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The damage control in tibial pilon open fractures with a new external fixator delta frame

Journal of Acute Disease 2017年第5期6卷 222-226页

作者： giuseppe rollo Andrea Pasquino Paolo Pichierri Michele Bisaccia Alessandro Stasi MarcoGiaracuni Niki Cazzella Luigi Meccariello Departement of Orthopedics and Traumatology Vito Fazzi HospitalLecceItaly Division of Orthopedics and Trauma Surgery University of PerugiaS.Maria della Misericordia Hospital PerugiaItaly

Objective: To evaluate the effectiveness of the damage control, in emergency to treat the open tibial pilon fractures with Dolphix? External Fixator Frame(CITIEFFE?, Calderara di Reno, Bologna, Italy). Methods: From January 2017 to August 2017, at the Department of Orthopedics and Traumatology of Vito Fazzi Hospital Lecce, we treated 23 open tibial pilon fractures with Dolphix? External Fixator Frame(CITIEFFE?, Calderara di Reno, Bologna, Italy). The evaluation criteria of the case series were: the time needed to assemble the external fixator;the time taked to treat the ankle associated lesions;the time of skin healing;the ankle alignment;the subjective/objective Ovadia and Beals score;and complications. The Endpoint assessment was set at the days of the definitive surgery. Results: The results in terms of alignment, biomechanical stability of the frame, healing of soft tissue, complications were as good as the objective and subjective results according Ovadia and Beals score. Conclusion:Pilon fractures are complex and often present complications;the damage control treatment, in emergency, with Dolphix? External Fixator Frame(CITIEFFE?, Calderara di Reno, Bologna, Italy) permits a stable osteotaxis with minimal soft tissue damage and permit the repair of muscles, blood vessels and nerves with a stable bone and the soft tissue healing with vaccum therapy.

关键词： Tibial Pilon External fixation Delta frame Damage control Ankle outcomes Open fracture Soft tissue injury

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Total hip arthroplastyvs. osteosynthesis in acute complex acetabular fractures in the elderly:Evaluation of surgical management and outcomes

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Journal of Acute Disease 2017年第1期6卷 12-17页

作者： Serafino Carta Gabriele Falzarano giuseppe rollo Predrag Grubor Mattia Fortina Luigi Meccariello Antonio Medici Alberto Riva Luca Sampieri Paolo Ferrata Department of Medical and Surgical Sciences and Neuroscience Section of Orthopedics and TraumatologyUniversity of SienaUniversity Hospital Santa Maria alle ScotteSienaItaly Department of Orthopedics and Traumatology Hospital Gaetano RummoBeneventoItaly Department of Orthopedics and Traumatology Vito Fazzi HospitalLecceItaly Clinic of Traumatology University Hospital Clinical Center Banja LukaBanja LukaBosnia and Herzegovina

Objective: To retrospectively evaluate the open reduction internal fixation and total hip arthroplasty directions, results and complications associated with internal fixation in managing these fractures. Methods: In 8 years at 4 centers, 61 patients with associated acetabular fractures (Letournel classification) were treated. The patients were divided into two groups. The total hip arthoplasty (THA) group consisted of 30 patients, while the open reduction internal fixation group had 31 patients. The average age of the patients was 74.7 years. The following parameters were compared: the duration of surgery and hospitalization, the international unit of red blood cell concentrate transfusion, the time for the verticalization of the patient, perioperative complications, Harris hip score, and the short form (12) health survey. The clinical and radiographic follow-up was performed at 1 month, 3 months, 6 months and 12 months and annually thereafter. Patients with post-traumatic osteoarthritis formed the third comparison group.P≤ 0.05 was considered statistically significant according to the analytical Student’s t-test. Results: TheP Conclusions: Our experience shows that theTHA treatment for acetabular fractures in the elderly is to be preferred.

关键词： Acetabulum Fracture Elderly Osteoporosis Total hip arthroplasty Osteosynthesis

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

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Journal of Acute Disease 2017年第4期6卷 169-174页

作者： giuseppe rollo Marco Filipponi Paolo Pichierri Valentina Russi Lorenzo Nalbone Michele D'Arienzo Sara Cavalera Gianfranco Corina Michele Bisaccia Luigi Meccariello Departement of Orthopedics and Traumatology Vito Fazzi HospitalLecceItaly Orthopaedics and Traumatology Clinic the University of Palermo Hospital'Paolo Giaccone'PalermoItaly Departement of Orthopedics and Traumatology University Hospital"Policlinico di Modena"ModenaItaly Departement of Orthopedics and Traumatology Di Summa-Perrino HospitalBrindisiItaly Division of Orthopedics and Trauma Surgery University of PerugiaS.Maria della Misericordia HospitalPerugiaItaly

Objective:To report our experience with the hybrid external fixator in ***:We assessed 80 cases of pilon fracture treated with the external fixator during the period of January 2009 and December 2016:55 men (69%) and 30 women (33%) with a mean age of 40 years (range between 16 and 70 ). About 45 occurred as isolated trauma, 35 instead were politrauma. Each patient underwent standard radiographic examination and a CT examination. There were 28 open fractures (35%), (Gustilo type 1, 2 and 3) while closed fractures showed soft tissue involvement of various grade (2-3 Tscherne classification). In all cases, the external fixation, sometimes associated with other reduction and synthesis techniques, was used. The timing of surgery was dictated by the condition of the soft tissues. For clinical evaluation, the Mazur score with mean follow-ups at 12 months was ***:The final range of ankle motion was 15 dorsal and 10 plantar flexion. In about 80 cases there was an average Mazur score of83. The mean score was 90;in open fractures 85 to 72. Radiographic healing of fractures in 60 patients occurred in 120 days (mean 105 days), at the time when the external fixator was ***:Pilon fractures are complex and often present complications;the definitive treatment, in emergency or delayed, with hybrid external fixator permits a stable synthesis with minimal soft tissue damage. Weight bearing maybe allowed early and functional recovery is generally good.

关键词： Tibial Pilon External fixation Hybrid external fixation Outcomes Open fracture Soft tissue Injury

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