October 2012 - MSE Congress Plus

Under the Auspices of
The Minister of Health
22nd
Final Program
Pancyprian
Accredited with 12 CME points.
Ankle
Orthopaedic
&
ot
Conference
Fo
In Association: with the
Hellenic Association of
26-28
Orthopaedic Surgery and
Traumatology and the Greek
College of Orthopaedic
Surgeons.
October 2012
The official language of the conference is English
Sponsors:
Hilton Cyprus Hotel
Organizer:
Accredited as:
EFORT FORA
MSE Congress Plus
tel. +35722466400 | fax.+35722767680 | email. [email protected] | www.mse.com.cy
2
26-28
Aγαπητοί Φίλοι,
October
2012
Σας καλωσορίζω στο 22ο Παγκύπριο Ορθοπαιδικό Συνέδριο, η θεματολογία
του οποίου αφορά στο πόδι και στην ποδοκνημική άρθρωση.
Η ΚΕΧΟΤ τα τελευταία 15-20 χρόνια έχει καταβάλει μεγάλες προσπάθειες για
την εκπαίδευση των ορθοπαιδικών ιατρών στη Κύπρο. Το φετεινό συνέδριο
εντάσσεται μέσα σε αυτά τα πλαίσια αλλά φέτος για πρώτη φορά κυπριακή
επιστημονική εταιρεία εκδίδει και δίνει στα μέλη της κατευθυντήριες γραμμές
για την αντιμετώπιση και θεραπεία συγκεκριμένων προβλημάτων. Γι αυτό
πρέπει να ευχαριστήσω θερμά το συνάδελφο Χριστόφορο Σολομωνίδη
ο οποίος είχε την ιδέα και δούλεψε σκληρά προς την ολοκλήρωση των
συγκεκριμένων οδηγιών.
Φέτος η εναρκτήρια τελετή του συνεδρίου θα γίνει στην αίθουσα τελετών του Πανεπιστημίου
Κύπρου και θα είναι αφιερωμένη στην έναρξη της λειτουργίας της πρώτης ιατρικής σχολής σε
κρατικό Πανεπιστήμιο της Κύπρου, το οποίο ευελπιστούμε να προσδώσει βαρύτητα στην άσκηση
της ιατρικής στη Κύπρο.
Tέλος θα ήθελα να εκφράσω τις θερμές μου ευχαριστίες στην EFORT (Εuropean Federation of National
Associations of Orthopaedics and Traumatology) για την πολύτιμη βοήθεια που μας παρέχει, στην
ΕΕΧΟΤ (Ελληνική Εταιρεία Χειρουργικής Ορθοπαιδικής και Τραυματολογίας) και στο ΚΕΟΧ (Κολλέγιο
Ελλήνων Ορθοπαιδικών Χειρουργών) για τη συνεργασία και συμπαράσταση όλα αυτά τα χρόνια.
Το κοινωνικό πρόγραμμα συμπληρώνεται με το επίσημο δείπνο του συνεδρίου που θα δοθεί στην
Πύλη Αμμοχώστου και θα είναι μεγάλη μας χαρά να σας δούμε εκεί.
Με συναδελφικούς χαιρετισμούς,
Νικόλαος Π. Μαρουδιάς
Πρόεδρος ΚΕΧΟΤ
Dear Friends,
Welcome to the 22nd Pancyprian Orthopaedic Conference!
In the past 15-20 years CAOST (Cyprus Association of Orthopaedic Surgery and Traumatology) has
endeavour to promote orthopaedic training and education in Cyprus and this year’s conference is
part of this ongoing effort. Also this year we have managed to issue and distribute to our members
a set of guidelines for the treatment of certain conditions.
For their help and continues support through the years we would like to thank EFORT and the
Hellenic Association of Orthopaedic Surgery and Traumatology as well as the Greek College of
Orthopaedic Surgeons for their SUPPORT.
The opening ceremony of the conference will be held at the University of Cyprus celebrating the
opening of the first public medical school in Cyprus.
We welcome you over and wishing you a pleasant stay.
Yours Sincerely,
Nicolaos P. Maroudias
President of CAOST
3
final program
22nd
PancyprianOrthopaedic
Conference
THE BOARD OF DIRECTORS
2011-2013
Chairman
Nicolaos P. Maroudias
Vice President
Tanos Andreas
Secretary
Georgiou Constantinos
Treasurer
Efstathiades Yiannis
Members
Sergiou Sergios
Shiamishis Georgios
Papaloukas Nicos
Spastris Petros
Athanatos Odysseas
Constantinou Vasos
Schizas Akis
Christou Andreas
Garpozis Demetris
4
5
Βέλτιστη ανάμιξη για οστικά τσιμέντα:
Εύκολο – ασφαλές – αποτελεσματικό*
Σύστ
η
ού
ανάμιξης κεν
μα
AEUS
ο σ τ ι κά τ σ ι μ έ
ντ
για
α
ΑΠΟ ΤΗ HER
PALAMIX® – εύκολος χειρισμός για όλες τις εφαρμογές
ομοιογενές και έτοιμο για εφαρμογή οστικό
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* ασφαλές
αξιόπιστος έλεγχος κενού μέσω δείκτη κενού
στο σωλήνα αέρα
* αποτελεσματικό ένα σύστημα για όλες τις εφαρμογές στην
προσθετική τσιμεντοποίησης χάρη σε μία
ποικιλία διαφορετικών μεγεθών φυσίγγων
και ειδικών παρελκομένων
* εύκολο
Heraeus Hellas EPE · ΛΕΩΦ.ΚΗΦΙΣΙΑΣ 124 · 11526 ΑΘΗΝΑ · ΕΛΛΑΔΑ · Τηλ: 210 6995 666 · Φαξ: 210 6995 664 · www.heraeus-medical.com
6
www.pitsilidis.gr
Π Ρ Ο Σ ΤΑ Σ Ι Α Α Π Ο Φ Θ Ε *
DC000718 12/2009
Ισορροπημένη Αποτελεσματικότητα και Ασφάλεια1,2
*ΦΘΕ: Φλεβική Θρομβοεμβολή
ΟΙ ΟΥΣΙΩΔΕΙΣ ΠΛΗΡΟΦΟΡΙΕΣ ΤΗΣ ΠΕΡΙΛΗΨΗΣ ΧΑΡΑΚΤΗΡΙΣΤΙΚΩΝ ΠΡΟΪΟΝΤΟΣ
ΕΜΦΑΝΙΖΟΝΤΑΙ ΣΕ ΕΠΟΜΕΝΗ ΣΕΛΙΔΑ ΤΟΥ ΕΝΤΥΠΟΥ
BOEHRINGER INGELHEIM EΛΛAΣ Α.Ε.
