate the safety and performance of a new construct (8-Plate Plus or Guided-Growth Plate System Plus, Orthofix S.r.l) used to correct angular deformities and LLD in non-skeletally mature children. The primary endpoint was safety (from plate implantation to removal). The secondary endpoint was performance; patients treated for LLD achieved complete correction if a pre- and post-surgery difference of <0 was observed; angular deformities performance was measured in terms of IMD, ICD, mMPTA, and mLDFA. RESULTS We performed 69 procedures in 41 patients. A total of 10 patients had an LLD, and 31 had an angular deformity. We observed nine minor complications in the hemiepiphysiodesis group. One patient experienced rebound. All 10 LLD patient treatments were successful. A total of 30/31 patients with an angular deformity had a successful treatment; the remaining patient had a partial correction. CONCLUSIONS Guided-growth by temporary epiphysiodesis or hemiepiphysiodesis was safe and effective for angular deformities and limb-length discrepancies. Further prospective and/or randomized controlled trial studies assessing more significant cohorts of patients and a comparison group could add evidence to our findings.
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Affiliation(s)
- Giovanni Luigi Di Gennaro
- Unit of Pediatric Orthopedics and Traumatology, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy; (G.L.D.G.); (G.T.); (M.R.); (G.R.)
| | - Giovanni Trisolino
- Unit of Pediatric Orthopedics and Traumatology, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy; (G.L.D.G.); (G.T.); (M.R.); (G.R.)
| | - Stefano Stallone
- Unit of Orthopedics and Traumatology, Ospedale Maggiore “Pizzardi”, 40133 Bologna, Italy;
| | - Marco Ramella
- Unit of Pediatric Orthopedics and Traumatology, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy; (G.L.D.G.); (G.T.); (M.R.); (G.R.)
| | - Gino Rocca
- Unit of Pediatric Orthopedics and Traumatology, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy; (G.L.D.G.); (G.T.); (M.R.); (G.R.)
| | - Giovanni Gallone
- Unit of Pediatric Orthopedics and Traumatology, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy; (G.L.D.G.); (G.T.); (M.R.); (G.R.)
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Tigani D, Banci L, Stallone S, Melucci G, Pieratelli G, Castiello E. Evolution and New Generation of Dual Mobility Cups. Orthopedics 2023; 46:e273-e280. [PMID: 37561099 DOI: 10.3928/01477447-20230804-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/11/2023]
Abstract
Although total hip arthroplasty (THA) is considered a successful procedure, hip dislocation remains the main cause of early failure. Dual mobility cups (DMCs) have been shown to significantly reduce the dislocation rate in both primary and revision THAs. During the past several decades, DMCs have evolved in design and fixation interface. There have been three generations of DMCs. This article addresses the rationale for a new cementless highly porous titanium DMC to improve component fixation and implant biocompatibility. [Orthopedics. 2023;46(5):e273-e280.].
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Trisolino G, Stallone S, Grassi A, Olivotto E, Battistelli M, Zarantonello P, Gallone G, Ferrari D, Di Gennaro GL, Zaffagnini S. The discoid lateral meniscus in children: a narrative review of pathology, diagnosis and treatment. Ann Jt 2022; 7:38. [PMID: 38529145 PMCID: PMC10929324 DOI: 10.21037/aoj-21-31] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 06/01/2022] [Indexed: 03/27/2024]
Abstract
Background and Objective The discoid lateral meniscus (DLM) is a congenital abnormality of the meniscal shape, characterized by a typical central hypertrophy and a diameter larger than a regular meniscus, potentially leading to knee pain and symptoms, especially in children. The present study provides an update and a general review of this uncommon meniscal pathology. The incidence of discoid meniscus is about 0.4-17% for the lateral and 0.1-0.3% for the medial, although, being often asymptomatic, the true prevalence is unknown. We aim to enhance awareness on this subject to medical care provider. Methods A literature search was performed on PubMed, including articles written in English until October 2021. Key Content and Findings The articles regarding etiology, diagnosis and management of DLM in children or in patients younger than 18 years were reviewed using the narrative approach. Conclusions Recent literature has shown that DLM is one of the most frequent congenital anomalies of the knee encountered during childhood. While asymptomatic children with incidental finding can be managed nonoperatively, symptomatic painful DLM should be addressed surgically, restoring typical anatomy using saucerization, tear repair, and stable fixation of the meniscus. The risk of osteoarthritis progression seems to be higher in children with operated DLM, imposing prolonged follow-up and cartilage preserving strategies for these patients.
