Coherent with previously published works, we confirm the Endo-Model prosthesis to provide excellent pain relief, restoration of walking capacity and intrinsic knee stability both in complex primary and in revision knee arthroplasty, with good or excellent results in the majority of patients and acceptable complication rate.
Shoulder hemiarthroplasty is a useful and effective solution for complex humeral fractures, with good results in the majority of patients. However, outcomes display a great variability in relation to X-ray alterations and age at surgery. A careful attention in patient selection is needed in order to standardize the clinical results associated with this kind of prosthetic implant.
Focal ESWT represents a valuable and safe solution in case of elbow lateral epicondylitis, both in newly diagnosed and previously treated cases, representing a definitive treatment in the majority of patients. Patients refractory to a 3- to 4-session ESWT cycle have lower chances of positive response after further ESWT cycles.
Pinning with metallic wires is a suitable therapeutic option for proximal humeral fractures. Loosening and migration of such devices from this site is uncommon. Despite infrequently occurring, however, the literature reports dramatic and potentially lethal complications related to wires dislocation. A 69-year-old woman underwent closed reduction and fixation of a proximal 3-part humeral fracture by mean of two retrograde Kirschner wires and one anterograde threaded pin. One month after surgery, during a routine follow-up control, it was diagnosed the migration of the threaded pin in the left lung parenchyma. In the meantime, the only symptom the patient complained was an episodic intercostal pain of mild intensity, with referred onset 1 week after surgery. The migrated pin was removed through thoracoscopic approach in the emergency setting, without intra- or post-operative complications. Only a few authors reported similar complications after fixation of proximal humeral fractures. Immediate surgical removal of the device is always mandatory. When considering pinning fixation for shoulder girdle's fractures, orthopedic surgeons should take into account the risk for wire dislocation, and take up adequate precautions during surgery and follow-up control visits.
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