ΕΛΛΗΝΙΚΟY 2, 167 77 ΕΛΛΗΝΙΚO, ΑΘHΝΑ, ΤΗΛ.: 210 8906 300,
ΓΡΑΦΕIΟ ΜΑΚΕΔΟΝIΑΣ ΘΡAΚΗΣ: ΑΝΤΩΝΗ ΤΡIΤΣΗ 15-17 & ΜΑΡIΑΣ ΚAΛΛΑΣ 6,
57001,ΘEΡΜΗ, ΘΕΣΣΑΛΟΝIΚΗ, ΤΗΛ. 2310 424618
7
Αλλάζει την αντιπηκτική αγωγή
22nd
PancyprianOrthopaedic
Conference
FRIDAY 26/10/2012
14:30-15:00
REGISTRATIONS
15:00-16:15
SESSION A. BASIC SCIENCES FOOT & ANKLE
Chairmen: Andreas Tanos and Yiannis Vasiliou
15:00-15:15
Clinical Examination
Speaker: Andreas Christou
The function of the foot - Biomechanics
Speaker: Vlatis Georgios
The foot and ankle - Radiology
Speaker: Demos Michaelides
The use of foot pressure platform in designing of orthotic-orthopaedic insoles
Speaker: Diamanto Malliotou Papasavvas
Discussion
15:15-15:30
15:30-15:45
15:45-16:00
16:00-16:15
16:15-17:10
SESSION B. METATARSALGIA
Chairman: Akis Schizas
16:15-16:35
Etiology
Speaker: Yves Tourné
Operative treatment when & how-metatarsal osteotomies
Speaker: Fernando Alvarez
Discussion
16:35-16:55
16:55-17:10
17:10-17:30
Lecture:
Historic Findings & Symbolisms of footprints
Speaker: Eleftherios E. Dounis
17:30-18:00
COMMERCIAL EXHIBITION OPENING
18:30-20:30
Opening Ceremony / Welcome Reception
Dedicated at the opening of the medical school of the University of Cyprus.
Venue: University of Cyprus
(The language of the opening ceremony is Greek. Written translation in English
will be given to all foreign participants)
18:30-18:50 ADRESSES:
1. Rector of the University of Cyprus, Mr. Christofides Constantinos
2. President of the Cyprus Association of Orthopaedic Surgery and Traumatology,
Dr. Nicolaos P. Maroudias
8
8
3. Representative of the Ministry of Education and Culture, Dr. Eleni Meli
4. President of the Hellenic Association of Orthopaedic Surgery and Traumatology,
Dr. Dionisios-Alexandros Verettas
5. Vice President of the Hellenic Association of Orthopaedic Surgery and
Traumatology, Professor at the University of Thessalia,
Dr. Malizos N. Konstantinos
18:50-19:05 LECTURE:
Τhe Medical School at the University of Cyprus: who needs it?
Prof. Andreas Adam, Chairman of the Interim IT Medical School Board Committee,
Professor of Interventional Radiology at King’s Col lege London, and Clinical
Director of Radiology, Nuclear Medicine and Medical Physics, at Guy’s and St
Thomas’ Hospital.
19:05-20:30
COCKTAIL PARTY
08:00 - 10:00
SATURDAY 27/10/2012
08:30-10:00
REGISTRATIONS
09:00-10:00
FREE PAPER PRESENTATIONS
Chairmen: Lanitis Venetoklis
and Petros Spastris
PARALLEL SESSION
Room: Ahera
PHYSIOTHERAPY SESSION
Physiotherapy Session programme
at page 13
Aποκλεισμός του κνημιαίου και του περονιαίου νεύρου για επεμβάσεις άκρου
ποδός και ποδοκνημικής.
Λέκκα Ν., Κορδαλής Ν., Μανουλίδου Ρ.
outcome measure.
Lambros Athanatos, Mathew Nixon, Gill Holmes, Leroy James, Alf Bass
Management strategy for ankle impingement in athletes: a ten-year experience.
George D. Tsikouris, Panagiotis I. Intzirtis, Emmanouil V. Zambiakis,
Lucas Tamprantzis, Demetrios Tsikouris, Eleftherios Tsikouris,
Panagiotis Kourougenis, Sotirios K. Plessas
9
Fixation of Mitchell osteotomy with bioabsorbable pins for treatment of hallux
valgus deformity.
