Enhancing pelvic fracture care: The impact of extraperitoneal pelvic packing on definitive Orthopaedic treatment.

This study investigates the impact of extraperitoneal pelvic packing (EPP) on the definitive surgical treatment of pelvic fractures (PF) in trauma patients. While EPP is recognized as an effective life-saving technique for controlling non-compressible retroperitoneal bleeding, concerns persist about its potential to complicate subsequent surgical interventions. A total of 220 trauma patients treated in a single First Level Trauma Centre from October 2016 to December 2021 were analysed.

Floating knee: A new prognostic classification.

Introduction: Usually ipsilateral fractures of the femur and tibia are not compatible with good results and require surgery. The unsatisfactory results are more likely due to complex patterns of fractures, compromised soft tissue, associated ligament injuries, and concomitant vital organ injuries. There are many classifications to describe this type of fracture but none of them is a prognostic classification.

Treatment options for unstable posterior pelvic ring lesions: A multicenter retrospective cohort study of the Italian Society for the Traumatology of the Pelvis.

Purpose: Posterior pelvic ring lesions are a common finding in patients with pelvic trauma, representing a challenging condition for trauma surgeons. Surgical options are different and there is not yet evidence about the best option. Aim of the study are: (i) to compare Lumbopelvic fixation (LPF) and ilio-sacral screw fixation (ISS) regarding clinical and radiological outcome in unstable posterior pelvic ring injuries, both as whole population and single similar fracture types according to Tile classification (C1vsC1, C2vsC2, C3vsC3); (ii) to analyze clinical outcomes and complications in lumbopelvic fixation group, comparing open and closed reduction technique.

Implementation of Robotic Exoscope in Minimally Invasive Corpectomy at Thoracolumbar Junction for the Treatment of Traumatic Spinal Cord Compression.

The development and diffusion of minimally invasive (MI) approaches have coincided with improvements in magnification systems. The exoscope will probably open a new era in new technologies in spinal surgery. This study reports a retrospective series of 19 thoracolumbar (T11-L2) burst fractures with anterior column failure and cord compression, treated with MI corpectomy and spinal decompression assisted by a three-dimensional high-definition exoscope (Video 1).

Consensus for management of sacral fractures: from the diagnosis to the treatment, with a focus on the role of decompression in sacral fractures.

Background: There is no evidence in the current literature about the best treatment option in sacral fracture with or without neurological impairment.

Materials And Methods: The Italian Pelvic Trauma Association (A.I.

Spring Plates as a Valid Additional Fixation in Comminuted Posterior Wall Acetabular Fractures: A Retrospective Multicenter Study.

The posterior wall fracture is the most frequent pattern of acetabular fractures. Many techniques of fixation have been described in the literature and involve plates, screws, or a combination of both. This study aims to investigate the clinical and radiological outcomes of spring plates in the treatment of comminuted posterior wall acetabular fractures.

Italian Consensus Conference on Guidelines for preoperative treatment in acetabular fractures.

Preoperative management of acetabular fracture is a major problem and no consensus has been reached in literature on the optimal treatment of this problem. We present the results of the First Italian Consensus Conference on Acetabular fracture. An extensive review of the literature has been undertaken by the organizing committee and forwarded to the panel.

Do standards of care and early outcomes of periprosthetic fractures change during the COVID-19 pandemic? A multicentre study.

Background: Periprosthetic fractures (PPFs) are a growing matter for orthopaedic surgeons, and patients with PPFs may represent a frail target in the case of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. The purpose of this study is to investigate whether hospital reorganisations during the most severe phase of the SARS-CoV-2 pandemic affected standards of care and early outcomes of patients treated for PPFs in Northern Italy.

Materials And Methods: Data were retrieved from a multicentre retrospective orthopaedics and traumatology database, including 14 hospitals.

Clinical Activities, Contaminations of Surgeons and Cooperation with Health Authorities in 14 Orthopedic Departments in North Italy during the Most Acute Phase of Covid-19 Pandemic.

