Orthopedics and Traumatology

Day Surgery / Day service

Phone: 0882 410349 

email: daysurgeryortopedia@operapadrepio.it

The Day Surgery/Day Service Unit is designed for patients requiring surgical treatment that necessitates only a brief observation period post-procedure, without the need for inpatient hospitalization.

Following surgery and a short period of observation in the ward, patients are discharged if no complications arise, with instructions for follow-up care. An on-call orthopedic surgeon is always available at the hospital to provide consultation for any immediate postoperative issues.

Conditions Treated:

• Knee arthroscopy.
• Hand conditions.
• Elbow conditions.
• Shoulder conditions.
• Foot conditions.
• Retained foreign bodies.
• Minor neoplasms.
• Removal of orthopedic hardware.

Head of Units: Dr. Domenico Cornacchia, Dott. M. Scarale

Doctor: Dott. F. Maruccia

Clinical Activities

The Hip and Pelvic Surgery Clinic specializes in the diagnosis and treatment of traumatic and degenerative hip conditions, with a strong emphasis on both clinical care and scientific advancements. Its primary focus is on selecting patients for hip replacement surgery and providing ongoing, specialized postoperative care through regular follow-ups. In primary hip arthroplasty, the choice of implants is tailored to the bone quality, joint morphology, and the underlying pathology. The preferred approach involves non-cemented components, utilizing ceramic-polyethylene or ceramic-ceramic pairings.

The surgical technique prioritizes the preservation of periarticular soft tissues, reconstruction of the joint capsule, and minimizing the surgical incision to the essential minimum. This technique supports faster functional recovery: On postoperative day one, patients begin active and passive joint mobilization; On postoperative day two, patients are assisted to stand and initiate a structured rehabilitation program for ambulation. Most patients can discontinue the use of walking aids within 2–3 weeks.

Special expertise is dedicated to: Hip replacement procedures for dysplastic or post-traumatic conditions, Revision arthroplasty for loosened or failed implants.

The clinic addresses a wide range of hip and pelvic disorders where hip arthroplasty is indicated, including:

• PRIMARY OSTEOARTHRITIS
• SECONDARY OSTEOARTHRITIS caused by:
  • Congenital hip dislocation or hip dysplasia.
  • Slipped capital femoral epiphysis.
  • Coxa plana resulting from Legg-Calvé-Perthes disease.
  • Post-traumatic conditions, including traumatic dislocation and acetabular fractures.
• Paget's disease of bone.
• Idiopathic avascular necrosis.
• Post-traumatic avascular necrosis.
• Corticosteroid-induced avascular necrosis.
• Alcohol-induced avascular necrosis.
• Femoral neck nonunion (pseudoarthrosis).

Heads of Units: Dr. Cirella Mario Pio

Clinical coordinator: Dr. Scarale Michele

Clinical Activities

• Canal Syndromes of the Upper Limb
  • Carpal tunnel syndrome.
  • Guyon’s canal syndrome.
  • Frohse’s arcade syndrome.
• Carpal Instability
  • Scaphoid pseudoarthrosis, treated with platelet-rich gel and bone grafting;
• Wrist Osteoarthritis
  • Arthrodesis
• Radiocarpal and Intercarpal Osteoarthritis

Carpal row resection

• Thumb Osteoarthritis (Rhizarthrosis)
  • Reduction arthrotomy.
  • Trapeziectomy combined with biological suspension arthrotenoplasty.
  • Arthroplasty and arthrodesis.
• Heberden’s Osteoarthritis

Aesthetic arthrodesis of the distal interphalangeal joint.

• Malformations

Syndactyly, clinodactyly and camptodactyly.

• Tendon Disorders
  • De Quervain’s disease, stenosing tenosynovitis, hypertrophic tenosynovitis, and similar conditions.
• Rheumatoid Arthritis
  • Wrist synovectomy.
  • Synovectomy of the metacarpophalangeal and proximal interphalangeal joints.
  • Placement of metacarpophalangeal joint prostheses.
• Finger Deformities

• Swan-neck deformity.
• Boutonniere deformity.
• Claw deformity.
• Mallet finger.
• Wrist and Hand Trauma
• Fractures.
• Tendon injuries, among other conditions.

Traumatic Conditions:

• Osteosynthesis procedures for fractures of the humerus and scapulohumeral complex.
• Shoulder prosthesis implantation for four-part proximal humerus fractures or fracture-dislocations.
• Acromioclavicular joint stabilization for both acute and chronic dislocations.
• Rotator cuff repair for acute tears.
• Arthroscopic stabilization using anchors or Latarjet procedures for recurrent shoulder dislocations.

