Pietro Maniscalco

• Head of Department at Azienda Unita Sanitaria Locale di Piacenza

Background: Posterior sternoclavicular joint (SCJ) dislocations are rare events that can evolve into real emergencies due to the vital structures in the mediastinum. When closed reduction maneuvers fail, open SCJ reconstruction becomes mandatory, with literature proposing several stabilization techniques that either preserve or remove the SCJ’s mob...

Previous scientific studies have highlighted how coupling is an important element affecting total hip arthroplasty's survival. This study aims to evaluate whether metal-on-metal (MOM) coupling could be a statistically significant risk factor. The data from the regional joint registry (Registro dell'Impiantologia Protesica Ortopedica, RIPO) was used...

Posterior dislocations of the sterno-clavicular joint (SCJ) are rare events, most commonly due to motor vehicle accidents or sports injuries and they often occur in young and active patients. This injury can represent a real emergency because of the vital structures located posterior to the medial clavicle such as anonymous artery, anonymous vein,...

Thoracic duct (TD) is the largest lymphatic vessel in the body and drains the lymph at the junction between the left subclavian and jugular veins. Chylothorax (CTX) represents an accumulation of lymphatic fluid in the pleural space. We present a case of a 65 years-old man with an histologically diagnosed mediastinal type B non-Hodgkin Lymphoma, tre...

Introduction:: Proximal humerus fractures are the seventh most frequent fracture in adults, and the third in patients over 65 years old, 5.7% of whole diagnosed fractures. Most of these fractures can be treated conservatively and achieve good results. However, more and more frequently we are confronted with dislocated and multifragmentary fracture...

Purpose The current indication for comminuted radial head fractures is radial head arthroplasty (RHA). The main purpose of this study was to investigate any statistical differences in terms of prosthesis revision or removal and radiographic degenerative changes by comparing patients who underwent RHA and ligaments repair to those who underwent only...

In patients with symptomatic intrahepatic biliary lithiasis, the treatment is usually discussed by a multidisciplinary team. Although hepatectomy is considered as definitive treatment, when lobar atrophy is absent, endoscopic procedures are frequently proposed as first-line treatment due the low invasiveness and for sparing liver parenchyma. Percut...

Background: Femoral neck fractures (FNF) is one of the most common traumatic events in elderly patients: the choice of an appropriate treatment is necessary to decrease the related mortality and to achieve the best possible outcomes. Nowadays, it is still debated whether or not to cement the stem in hemiarthroplasty and above all, which stem to us...

Aim: evaluate the outcome of proximal humeral nailing over 5 years follow-up, focusing on possible complications. Secondary endpoint is the description and analysis of some technical notes to simplify surgical procedure. Materials and methods: the cohort is composed by 194 fractures fixed with short nail. Neer Classification was used to assess t...

Background: Clear recommendations about the optimal treatment of traumatic tarsal navicular fractures are still very debated in the literature, and this is due to several factors: navicular fractures are rare and often misdiagnosed injuries, they are frequently associated with other fractures or a dislocation of the midfoot, and the current knowled...

Objectives The multiwire technique (MWT) in carotid artery stenting (CAS), characterized by the use of more than one guidewire to support guiding catheter in patients with hostile neck anatomy, increases procedural time, enhancing the risk of periprocedural stroke. The aim of the present study was to identify which factors are predictors of the MWT...

Background and aim: After the first Italian case of Covid-19, the Government imposed the complete closure of all areas involved by the spread of the virus to contain transmissions. There was a massive reorganization of Hospitals, a stop of all elective activities and a convertion of many hospitals in "Covid Centers''. AITOG (Associazione Italiana...

North Italy emerged as an epicenter of COVID-19 in the Western world. The majority of studies of patients with COVID-19 have focused on hospitalized patients, and data on early outpatient treatment are limited. This research retrospectively examines consecutive symptomatic adults who did not present to a hospital but who experience laboratory confi...

Background: Lateral fractures of proximal femur are the most frequent to treat for the traumatologist surgeon. Intramedullary nailing is the gold standard treatment of this type of fracture. The aim of the study is to analyze the results obtained with the Elos Intrauma nail by the experience of two Departments of Orthopedics and Traumatology ("Gug...

