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  1. Article ; Online: Role of fibular autograft in ankle arthrodesis fixed using cannulated screws

    Alessio Bernasconi / Antonio Izzo / Martina D’Agostino / Massimo Mariconda / Antonio Coviello

    Scientific Reports, Vol 13, Iss 1, Pp 1-

    a proportional meta-analysis and systematic review

    2023  Volume 9

    Abstract: Abstract Ankle arthrodesis is commonly performed to treat end-stage ankle osteoarthritis. The aim of this study was to determine whether the use of fibular autograft might increase the fusion rate and decrease the complication rate in ankle arthrodesis ( ... ...

    Abstract Abstract Ankle arthrodesis is commonly performed to treat end-stage ankle osteoarthritis. The aim of this study was to determine whether the use of fibular autograft might increase the fusion rate and decrease the complication rate in ankle arthrodesis (AA) fixed using cannulated screws. To perform this PRISMA-compliant proportional meta-analysis, multiple databases were searched for studies in which patients undergone AA (using exclusively cannulated screws and augmented with fibular bone graft) were followed. The characteristics of the cohort, the study design, surgical details, the nonunion and complication rate at the longest follow-up were extracted and recorded. The modified Coleman Methodology Score (mCMS) was applied to appraise the quality of studies. Two groups were built: arthrodeses fixed with screws combined with cancellous autograft (G1) and arthrodeses fixed with screws combined with cancellous autograft and augmented with a lateral fibular onlay (G2). A third group (arthrodeses fixed with screws and no graft, G3) was extracted from previous literature for a further comparison. Overall, we included 306 ankles (296 patients) from ten series (ten studies). In G1 and G2 there were 118 ankles (111 patients) and 188 ankles (185 patients), respectively. In patients where cancellous autograft was used, a further augmentation with a fibular lateral strut autograft did not change significantly the nonunion (4% [95% CI 1–9] in G1 vs. 2% [95% CI 0–5) in G2, p = 0.99) nor the complication rate (18% [95% CI 0–36] in G1 vs. 13% [95% CI 6–21) in G2, p = 0.71). Upon comparison with 667 ankles (659 patients, G3) in which arthrodeses had been performed without grafting, the nonunion and complication rates did not differ significantly either (pooled estimates: 3% [95% CI 1–3) in G1 + G2 vs. 3% [95% CI 2–4] in G3, p = 0.73 for nonunion; 15% [8–23] in G1 + G2 vs. 13% [95% CI 9–17] in G3, p = 0.93 for complications). In ankle arthrodesis fixed with cannulated screws combined with cancellous autograft at the fusion ...
    Keywords Medicine ; R ; Science ; Q
    Subject code 796
    Language English
    Publishing date 2023-10-01T00:00:00Z
    Publisher Nature Portfolio
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  2. Article ; Online: CLINICAL RESULTS OF COLLAGENASE TREATMENT FOR DUPUYTREN’S DISEASE

    Morena Anna Basso / Alessio Bernasconi / Giovanni Balato / Andrea Cozzolino / Giulia Famiglietti / Francesco Smeraglia

    Acta Ortopédica Brasileira, Vol 31, Iss spe

    A CASE SERIES STUDY WITH 2-YEARS FOLLOW-UP

    2023  Volume 1

    Abstract: ABSTRACT Objectives: This study aims to report our experience with Clostridium Histolyticum collagenase (CCH) to support the importance of its clinical use and assess its clinical efficacy, complications, and recurrences. Methods: This prospective ... ...

