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Papers by Stefano Di Fabio

JSES international, Jul 1, 2023

Journal of Orthopaedics and Traumatology, 2013

The ideal treatment for displaced intraarticular calcaneal fractures is still under debate. Open ... more The ideal treatment for displaced intraarticular calcaneal fractures is still under debate. Open reduction and internal fixation is the most popular surgical procedure; however, wound complications, hardware failure and infection remain a major concern. The aim of this study was to evaluate the results of a new minimally-invasive surgical procedure: closed reduction technique combined with balloon-assisted fracture augmentation with cement or calcium phosphate (minimally-invasive percutaneous calcaneoplasty). We retrospectively reviewed 11 patients that sustained Sander's type II and III calcaneal fractures treated in our institution from January 2008 to June 2010. The same approach and technique was utilized in all cases. Conventional X-rays and CT scan have been performed pre-and post-operatively. The average follow-up was 24 months. The American Orthopaedic Foot and Ankle Society ankle/hindfoot score has been utilized for clinical evaluation and Bohler's angle to assess bone reduction. All cases obtained bony union in 2/3 months, with average Bohler's angle of 22.97°(from 14.21°to 32.83°). No skin complications or adverse reactions were observed, with only one patient complaining of residual pain in the hindfoot. Minimally-invasive percutaneous calcaneoplasty can represent an alternative to open reduction internal fixation in the treatment of calcaneal fractures, allowing stable reduction without plating, early function recovery and short hospital stay.

Journal of Orthopaedics and Traumatology, 2010

LO SCALPELLO-OTODI Educational, 2008

Abstract Surgical indications for the treatment of distal radial fractures are evolving and beco... more Abstract Surgical indications for the treatment of distal radial fractures are evolving and becoming more common among surgeons, but, as shown in many studies, these fractures can be successfully managed by a range of methods and techniques, including conservative treatment based on closed reduction by manipulation and cast. The keys to a successful outcome appear to be understanding the patient’s needs and expectations; adequate imaging to enable identification of displacement of key bony and soft-tissue components; adequate reduction and stabilization of these critical fragments. Looking at these common fractures, several studies have raised additional questions about the optimal treatment, particularly in children and older patients where conservative treatment still plays an important role.

European journal of orthopaedic surgery & traumatology : orthopedie traumatologie, 2016

Different surgical approaches are currently available to treat knee chondral defects. Microfractu... more Different surgical approaches are currently available to treat knee chondral defects. Microfracture is the most commonly applied, but it often leads to a mechanically inferior fibrocartilaginous tissue. To overcome this shortcoming, the Autologous, Matrix-Induced Chondrogenesis (AMIC) technique has been proposed. To further enhance the outcome of AMIC, the addition of haemoderivatives containing growth factors that stimulate cartilage healing has emerged as a new treatment method. Recently, a novel leucocyte-platelet-concentrated membrane (CLP-MB), highly enriched in platelets, monocytes/macrophages, fibrinogen, CD34(+) and CD34(+)VEGFR-2(+)CD133(+) cells, has been developed. Additionally, an injectable collagen scaffold (Cartifill) has been proposed as a replacement of the AMIC standard collagen membrane. This preliminary study is aimed to evaluate the short-term safety and efficacy of the use of the CLP-MB membrane and injectable collagen scaffold when combined in single-step AMIC...

The increasing incidence of complications after hip replacement surgery is a consequence of two m... more The increasing incidence of complications after hip replacement surgery is a consequence of two main factors: the prolonged survival time in the general population and the increasing number of primary implants made worldwide in the last decades. Among the possible complications, periprosthetic femoral fractures represent a challenge for orthopaedic surgeons. In terms of treatment, it is crucial to distinguish between intraoperative (or perioperative) fractures and post-traumatic fractures. The former may be minor fractures that do not necessitate surgical treatment. Posttraumatic fractures usually require operative treatment and are associated both with predisposing factors such as osteolysis, osteopenia and aseptic loosening of the implant as well as with determining factors such as minor traumatic events. The incidence of intraoperative periprosthetic fractures in cementless total hip arthroplasty ranges from 1 to 20% and is higher in revision surgery [2, 6, 7, 8, 11, 15]. Lower r...

Reverse Shoulder Arthroplasty, 2018

Fractures of the proximal humerus are common, and the majority of them unite successfully, many w... more Fractures of the proximal humerus are common, and the majority of them unite successfully, many without surgical operation. A small percentage develop into nonunion. Nonunion of the proximal humerus presents different challenges due to biological insults from the initial injury and previous surgeries, bone loss, humeral head cavitation, osteopenia, soft tissue contractures, and infection.