Purpose: The current indication for comminuted radial head fractures is radial head arthroplasty (RHA). The main purpose of this study was to investigate any statistical differences in terms of prosthesis revision or removal and radiographic-degenerative changes by comparing patients who underwent RHA and ligaments repair to those who underwent onl...

Introduction. Proximal humerus fracture is the most common fracture of the shoulder gir- dle, accounting for approximately 4-7% of all fractures. The aim of this study is to provide surgeons safe and effective surgical solutions, minimizing the risk of complications.Materials and methods. We retrospectively analyzed all 3-fragment proximal humerus...

INTRODUCTION Distal femur fractures in adults have an estimated annual incidence of 6% of all femur fracture. Choice of the type of fixation depends on the characteristics of the fracture and the general condition of the fractures Carbon fiber reinforced—polyetheretherketone (CFRPEEK) offer several potential benefits when compared with metal alloy...

Introduction: Coronavirus disease (CoVID-19) is causing millions of deaths worldwide and the crisis of the global healthcare system. Aim Of The Study: evaluate the preliminary impact of CoVID-19 in three Italian Orthopedics and Traumatology Departments in the first 10 weeks of the national lockdown. We focused on proximal humerus fractures, analyz...

Introduction and aim: The Coronavirus pandemic represents one of the most massive health emergencies in the last century. Aim of the study is to evaluate the trend of E.R. accesses and orthopaedic events during the pandemic of Covid-19. Materials and methods: we retrospectively analysed all data related to patients admitted to the E.R. Departmen...

Introduction: During the pandemic, Piacenza's Orthopedic and Traumatology Dep. firstly dealt with the emergency with the complete closure of all the elective surgical and outpatient activities.As general population, also healthcare workers were affected by Coronavirus, increasing difficulties of epidemic management.The aim of our study is to evalu...

Introduction Volar locked plates represent the most popular fixation technique for distal radius fracture (DRF). However, threaded screw-hole angular stability mechanism has some issues. The purpose of our study is to evaluate clinical and radiological outcome of a tronco-conical locking mechanism for volar plating of DRF. Materials and methods Ei...

Background: The COVID epidemic hit like a tsunami worldwide. At the time of its arrival in Italy, available literary data were meager, and most of them concerned its epidemiology. World Health Organization proposed guidelines in march 2020, a strategy of treatment has been developed, and a significant number of subsequent articles have been publis...

PurposeNeck modularity was introduced to improve total hip arthroplasty (THA) accuracy, but it has been associated with early breakages and corrosion issues. In our hospital, modular necks have been in clinical use since the 1990s. We retrospectively analysed the occurrence of these sequelae in implants placed between January 2000 and December 2014...

Background From February 21, the day of hospitalisation in ICU of the first diagnosed case of Covid-19, the social situation and the hospitals’ organisation throughout Italy dramatically changed.Methods The CIO (Club Italiano dell’Osteosintesi) is an Italian society devoted to the study of traumatology that counts members spread in public and priva...

Background: The idea of ''de-escalation'' (DE) indicates an arthroplasty revision performed by changing a revision component by a primary component. Aim of this study is to verify if this technique can represent an option in case of cage or ring failure. Methods: We observed five cases of revision hip cage loosening with complete allograft conso...

Background and aim of the work: The worldwide incidence of fractures of the proximal end of the femur is increasing as the average age of the population rises. The current surgical gold treatment standard is intramedullary nail fixation. The Authors present their experience with the D-Nail system for intertrochanteric femur fractures. Methods: F...

Introduction: CoVID-19 (Coronavirus disease) is a worldwide infection which is causing millions of deaths. A significant number of elderly patients require hospitalization and develop serious and sometimes life-threatening complications. The aim of this study is to evaluate the preliminary impact (8 weeks) of CoVID-19, focusing on proximal femur f...