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Affiliation(s)
- Giovanni Trisolino
- Pediatric Orthopedics and Traumatology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Stefano Stallone
- Pediatric Orthopedics and Traumatology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Alberto Grassi
- IIa Clinica Ortopedica e Traumatologica, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Eleonora Olivotto
- RAMSES Laboratory, RIT Department, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Michela Battistelli
- Department of Biomolecular Sciences, University of Urbino “Carlo Bo”, Urbino, Italy
| | - Paola Zarantonello
- Pediatric Orthopedics and Traumatology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Giovanni Gallone
- Pediatric Orthopedics and Traumatology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Daniele Ferrari
- Pediatric Orthopedics and Traumatology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | | | - Stefano Zaffagnini
- IIa Clinica Ortopedica e Traumatologica, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
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Olivotto E, Trisolino G, Belluzzi E, Lazzaro A, Strazzari A, Pozzuoli A, Cigolotti A, Ruggieri P, Evangelista A, Ometto F, Stallone S, Goldring SR, Goldring MB, Ramonda R, Grigolo B, Favero M. Macroscopic Synovial Inflammation Correlates with Symptoms and Cartilage Lesions in Patients Undergoing Arthroscopic Partial Meniscectomy: A Clinical Study. J Clin Med 2022; 11:jcm11154330. [PMID: 35893418 PMCID: PMC9330366 DOI: 10.3390/jcm11154330] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 07/14/2022] [Accepted: 07/21/2022] [Indexed: 02/01/2023] Open
Abstract
Background: The aim of the study was to examine the relationship among patients’ characteristics, intraoperative pathology and pre/post-operative symptoms in a cohort of patients undergoing arthroscopic partial meniscectomy for symptomatic meniscal tears. Methods: Clinical data were collected (age, sex, body mass index, time to surgery, trauma). Intraoperative cartilage pathology was assessed with Outerbridge score. Meniscal tears were graded with the ISAKOS classification. Synovial inflammation was scored using the Macro-score. Patient symptoms were assessed pre/post-operatively using the KOOS instrument. Results: In the series of 109 patients (median age 47 years), 50% of the meniscal tears were traumatic; 85% of patients showed mild to moderate synovitis; 52 (47.7%) patients had multiple cartilage defects and 31 (28.4%) exhibited a single focal chondral lesion. Outerbridge scores significantly correlated with patient age, BMI and synovial inflammation. There was a correlation between severity of chondral pathology and high-grade synovial hyperplasia. Pre-operative KOOS correlated with BMI, meniscal degenerative changes and symptom duration. Obesity, time to surgery, presence of high-grade synovial hyperplasia and high-grade cartilage lesions were independent predictors of worse post-operative pain and function. Conclusion: We demonstrated that pre-operative symptoms and post-operative outcomes correlate with synovitis severity and cartilage pathology, particularly in old and obese patients that underwent arthroscopic partial meniscectomy. Importantly, patients with a degenerative meniscal pattern and with longer time to surgery experienced more severe cartilage damage and, consequentially, pain and dysfunction. These findings are fundamental to identify patients suitable for earlier interventions.
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Affiliation(s)
- Eleonora Olivotto
- RAMSES Laboratory, RIT Department, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy
| | - Giovanni Trisolino
- Reconstructive Hip and Knee Joint Surgery, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy
- Pediatric Orthopedic and Traumatology, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy
| | - Elisa Belluzzi
- Musculoskeletal Pathology and Oncology Laboratory, Department of Surgery, Oncology and Gastroenterology, University of Padova, 35128 Padova, Italy
- Orthopedics and Orthopedic Oncology, Department of Surgery, Oncology and Gastroenterology, University-Hospital of Padova, 35128 Padova, Italy
| | - Antonello Lazzaro
- Orthopedics and Orthopedic Oncology, Department of Surgery, Oncology and Gastroenterology, University-Hospital of Padova, 35128 Padova, Italy
| | - Alessandro Strazzari
- Reconstructive Hip and Knee Joint Surgery, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy
| | - Assunta Pozzuoli
- Musculoskeletal Pathology and Oncology Laboratory, Department of Surgery, Oncology and Gastroenterology, University of Padova, 35128 Padova, Italy
- Orthopedics and Orthopedic Oncology, Department of Surgery, Oncology and Gastroenterology, University-Hospital of Padova, 35128 Padova, Italy
| | - Augusto Cigolotti
- Orthopedics and Orthopedic Oncology, Department of Surgery, Oncology and Gastroenterology, University-Hospital of Padova, 35128 Padova, Italy
| | - Pietro Ruggieri
- Orthopedics and Orthopedic Oncology, Department of Surgery, Oncology and Gastroenterology, University-Hospital of Padova, 35128 Padova, Italy
| | - Andrea Evangelista
- General Affairs Unit, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy
| | - Francesca Ometto
- Rheumatology Unit, Department of Medicine, University-Hospital of Padova, 35128 Padova, Italy
| | - Stefano Stallone
- Pediatric Orthopedic and Traumatology, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy
| | - Steven R Goldring
- Hospital for Special Surgery, Weill Cornell Medical College, New York, NY 10021, USA
| | - Mary B Goldring
- Hospital for Special Surgery, Weill Cornell Medical College, New York, NY 10021, USA
| | - Roberta Ramonda
- Rheumatology Unit, Department of Medicine, University-Hospital of Padova, 35128 Padova, Italy
| | - Brunella Grigolo
- RAMSES Laboratory, RIT Department, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy
| | - Marta Favero
- Rheumatology Unit, Department of Medicine, University-Hospital of Padova, 35128 Padova, Italy
- Internal Medicine Unit I, Ca' Foncello Hospital, 31100 Treviso, Italy
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Trisolino G, Stallone S, Zarantonello P, Evangelista A, Boarini M, Faranda Cordella J, Lerma L, Veronesi L, Guerra CC, Sangiorgi L, Di Gennaro GL, Toniolo RM. Translation and Cross-Cultural Adaptation of the Pediatric Outcomes Data Collection Instrument into the Italian Language. Children 2022; 9:children9060853. [PMID: 35740791 PMCID: PMC9221952 DOI: 10.3390/children9060853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Revised: 06/06/2022] [Accepted: 06/06/2022] [Indexed: 11/29/2022]
Abstract
(1) Background: The Pediatric Outcomes Data Collection Instrument (PODCI) is an English-language questionnaire specifically designed to assess health-related quality of life in children and adolescents with musculoskeletal disorders. This scoring system has been translated into several languages. Given the lack of an Italian version of the PODCI, this study aimed to translate, cross-culturally adapt, and assess the psychometric properties of the PODCI score in the Italian pediatric population. (2) Methods: The PODCI questionnaire was culturally adapted to Italian patients in accordance with the literature guidelines. The study included 59 participants from a single orthopedic institution who underwent orthopedic surgery for various skeletal conditions. The questionnaire was administered to participants at multiple time-points (T0, T1, T2). Internal consistency was evaluated using Cronbach’s alpha. Reproducibility was assessed using the intraclass correlation coefficient (ICC) between T0 and T1 assessment. Criterion validity was assessed using Spearman’s correlation coefficients between PODCI and the Hospital for Special Surgery Pediatric Functional Activity Brief Scale (HSS Pedi-FABS). Responsiveness was evaluated by the difference between T0 and T2 using the effect size (ES) and the standardized response mean (SRM) calculation. (3) Results: Cronbach’s alpha was acceptable in both the self- and parent-reported versions with values of 0.78 (0.68–0.90) and 0.84 (0.60–0.92), respectively. The ICC fluctuated between 0.31 and 0.89 for self-reported and 0.49 to 0.87 for pediatrics. The Spearman’s r showed a moderate correlation between HSS Pedi-FABS and the “Sport & Physical Functioning” and “Global Functioning” domains. ES and SRM varied from small to moderate across all the domains. (4) Conclusions: This study demonstrates that the Italian version of the PODCI, translated following the international standardized guidelines, is reliable, valid, and responsive in pediatric patients who underwent orthopedic surgery.