    Abstract ABSTRACT Objectives: This study aims to report our experience with Clostridium Histolyticum collagenase (CCH) to support the importance of its clinical use and assess its clinical efficacy, complications, and recurrences. Methods: This prospective observational study of 66 patients with a 2-year follow-up. Patients with an extension lag major of 20° at the metacarpophalangeal joint (MPJ) and/or proximal interphalangeal joint (PIPJ) were included. We collected data on demographic and anamnestic details, MPJ and PIPJ contracture degrees, DASH score, complications, and recurrences. Results: The mean pre-injection contracture was 34° for MPJ and 31° for PIPJ. At the 2-year follow-up, the mean contracture for the MPJ and PIPJ were respectively 3° and 14.5°. The mean DASH score decreased from 21.8 before injection to 10,4 after 2 years. The disease recurrence occurred in 34.8% of the patients, all with PIPJ contracture. The main complication was skin breakage (25.7%). Conclusion: The CCH injections remain a consistent option in treating DD; withdrawal from the European market deprives surgeons and patients of low invasiveness and safe tool for treating DD. Level of evidence IV, Therapeutic study investigating treatment results, Case series.
    Keywords Dupuytren Contracture ; Palmar Fibromatosis ; Microbial Collagenase ; Recurrence ; Medicine ; R ; Orthopedic surgery ; RD701-811
    Subject code 616
    Language English
    Publishing date 2023-04-01T00:00:00Z
    Publisher Sociedade Brasileira de Ortopedia e Traumatologia
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  3. Article ; Online: Tetra-block

    Antonio Coviello / Carmine Iacovazzo / Dario Cirillo / Pasquale Diglio / Alessio Bernasconi / Andrea Cozzolino / Antonio Izzo / Annachiara Marra / Giuseppe Servillo / Maria Vargas

    Journal of Medical Case Reports, Vol 17, Iss 1, Pp 1-

    ultrasound femoral, lateral femoral-cutaneous, obturator, and sciatic nerve blocks in lower limb anesthesia: a case series

    2023  Volume 10

    Abstract: Abstract Background The gold standard anesthesiologic procedure for urgent femur fracture surgery is Spinal Anesthesia. It is not always feasible because of patients' severe comorbidities and difficulties in optimizing drug therapy in the appropriate ... ...

    Abstract Abstract Background The gold standard anesthesiologic procedure for urgent femur fracture surgery is Spinal Anesthesia. It is not always feasible because of patients' severe comorbidities and difficulties in optimizing drug therapy in the appropriate time frame such as discontinuation of anticoagulant drugs. The use of four peripheral nerve blocks (tetra-block) can be a winning weapon when all seems lost. Case presentation We present, in this case series, three Caucasian adult femur fractures (an 83-year-old woman, a 73-year-old man, and a 68-year-old woman) with different and major comorbidities (cardiac or circulatory disorders on anticoagulants therapy that were not discontinued on time; breast cancer and others) underwent the same anesthesiologic approach in the urgent setting. Ultrasound peripheral nerve blocks, that is femoral, lateral femoral cutaneous, obturator, and sciatic with parasacral approach were successfully performed in all patients who underwent intramedullary nailing for intertrochanteric fracture. We evaluated the adequacy of the anesthesia plane, postoperative pain control with the VAS scale, and the incidence of postoperative side effects. Conclusions Four peripheral nerve blocks (Tetra-block) can be alternative anesthesiologic management in urgent settings, in patients where drug therapy cannot be optimized, as in antiplatelet and anticoagulant therapy.
    Keywords Case series ; Locoregional anesthesia ; Femoral nerve block ; Lateral femoral cutaneous nerve block ; Obturator nerve block ; Sciatic nerve block ; Medicine ; R
    Subject code 616
    Language English
    Publishing date 2023-07-01T00:00:00Z
    Publisher BMC
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  4. Article ; Online: Weight-bearing cone-beam computed tomography in the foot and ankle specialty

    Alexandre Leme Godoy-Santos / Alessio Bernasconi / Marcelo Bordalo-Rodrigues / François Lintz / Carlos Felipe Teixeira Lôbo / Cesar de Cesar Netto

    Radiologia Brasileira, Vol 54, Iss 3, Pp 177-

    where we are and where we are going - an update

    2021  Volume 184

    Abstract: Abstract Cone-beam computed tomography (CBCT) has been applied in dentistry and medicine for nearly two decades. Its application in the foot and ankle specialty has grown exponentially in recent years. Weight-bearing CBCT allows clinicians to obtain ... ...