N. Efstathopoulos, S. Lallos, J. Lazarettos, D. Korres, L. Roumeliotis, VS Nikolaou
22nd
PancyprianOrthopaedic
Conference
The scarf osteotomy in hallux valgus surgery.
Malizos K.N, Samaras D, Dailiana Z, Gougoulias N, Varitimidis S, Hantes Mr
The LCP distal ulna hook plate for the fixation of distal ulna fractures.
Constantinos Kritiotis, Claire Simpson, Manish Gupta, Dominic Power
The medial femoral condyle vascularised bone graft for the treatment of non
union of the clavicle. A report of two cases.
Constantinos Kritiotis, Claire Simpson, Simon Tan, Dominic Power
10:00-10:30
BREAK / COMMERCIAL EXHIBITION
VISITING TIME
10:30-12:30
SESSION C. EFORT FORUM - FIRST RAY PATHOLOGY (H.V= Hallux Valgus)
Chairmen: Eleftherios E. Dounis, Louis Loizou
10:30-10:45
12:15-12:30
Opening of the EFORT forum
Speaker: Nicolaos P. Maroudias & Thierry Begue (EFORT)
Etiology - Natural History of Hallux Valgus
Speaker: Eleftheriou Kyriacos
How do you treat Algorithm + Conservative treatment
Speaker: Don Mc Bride
Distal osteotomies, when & how
Speaker: Yves Tourne
Proximal osteotomies, when & how
Speaker: Fernando Alvarez
Tarsometatarsal arthrodesis for the treatment of Hallux Valgus
Speaker: Thanos Badekas
Hallux Rigidus
Speaker: Don Mc Bride
Discussion & Summary of the EFORT Forum
12:30-15:30
LUNCH BREAK
12:30-14:00
Industrial symposium by AstraZeneca/Alector Pharmaceuticals
Room: Kantara
“Γαστροπροστασία από Μη Στεροειδή Αντιφλεγμονώδη: ο ρόλος των PPIs“
(Gastroprotection from NSAIDs: The role of PPIs)
Ομιλητής / Speaker: Σπήλιος Μανωλακόπουλος
Επίκουρος Καθηγητής Παθολογίας-Γαστρεντερολογίας,
Ιατρική Σχολή Πανεπιστημίου Αθηνών,
2η Πανεπιστημιακή Παθολογική Κλινική,
Γενικό Νοσοκομείο Αθηνών ¨ΙΠΠΟΚΡΑΤΕΙΟ¨
10:45-11:00
11:00-11:15
11:15-11:30
11:30-11:45
11:45-12:00
12:00-12:15
Light lunch will follow for all symposium participants
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13:45-15:30
26-28
Workshop by Orthofix Srl
Room: Ahera
“In a world of trauma a Galaxy of solutions”
October
2012
15:30-16:00
Keynote Lecture:
Chairman: Nicolaos P.Maroudias
Interventional Radiology: It’s Surgery, but not as surgeons
know it
Speaker: Andreas Adam
16:00-16:30
BREAK / COMMERCIAL EXHIBITION
VISITING TIME
16:30-19:30
SESSION D. TRAUMA
Chairmen: Malizos N. Konstantinos and Stathis Tourvas
16:30-16:50
19:10-19:30
Pilon Fractures
Speaker: Antoniou Constantinos
Calcaneal fractures open or minimal invasive Reconstruction
Speaker: Peter Rosenfeld
Calcaneal fracture management with circular frames below the ankle joint.
An innovative approach.
Speaker: Malizos N. Konstantinos
Talus fractures
Speaker: Dionysios - Alexandros Verettas
Lisfranc fracture dislocation
Speaker: Thierry Begue
Achilles tendon acute ruptures
Speaker: Antoniou Constantinos
Ankle instability acute and chronic
Speaker: Peter Rosenfeld
Diabetic Ankle Fractures
Speaker: Thanos Badekas
Discussion
20:30
Gala Dinner
16:50-17:10
17:10-17:30
17:30-17:50
17:50-18:10
18:10-18:30
18:30-18:50
18:50-19:10
SUNDAY 28/10/2012
09:00-11:00
SESSION E. ARTHROSCOPY IN THE ANKLE AND FOOT
Chairmen: Odysseas Athanatos and Nicos Papaloukas
09:00-09:15
Basic Principles and practical aspects of the Foot and Ankle Arthroscopy
Speaker: Peter Rosenfeld
11
final program
22nd
PancyprianOrthopaedic
09:15-09:30
Conference
10:30-11:00
Arthroscopic treatment of ankle impingement
Speaker: Prof Kang-lai Tang
Subtalar joint arthroscopy
Speaker: Prof Kang-lai Tang
Small joints arthroscopy of the Foot
Speaker: Kyriacos Eleftheriou
Endoscopy of the non joint disease of foot
Speaker: Prof Kang-lai Tang
Arthroscopic treatment of ankle osteochondral lesions
Speaker: Kyriacos Eleftheriou
Discussion
11:00-11:30
BREAK / COMMERCIAL EXHIBITION VISITING TIME
11:30-11:50
Lecture:
Chairman: Andreas Tanos
Problems of the lumbar spine associated to the kinematics of the lower limbs
Speaker: George S. Sapkas
11:50-13:35
SESSION F. ANKLE ARTHRITIS DEFORMITIES AND CONDITIONS
Chairmen: Yiannis Papayiannis and Sergios Sergiou
11:50-12:05
Adult acquired flatfoot deformity
Speaker: Vlatis Georgios
The Diabetic foot general principles of treatment
Speaker: Eleftherios E. Dounis
Open & Arthroscopic ankle arthrodesis
Speaker: Prof. Kang-lai Tang
Ankle arthritis ankle arthroplasty treatment
Speaker: Thanos Badekas
Triple arthrodesis and isolated fusions
Speaker: Vlatis Georgios
Cavovarus foot reconstruction
Speaker: Thanos Badekas
Discussion
09:30-09:45
09:45-10:00
10:00-10:15
10:15-10:30
11:05-12:20
12:20-12:35
12:35-12:50
12:50-13:05
13:05-13:20
13:20-13:35
END OF CONFERENCE
12
26-28
ΠΡΟΓΡΑΜΜΑ ΦΥΣΙΚΟΘΕΡΑΠΕΥΤΙΚΗΣ
ΕΝΟΤΗΤΑΣ
October
2012
ROOM: Ahera
προεδρείο: Δρ Γιάννης Ευσταθιάδης - Λάκης Δρουσιώτης
Θεματολογία Α
08:00 - 08:15
Α1. Δρ Άκης Ελευθερίου - Αντιμετώπιση των ασθενών με κατάγματα ποδοκνημικής
στην ορθοπεδική. Προτεινόμενοι τρόποι αξιολόγησης και αποκατάστασης
ασθενών με την συγκεκριμένη παθολογία.
