Giovanni Colleluori

Articular fractures of distal radius: comparison of treatment and clinical and radiological outcomes with volar plate versus Hoffmann bridging external fixator.

The Wrist fractures are one of the most frequent traumatic pathologies. Surgery is now more commonly recommended for this type of fracture as a means to improve the outcome of patients. The objective of this study is to compare treatment with volar plate vs. external fixation in these types of fractures. A total of 158 consecutive patients who had been operated on for distal radius fractures with or without ulnar involvement, were included in this study. 109 were treated with a volar plate and 49 with Hoffmann II external fixator. The exclusion criteria were patients with a history of wrist fractures, with neurological diseases, pathological fractures and polytrauma patients. Clinical and radiographic results were evaluated in both groups of patients. Clinical parameters were: average flexion, average extension, average pronation and supination, and the average radial and ulnar deviation. The radiographic parameters that we considered were the radial tilt and ulnar variance. In both groups, we evaluated the clinical results with the DASH score and the Mayo-Wrist score. The unstable and intra-articular fractures of the distal radius can be treated with different methods, among which the most commonly used are the open reduction and internal fixation with plates or the synthesis with external fixation. Our study shows how both methods provide similar clinical and radiographic results, so the choice of which to use depends more on the surgeons experience and the patients compliance rather than on the type of fracture.

Tailor’s bunion: revisione della recente letteratura nelle tecniche mini-invasive

The purpose of this study was to review the most recent literature available on the treatment of bunionette (also named tailor’s bunion) with percutaneous and mini-invasive techniques. A topical review of the PubMed/MEDLINE, EMBASE and Google Scholar databases was conducted in December 2015 utilising the keywords percutaneous (OR mini invasive OR minimally invasive) AND bunionette (OR tailor’s bunion) AND treatment (OR surgery). Studies that reported the outcomes of the surgical treatment of bunionette were included in our review. The search yielded a total of 111 publications from PubMed/MEDLINE, EMBASE and Google Scholar. After abstract and full-text review, 9 articles were included in this review. Treatment methods were placed into two broad surgical treatment categories: with or without fixation of the osteotomy. The most common treatment strategy employed was with fixation. The pooled rates of success for the techniques with fixation and without fixation were respectively 93.5 and 97.8. The current evidence on the treatment of bunionette deformity is limited to retrospective case series. Future high-level studies are required to distinguish the most appropriate treatment for this type of deformity.