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Affiliation(s)
- Giovanni Trisolino
- Pediatrics Orthopedics and Traumatology, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy; (G.T.); (S.S.); (P.Z.); (L.L.); (L.V.); (C.C.G.); (G.L.D.G.)
| | - Stefano Stallone
- Pediatrics Orthopedics and Traumatology, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy; (G.T.); (S.S.); (P.Z.); (L.L.); (L.V.); (C.C.G.); (G.L.D.G.)
| | - Paola Zarantonello
- Pediatrics Orthopedics and Traumatology, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy; (G.T.); (S.S.); (P.Z.); (L.L.); (L.V.); (C.C.G.); (G.L.D.G.)
| | - Andrea Evangelista
- Unit of Clinical Epidemiology, CPO Piemonte, AOU Città della Salute e della Scienza di Torino, 10126 Turin, Italy;
| | - Manila Boarini
- Department of Rare Skeletal Disorders, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy;
- Correspondence: ; Tel.: +39-051-6366062
| | | | - Luca Lerma
- Pediatrics Orthopedics and Traumatology, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy; (G.T.); (S.S.); (P.Z.); (L.L.); (L.V.); (C.C.G.); (G.L.D.G.)
| | - Luisa Veronesi
- Pediatrics Orthopedics and Traumatology, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy; (G.T.); (S.S.); (P.Z.); (L.L.); (L.V.); (C.C.G.); (G.L.D.G.)
| | - Cosma Caterina Guerra
- Pediatrics Orthopedics and Traumatology, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy; (G.T.); (S.S.); (P.Z.); (L.L.); (L.V.); (C.C.G.); (G.L.D.G.)
| | - Luca Sangiorgi
- Department of Rare Skeletal Disorders, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy;
| | - Giovanni Luigi Di Gennaro
- Pediatrics Orthopedics and Traumatology, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy; (G.T.); (S.S.); (P.Z.); (L.L.); (L.V.); (C.C.G.); (G.L.D.G.)
| | - Renato Maria Toniolo
- Department of Orthopedics and Traumatology, IRCCS Ospedale Pediatrico Bambino Gesù, 00146 Rome, Italy;
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Trisolino G, Stallone S, Castagnini F, Bordini B, Cosentino M, Lucchini S, Zarantonello P, Ferrari D, Dallari D, Traina F. Cementless Ceramic-on-Ceramic Total Hip Replacement in Children and Adolescents. Children (Basel) 2021; 8:children8100858. [PMID: 34682123 PMCID: PMC8534320 DOI: 10.3390/children8100858] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 09/22/2021] [Accepted: 09/23/2021] [Indexed: 02/07/2023]
Abstract
Background: total hip replacement (THR) is a rare surgical option in children and adolescents with disabling hip diseases. The aim of this study is to report results from a retrospective cohort of patients aged 18 years or less who underwent cementless Ceramic-on-Ceramic (CoC) THR at a single institution, investigating clinical and radiographic outcomes, survival rates, and reasons for revision of the implants. Materials and methods: we queried the Registry of Prosthetic Orthopedic Implants (RIPO) to identify all children and adolescents undergoing THR between 2000 and 2019 at a single Institution. Inclusion criteria were patients undergoing cementless CoC THR, aged less than 18 years at surgery, followed for at least 2 years. Sixty-eight patients (74 hips) matched all the inclusion criteria and were enrolled in the study. We assessed the clinical and radiographic outcomes, the rate of complications, the survival rate, and reasons for revision of the implants. Results: The mean follow-up was 6.6 ± 4.4 years (range 2-20). The most frequent reason for THR was post-traumatic or chemotherapy-induced avascular necrosis (38%). The overall survival rate of the cohort was 97.6% (95% CI: 84.9-99.7%) at 5 years of follow-up, 94.4% (95% CI: 79.8-98.6%) at 10 years and 15 years of follow-up. Two THR in two patients (2.7%) required revision. With the numbers available, Cox regression analysis could not detect any significant interaction between preoperative or intraoperative variables and implant survivorship (p-value 0.242 to 0.989)." The average HOOS was 85 ± 14.3 (range 30.6-100). Overall, 23 patients (48%) reported excellent HOOS scores (>90 points), 21 patients (44%) reported acceptable HOOS scores (60-90 points) while 4 patients (8%) reported poor outcomes (<60 points). Twenty-one patients (43%) were regularly involved into moderate- to high-intensity sport activities (UCLA ≥ 6). Conclusions: Cementless CoC THR is a successful procedure in children and teenagers, having demonstrated high implant survivorship and low rates of complications and failure. A meticulous preoperative planning and implant selection is mandatory, to avoid implant malposition, which is the main reason of failure and revision in these cases. Further studies are needed to assess the impact of the THR on the psychosocial wellbeing of teenagers, as well as risks and benefits and cost-effectiveness in comparison to the hip preserving surgical procedures.