08:15 - 08:30
Α2. Χρίστος Καραγιάννης - Φυσιοθεραπευτική αντιμετώπιση των ασθενών με
κατάγματα ποδοκνημικής. Προτεινόμενοι τρόποι αξιολόγησης και
αποκατάστασης ασθενών με την συγκεκριμένη παθολογία
08:30 - 08:40
Συζήτηση
Θεματολογία Β
08:40-08:55
Β1. Δρ Γιάννης Ευσταθιάδης - Αντιμετώπιση των ασθενών με τενοντοπάθεια
αχίλλειου στην ορθοπεδική. Προτεινόμενοι τρόποι αξιολόγησης και αποκατάστασης
των ασθενών με τη συγκεκριμένη παθολογία.
08:55-09:10
Β2. Μιχάλης Ευσταθίου - Φυσιοθεραπευτική αντιμετώπιση των ασθενών με
τενοντοπάθεια αχίλλειου. Προτεινόμενοι τρόποι αξιολόγησης και
αποκατάστασης ασθενών με την συγκεκριμένη παθολογία
09:10-09:20
Συζήτηση
Θεματολογία Γ
13
09:20-09:35
Γ1. Δρ Φοίβος Κυνηγός - Αντιμετώπιση ασθενών με χρόνια αστάθεια ποδοκνημικής
άρθρωσης στην ορθοπεδική. Προτεινόμενοι τρόποι αξιολόγησης και αποκατάστασης
ασθενών με την συγκεκριμένη παθολογία.
09:35-09:50
Γ2. Χρίστος Σάββα - Φυσιοθεραπευτική αντιμετώπιση των ασθενών με
χρόνια αστάθεια ποδοκνημικής άρθρωσης. Προτεινόμενοι τρόποι
αξιολόγησης και αποκατάστασης ασθενών με την συγκεκριμένη παθολογία
09:50-10:00
Συζήτηση
final program
Invited Speakers:
Andreas Adam
Professor of Interventional Radiology at King’s
College London
Clinical Director of Radiology
Nuclear Medicine and Medical Physics at Guy’s
and Thomas’ Hospital
Andreas Christou
Orthopaedic Surgeon
Antoniou Constantinos MD,MSc
Orthopaedic Surgeon - Traumatologist
Demos Michaelides
Radiologist
A Evresis Diagnostic Centre
Nicosia - Cyprus
Diamanto Malliotou-Papasavvas
Podologist
Nicosia - Cyprus
Dionysios - Alexandros Verettas MD, PhD,
MSc (Orth)
Democritus University of Thrace, Greece
President of Hellenic Association of Orthopaedic
Surgery and Traumatology (HAOST)
Don Mc Bride
Consultant Orthopaedic Foot and Ankle Surgeon
University Hospital North Staffordshire
Past President British Orthopaedic Foot and
Ankle Society
Council Member European Foot and Ankle Society
Council Member British Orthopaedic Association
Eleftherios E. Dounis M.D F.A.C.S
Consultant Foot Surgeon (emeritus)
Athens
Fernando Alvarez
Head of Foot and Ankle Unit
Hospital Sant Rafael, Barcelona, Spain
George S. Sapkas
Associate Professor in Orthopaedics
Medical School Athens University Greece
President of the Greek College of Orthopaedic
Surgeons
Kang-lai Tang, MD, PhD, Professor
Chief, Division of Foot and Ankle Surgery
Chief, Division of Shoulder and Elbow Surgery
Department of Orthopaedic Surgery
Southwest Hospital
The Third Military Medical University
Kyriacos Eleftheriou
MD, FRCS(Orth)
Foot & Ankle Fellow
Chelsea and Westminster Hospital
London
Malizos N. Konstantinos, MD, PhD
Professor & Chairman, Dpt of Orthopaedic
Surgery & Musculoskeletal Trauma, University
of Thessalia, Greece
Peter Rosenfeld
Consultant Foot & Ankle Surgeon
Imperial Hospital, Fortius Clinic
U.K
Thanos Badekas M.D
Director Foot & Ankle Clinic
Metropolitan Hospital Athens
Hon Treasurer European Foot & Ankle Society
Past President Greek Foot & Ankle Society
Thierry Begue (EFORT) M.D., Ph.D.
