WAGNER HITSCHFELD, PABLO
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WAGNER HITSCHFELD, PABLO
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pwagner@udd.cl
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57194498847

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Early Weight-Bearing After Percutaneous Reduction and Screw Fixation for Low-Energy Lisfranc Injury

2013 , WAGNER HITSCHFFELD, EMILIO , Cristian Ortiz , Ignacio E. Villalón , Andrés Keller , Pablo Wagner

Background:Anatomic restoration and postoperative rehabilitation of displaced fracture-dislocations of the tarsometatarsal junction of the foot are essential. Our objective was to report percutaneous reduction and screw fixation results in low-energy Lisfranc fracture dislocation injuries that were treated with early weight-bearing and rehabilitation.Methods:We retrospectively evaluated patients with low-energy Lisfranc injuries who underwent surgery between May 2007 and April 2011. The study reviewed 22 patients (12 men and 10 women) with an average age of 36.2 years (range, 16-50 years) and an average follow-up of 33.2 months (range, 12-50 months). We report the mechanism of trauma; quality of reduction in the postoperative digital radiographs; subjective satisfaction; AOFAS score; time required to return to work, recreational activities, and low-impact sports; and complications. Postoperatively, all of the patients were instructed to be non-weight-bearing for 3 weeks, and the stitches were removed after 2 weeks. At the third postoperative week, the patients were encouraged to bear weight as tolerated.Results:Quality of reduction was anatomic or near anatomic in 100% of cases. The subjective satisfaction reported by patients was very good, with complete satisfaction in 20 of them (90.9%). The AOFAS average was 94 points (range, 90-100 points). Average return to work was at 7 weeks (range, 6-9 weeks), recreational activities 7.2 weeks (range, 6-9 weeks), training for low-impact sports 7.6 weeks (range, 7-8 weeks), and symptom-free sport activities 12.4 weeks (range, 11-13 weeks).Conclusion:In this selected group of patients with low-energy Lisfranc fracture dislocation, anatomic or near-anatomic reduction can be achieved with percutaneous reduction and screw fixation. Early weight-bearing is possible in these patients, and early return to regular activities and low-impact sport can be expected.Level of Evidence:Level IV, retrospective case series.

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Angle to Be Corrected in Preoperative Evaluation for Hallux Valgus Surgery: Analysis of a New Angular Measurement

2016 , Cristian Ortiz , WAGNER HITSCHFELD, PABLO , Omar Vela , Daniel Fischman , Gabriel Cavada , WAGNER, EMILIO

Background: The most common methods for assessing severity of hallux valgus deformity and the effects of an operative procedure are the angular measurements in weightbearing radiographs, specifically the hallux valgus angle and intermetatarsal angle (IMA). Our objective was to analyze the interobserver variability in hallux valgus patients of a new angle called the “angle to be corrected” (ATC), and to compare its capacity to differentiate between different deformities against IMA. Methods: We included 28 symptomatic hallux valgus patients with 48 weightbearing foot x-rays. Three trained observers measured the 1 to 2 IMA and the ATC. We then identified retrospectively 45 hallux valgus patients, which were divided into 3 operative technique groups having used the ATC as reference, and analyzed the capacity of the IMA to differentiate between them. Results: The IMA average value was 13.6 degrees, and there was a significant difference between observer 3 and observer 1 ( P = .001). The average value for the ATC was 8.9 degrees, and there was no difference between observers. Both angles showed a high intraclass correlation. Regarding the capacity to differentiate between operative technique groups, the ATC was different between the 3 operative technique groups analyzed, but the IMA showed differences only between 2. Conclusions: The ATC was at least as reliable as the intermetatarsal angle for hallux valgus angular measurements, showing a high intraclass correlation with no interobserver difference. It can be suggested that the ATC was better than the IMA to stratify hallux valgus patients when deciding between different operative treatments. Level of Evidence: Level III, comparative study.

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Rotational Osteotomy for Hallux Valgus. A New Technique for Primary and Revision Cases

2017 , Pablo Wagner , Cristian Ortiz , EMILIO WAGNER HITSCHFFELD

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Achilles tendoscopy for non insertional Achilles tendinopathy. A case series study

2020 , WAGNER HITSCHFELD, PABLO , WAGNER, EMILIO , Cristian Ortiz , Diego Zanolli , Andres Keller , Nicola Maffulli

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Minimally Invasive Achilles Tendon Repair

2016 , EMILIO WAGNER HITSCHFFELD , Pablo Wagner , Andres Keller , Diego Zanolli , Cristian Ortiz

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Biomechanical Evaluation of Various Suture Configurations in Side-to-Side Tenorrhaphy

2014 , EMILIO WAGNER HITSCHFFELD , Cristian Ortiz , Pablo Wagner , Rodrigo Guzman , Ximena Ahumada , Nicola Maffulli

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Using the Center of Rotation of Angulation Concept in Hallux Valgus Correction Why Do We Choose the Proximal Oblique Sliding Closing Wedge Osteotomy?

2018 , EMILIO WAGNER HITSCHFFELD , Cristian Ortiz , Pablo Wagner

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Biomechanical Cadaveric Evaluation of Partial Acute Peroneal Tendon Tears

2018 , WAGNER, EMILIO , WAGNER HITSCHFELD, PABLO , Cristian Ortiz , Ruben Radkievich , Felipe Palma , Rodrigo Guzmán-Venegas

Background: No clear guideline or solid evidence exists for peroneal tendon tears to determine when to repair, resect, or perform a tenodesis on the damaged tendon. The objective of this study was to analyze the mechanical behavior of cadaveric peroneal tendons artificially damaged and tested in a cyclic and failure mode. The hypothesis was that no failure would be observed in the cyclic phase. Methods: Eight cadaveric long leg specimens were tested on a specially designed frame. A longitudinal full thickness tendon defect was created, 3 cm in length, behind the tip of the fibula, compromising 66% of the visible width of the peroneal tendons. Cyclic testing was initially performed between 50 and 200 N, followed by a load-to-failure test. Tendon elongation and load to rupture were measured. Results: No tendon failed or lengthened during cyclic testing. The mean load to failure for peroneus brevis was 416 N (95% confidence interval, 351–481 N) and for the peroneus longus was 723 N (95% confidence interval, 578–868 N). All failures were at the level of the defect created. Conclusion: In a cadaveric model of peroneal tendon tears, 33% of remaining peroneal tendon could resist high tensile forces, above the physiologic threshold. Clinical Relevance: Some peroneal tendon tears can be treated conservatively without risking spontaneous ruptures. When surgically treating a symptomatic peroneal tendon tear, increased efforts may be undertaken to repair tears previously considered irreparable.

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Interosseous membrane window size for tibialis posterior tendon transfer-Geometrical and MRI analysis

2016 , WAGNER HITSCHFELD, PABLO , Cristian Ortiz , Omar Vela , Paul Arias , Diego Zanolli , WAGNER, EMILIO

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