Degenerative Conditions:

• Arthroscopic acromioplasty and subacromial debridement for impingement syndromes and calcific tendinopathy.
• Lateral clavicle resection performed arthroscopically or via open surgery, for acromioclavicular joint arthritis.
• Rotator cuff reinsertion, performed through mini-open or arthroscopic approaches.
• Shoulder prosthesis implantation, including resurfacing prostheses, total shoulder replacements, and reverse shoulder prostheses, for concentric and eccentric arthritis.

Dr. G. Di Maggio, Dr. G. Doronzo

Clinical Activities

• Ankle Pathologies: Management of osteochondral lesions, ankle fractures and dislocations, and complications of malleolar fractures.
• Hindfoot Pathologies: Treatment of retrocalcaneal bursitis, talus and calcaneus fractures, and calcaneal deformities with directional osteotomies.
• Midfoot Pathologies: Addressed through osteotomies and arthrodesis procedures.
• Forefoot Pathologies: Management of axial deviations of the toes, hallux valgus, hallux rigidus, hammer toes, claw toes, and syndromes caused by functional overload.
• Joint Prostheses: Implantation of ankle and hallux prostheses.
• Pediatric and Adolescent Deformities: Surgical treatment of congenital clubfoot, flatfoot, and other structural deformities.
• Rheumatoid Foot: Orthotic and surgical management of deformities associated with rheumatoid arthritis.
• Neurogenic Foot: Comprehensive care, including orthotic and surgical interventions, such as tendon lengthening, tendon transfer, and osteotomies.

Clinical Activities

The Pediatric Orthopedics Clinic, located in the Giovanni Paolo II outpatient center, provides evaluations and therapeutic treatments for pediatric orthopedic conditions that do not require hospitalization.

Surgical treatments involving inpatient care are performed at the C.O.U. of Orthopedics and Traumatology in the Monumental Building.

The primary conditions managed include:

• Foot disorders: Metatarsus adductus, flat valgus foot, congenital clubfoot (equinovarus), calcaneovalgus, syndactyly, clinodactyly, and more.
• Limb length discrepancies.
• Lower limb axial deformities: Genu valgum (knock knees) and genu varum (bowlegs).
• Hip disorders: Congenital hip dysplasia, Perthes disease, slipped or displaced capital femoral epiphysis, and similar conditions.
• Conservative management of scoliosis.
• Conservative management of kyphosis.
• Cerebral palsy.
• Musculoskeletal disorders associated with spina bifida.
• Benign bone tumors and pseudotumoral conditions, including the application of autologous platelet-rich gel for bone regeneration in specific pediatric cases, such as bone cysts.
• Traumatology: Treatment of epiphyseal fractures, growth plate slips, fractures, tendon injuries, and related conditions.
• Pseudoarthrosis: Use of platelet-rich gel to enhance bone regeneration.
• Congenital muscular torticollis: Diagnosis and conservative or surgical treatment.

The Pediatric Orthopedics Clinic collaborates closely with: the Genetics Department for the study and management of genetically based disorders and the C.O.U. of Pediatrics, enabling inpatient care for young patients requiring hospitalization for diagnostic procedures, such as MRI under anesthesia.

Additionally, the clinic is integrated with the Multispecialty Spina Bifida Clinic, offering comprehensive care for conditions related to spina bifida.

Trauma patients are typically classified as "fragile" due to the urgent and often multispecialty nature of their conditions. Initial evaluation is conducted in the Emergency Department, where all necessary specialists are readily available as required.

The highly specialized physicians at Casa Sollievo della Sofferenza ensure that polytrauma patients receive comprehensive surgical interventions and management for any region-specific complications resulting from trauma.

Surgical treatment of fractures adheres to the most authoritative guidelines, such as those established by the AO Foundation (Association for the Study of Internal Fixation).

Special attention is dedicated to managing fractures in elderly patients, particularly medial and lateral femoral neck fractures, with surgical intervention performed within 48 hours to minimize mortality risks.

This protocol is applied only when the patient is free of severe comorbidities. For patients with significant clinical instability, initial stabilization is prioritized with the essential support of the Ortho-Geriatrics Service. If surgical risk remains prohibitively high, the orthopedic-geriatric care pathway concludes with conservative treatment and, where appropriate, transfer to a long-term care facility.

.