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    Students perception regarding the replacement of restorations [PercepciC3n de estudiantes respecto al recambio de restauraciones]
    (2021)
    Roque Arias
    ;
    IGNACIA HERRERA
    ;
    Cristian Bersezio
    ;
    Alain Manuel Chaple Gil
    ;
    Eduardo Fernández
      1
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      9Scopus© Citations 7
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    Evidence-Based Treatment Algorithm for Freiberg Disease
    (2023)
    Ichiro Yoshimura
    ;
    Masato Takao
    ;
    WAGNER HITSCHFFELD, EMILIO  
    ;
    Sjoerd Stufkens
    ;
    Jari Dahmen
    <jats:p> Freiberg disease is a type of osteonecrosis of the metatarsal head that predominantly occurs in young females and adolescents, although it may occur at any age. The pathophysiology is multifactorial and may involve trauma, altered foot biomechanics, systemic disorders, and arterial insufficiency. The most typical location is the second metatarsal head, but Freiberg disease may also occur in other lesser toes. Nonoperative treatment is best applied in the early stage of the disease; if this is ineffective, surgical treatment is recommended. Currently available surgical procedures include debridement, osteotomy, osteochondral grafting, microfracture, interposition arthroplasty, implant arthroplasty, and metatarsal shortening arthroplasty. In this article, we propose a treatment algorithm for Freiberg disease based on the current literature and expert opinion. </jats:p>
    Scopus© Citations 9  1
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    Posterolateral corner knee injuries: a narrative review
    (2021)
    FIGUEROA BERRIOS, FRANCISCO JAVIER  
    ;
    FIGUEROA POBLETE, DAVID HUMBERTO  
    ;
    Sven Putnis
    ;
    Rodrigo Guiloff
    ;
    Patricio Caro
    <jats:p>Limited knowledge of the anatomy and biomechanics of the posterolateral corner (PLC) of the knee, coupled with poor patient outcomes with non-operative management, resulted in the PLC often being labelled as the ‘dark side’ of the knee. In the last two decades, extensive research has resulted in a better understanding of the anatomy and function of the PLC, and has led to the development of anatomic reconstructions that have resulted in improved patient outcomes. Despite considerable attention in the clinical orthopaedic literature (nearly 400 articles published in the last decade), a standardized algorithm for the diagnosis and treatment of the PLC is still lacking, and much controversy remains. Considering the literature review, there is not a reconstruction technique that clearly prevails over the others. As anatomic, biomechanical, and clinical knowledge of PLC injuries continues to progress, finding the balance between re-creating native anatomy and safely performing PLC reconstruction provides a big challenge. Treatment decisions should be made on a case-by-case basis.</jats:p><jats:p>Cite this article: EFORT Open Rev 2021;6:676-685. DOI: 10.1302/2058-5241.6.200096</jats:p>
      16Scopus© Citations 23
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    Achilles insertional tendinopathy: state of the art
    (2019)
    Nicola Maffulli
    ;
    Amol Saxena
    ;
    WAGNER, EMILIO  
    ;
    Guglielmo Torre
    Scopus© Citations 40  1
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      1
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    The double posteromedial portals endoscopy for posterior ankle impingement syndrome in athletes
    (2022)
    Nicola Maffulli
    ;
    Rocco Aicale
    ;
    Filippo Migliorini
    ;
    WAGNER, EMILIO  
    ;
    Amol Saxena
    <jats:title>Abstract</jats:title><jats:sec> <jats:title>Background</jats:title> <jats:p>Posterior ankle impingement syndrome (PAIS) may result from flexor hallucis longus tendinopathy, compression of the posterior process of the talus from the presence of an os trigonum, soft-tissue impingement, or a combination of these. Posterior extra-articular endoscopy performed with the patient supine through the double posteromedial portals, with excision of adhesions, excision of the posterior process of the talus or an os trigonum, and decompression of the tendon of the flexor hallucis longus (FHL), can be used in athletes with PAIS.