Background. Il trattamento delle fratture diafisarie dellʼomero è, da sempre, oggetto di discussi... more Background. Il trattamento delle fratture diafisarie dellʼomero è, da sempre, oggetto di discussione. Diverse sono le metodiche raccomandate, sia cruente che incruente, nessuna, peraltro, scevra da possibili complicanze. Metodi. Dal Giugno 2003 al Giugno 2006 sono state trattate, con chiodo endomidollare bloccato T2, 50 fratture consecutive diafisarie di omero. Diciotto fratture erano del terzo prossimale dellʼomero, dodici del terzo medio e venti del terzo distale. In 38 casi (76%) è stato eseguito un inchiodamento per via anterograda ed in 12 casi (24%) per via retrograda. Risultati. Quarantotto (96%) fratture sono consolidate in circa 3 mesi. I due casi di pseudoartrosi sono stati trattati con un nuovo intervento di osteosintesi con placca ed innesto di osso omologo. Su 38 pazienti trattati con inchiodamento anterogrado, in tre (7,8%) è residuata una limitazione funzionale della spalla. Tutti i pazienti hanno recuperato lʼarticolarità completa del gomito. Nessun caso di infezione...

Obiettivo. Le fratture scomposte a due e tre frammenti dell'epifisi prossimale dell'omero non pre... more Obiettivo. Le fratture scomposte a due e tre frammenti dell'epifisi prossimale dell'omero non prevedono, allo stato attuale, un trattamento chirurgico univoco. Scopo del lavoro è valutare l'efficacia del chiodo Sirus, introdotto a cielo chiuso per via anterograda con un sistema di bloccaggio guidato, nel trattamento delle fratture prossimali di omero. Metodi. Da gennaio 2005 a giugno 2006, presso l'UOA di Ortopedia e Traumatologia dell'Ospedale "San Martino" di Belluno, sono stati trattati, con chiodo Sirus, 15 pazienti (9 femmine e 6 maschi). Sono stati valutati il tempo di guarigione della frattura, l'intensità del dolore, la funzionalità della spalla operata in accordo con i criteri di Neer, il grado di soddisfazione dei pazienti e le complicanze post-operatorie. Risultati. In tutti i casi trattati con chiodo Sirus abbiamo ottenuto la consolidazione della frattura in un tempo medio di circa 3 mesi. Solo in 2 pazienti la funzionalità residua della spalla operata è stata insufficiente con dolore alla mobilizzazione. Conclusioni. Il chiodo endomidollare Sirus rappresenta una valida alternativa nel trattamento di fratture dell'epifisi prossimale dell'omero a 2 e 3 frammenti, in particolare nei pazienti osteoporotici.

JSES international, Jul 1, 2023

Journal of Orthopaedics and Traumatology, 2013

The ideal treatment for displaced intraarticular calcaneal fractures is still under debate. Open ... more The ideal treatment for displaced intraarticular calcaneal fractures is still under debate. Open reduction and internal fixation is the most popular surgical procedure; however, wound complications, hardware failure and infection remain a major concern. The aim of this study was to evaluate the results of a new minimally-invasive surgical procedure: closed reduction technique combined with balloon-assisted fracture augmentation with cement or calcium phosphate (minimally-invasive percutaneous calcaneoplasty). We retrospectively reviewed 11 patients that sustained Sander's type II and III calcaneal fractures treated in our institution from January 2008 to June 2010. The same approach and technique was utilized in all cases. Conventional X-rays and CT scan have been performed pre-and post-operatively. The average follow-up was 24 months. The American Orthopaedic Foot and Ankle Society ankle/hindfoot score has been utilized for clinical evaluation and Bohler's angle to assess bone reduction. All cases obtained bony union in 2/3 months, with average Bohler's angle of 22.97°(from 14.21°to 32.83°). No skin complications or adverse reactions were observed, with only one patient complaining of residual pain in the hindfoot. Minimally-invasive percutaneous calcaneoplasty can represent an alternative to open reduction internal fixation in the treatment of calcaneal fractures, allowing stable reduction without plating, early function recovery and short hospital stay.

Journal of Orthopaedics and Traumatology, 2010

LO SCALPELLO-OTODI Educational, 2008

Abstract Surgical indications for the treatment of distal radial fractures are evolving and beco... more Abstract Surgical indications for the treatment of distal radial fractures are evolving and becoming more common among surgeons, but, as shown in many studies, these fractures can be successfully managed by a range of methods and techniques, including conservative treatment based on closed reduction by manipulation and cast. The keys to a successful outcome appear to be understanding the patient’s needs and expectations; adequate imaging to enable identification of displacement of key bony and soft-tissue components; adequate reduction and stabilization of these critical fragments. Looking at these common fractures, several studies have raised additional questions about the optimal treatment, particularly in children and older patients where conservative treatment still plays an important role.