Senior orthopedic Surgeon
Professor of Orthopedic and Trauma Surgery
Chairman Department of Orthopaedic and
Trauma Surgery, Antoine Beclere Hospital,
University Paris-Sud XI, Clamart, France.
Professor of Orthopaedic Surgery, Bicetre Medical School, University Paris-Sud XI.
Vlatis Georgios
Orthopaedic Surgeon
Athens - Greece
Yves Tourne
Orthopaedic Surgery, Foot & Ankle Surgery
Past-President of the Association Francaise
de Chirurgie du Pied
Chairman Education Committee of EFAS
Groupe Chirurgical République-Grenoble-France
[email protected]
14
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ABSTRACT
BOOK
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FREE
PAPER
ABSTRACTS
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26-28
October
2012
ΑΠΟΚΛΕΙΣΜΟΣ ΤΟΥ ΚΝΗΜΙΑΙΟΥ ΚΑΙ ΤΟΥ ΠΕΡΟΝΙΑΙΟΥ ΝΕΥΡΟΥ ΓΙΑ ΕΠΕΜΒΑΣΕΙΣ ΑΚΡΟΥ
ΠΟΔΟΣ ΚΑΙ ΠΟΔΟΚΝΗΜΙΚΗΣ
Λέκκα Ν., Κορδαλής Ν., Μανουλίδου Ρ.
Γενικό Νοσοκομείο Αμμοχώστου
Σκοπός αυτής της εργασίας είναι να τονισθεί η αποτελεσματικότητα και η ασφάλεια του αποκλεισμού
του ισχιακού νεύρου στο επίπεδο του ιγνυακού βόθρου ως τεχνική επιλογής για χειρουργική
αναισθησία άκρου ποδός με τη χρήση και μη της ίσχαιμης περίδεσης. Ο αποκλεισμός αυτός αφορά
τεχνική επιλογής για ασθενείς μιας μέρας νοσηλείας, για επιβεβαρυμμένους ασθενείς, για ασθενείς
με αντένδειξη χορήγησης γενικής αναισθησίας και όταν δεν είναι εφικτοί οι κεντρικοί αποκλεισμοί.
Μελετήσαμε 13 ασθενείς, όπου οι 7 αφορούσαν κατάγματα έσω/έξω σφυρού, οι 3 κατάγματα
μεταταρσίων και οι 3 διόρθωση βλαισού μεγάλου δαχτύλου. Οι ασθενείς έλαβαν 30cc όγκου διαλύματος
Ropivacaine 0,5 %. Τοποθετήθηκαν σε πρηνή θέση, με υποστήριξη του άκρου. Αναγνωρίστηκε η
πτυχή με τα όρια του τένοντα του δικεφάλου του μηριαίου και του τένοντα του ημιυμενώδους
μυός. Στο μέσον τους σε απόσταση 7 εκατοστών από την πτυχή του γόνατος γίνεται η έγχυση του
τοπικού αναισθητικού μετά από ανίχνευση μυϊκής διέγερσης με τη χρήση νευροδιεγέρτη
( 2Hz,
100μsec) στα 0.4-0.6 mA σε βάθος 3- 5 εκατοστών. Ίσχαιμη περίδεση .τοποθετήθηκε κάτω από το
γόνατο σε 10 ασθενείς. Σημειώσαμε το χρόνο ανάγκης της πρώτης μετεγχειρητικής αναλγησίας,
την εμφάνιση τυχόν επιπλοκών και την ικανοποίηση των ασθενών.
Ο συγκεκριμένος αποκλεισμός αποτελεί εξαιρετική τεχνική για επεμβάσεις άκρου ποδός και
ποδοκνημικής . Παρατηρήσαμε δε ότι η μέση διάρκεια της μετεγχειρητικής αναλγησίας ήταν
280λεπτά. Δεν παρουσιάστηκε καμία επιπλοκή (παραισθησίες, ενδαγγειακή έγχυση) και οι ασθενείς
δήλωσαν ικανοποιημένοι από την τεχνική αυτή.
Ο α π ο κ λ ε ι σ μ ό ς α υ τό ς α π ο τ ε λ ε ί μ έ θ ο δ ο ε π ι λ ο γ ή ς σ ε ε π ε μ β ά σ ε ι ς ά κ ρ ο υ π ο δ ό ς
και ποδοκνημικής , ιδιαιτέρως σε επεμβάσεις με νοσηλεία μιας ημέρας.
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PancyprianOrthopaedic
Conference
THE ROLE OF PEDOBRAPRAPHIC ASSESSMENT OF FLATFOOT AND IT’S PLACE AS AN OUTCOME MEASURE
Lambros Athanatos 1, Mathew Nixon1, Gill Holmes2, Leroy James1 and Alf Bass1
1 Alder Hey Children’s Hospital, Trauma & Orthopaedics, Liverpool, UK
2 Alder Hey Children’s Hospital, North West Movement Analysis Centre, Liverpool, UK
Author correspondence: [email protected]
This paper is submitted as a free paper.
SCOPE OF THE PAPER
Flexible flat foot is considered one of the commonest normal variants in children’s orthopaedic
practice. The weight-bearing foot is usually regarded as flexible on the basis of results from clinical
and radiographic examination as well as measured foot-ground pressure pattern.