Since February 21st, 2020 CoVID-19 spread throughout all Italy expanding like a "tsunami" from Codogno (Lodi, Lombardy, Northern Italy) to neighboring cities. In a few days Lodi, Piacenza, Milano, Brescia and Bergamo were forced to deal with this disaster starting the lockdown at different time. No national plan had been prepared. As result, CoVID-...

ntroduction: In this paper we present the preliminary results obtained in our clinic with the use of BIOS screws associated with injection of growth factors in the treatment of cephalic necrosis of the femoral head. Materials and methods: In the division of Orthopedics and Traumatology at Guglielmo da Saliceto" hospital in Piacenza were treated b...

Background and aim of the study: The Authors report their implant's analysis and preliminary experience with a new fixation device, the MEDGAL DHS for treatment of proximal femoral fractures, producted by MEDGAL Sp.z o.o, Niewodnicka, Poland. Materials: Between January 2019 and September 2019 in Orthopedics and Traumatology Department of Piacenz...

Background and aim of the study: The Authors report their preliminary experience with a new fixation device for treatment of pertrochanteric fractures. The EBA ONE nail, produced by Citieffe in Bologna - Italy. Materials: Between April 2019 and August 2019 in Orthopedics and Traumatology Department of Piacenza, 11 patients (all female) with stab...

Introduction: In this retrospective study we have analyzed a consecutive series of patients affected by isolated radial head Mason III fractures and treated with bone resection or prosthesis. Patients and methods: This study includes 24 patients affected by fractures mentioned above and treated between July 2009 and November 2015. 15 patients (a...

Introduction: Horse racing is a hazardous sport. We analyzed the incidence and characteristics of jockey injuries in a typical horse race. Methods: We analyzed all injuries sustained by 224 jockeys in the last 72 years. Results: It was found that in 96.1% of the races there was at least one fall and in 28.6% of the races 50% or more of the joc...

Background and aim of the study: Fractures involving the tibial plateau make up 1% of all fractures. Treatment can take advantage of various techniques, including arthroscopically assisted surgical reduction. This procedure is certainly viable for Schatzker III fractures and, in some cases, for Schatzker II. The use of the arthroscope makes possib...

The Publisher regrets that this article is an accidental duplication of an article that has already been published in Injury, 50(2) 2019 382–385, https://doi.org/https://doi.org/10.1016/j.injury.2018.11.044. The duplicate article has therefore been withdrawn. The full Elsevier Policy on Article Withdrawal can be found at https://www.elsevier.com/ab...

The Publisher regrets that this article is an accidental duplication of an article that has already been published in Injury, 50(2) 2019 365–368, https://doi.org/10.1016/j.injury.2018.12.014. The duplicate article has therefore been withdrawn. The full Elsevier Policy on Article Withdrawal can be found at https://www.elsevier.com/about/our-business...

Background Healing of tibia fractures occurs over a wide time range of months, with a number of risk factors contributing to prolonged healing. In this prospective, multicentre, observational study, we investigated the capability of FRACTING (tibia FRACTure prediction healING days) score, calculated soon after tibia fracture treatment, to predict h...

Introduction Open reduction and internal fixation (ORIF) with plate and screws represents the recommended treatment for unstable intra-articular distal radius fractures. Although significant progresses in surgical technique have been made, anatomical reconstruction of radio-carpal articular surface still represent a difficult task, especially in mu...

Introduction Carbon fiber reinforced (CFR) implants have been proposed for the treatment of fractures or impending fractures of the long bones in the oncology patient. Aim of this study is to present the largest cohort of oncology patients operated by CFR nailing by the Italian Orthopaedic Society (SIOT) Bone Metastasis Study Group. Methods 53 adu...

Introduction: Proximal humeral fractures with a spiral line of fracture extending from the humeral head to the diaphyseal region are increasing. Treatment for these fractures is comparable to that for shaft fractures. The purpose of this study was to evaluate the use of a new "Long" humeral nail for this type of lesion and identify the best distal...

Background: The aim of the surgical treatment in proximal humeral fractures is to maintain bone alignment facilitating an early shoulder mobilization. This can be obtained with the use of an endomedullary nail with specific characteristics: a proximal angular multiplanar stability and the possibility to place proximal screws in the calcar region....