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Affiliation(s)
- Giovanni Trisolino
- Pediatric Orthopedics and Traumatology, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy; (P.Z.); (D.F.)
- Correspondence: (G.T.); (S.S.)
| | - Stefano Stallone
- Pediatric Orthopedics and Traumatology, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy; (P.Z.); (D.F.)
- Correspondence: (G.T.); (S.S.)
| | - Francesco Castagnini
- Orthopaedic-Traumatology and Prosthetic Surgery and Revisions of Hip and Knee, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy; (F.C.); (S.L.); (F.T.)
| | - Barbara Bordini
- Medical Technology Laboratory, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy; (B.B.); (M.C.)
| | - Monica Cosentino
- Medical Technology Laboratory, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy; (B.B.); (M.C.)
| | - Stefano Lucchini
- Orthopaedic-Traumatology and Prosthetic Surgery and Revisions of Hip and Knee, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy; (F.C.); (S.L.); (F.T.)
| | - Paola Zarantonello
- Pediatric Orthopedics and Traumatology, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy; (P.Z.); (D.F.)
| | - Daniele Ferrari
- Pediatric Orthopedics and Traumatology, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy; (P.Z.); (D.F.)
| | - Dante Dallari
- Conservative Orthopedic Surgery and Innovative Techniques, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy;
| | - Francesco Traina
- Orthopaedic-Traumatology and Prosthetic Surgery and Revisions of Hip and Knee, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy; (F.C.); (S.L.); (F.T.)
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Quattrini F, Ortolani A, Ciatti C, Puma Pagliarello C, Martucci A, Gurrieri L, Stallone S, Melucci G, Domenico T, Maniscalco P. Static vs dinamic short nail in pertrochanteric fractures: experience of two center in Northern Italy. Acta Biomed 2021; 92:e2021021. [PMID: 34313660 PMCID: PMC8420836 DOI: 10.23750/abm.v92is3.11745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 07/01/2021] [Indexed: 11/23/2022]
Abstract
BACKGROUND Lateral fractures of proximal femur are the most frequent to treat for the traumatologist surgeon. Intramedullary nailing is the gold standard treatment of this type of fracture. The aim of the study is to analyze the results obtained with the Elos Intrauma nail by the experience of two Departments of Orthopedics and Traumatology ("Guglielmo da Saliceto" Hospital in Piacenza and the Maggiore hospital in Bologna). METHODS We performed a retrospective cohort study of 400 patients with lateral femoral neck fracture surgically treated with Elos Intrauma standard nail. The examined period is from 1st Jannuary 2018 to 31st Dicember 2020. In all patients we implanted Elos® - Intrauma nail, a titanium cervical diaphyseal nail, according to the standard technique. RESULTS We evaluate at a minumum of three months of follow up 286/400 patients. Average follow up was 3.94 months, minimum 3 months and maximum 24 months. We obtain the 96.85 % of fracture healing, recording 33 complications (11.54%). The incidence of surgical revision was 2.8% (8 cases). No mechanical complications was found in stable fractures treated with short nail and without distal locking. CONCLUSIONS With the use of Elos nail we obtained 95% of radiographic healings within three months with a complication rate comparable to literature report. Distal locking is absolutely recommended in complex fractures, it may be superfluous after careful evaluation of the fracture pattern and morphological characteristics of the femur to be treated; future in-depth studies may narrow the criteria to choose distal locking or non locking.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Pietro Maniscalco
- Orthopedics and Traumatology Department, Guglielmo da Saliceto Hospital, Piacenza, Italy.
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9
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Trisolino G, Toniolo RM, Marengo L, Dibello D, Guida P, Panuccio E, Evangelista A, Stallone S, Sansò ML, Amati C, Costici PF, Boero S, Farsetti P, De Sanctis N, Verdoni F, Memeo A, Gigante C. Resilience Against COVID-19: How Italy Faced the Pandemic in Pediatric Orthopedics and Traumatology. Children (Basel) 2021; 8:children8070530. [PMID: 34206218 PMCID: PMC8305147 DOI: 10.3390/children8070530] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Revised: 06/09/2021] [Accepted: 06/10/2021] [Indexed: 11/16/2022]
Abstract
Background: We aimed to investigate the variation of medical and surgical activities in pediatric orthopedics in Italy, during the year of the COVID-19 pandemic, in comparison with data from the previous two years. The differences among the first wave, phase 2 and second wave were also analyzed. Methods: We conducted a retrospective multicenter study regarding the clinical and surgical activities in pediatric orthopedics during the pandemic and pre-pandemic period. The hospital databases of seven tertiary referral centers for pediatric orthopedics and traumatology were queried for events regarding pediatric orthopedic patients from 1 March 2018 to 28 February 2021. Surgical procedures were classified according to the “SITOP Priority Panel”. An additional classification in “high-priority” and “low-priority” surgery was also applied. Results: Overall, in 2020, we observed a significant drop in surgical volumes compared to the previous two years. The decrease was different across the different classes of priority, with “high-priority” surgery being less influenced. The decrease in emergency department visits was almost three-fold greater than the decrease in trauma surgery. During the second wave, a lower decline in surgical interventions and a noticeable resumption of “low-priority” surgery and outpatient visits were observed. Conclusion: Our study represents the first nationwide survey quantifying the impact of the COVID-19 pandemic on pediatric orthopedics and traumatology during the first and second wave.