Our aim was to compare the pedobarographic and radiographic findings of normal arched and
symptomatic flexible flat feet and investigate if there were sensitive markers that could be used in
selecting patients for surgical correction.
PATIENTS/MATERIALS and METHODS
We retrospectively collected data from eighteen patients (ten to sixteen year old). Our control
group consisted of ten patients (twenty feet) with normal arched feet and the study group of eight
patients (fifteen feet) with symptomatic flat feet who were awaiting surgical correction. The mean
and standard deviations of three radiographic markers (Calcaneal pitch, Naviculocuboid overlap
and lateral Talo-1st metatarsal angle) in addition to foot pressures measured at the hindfoot, medial/
lateral/total midfoot (MMF, LMF, TMF), forefoot and the percentage of weight going through the
MMF over the TMF (medial midfoot ratio (MMFR) during the mid-stance gait phase are reported. In
addition, the sensitivity, specificity, positive predictive value and negative predictive value of the
pedobarographic parameters were estimated.
RESULTS
There was a significant difference in the Naviculocuboid overlap (P<0.001 T test) and Calcaneal pitch
(P<0.05 T test) between both groups. The flat feet group had significantly higher MMF, LMF, TMF
and MMFR (P < 0.001 Mann-Whitney). LMF had the highest sensitivity and negative predictive value
(94%) whereas MMF, TMF and MMFR had the highest specificity and positive predictive value (100%).
CONCLUSIONS
Compared to our control group, patients with symptomatic flexible flat feet had significantly higher
pressures distributed in the midfoot, in particular in the medial midfoot. Pedobarography appears
to be a sensitive and specific tool that can be
used, in conjunction with clinical and radiographic findings, in diagnosing flat feet.
Our study suggests that pedobarography could be used to measure the degree of deformity before
and after surgical intervention.
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October
2012
MANAGEMENT STRATEGY FOR ANKLE IMPINGEMENT IN AHTLETES: A TEN – YEAR EXPERIENCE
George D. Tsikouris1, Panagiotis I. Intzirtzis1, Emmanouil V. Zampiakis1,
Lucas Tamprantzis1,
Demetrios P. Tsikouris1, Eleftherios P. Tsikouris1,
Panagiotis T. Kourougenis1, Sotirios K. Plessas1
1Athens Kolonaki Orthopaedics & Sports Medicine Center
BACKGROUND: Soft-tissue and osseous anterior impingement syndromes of the ankle can be an
important cause of painful limitation of ankle movement, particularly in athletes. These conditions
arise from initial ankle injuries which, in a subacute or chronic basis, lead to development of abnormal osseous and soft-tissue thickening within the ankle joint.
AIM: To present the outcome of arthroscopic excision of restrictors in ankle movement with concomitant anatomic ankle ligament reconstruction in athletes.
PATIENTS and METHODS : Eighteen athletes, 12 males and 6 females, (of which, 9 basketball-players,
4 football-players, 2 dancers) were treated over the last 10 years. The mean age was 22 years. The
sports activities of all patients were dramatically deteriorated due to chronic ankle pain and/or a
“giving way” feeling. The thorough clinical examination included reproduction of impingement
pain (anterior, anterolateral, anteromedial, or posterior) and stability testing in comparison to the
contralateral ankle. Radiographs included anteroposterior, lateral and oblique views in a weightbearing position. Ultrasound and plain MRI testing was performed without exception. Each patient
underwent arthroscopic evaluation. Arthroscopic debridement of hypertrophic tissue arising from
AITFL, ATFL or deltoid was performed in 16 patients. Arthroscopic decompression of bony impingement (excision of tibial or talar osteophyte) was needed in 10 patients. Ankle ligament reconstruction
was performed in 13 cases (modified Brostrom in 11 athletes, deltoid reconstruction in 2 others).
Excision of osseous and soft-tissue components of posterior impingement via open posterolateral
approach was performed in 2 dancers. In addition, debridement and microfractures were indicated
in 4 patients with osteochondral lesions and to 2 patients was applied Autologus Chondrocyte
Implantation. A custom rehabilitation program was utilized for each individual.
RESULTS: Patients were followed up at 1, 3, 6, 9, and 12 months postoperatively using the FADI score.
The results at 12 months were ranged above 90 for 13 athletes, between 85 – 90 for 4 athletes and
between 80 – 85 for 1 athlete. Poorer results are correlated with concomitant osteochondral lesions.
The highest scores were achieved when ligament reconstruction had been performed.
DISCUSSION: Inadequately and inappropriately healed ligaments do not regain the mechanical
integrity that is necessary to stabilize the ankle against physiologic stresses. Chronic ankle instability
should always be suspected in an athlete with chronic ankle pain and findings of ankle impingement. A clinical exam and an ultrasound exam contribute in a more accurate diagnosis for an ankle
instability. The appearance of an injured ligament on plain MRI varies and is not reliable to estimate
the functional sufficiency of the ligament. Ankle arthroscopy provides great visualization of joint
pathology in impingement syndromes that is amenable to repair. Open ligament repair is reliable
and optimizes the functional results.
CONCLUSION: Arthroscopic treatment of anterior ankle impingement together with ankle ligament
reconstruction, when indicated, is essential for obtaining a stable and functionally efficient ankle.
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Fixation of Mitchell Osteotomy With Bioabsorbable Pins For Treatment Of Hallux Valgus
Deformity.
