Iacopo Castellini

Treatment of Scaphoid Waist Nonunion Using Olecranon Bone Graft and Stryker Asnis Micro Cannulated Screw: A Retrospective Study-80 Case Studies and 6 Years of Follow-Up.

Background Screw fixation and bone grafting are the gold standard for scaphoid waist nonunion without avascular necrosis. Question/Purpose Assesses the scaphoid waist nonunion healing rate with use of an uncommon cancellous bone graft (olecranon) and an unusual fixation system (Asnis Micro Cannulated Screw System; Stryker Inc., Kalamazoo, MI, USA). Material and Methods A series of 102 consecutive patients were treated for scaphoid waist nonunion (without deformity). Of these, 80 patients subjected to clinical (Modified Mayo Wrist Score (MMWS), Jamar hydraulic dynamometer) and radiographic examination before and after surgery were evaluated. Ipsilateral olecranon cancellous bone graft and the ASNIS Micro 3.0-mm diameter screw, were used. The average follow up was 6 years (min 3; max 10). Results Radiographic consolidation was achieved in 90% of patients; dorsal intercalated segment instability (DISI) deformities were corrected in 71.4% of cases. Ninety percent improved the range of motion of the wrist and grip strength. All patients showed a significant reduction of peak force in the operated hand. In 6.25% we observed clinical and radiographic screw head-trapezium impingement. Twenty-six patients developed a degenerative wrist sign. The MMWS yielded 68 optimal, 8 good, and 4 bad results. Conclusions To treat scaphoid waist nonunions without misalignment, low-profile headed screw and olecranon bone graft allowed a high consolidation rate with positive results to long-term follow-up. The Asnis Micro 3.0 mm diameter screw may be a suitable option for treating scaphoid waist nonunion. Level of Evidence IV.

Surgical Treatment for a Relapsing Malleolar Bursitis in a Professional Figure Skating: Case Report

The increase of popularity in sports as Roller Skating, Figure Skating and Ice Hockey has simultaneously increased the number of skating-related injuries. Lesions of chronic dermatological nature and muscle and tendon lesions have high number of case reports. Ankle and foot are peculiarly involved and this condition suggests the correlation with the use of the skating boot, which with its high-cut and hard-fit changes the joint biomechanics and function and, as a result, the intergumentary system is continuously damaged by the compression and rubbing on the foot. The frequent onset of non-septic chronic relapsing bursitis at the level of the malleolar region is common in all sports requiring the use of skating boots. The conservative treatment is usually compromised by the repetition of the traumatic event due to the use of the skating boot. The case report of a 19 year old professional figure skater affected by non-septic relapsing malleolar bursitis at the level of the malleolar region is presented.