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Affiliation(s)
- Giovanni Trisolino
- Unit of Pediatric Orthopaedics and Traumatology, Istituto Ortopedico Rizzoli, IRCCS, 40136 Bologna, Italy;
- Correspondence: ; Tel.: +39-051-636-6484 or +39-340-264-3380
| | - Renato Maria Toniolo
- Department of Orthopaedics and Traumatology, Bambino Gesù Children’s Hospital, IRCCS, 00146 Rome, Italy;
| | - Lorenza Marengo
- Unit of Pediatric Orthopaedics and Traumatology, Istituto Giannina Gaslini, IRCCS, 16147 Genova, Italy; (L.M.); (S.B.)
| | - Daniela Dibello
- Unit of Pediatric Orthopaedics and Traumatology Giovanni XXIII Children’s Hospital, University of Bari, 70126 Bari, Italy; (D.D.); (C.A.)
| | - Pasquale Guida
- Unit of Pediatric Orthopaedics and Traumatology, Azienda Ospedaliera di Rilievo Nazionale Santobono Pausillipon, 80122 Napoli, Italy; (P.G.); (M.L.S.)
| | - Elena Panuccio
- Department of Paediatric Orthopaedics and Traumatology, Centro Specialistico Ortopedico Traumatologico Gaetano Pini-CTO, 20122 Milano, Italy; (E.P.); (A.M.)
| | - Andrea Evangelista
- Unit of General Affairs, Istituto Ortopedico Rizzoli, IRCCS, 40136 Bologna, Italy;
| | - Stefano Stallone
- Unit of Pediatric Orthopaedics and Traumatology, Istituto Ortopedico Rizzoli, IRCCS, 40136 Bologna, Italy;
| | - Maria Lucia Sansò
- Unit of Pediatric Orthopaedics and Traumatology, Azienda Ospedaliera di Rilievo Nazionale Santobono Pausillipon, 80122 Napoli, Italy; (P.G.); (M.L.S.)
| | - Carlo Amati
- Unit of Pediatric Orthopaedics and Traumatology Giovanni XXIII Children’s Hospital, University of Bari, 70126 Bari, Italy; (D.D.); (C.A.)
| | - Pier Francesco Costici
- Orthopedic Unit, Department of Surgery, Bambino Gesù Children’s Hospital, IRCCS, 00050 Rome, Italy;
| | - Silvio Boero
- Unit of Pediatric Orthopaedics and Traumatology, Istituto Giannina Gaslini, IRCCS, 16147 Genova, Italy; (L.M.); (S.B.)
| | - Pasquale Farsetti
- Department of Orthopaedics Surgery, University of Rome “Tor Vergata”, 00133 Rome, Italy;
| | - Nando De Sanctis
- Unit of Pediatric Orthopaedics and Traumatology, Campolongo Hospital, 84025 Marina di Eboli, Italy;
| | - Fabio Verdoni
- Unit of Pediatric Orthopaedics and Traumatology, Istituto Galeazzi, IRCCS, 20161 Milan, Italy;
| | - Antonio Memeo
- Department of Paediatric Orthopaedics and Traumatology, Centro Specialistico Ortopedico Traumatologico Gaetano Pini-CTO, 20122 Milano, Italy; (E.P.); (A.M.)
| | - Cosimo Gigante
- Pediatric Orthopaedic Unit, Department of Woman and Child Health, Padua General Hospital, 35121 Padua, Italy;
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10
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Frizziero L, Santi GM, Leon-Cardenas C, Donnici G, Liverani A, Papaleo P, Napolitano F, Pagliari C, Di Gennaro GL, Stallone S, Stilli S, Trisolino G, Zarantonello P. In-House, Fast FDM Prototyping of a Custom Cutting Guide for a Lower-Risk Pediatric Femoral Osteotomy. Bioengineering (Basel) 2021; 8:bioengineering8060071. [PMID: 34073324 PMCID: PMC8230284 DOI: 10.3390/bioengineering8060071] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 05/11/2021] [Accepted: 05/20/2021] [Indexed: 12/01/2022] Open
Abstract
Three-dimensional printed custom cutting guides (CCGs) are becoming more and more investigated in medical literature, as a patient-specific approach is often desired and very much needed in today’s surgical practice. Three-dimensional printing applications and computer-aided surgical simulations (CASS) allow for meticulous preoperatory planning and substantial reductions of operating time and risk of human error. However, several limitations seem to slow the large-scale adoption of 3D printed CCGs. CAD designing and 3D printing skills are inevitably needed to develop workflow and address the study; therefore, hospitals are pushed to include third-party collaboration, from highly specialized medical centers to industrial engineering companies, thus increasing the time and cost of labor. The aim of this study was to move towards the feasibility of an in-house, low-cost CCG 3D printing methodology for pediatric orthopedic (PO) surgery. The prototype of a femoral cutting guide was developed for its application at the IOR—Rizzoli Orthopedic Institute of Bologna. The element was printed with an entry-level 3D printer with a high-temperature PLA fiber, whose thermomechanical properties can withstand common steam heat sterilization without bending or losing the original geometry. This methodology allowed for extensive preoperatory planning that would likewise reduce the overall surgery time, whilst reducing the risks related to the intervention.
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Affiliation(s)
- Leonardo Frizziero
- Department of Industrial Engineering, Alma Mater Studiorum University of Bologna, 40136 Bologna, Italy; (G.M.S.); (C.L.-C.); (G.D.); (A.L.); (P.P.); (F.N.); (C.P.)