Without thromboprophylaxis, knee arthroscopy (KA) carries a low to moderate risk of venous thromboembolism. Over 5 million arthroscopies are performed worldwide yearly. It was our study objective to assess the efficacy and safety of rivaroxaban for thromboprophylaxis after therapeutic KA. Patients undergoing KA in nine Italian teaching or community...

Synthetic ligaments must have a good elongation, torsion and abrasion resistance and be biocompatible, that is, chemically inert. They should be as similar as possible to natural ligaments. The effective benefits in their use for anterior cruciate ligament reconstruction are represented by a reduction in iatrogenic damage, faster recovery times, le...

The Authors report their preliminary experience about a new kind of synthesis for intertrochanteric fractures. The EBA 2 nail was born from the evolution of Endovis nail, produced by Citieffe in Bologna - Italy, to simplify the surgical procedure and to reduce the risks of complications like effect Z which has affected the results of intramedullary...

The aim of this study is emphasize the role of an hinged external fixator to support an internal synthesis and permit a early joint mobilization. We have studied retrospectively 22 patients treated for elbow complex instabilities in our Department between January 2010 and June 2013. We have just excluded from study patients in rehanimation room or...

The preferred surgical treatment of pathological humeral shaft fractures is the intramedullary nailing. A carbon-fiber-reinforced polyether ether ketone (CFR-PEEK) radiolucent nail allows for a stable internal fixation and better visualization of the fracture or pathological site on X-ray plain films, on computed tomography scan or magnetic resonan...

There is still debate over the limits of age and bone stock quality of patients on whom to use an un-cemented straight stem coated with hydroxyapatite (HA). We studied a group of 244 patients with a displaced intracapsular fracture of the femoral neck who underwent cementless hemiarthroplasty or total hip arthroplasty. 143 patients were reviewed at...

Management of displaced proximal humerus fractures is a challenge. Intramedullary nailing remains an appropriate fixation technique in selected patients, above all with surgical neck 2-part fractures or with extension into the proximal diaphysis. The balance between advantages and disadvantages increases in expert hands but especially with right pr...

The incidence of the metatarso-phalangeal joint artrofibrosis is increasing as result of the increment of biomechanical and structural anomalies of foot support. The current surgical indication is given to patients with high functional demands in the first and second degree stiff and painful big toe or in thirth and fourth degree stiff big toe. The...

Aim: The need to treat all patients with hip fracture within 48 hours from hospital admission makes it necessary to continue the surgical sessions in the afternoon and the evening. The aim of this retrospective study is to establish if there is a correlation between the pre-surgical time and the occurrence of postsurgical complications like respira...

All tendinopathies are mainly associated with repeated or overload injuries in sport activities: one of preferential sites of these disorders is Achilles Tendon (AT). Clinical evolution of this pathology is often chronic and very challenging to manage in long term period. Achilles tendinopathy is common, till 11% of all running injuries. The best c...

Ankle fractures cover a big part of traumatology and are increasing for road and sport’s injuries: these affect male and female. Although we have made significant progress in care and treatment of these injuries, when we treat surgically ankle fractures we are faced with many worries. These are articular fractures, whose anatomical surface reinstat...

Tailor's Bunion (TB) is a prominence of the Vth metatarsal bone at the base of the little toe. Scarf Osteotomy (SO) is a very useful technique to treat TB and in some cases it represents the first-rate surgical treatment for this deformity. The aim of this paper is to describe this little known pathology, analyze all surgical techniques of the past...

Despite current guidelines recommendations about anticoagulant prophylaxis, many studies have shown an high venous thromboembolism (VTE) incidence in patients undergoing total hip and knee arthroplasty. A number of anticoagulants are currently available, but they have some limitations that affect their applicability and consequently their effective...

AIM: The need to treat all patients with hip fracture within 48 hours from hospital admission makes it necessary to continue the surgical sessions in the afternoon and the evening. The aim of this retrospective study is to establish if there is a correlation between the pre-surgical time and the occurrence of postsurgical complications like respira...