N. Efstathopoulos, S. Lallos, J. Lazarettos, D. Korres, L. Roumeliotis, VS Nikolaou,
2nd Department of Orthopaedics, Athens University, Konstantopoulio Hospital, Greece
ORAL PRESENTATION
Objective: We hypothesised that the use of bioabsorbable pins in Mitchell΄s osteotomy would
improve the outcome of patients treated for Hallux Valgus deformity.
Patients and methods: 68 patients underwent Mitchell osteotomy to correct hallux valgus deformity.
33 patients(Group A) had Mitchell osteotomy augmented with bioabsorbable pins. 35 patients were
treated with the classical operative procedure(Group B). Hallux valgus angle(HVA), intermetatarsal
angle(IMA), the AOFAS’ hallux–metatarsophalangeal–interphalangeal scale and the pain visual
analog score(VAS) were measured preoperatively and postoperatively.
Results: There was no statistical significant difference between the two groups as far as the improvement of the IMA , HVA and the AOFAS’ scale concerns. Patients of group A had significantly less
postoperative pain and returned to the previous activities earlier than patients of group B.
Conclusions: The usage of the pins didn’t improve the final outcome of the osteotomy. However,
allowed for faster rehabilitation due to less postoperative pain.
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October
2012
THE SCARF OSTEOTOMY IN HALLUX VALGUS SURGERY
Samaras D., Dailiana Z., Gougoulias N., Varitimidis S., Hantes M., Malizos K.N.
Department of Orthopaedic Surgery, University of Thessalia, Larissa, Greece
Aim: To evaluate the long-term results and present our experience with Scarf osteotomy.
Patients & Methods: Between 2001 and 2011, 84 patients (79 women and five men with mean age
of 53,7 years) underwent 96 scarf osteotomies. All operations (except 4 cases with spinal anesthesia)
were performed under peripheral nerve block. Akin osteotomy was performed in four cases and
44 lesser metatarsal osteotomies in 33 feet (38 Helal, 6 Weil). Toe deformities were corrected in 18
cases. Excision of Morton’s neuroma was done in one patient. Postoperatively a heel weight-bearing
shoe was worn for six weeks. Prophylaxis for thromboembolism was administered for 3 weeks. Mean
follow-up was 60 months (12-123).
Results: There was decrease of Hallux Valgus Ankle (HVA) from 37o (26-62) preoperatively to 17o
(5-28) postoperatively and of IMA from 16º (10-27) to 10º (5-16) respectively. The forefoot AOFAS
score improved from 45 (35-60) preoperatively to 87 (65-98) postoperatively. Nine early complications: intraoperative fractures (2), confirmed DVT (1), CRPS- type I (4), superficial infection (2) were
encountered successfully. There were 3 cases of failure of fixation – one required new ORIF with
plate. In two patients removal of prominent screws was necessary. In 3 cases with recurrence of
the deformity revision of lateral release was performed, but in one case an arthrodesis of 1st metatarsophalangeal joint was performed 5 years after initial procedure. In 9 of 96 operated feet the
patients were not satisfied.
Conclusions: Although the procedure is technically demanding with extending learning curve, it is
effective with acceptable rate of complications.
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PancyprianOrthopaedic
Conference
THE LCP DISTAL ULNA HOOK PLATE FOR THE FIXATION OF DISTAL ULNA FRACTURES
Constantinos KRITIOTIS, Claire SIMPSON, Manish GUPTA, Dominic POWER
Birmingham Hand Centre
Queen Elizabeth Hospital Birmingham
University Hospital Birmingham NHS Trust
Birmingham UK
Purpose : To report our early results with the use of an anatomical locking hook plate for the fixation of distal ulna fractures.
Methods : We performed a retrospective review of all cases of distal radius fractures requiring
simultaneous ulna fixation at the Birmingham Hand Centre between May 2010 and September
2012. The distal ulna fractures were classified using the Fernandez classification. The mean follow up
period was 28 months. Patients were assessed measuring both radiological and clinical outcomes.
Results : 436 patients had operative stabilization of distal radius fractures during the study period.
15 of the patients who required stabilization of the associated distal ulna fracture were treated with
a 2mm anatomical fixed angle locking plate. The age range of patients was 17 to 81 years (mean
47 years). All fractures united. There were no infections. One patients had a subsequent Darrach’s
procedure for DRUJ arthritis due to screw penetration. Three other patients had the plates removed
due to hardware giving them symptoms, which completely resolved after the removal of plates.
One patient had a malunion of the distal ulna due to inappropriate implant selection.
Conclusions : The LCP distal ulna hook plate provides reliable union of distal ulna fractures.
Type of Study/Level of Evidence : Therapeutic IV
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October
2012
THE MEDIAL FEMORAL CONDYLE VASCULARISED BONE GRAFT FOR THE TREATMENT OF NON
UNION OF THE CLAVICLE. A REPORT OF TWO CASES
Constantinos KRITIOTIS, Claire SIMPSON, Simon TAN, Dominic POWER
Birmingham Hand Centre
Queen Elizabeth Hospital Birmingham
University Hospital Birmingham NHS Trust
Birmingham UK
Purpose : To report our results from the use of medial femoral condyle vascularized bone graft in
two cases with clavicle non union.
Methods : In 28/02/12 and in 08/05/12 we performed in two patients medial femoral condyle vascularized bone grafting for clavicle non unions. The first case was an infected non union of the left
clavicle in a 46-year old female patient with concomitant iatrogenic brachial plexus damage and
the second case was a non union in a 46-year old patient following a corrective osteotomy of the
clavicle for brachial plexus entrapment in the callus after a malunion of the clavicle.