European journal of orthopaedic surgery & traumatology : orthopedie traumatologie, 2016

Different surgical approaches are currently available to treat knee chondral defects. Microfractu... more Different surgical approaches are currently available to treat knee chondral defects. Microfracture is the most commonly applied, but it often leads to a mechanically inferior fibrocartilaginous tissue. To overcome this shortcoming, the Autologous, Matrix-Induced Chondrogenesis (AMIC) technique has been proposed. To further enhance the outcome of AMIC, the addition of haemoderivatives containing growth factors that stimulate cartilage healing has emerged as a new treatment method. Recently, a novel leucocyte-platelet-concentrated membrane (CLP-MB), highly enriched in platelets, monocytes/macrophages, fibrinogen, CD34(+) and CD34(+)VEGFR-2(+)CD133(+) cells, has been developed. Additionally, an injectable collagen scaffold (Cartifill) has been proposed as a replacement of the AMIC standard collagen membrane. This preliminary study is aimed to evaluate the short-term safety and efficacy of the use of the CLP-MB membrane and injectable collagen scaffold when combined in single-step AMIC...

The increasing incidence of complications after hip replacement surgery is a consequence of two m... more The increasing incidence of complications after hip replacement surgery is a consequence of two main factors: the prolonged survival time in the general population and the increasing number of primary implants made worldwide in the last decades. Among the possible complications, periprosthetic femoral fractures represent a challenge for orthopaedic surgeons. In terms of treatment, it is crucial to distinguish between intraoperative (or perioperative) fractures and post-traumatic fractures. The former may be minor fractures that do not necessitate surgical treatment. Posttraumatic fractures usually require operative treatment and are associated both with predisposing factors such as osteolysis, osteopenia and aseptic loosening of the implant as well as with determining factors such as minor traumatic events. The incidence of intraoperative periprosthetic fractures in cementless total hip arthroplasty ranges from 1 to 20% and is higher in revision surgery [2, 6, 7, 8, 11, 15]. Lower r...

Reverse Shoulder Arthroplasty, 2018

Fractures of the proximal humerus are common, and the majority of them unite successfully, many w... more Fractures of the proximal humerus are common, and the majority of them unite successfully, many without surgical operation. A small percentage develop into nonunion. Nonunion of the proximal humerus presents different challenges due to biological insults from the initial injury and previous surgeries, bone loss, humeral head cavitation, osteopenia, soft tissue contractures, and infection.

Background. Il trattamento delle fratture diafisarie dellʼomero è, da sempre, oggetto di discussi... more Background. Il trattamento delle fratture diafisarie dellʼomero è, da sempre, oggetto di discussione. Diverse sono le metodiche raccomandate, sia cruente che incruente, nessuna, peraltro, scevra da possibili complicanze. Metodi. Dal Giugno 2003 al Giugno 2006 sono state trattate, con chiodo endomidollare bloccato T2, 50 fratture consecutive diafisarie di omero. Diciotto fratture erano del terzo prossimale dellʼomero, dodici del terzo medio e venti del terzo distale. In 38 casi (76%) è stato eseguito un inchiodamento per via anterograda ed in 12 casi (24%) per via retrograda. Risultati. Quarantotto (96%) fratture sono consolidate in circa 3 mesi. I due casi di pseudoartrosi sono stati trattati con un nuovo intervento di osteosintesi con placca ed innesto di osso omologo. Su 38 pazienti trattati con inchiodamento anterogrado, in tre (7,8%) è residuata una limitazione funzionale della spalla. Tutti i pazienti hanno recuperato lʼarticolarità completa del gomito. Nessun caso di infezione...

Obiettivo. Le fratture scomposte a due e tre frammenti dell'epifisi prossimale dell'omero non pre... more Obiettivo. Le fratture scomposte a due e tre frammenti dell'epifisi prossimale dell'omero non prevedono, allo stato attuale, un trattamento chirurgico univoco. Scopo del lavoro è valutare l'efficacia del chiodo Sirus, introdotto a cielo chiuso per via anterograda con un sistema di bloccaggio guidato, nel trattamento delle fratture prossimali di omero. Metodi. Da gennaio 2005 a giugno 2006, presso l'UOA di Ortopedia e Traumatologia dell'Ospedale "San Martino" di Belluno, sono stati trattati, con chiodo Sirus, 15 pazienti (9 femmine e 6 maschi). Sono stati valutati il tempo di guarigione della frattura, l'intensità del dolore, la funzionalità della spalla operata in accordo con i criteri di Neer, il grado di soddisfazione dei pazienti e le complicanze post-operatorie. Risultati. In tutti i casi trattati con chiodo Sirus abbiamo ottenuto la consolidazione della frattura in un tempo medio di circa 3 mesi. Solo in 2 pazienti la funzionalità residua della spalla operata è stata insufficiente con dolore alla mobilizzazione. Conclusioni. Il chiodo endomidollare Sirus rappresenta una valida alternativa nel trattamento di fratture dell'epifisi prossimale dell'omero a 2 e 3 frammenti, in particolare nei pazienti osteoporotici.