Conclusioni Tutti i pazienti hanno raggiunto eccellenti risultati a eccezione di uno dove, a seguito di una calcificazione eterotopica a livello dell'olecrano, si evidenziava una riduzione dell'estensione, rendendo quindi il risultato inferiore, ma comunque buono. Non sono state evidenziate complicanze di dolore residuo o infezioni dei tramiti dell...

Nelle fratture omerali a rima spiroide lunga estesa alla diafisi l'inchiodamento endomidollare è una tecnica di scelta perché riduce perdite ematiche e gli accessi chirurgici, consente il principio dell'osteosintesi biologica e stabilizza in maniera ottimale la frattura 3 . Inoltre se questa risulta associata a distacco delle tuberosità solo un chi...

I risultati ottenuti a breve e medio termine, in considerazione del design più anatomico, del doppio vitone cefalico per ridurre rischi di cut-out, del materiale più idoneo per trattare fratture in pazienti osteoporotici e dell'esiguo strumentario semplice e intuitivo, non hanno evidenziato alcuna complicanza portando a guarigione tutte le fratture...

Non abbiamo avuto complicanze post-chirurgiche. Ai controlli ambulatoriali il punteggio della scala Lysholm Questionnaire presentava valori medi in aumento: in particolare quelli riguardanti il dolore residuo evidenziavano un trend in netto miglioramento. Viceversa quello riguardante la stabilità articolare rimaneva costante, essendo già massimo al...

Per studiare la reale utilità pratica delle placche radiotrasparenti a febbraio 2014 sono stati analizzati retrospettivamente i casi di fratture trimalleolari con età compresa tra i 36 e 62 anni, trattati nei tre anni precedenti tutti dal medesimo operatore. A 12 pazienti sono state impiantate placche tradizionali, a 15 placche radiotrasparenti (CF...

The Reverdin-Isham percutaneous osteotomy is indicated in the treatment of mild to moderate hallux valgus deformity. The aim of the work is the evaluation of the technique itself as a possible future landmark in the hallux valgus treatment. Between January 2010 and January 2011 we have performed 138 percutaneous osteotomies. The patients were asses...

"Questo volume nasce dall’esigenza di fornire concetti chiari e aggiornati per l’apprendimento delle patologie dell’apparato locomotore tipiche del paziente anziano e delle eventuali problematiche ad esse connesse. L’anziano, infatti, può essere un paziente complesso con plurime patologie che richiedono un approccio multidimensionale meritevole di...

Le fratture articolari di ginocchio sono frequenti ed appannaggio di una popolazione giovane e sportiva. Generalmente sono determinate da un trauma ad alta energia come incidenti stradali o cadute dall’alto; rare ma esistenti sono le fratture causate da traumi a bassa energia che interessano la popolazione anziana osteoporotica. Il trauma è spesso...

The role of enhanced fluorodeoxyglucose F 18 uptake of giant cell tumor of bone (GCTB) should be mentioned in an overview such as that reported by van der Heijden et al., with regard not only to the response to denosumab treatment for unresectable GCTB but also to the clinical implications for the diagnosis of this disease.

Introduction. Historically, many kinds of treatment were used for proximal humerus fractures dislocations, like open reduction and synthesis or prosthetic solution. Aim of Study. The authors intend to discuss about the treatment and evolution of two cases of proximal humerus anterior dislocationfracture in 2 border-line patients, where there is not...

INTRODUZIONE: La fissazione esterna riveste un ruolo fondamentale nella stabilizzazione estemporanea delle fratture articolari e periarticolari di ginocchio, trauma caratterizzato da importanti complicanze post chirurgiche quali da un lato la consolidazione della frattura e dall’altro la rigidità articolare. Oltre al suo utilizzo in casi di esposiz...

INTRODUZIONE: Le tendinopatie inserzionali e non inserzionali sono principalmente associate a lesioni reiterate o da sovraccarico. Sono riconosciute alcune sedi preferenziali per lo sviluppo di questi disturbi, tra cui il tendine rotuleo e l’achilleo. I disordini a carico di questi tendini sono spesso cronici e di difficile gestione nel lungo termi...