: From 10 March up until 3 May 2020 in Northern Italy, the SARS-CoV-2 spread was not contained; disaster triage was adopted. The aim of the present study is to assess the impact of the COVID-19-pandemic on the Orthopedic and Trauma departments, focusing on: hospital reorganization (flexibility, workload, prevalence of COVID-19/SARS-CoV-2, standards of care); effects on staff; subjective orthopedic perception of the pandemic. : Data regarding 1390 patients and 323 surgeons were retrieved from a retrospective multicentric database, involving 14 major hospitals.

Mortality and morbidity in COVID-19 orthopedic trauma patients: is early surgery the keystone?

In the pandemic disease caused by SARS-CoV-2 virus, trauma surgery continued the management of patients with fractures. The purpose of the study is to evaluate mortality and morbidity in orthopedic trauma patients surgically treated with a diagnosis of COVID-19 infection, comparing them to a control group of COVID-19 negative. We retrospectively identified patients admitted to our Emergency Room from March 8 to May 4 2020 (time frame corresponding to the first wave of the pandemic peak, one of the most severe in the world at that time) with a diagnosis of fracture that were subsequently surgically treated.

Early mortality in hip fracture patients admitted during first wave of the COVID-19 pandemic in Northern Italy: a multicentre study.

Background: Treatment of hip fractures during the coronavirus disease 2019 (COVID-19) pandemic has posed unique challenges for the management of COVID-19-infected patients and the maintenance of standards of care. The primary endpoint of this study is to compare the mortality rate at 1 month after surgery in symptomatic COVID-positive patients with that of asymptomatic patients. A secondary endpoint of the study is to evaluate, in the two groups of patients, mortality at 1 month on the basis of type of fracture and type of surgical treatment.

How we managed elective, urgent, and emergency orthopedic surgery during the COVID-19 pandemic: The Milan metropolitan area experience.

The COVID-19 virus is a tremendous burden for the Italian health system. The regionally-based Italian National Health System has been reorganized. Hospitals' biggest challenge was to create new intensive care unit (ICU) beds, as the existing system was insufficient to meet new demand, especially in the most affected areas.

Development of the Italian fractures registry (RIFra): A call for action to improve quality and safety.

In recent years, there has been an increasing interest in the development of arthroplasty registries, therefore, in our country, the Italian Arthroplasty Registry (RIAP), was issued by the National Law No. 221/2012. In the last decade, however, some European countries -namely Sweden, Denmark, Norway, and Germany (in development)- have introduced another nationwide orthopaedic registry than arthroplasty registers: the fracture registry.

Orthopedic injuries in patients with multiple injuries: Results of the 11th trauma update international consensus conference Milan, December 11, 2017.

Background: In blunt trauma, orthopedic injuries are often associated with cerebral and torso injuries. The optimal timing for definitive care is a concern. The aim of the study was to develop evidence-based guidelines for damage-control orthopedic (DCO) and early total care (ETC) of pelvic and long-bone fractures, closed or open, and mangled extremities in adult trauma patients with and without associated injuries.

Treatment of fractures of the tibial plateau (Schatzker VI) with external fixators versus plate osteosynthesis.

Introduction: The purpose of this study was to determine the effectiveness of circular external fixation (CEF) as a definitive treatment option for patients with complex tibial plateau fractures (Schatzker VI) compared with the outcomes of a fixed angle locking plates' group.

Methods: Level III evidence. Retrospective, comparative study in a Level I Trauma Center.

Open Supracondylar-Intercondylar Fractures of the Femur Treatment With Taylor Spatial Frame.

Objectives: To evaluate the Taylor spatial frame (TSF) for primary and definitive fixation of open supracondylar-intracondylar femoral (SIF) fractures.

Design: Retrospective.

Setting: Level I trauma center.

Treatment of femoral diaphyseal non-unions: our experience.

Despite the continuous advances of surgical solutions, still 1-7% of fractures develop non-unions. The delays in fracture healing increase the period of incapacity of the patient with major consequences, on the psychological and functional recovery, but also on the direct and indirect health-related costs. In particular, femoral diaphyseal non-unions are often characterised by a challenging and long-lasting period of healing.