- Correspondence:
| | - Gian Maria Santi
- Department of Industrial Engineering, Alma Mater Studiorum University of Bologna, 40136 Bologna, Italy; (G.M.S.); (C.L.-C.); (G.D.); (A.L.); (P.P.); (F.N.); (C.P.)
| | - Christian Leon-Cardenas
- Department of Industrial Engineering, Alma Mater Studiorum University of Bologna, 40136 Bologna, Italy; (G.M.S.); (C.L.-C.); (G.D.); (A.L.); (P.P.); (F.N.); (C.P.)
| | - Giampiero Donnici
- Department of Industrial Engineering, Alma Mater Studiorum University of Bologna, 40136 Bologna, Italy; (G.M.S.); (C.L.-C.); (G.D.); (A.L.); (P.P.); (F.N.); (C.P.)
| | - Alfredo Liverani
- Department of Industrial Engineering, Alma Mater Studiorum University of Bologna, 40136 Bologna, Italy; (G.M.S.); (C.L.-C.); (G.D.); (A.L.); (P.P.); (F.N.); (C.P.)
| | - Paola Papaleo
- Department of Industrial Engineering, Alma Mater Studiorum University of Bologna, 40136 Bologna, Italy; (G.M.S.); (C.L.-C.); (G.D.); (A.L.); (P.P.); (F.N.); (C.P.)
| | - Francesca Napolitano
- Department of Industrial Engineering, Alma Mater Studiorum University of Bologna, 40136 Bologna, Italy; (G.M.S.); (C.L.-C.); (G.D.); (A.L.); (P.P.); (F.N.); (C.P.)
| | - Curzio Pagliari
- Department of Industrial Engineering, Alma Mater Studiorum University of Bologna, 40136 Bologna, Italy; (G.M.S.); (C.L.-C.); (G.D.); (A.L.); (P.P.); (F.N.); (C.P.)
| | - Giovanni Luigi Di Gennaro
- IRCCS—Istituto Ortopedico Rizzoli (Rizzoli Orthopaedic Institute), Paediatric Orthopaedics and Traumatology, 40136 Bologna, Italy; (G.L.D.G.); (S.S.); (S.S.); (G.T.); (P.Z.)
| | - Stefano Stallone
- IRCCS—Istituto Ortopedico Rizzoli (Rizzoli Orthopaedic Institute), Paediatric Orthopaedics and Traumatology, 40136 Bologna, Italy; (G.L.D.G.); (S.S.); (S.S.); (G.T.); (P.Z.)
| | - Stefano Stilli
- IRCCS—Istituto Ortopedico Rizzoli (Rizzoli Orthopaedic Institute), Paediatric Orthopaedics and Traumatology, 40136 Bologna, Italy; (G.L.D.G.); (S.S.); (S.S.); (G.T.); (P.Z.)
| | - Giovanni Trisolino
- IRCCS—Istituto Ortopedico Rizzoli (Rizzoli Orthopaedic Institute), Paediatric Orthopaedics and Traumatology, 40136 Bologna, Italy; (G.L.D.G.); (S.S.); (S.S.); (G.T.); (P.Z.)
| | - Paola Zarantonello
- IRCCS—Istituto Ortopedico Rizzoli (Rizzoli Orthopaedic Institute), Paediatric Orthopaedics and Traumatology, 40136 Bologna, Italy; (G.L.D.G.); (S.S.); (S.S.); (G.T.); (P.Z.)
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11
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Trisolino G, Boarini M, Mordenti M, Evangelista A, Gallone G, Stallone S, Zarantonello P, Antonioli D, Di Gennaro GL, Stilli S, Sangiorgi L. Outcomes of Temporary Hemiepiphyseal Stapling for Correcting Genu Valgum in Children with Multiple Osteochondromas: A Single Institution Study. Children (Basel) 2021; 8:children8040287. [PMID: 33917765 PMCID: PMC8068200 DOI: 10.3390/children8040287] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 03/31/2021] [Accepted: 04/06/2021] [Indexed: 11/29/2022]
Abstract
Background: Multiple osteochondromas is a rare skeletal disorder characterized by the presence of osteocartilaginous protrusions causing bony deformities, especially around the knee. Guided growth by temporary hemiepiphyseal stapling is the treatment of choice to correct the deformity by modulating the residual physeal growth of the lower limbs. Although this procedure is increasingly practiced, inconclusive evidence exists regarding its effectiveness in children with multiple osteochondromas. The study aims to compare the outcomes of temporary hemiepiphyseal stapling for correcting genu valgum in children with multiple osteochondromas vs. idiopathic cases. Methods: In this retrospective cohort study, we included patients admitted at a single institution from 2008 to 2018. A total of 97 children (77 idiopathic, 20 multiple osteochondromas) were enclosed, accounting for 184 limbs treated by temporary hemiepiphyseal stapling. We investigated if children with multiple osteochondromas had a similar successful rate of correction, rate of complications, and correction velocity compared to children with idiopathic genu valgum. Results: Overall, 151 limbs (82%) achieved complete correction or overcorrection, with idiopathic cases having a significantly higher rate of success compared to pathologic cases (88% vs. 55%; p < 0.001). In addition, multiple osteochondromas children sustained a higher rate of major complications (p = 0.021) and showed significantly lower correction velocity (p = 0.029). Conclusion: Temporary hemiepiphyseal stapling is effective in both idiopathic and multiple osteochondromas children, although the latter often achieved incomplete correction, had a higher risk of complications, and required a longer time of stapling. We suggest to anticipate the timing of intervention; otherwise, children with multiple osteochondromas and severe valgus deformity, approaching skeletal maturity, could undergo combined femoral and tibial stapling.