    Abstract Abstract Cone-beam computed tomography (CBCT) has been applied in dentistry and medicine for nearly two decades. Its application in the foot and ankle specialty has grown exponentially in recent years. Weight-bearing CBCT allows clinicians to obtain weight-bearing images that can be viewed in all three planes and to construct three-dimensional models, similar to those constructed from traditional CT scans, as well as exposing patients to less radiation than do traditional CT scans. This technology has revolutionized diagnoses, improving the understanding of various lesions and surgical planning in the foot and ankle specialty. Ongoing studies of the use of weight-bearing CBCT in foot and ankle surgery are focused on fully automated and semi-automated three-dimensional measurements, as well as bone segmentation, mapping of the distances/orientation of the joints, and the production of customized implants. The aims of this review article are to show the evolution of this emerging tool in the foot and ankle specialty, to update those in related specialties on its use in current clinical practice, and to indicate where the research community is heading.
    Keywords Tomography ; X-ray computed/methods ; Cone-beam computed tomography ; Weight-bearing ; Foot/diagnostic imaging ; Ankle/diagnostic imaging ; Imaging ; three-dimensional/methods ; Medical physics. Medical radiology. Nuclear medicine ; R895-920
    Subject code 796
    Language English
    Publishing date 2021-05-01T00:00:00Z
    Publisher Colégio Brasileiro de Radiologia e Diagnóstico por Imagem
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  5. Article ; Online: FOOT ALIGNMENT IN SYMPTOMATIC NATIONAL FOOTBALL LEAGUE (NFL) ATHLETES

    ALESSIO BERNASCONI / CESAR DE CESAR NETTO / LAUREN ROBERTS / FRANÇOIS LINTZ / ALEXANDRE LEME GODOY-SANTOS / MARTIN JOSEPH O’MALLEY

    Acta Ortopédica Brasileira, Vol 29, Iss 3, Pp 118-

    A WEIGHTBEARING CT ANALYSIS

    2021  Volume 123

    Abstract: ABSTRACT Objective: Our aim was to describe the foot alignment in National Football League (NFL) players with different symptomatic foot and ankle pathologies using weightbearing cone-beam computed tomography (WBCBCT), comparing them to normally aligned ... ...

    Abstract ABSTRACT Objective: Our aim was to describe the foot alignment in National Football League (NFL) players with different symptomatic foot and ankle pathologies using weightbearing cone-beam computed tomography (WBCBCT), comparing them to normally aligned feet as control group. Methods: 41 feet (36 active NFL players) were assessed using WBCBCT and compared to 20 normally aligned controls from a normal population. Measurements included: Foot and Ankle Offset (FAO); Calcaneal Offset (CO); Hindfoot Alignment Angle (HAA); angle between inferior and superior facets of the talus (Inftal-Suptal); angle between inferior facet of the talus and the horizontal/floor (Inftal-Hor); Forefoot Arch Angle (FAA); navicular- and medial cuneiform-to-floor distance. Results: NFL athletes showed a neutrally aligned hindfoot when compared to controls (FAO: 1% vs 0.5%; CO: 2.3 mm vs 0.8 mm; HAA: 2.9° vs 0.8° in two groups, with all p > 0.05) and a normal morphology of the subtalar joint (no difference in Inftal-Suptal and Inftal-Hor angles). Conversely, in athletes we found a decreased medial longitudinal arch (FAA: 15° vs 18.3°, p = 0.03) with smaller navicular (38.2 mm vs 42.2 mm, p = 0.03) and medial cuneiform (27 mm vs 31.3 mm, p = 0.01) mean distances to the floor when compared to controls. Conclusion: In our series, NFL players presented a lower medial longitudinal arch than controls but a neutrally aligned hindfoot. WBCBCT may help shed light on anatomical risk factors for injuries in professional players. Level of Evidence III, Retrospective comparative study.
    Keywords Foot ; Athletes ; Tomography ; Medicine ; R ; Orthopedic surgery ; RD701-811
    Subject code 796
    Language English
    Publishing date 2021-07-01T00:00:00Z
    Publisher Sociedade Brasileira de Ortopedia e Traumatologia
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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