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

Author

D'ARIENZO, Michele, CAMARDA, Lawrence, D'ARIENZO, Antonio, Costarella, L, Pavone, V, Sessa, G., D’Arienzo, M, Camarda, L, Costarella, L, D’Arienzo, A, Pavone, V, and Sessa, G

Subjects
fratture femore, fast-track fratture, over 65 fratture femore, mortalità fratture femore, trattamento chirurgico precoce, 48 ore fratture, Settore MED/33 - Malattie Apparato Locomotore
Abstract

Le attuali linee guida raccomandano di effettuare il trattamento chirurgico di stabilizzazione o sosti- tuzione protesica entro 24-48 ore dall’accesso ospedaliero, al ne di migliorare il risultato funziona- le, ridurre il rischio di mortalità, la degenza ospedaliera e le complicazioni post-operatorie. Tuttavia, la mancanza di studi randomizzati rappresenta un importantissimo limite scienti co dal momento che ad oggi la migliore evidenza scienti ca sul timing chirurgico nelle fratture di collo femore si basa esclusivamente su studi prospettici e retrospettivi. In questo articolo, viene descritto il percorso ospedaliero per il trattamento delle fratture del collo del femore nel paziente anziano analizzando i diversi passaggi volti proprio all’ottimizzazione dei tempi di attesa pre-chirurgici. Inoltre, attraverso una revisione della letteratura vengono analizzati i rapporti esistenti tra timing chirurgico, complicanze post-operatorie e mortalità..

Published
2016

9. L'accoppiamento ceramica - polietilene

Author

Sessa, Giuseppe, Evola, Fr, Pavone, Vito, GIOITTA IACHINO, S., and Costarella, L.

Subjects
Protesi totale d’anca, tribologia, Protesi totale d’anca, ceramica-polietilene, tribologia, ceramica-polietilene
Published
2015

14. Congenital idiopathic talipes equinovarus: an evaluation in infants treated by the Ponseti method

Author

Pavone, V., Gianluca Testa, Costarella, L., Pavone, P., and Sessa, G.

Subjects
Male, Casts, Surgical, Clubfoot, Splints, Infant, Newborn, Humans, Infant, Manipulation, Orthopedic, Female
Abstract

Congenital talipes equinovarus (CTEV) is a common but still not fully understood disorder of the lower limb. It is usually defined as a fixation of the foot in adduction, supination, and varus. Different treatment options exist including the Ponseti method.We report here the results obtained in infants with CTEV treated by the Ponseti method.Eighty two patients (114 clubfeet) were enrolled at the Orthopaedic Clinic of Catania University during the period of March 2004 to January 2010 and followed prospectively up to February 2011: 56 patients (68.29%) were male, the anomaly was bilateral in 32 (39%) cases, unilateral in 50 (60.9%) in the right side in 28 (56%). The mean age at initiation of treatment was 14 days (range 3-81 days), severity of the club foot deformity by the Pirani Severity score was 5.56 points (range 4.3-6 points). Total numbers of Ponseti casts before tenotomy, details of tenotomy, and compliance with CTEV brace were recorded. Clinical evaluation was performed using the functional Ponseti Scoring System. Mean follow up was 4 years: range 13-83 months.An average of 6.6 casts was necessary before performing the tenotomy. Tenotomy was performed by a single surgeon (V.P.) in a total of 68 patients (82.93%) always in an operating room under general anaesthesia by a percutaneous approach at a mean age of 106 days (range 45-213 days). Compliance with CTEV brace was satisfactory in 79 patients (96.3%). Functional Ponseti Scores were good/excellent in 79 (96.34%) patients (109 clubfeet; 95.61%). Only 3 patients; 3.7% (5 clubfeet; 4.4%) suffered relapse. Poor compliance with the Denis Browne splint was thought to be the main cause of failure.The Ponseti method provides an excellent outcome at follow up in the treatment of congenital idiopathic clubfoot.

Published
2013

17. Osteosynthesis systems in fragility fracture

Author

Sessa, Giuseppe, Evola, Fr, and Costarella, L.

Subjects
Fracture Healing, Fracture Fixation, Internal, Fractures, Bone, Bone Density, Humans, Osteoporosis, Prostheses and Implants, Bone Nails, Bone and Bones, Osteoporotic Fractures, Biomechanical Phenomena
Abstract

Atraumatic fractures, more commonly known as "fragility fractures", have as their basis the decreased bone strength due to osteoporosis. The major technical problem is the difficulty in obtaining secure fixation in osteoporotic bone, because the pull-out strength of implant is significantly reduced. The high rate of complications has encouraged extensive research into the development of implant which can improve the bone-implant interface by preventing high stress and distributing the forces transmitted to bone in a load-sharing, rather than load-bearing way.

Published
2011

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