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Affiliation(s)
- Giovanni Trisolino
- Unit of Pediatric Orthopedics and Traumatology, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy; (G.T.); (G.G.); (S.S.); (P.Z.); (D.A.); (G.L.D.G.); (S.S.)
| | - Manila Boarini
- Department of Rare Skeletal Disorders, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy; (M.B.); (A.E.); (L.S.)
| | - Marina Mordenti
- Department of Rare Skeletal Disorders, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy; (M.B.); (A.E.); (L.S.)
- Correspondence: ; Tel.: +39-051-6366062
| | - Andrea Evangelista
- Department of Rare Skeletal Disorders, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy; (M.B.); (A.E.); (L.S.)
| | - Giovanni Gallone
- Unit of Pediatric Orthopedics and Traumatology, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy; (G.T.); (G.G.); (S.S.); (P.Z.); (D.A.); (G.L.D.G.); (S.S.)
| | - Stefano Stallone
- Unit of Pediatric Orthopedics and Traumatology, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy; (G.T.); (G.G.); (S.S.); (P.Z.); (D.A.); (G.L.D.G.); (S.S.)
| | - Paola Zarantonello
- Unit of Pediatric Orthopedics and Traumatology, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy; (G.T.); (G.G.); (S.S.); (P.Z.); (D.A.); (G.L.D.G.); (S.S.)
| | - Diego Antonioli
- Unit of Pediatric Orthopedics and Traumatology, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy; (G.T.); (G.G.); (S.S.); (P.Z.); (D.A.); (G.L.D.G.); (S.S.)
| | - Giovanni Luigi Di Gennaro
- Unit of Pediatric Orthopedics and Traumatology, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy; (G.T.); (G.G.); (S.S.); (P.Z.); (D.A.); (G.L.D.G.); (S.S.)
| | - Stefano Stilli
- Unit of Pediatric Orthopedics and Traumatology, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy; (G.T.); (G.G.); (S.S.); (P.Z.); (D.A.); (G.L.D.G.); (S.S.)
| | - Luca Sangiorgi
- Department of Rare Skeletal Disorders, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy; (M.B.); (A.E.); (L.S.)
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12
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Trisolino G, Antonioli D, Gallone G, Stallone S, Zarantonello P, Tanzi P, Olivotto E, Stilli L, Di Gennaro GL, Stilli S. Neglected Fractures of the Lateral Humeral Condyle in Children; Which Treatment for Which Condition? Children (Basel) 2021; 8:children8010056. [PMID: 33477426 PMCID: PMC7830377 DOI: 10.3390/children8010056] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 01/10/2021] [Accepted: 01/13/2021] [Indexed: 11/22/2022]
Abstract
Background: Neglected fractures of the lateral humeral condyle (LHC) are misdiagnosed or insufficiently treated fractures, presenting later than 3 weeks after injury. The management of neglected LHC fractures in children remains controversial. Methods: Twenty-seven children were included in this retrospective study. Charts and medical records were investigated for demographics, time interval between injury and treatment, and type of treatment. Baseline radiographs were assessed for fracture grading and displacement. Final radiographs were investigated for bone healing, avascular necrosis, elbow deformities and growth disturbances. Complications were classified by the Clavien–Dindo–Sink (CDS) system. Outcomes were assessed according to the Dhillon Score (DhiS) and Mayo Elbow Performance Score (MEPS). Results: The mean time from injury to presentation was 27 months. Treatments included nonoperative management (6 patients), “in-situ” fixation (7 patients), open reduction and internal fixation (11 patients) and corrective osteotomy (3 patients). The mean follow-up was 7 years (range: 2–16). Overall, we observed complications in 16 patients (59%); six complications were considered major (22%) and occurred in Weiss Grade 3 fractures, with lateral displacement ≥5 mm. At the latest follow-up, pain and functional scores improved in 23 of 27 patients (85%). Mean MEPS increased from an average of 62 points preoperatively to 98 points postoperatively, while mean DhiS improved on average from 5 to 8 points. CDS score and time interval between injury and treatment were independent predictors of MEPS and DhiS. Conclusion: Our study describes outcomes from a cohort of children undergoing different treatments for neglected LHC fractures. Prolonged time interval between injury and treatment and perioperative major complications negatively impacted the treatment outcomes. Our findings strengthen the requirement for widely agreed guidelines of surgical management in neglected LHC fractures.
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Affiliation(s)
- Giovanni Trisolino
- Unit of Pediatric Orthopaedics and Traumatology, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy; (D.A.); (G.G.); (S.S.); (P.Z.); (P.T.); (L.S.); (G.L.D.G.); (S.S.)
- Correspondence: ; Tel.: +39-051-6366186
| | - Diego Antonioli
- Unit of Pediatric Orthopaedics and Traumatology, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy; (D.A.); (G.G.); (S.S.); (P.Z.); (P.T.); (L.S.); (G.L.D.G.); (S.S.)
| | - Giovanni Gallone
- Unit of Pediatric Orthopaedics and Traumatology, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy; (D.A.); (G.G.); (S.S.); (P.Z.); (P.T.); (L.S.); (G.L.D.G.); (S.S.)
| | - Stefano Stallone
- Unit of Pediatric Orthopaedics and Traumatology, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy; (D.A.); (G.G.); (S.S.); (P.Z.); (P.T.); (L.S.); (G.L.D.G.); (S.S.)
| | - Paola Zarantonello
- Unit of Pediatric Orthopaedics and Traumatology, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy; (D.A.); (G.G.); (S.S.); (P.Z.); (P.T.); (L.S.); (G.L.D.G.); (S.S.)
| | - Piergiuseppe Tanzi
- Unit of Pediatric Orthopaedics and Traumatology, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy; (D.A.); (G.G.); (S.S.); (P.Z.); (P.T.); (L.S.); (G.L.D.G.); (S.S.)
| | - Eleonora Olivotto
- RAMSES Laboratory, RIT Department, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy;
| | - Luca Stilli
- Unit of Pediatric Orthopaedics and Traumatology, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy; (D.A.); (G.G.); (S.S.); (P.Z.); (P.T.); (L.S.); (G.L.D.G.); (S.S.)
| | - Giovanni Luigi Di Gennaro
- Unit of Pediatric Orthopaedics and Traumatology, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy; (D.A.); (G.G.); (S.S.); (P.Z.); (P.T.); (L.S.); (G.L.D.G.); (S.S.)
| | - Stefano Stilli
- Unit of Pediatric Orthopaedics and Traumatology, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy; (D.A.); (G.G.); (S.S.); (P.Z.); (P.T.); (L.S.); (G.L.D.G.); (S.S.)