Il trattamento delle fratture dell’epifisi prossimale dell’omero rappresenta una sfida tutt’oggi difficile. L’inchiodamento endomidollare risulta una tecnica chirurgica validata ed appropriata in pazienti selezionati, specialmente nei casi di fratture a 2 frammenti. Il rapporto tra i vantaggi e gli svantaggi di tale metodica aumenta in mani esperte...

Ankle fractures cover a big part of traumatology and are increasing for road and sport’s injuries. Although we have made significant progress in care and treatment of these injuries, when we treat surgically ankle fractures we are faced with many worries. Fractures are usually multiplanar and x-ray devices, giving a mono-planar view, don’t allow th...

Le fratture a 3-4 frammenti rappresentano il 13 - 16% di tutte le fratture dell'omero prossimale e sono senz’altro le più insidiose: sono molto difficili da gestire perché generalmente sono scomposte. L'obiettivo del trattamento è quello di realizzare una spalla indolore e funzionalmente attiva. Varie tecniche chirurgiche sono state validate: sinte...

Proximal humerus fractures represent approximately 4-5% of all fractures, most commonly occur in the elderly and for years conservative treatment is the first choice in about 80% of cases. However there is not an unique surgical treatment about displaced 2 and 3 fragments proximal humeral fractures. The aim of any treatment is to achieve a good sho...

Le complicanze nelle fratture della regione trocanterica del femore e loro evoluzione Autori: Marco Caforio, Patrizia Mantelli, Pietro Maniscalco, Luigi Bisogno Ospedale Guglielmo da Saliceto di Piacenza, Dipartimento Chirurgie Specialistiche, UOC Ortopedia e Traumatologia (0523-303120, 349-4507950) INTRODUZIONE: L’inchiodamento endomidollare rap...

Introduction. The Authors report their preliminary experience with a new fixation device for pertrochanteric fractures. The EBA2 nail is an evolution of the Endovis Nail, both produced by Citieffe in Bologna - Italy, to simplify the surgical procedure and to minimize the risk of complications such as the Z effect reported in the literature with int...

Intramedullary locking nailing combined with a Platelet Rich Plasma application is an option usually indicated in non-infected pseudoarthrosis of the long bones. Sometimes these treatments can be complicated by infections, considered general or local patients conditions. We present a case of a female 27-years-old who had an atropic tibial pseudarth...

L'incidenza dell'artrofibrosi dell'articolazione metatarso-falangea dell'alluce è in aumento a seguito dell'incremento delle anomalie strutturali e biomeccaniche dell'appoggio plantare. L'attuale indicazione chirurgica viene posta ai pazienti con elevate richieste funzionali in alluce rigido di I e II grado molto dolenti o in pazienti portatori di...

Il paziente con ginocchio valgo presenta una deformità complessa da gestire che rimane ad oggi una sfida importante per tutti i chirurghi, indipendentemente dalla filosofia dell'impianto adottato. In questi casi il legamento crociato posteriore è funzionalmente inefficiente e può determinare un ostacolo alla correzione chirurgica.

Introduction. There is not, at present, a unique treatment for 3 and 4 part displaced proximal humeral fractures. The purpose of our study is to evaluate the effectiveness of the use of the antegrade humeral intramedullary Diphos Nail - Lima Corporate. Materials. Between April 2011 to October 2012, 30 patients, 19 females and 11 males, affected by...

Le fratture di polso sono molto frequenti, si verificano soprattutto nella popolazione anziana con osteoporosi in seguito a modesti traumi. Il trattamento può essere conservativo, con riduzione e gesso di posizione, o chirurgico, utilizzando i numerosi mezzi di sintesi in commercio come le placche a stabilità angolare, i fissatori esterni, i fili d...

Nail impingement against the anterior femoral cortex during nail insertion, or anterior cortex penetration, has been described in the literature as a worrying complication. We describe a previously unreported surgical failure due to a compromised dynamic distal locking caused by distal jamming of the nail. An 80-year-old male suffered a closed righ...