</jats:p> </jats:sec><jats:sec> <jats:title>Methods</jats:title> <jats:p>Thirty-four athletes with PAIS in whom conservative management had failed underwent posterior ankle endoscopy in the supine position using the double posteromedial portals. The patients were assessed pre- and postoperatively using the American Orthopaedic Foot and Ankle Society hindfoot scale score, the Tegner scale, and the simple visual analogue scale. Time of surgery, return to sports, patient satisfaction, and complications were recorded and analysed. The average length of postoperative follow-up was 26.7 ± 12.6 (range 24 to 72) months.</jats:p> </jats:sec><jats:sec> <jats:title>Results</jats:title> <jats:p>The mean Tegner activity scale score improved to 9 ± 0.2 postoperatively (<jats:italic>p</jats:italic> &lt; 0.05), while the mean American Orthopaedic Foot and Ankle Society scale score improved to 96 ± 5.1 (range 87 to 100) postoperatively, with 29 of 34 patients (85.3%) achieving a perfect score of 100 (<jats:italic>p</jats:italic> &lt; 0.05). The mean time to return to sports was 8.7 ± 0.7 (range 8 to 10) weeks. The complication rate was low, with no superficial wound infections or venous thromboembolism events; only two patients (5.9%) reported pain and tenderness by 3 months after the index procedure.</jats:p> </jats:sec><jats:sec> <jats:title>Conclusion</jats:title> <jats:p>Posterior ankle endoscopy for the resection of a posterior process of the talus or an os trigonum and decompression of the tendon of FHL is safe and allows excellent outcomes with low morbidity in athletes with PAIS.</jats:p> </jats:sec>
    Scopus© Citations 4  1
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    Fracture of the anterior tibial tuberosity in children
    (2020)
    Ignacio Rodriguez
    ;
    Matías Sepúlveda
    ;
    Estefanía Birrer
    ;
    TUCA, MARIA JESUS  
    <jats:p>Fractures of the anterior tibial tuberosity during childhood are an infrequent pathology (around 3% of all proximal tibial fractures), but the incidence of this injury has risen over recent years, likely due to the increased involvement of this age group in sports activities. This fracture is more commonly seen in children 12–14 years old. It is vital to identify the anatomical structures associated with this type of fracture, along with the pathophysiological mechanisms involved. Treatment includes non-operative and operative options, with the goal of achieving articular congruency, restoring the extensor mechanism function, and avoiding damage to the proximal tibial physis. Understanding the management of this fracture, and the complications that might arise, is critical. The provision of an appropriate clinical management plan and the avoidance of complications are vital in the prevention of disability.</jats:p><jats:p>Cite this article: EFORT Open Rev 2020;5:260-267. DOI: 10.1302/2058-5241.5.190026</jats:p>
    Scopus© Citations 15  1
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    Scopus© Citations 13  3
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    Quiste pilonidal del ombligo: presentación de dos casos
    (2021)
    Juan Hepp
    ;
    Horacio Rios Rivas
    ;
    Juan Hepp Valenzuela
    ;
    Paulina Fuenzalida Soffia
    <jats:p>Introducción: El quiste pilonidal del ombligo (QPO) es una entidad muy infrecuente y por eso no es reconocida precozmente. El objetivo de este manuscrito es dar a conocer esta patología. Reporte de casos: Presentamos dos pacientes referidos por un proceso inflamatorio del ombligo, con descarga de mal olor. El primer paciente, luego de dos meses de tratamiento local sin resolución, es intervenido resecando la lesión umbilical, comprobando en ese momento la existencia de contenido piloso en el quiste. En el segundo paciente se plantea el diagnóstico durante la anamnesis y se confirma con el examen físico. En ambos casos se efectuó una resección parcial del ombligo incluyendo la lesión pilonidal. La biopsia confirmo el diagnóstico. El resultado postoperatorio ha sido satisfactorio y sin recaídas. Discusión y conclusión: hay escasa literatura relacionada con el QPO. Se proponen el tratamiento conservador y la opción de resección quirúrgica del quiste. En nuestra limitada experiencia se procedió a resecar la lesión y recomendar la depilación de la región periumbilical. No podemos descartar la alternativa de manejo conservador en futuros casos, antes de proponer la cirugía.</jats:p>
      15