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13
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Di Gennaro GL, Stallone S, Olivotto E, Zarantonello P, Magnani M, Tavernini T, Stilli S, Trisolino G. Operative versus nonoperative treatment in children with painful rigid flatfoot and talocalcaneal coalition. BMC Musculoskelet Disord 2020; 21:185. [PMID: 32209079 PMCID: PMC7093982 DOI: 10.1186/s12891-020-03213-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Accepted: 03/13/2020] [Indexed: 11/23/2022] Open
Abstract
Background The management of painful rigid flatfoot (RFF) with talocalcaneal coalition (TCC) is controversial. We aimed to compare operative and nonoperative treatment in children with RFF and TCC. Methods We retrospectively reviewed medical records and radiographs of children with RFF and TTC treated between 2005 and 2015. The nonoperative treatment consisted of manipulation under anesthesia, cast immobilization and shoe insert after cast removal. The operative treatment consisted of combined TCC resection, graft interposition and subtalar arthroereisis. Results Thirty-four children (47 ft) in the nonoperative group and twenty-one children (34 ft) in the operative group were included. No differences were found between groups, concerning baseline characteristics. The mean age at treatment was 11.8 years (9–17): 11.6 (9–17) for the nonoperative group, 12.2 (10–15) for the operative group. The mean follow-up averaged 6.6 (3–12) years and was significantly longer in the nonoperative group (7.8 versus 4.7 years; p < 0.0005), since the operative procedure was increasingly practiced in the latest years. There were no complications in either groups, but 6 patients (7 ft) in the nonoperative group were unsatisfied and required surgery. At the latest follow-up, the AOFAS-AHS improved in both groups, although the operative group showed significantly better improvement. The operative group reported also significantly better FADI score, after adjustment for follow-up and baseline variables. Conclusion The operative treatment showed better results compared to the nonoperative treatment. Symptomatic RFF with TCC in children can be effectively treated in one step with resection, graft interposition and subtalar arthroereisis. Further prospective randomized studies are needed to confirm our findings and to identify the best operative strategy in this condition.
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Affiliation(s)
| | - Stefano Stallone
- Pediatric Orthopedics and Traumatology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Eleonora Olivotto
- RAMSES Laboratory, RIT Department, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Paola Zarantonello
- Pediatric Orthopedics and Traumatology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Marina Magnani
- Pediatric Orthopedics and Traumatology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Tullia Tavernini
- Pediatric Orthopedics and Traumatology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Stefano Stilli
- Pediatric Orthopedics and Traumatology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Giovanni Trisolino
- Pediatric Orthopedics and Traumatology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy.
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14
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Martikos K, Greggi T, Vommaro F, Boriani L, Scarale A, Zarantonello P, Carbone G, Stallone S, Zucchini R. Vertebroplasty in the treatment of osteoporotic vertebral compression fractures: patient selection and perspectives. Open Access Rheumatol 2019; 11:157-161. [PMID: 31308767 PMCID: PMC6613358 DOI: 10.2147/oarrr.s174424] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Accepted: 06/14/2019] [Indexed: 11/23/2022] Open
Abstract
Osteoporotic vertebral fractures represent a constantly increasing pathology that may compromise life quality and general health. Among various treatment options, percutaneous vertebroplasty has been used widely over the past 20 years. Although there is a vast amount of retrospective reports in the literature, high-level evidence has emerged only recently. In this paper, the authors provide a synopsis of the current literature on the efficacy and safety of percutaneous vertebroplasty while also presenting a step-by-step description of the surgical procedure, focusing on details that may help in optimizing quality and safety.
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Affiliation(s)
- Konstantinos Martikos
- Spine Deformities Surgery Division, Istituto Ortopedico Rizzoli , Bologna 40136, Italy
| | - Tiziana Greggi
- Spine Deformities Surgery Division, Istituto Ortopedico Rizzoli , Bologna 40136, Italy
| | - Francesco Vommaro
- Spine Deformities Surgery Division, Istituto Ortopedico Rizzoli , Bologna 40136, Italy
| | - Luca Boriani
- Spine Deformities Surgery Division, Istituto Ortopedico Rizzoli , Bologna 40136, Italy
| | - Antonio Scarale
- Spine Deformities Surgery Division, Istituto Ortopedico Rizzoli , Bologna 40136, Italy
| | - Paola Zarantonello
- Spine Deformities Surgery Division, Istituto Ortopedico Rizzoli , Bologna 40136, Italy
| | - Giuseppe Carbone
- Spine Deformities Surgery Division, Istituto Ortopedico Rizzoli , Bologna 40136, Italy
| | - Stefano Stallone
- Spine Deformities Surgery Division, Istituto Ortopedico Rizzoli , Bologna 40136, Italy
| | - Riccardo Zucchini
- Spine Deformities Surgery Division, Istituto Ortopedico Rizzoli , Bologna 40136, Italy
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