Results : The patients were assessed with radiological and clinical criteria. Both patients recovered
completely from their neurological problems due to the fact that there was not significant plexus
injury. The first patient progressed into complete union seven months after the operation and has
returned to her everyday activities (including working as a bus driver). The second patient is also
making a very good recovery and is able to perform his everyday activities without pain. His x-rays
reveal that his fracture is progressing to full union as well.
Conclusion : The vascularized medial femoral condyle bone graft proves to be a versatile tool in the
hands of the surgeon. It can help reconstruct small to medium size bone defects anywhere in the body
and certainly can be a very good alternative for the reconstruction of bone defects in the clavicle.
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POSTER
ABSTRACTS
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October
2012
TRANSCALCANEAL TALONAVICULAR DISLICATION ASSOCIATED WITH AN OPEN COMMINUTED
CALCANEAL FRACTURE: A CASE REPORT.
Vassilios Papathanasiou, Spyridon P. Galanakos, Stamatis Kyriakopoulos Helias Kotoulas, Ioannis
P. Sofianos
Orthopaedic Department General Hospital of Levadia Greece.
Patients and methods:
A 27-year-old injured his left hindfoot after a fall from height while at work. He was found to have
a deformity of his hindfoot and a wound measuring approximately 15 cm long extended from the
medial malleolus to the plantar aspect of his heel with
small bone fragments exposed in the wound. There was no neurovascular compromise
in his injured left foot. Anteroposterior, lateral, and oblique radiographs of the foot and ankle were
obtained and revealed a multifragmentary fracture of the calcaneum associated with a talonavicular
dislocation. The talus was planterflexed with its head portion displaced plantarwards through the
calcaneal fracture. The talonavicular joint was stabilized with 2-mm Kirschner wires (K-wires) introduced from the dorsal and medial aspect of the foot transfixing the talonavicular joint. Furthermore,
the calcaneal fracture was manipulated through the open wound to obtain better alignment and
using a hybrid Ace-Fisher External Fixation System (DePuy Ace, Warsaw, IN, USA).
Results: Three weeks later, the wound was healed completely without any further complications and
after that it was managed with normal dry sterile dressing changes At 6 weeks postoperatively, the
K-wires from the talonavicular joint were removed, but the hybrid fixator remained for an additional
10 weeks. At the end of the first postoperative year, range of motion of his left ankle was dorsiflexion
5_, plantarflexion 40°, inversion 20° and eversion 10°. The American Orthopaedic Foot and Ankle
Society hindfoot score6 at 18 months was 63.
Discussion Association of dorsal dislocation of the navicular from the talus with an open fracture
of the calcaneus is an uncommon but severe injury. It is known that the goals of open calcaneal
fracture management include timely healing of the soft tissue without infection and maintenance
of bony alignment Besides the good results of the case patient, the prognosis for most of these
types of injuries varies from severe functional limitations and/or chronic pain to even amputation.
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Conference
ΧΡΗΣΗ ΕΙΔΙΚΗΣ ΔΙΑΜΟΡΦΩΣΗΣ ΚΛΕΙΔΟΥΜΕΝΩΝ ΠΛΑΚΩΝ ΣΤΗ ΧΕΙΡΟΥΡΓΙΚΗ ΤΟΥ ΑΚΡΟΥ ΠΟΔΑ
Στ. Κυριακόπουλος, Η. Κωτούλας , Δ. Σκουτέρης , Η. Τσολής, Ι.Π Σοφιανός Ορθοπαιδική κλινική
Γενικού Νοσοκομείου Λιβαδειάς
Σκοπός: Σκοπός της εργασίας είναι η παρουσίαση της εμπειρίας της κλινικής μας στη χειρουργική
του άκρου πόδα με την εφαρμογή ειδικών κλειδούμενων πλακών τύπου DARKΟ
Υλικό και Μέθοδος: Πρόκειται για 15 ασθενείς 10 γυναίκες και 5 άνδρες ηλικίας από 25 ως 82
ετών οι οποίοι έπασχαν από βλαισό μέγα δάκτυλο (12 περιπτώσεις) και χρόνιο υπεξάρθρημα της
1ης Μεταταρσιοφαλαγγικής άρθρωσης (3 περιπτώσεις συνεπεία Ρευματοειδούς Αρθρίτιδας). Η
αντιμετώπιση του βλαισού μεγάλου δακτύλου έγινε με ανοικτή έσω οστεοτομία βάσης, συγκράτηση
της οστεοτομίας με ειδική τετράπλευρη πλάκα η οποία στο κέντρο έχει κατάλληλη διαμόρφωσησφήνα η οποία εισχωρεί ανάμεσα στην οστεοτομία και χρήση 4 κλειδούμενων κοχλιών. Στις
περιπτώσεις του υπεξαρθρήματος έγινε αρθρόδεση της μεταταρσιοφαλαγγικής άρθρωσης ύστερα
από κατάλληλη διαμόρφωση των επιφανειών με ειδικά ανατομικά γλύφανα
Αποτελέσματα: Η πόρωση των οστεοτομιών και η επίτευξη της αρθρόδεσης επετεύχθη σε όλες τις
περιπτώσεις. Η βάδιση έγινε άμεσα με τη χρήση ειδικού υποδήματος αποφόρτισης του προσθίου
ποδός για διάρκεια 20 ημερών.
Συμπεράσματα: Η χρήση των κλειδούμενων πλακών ανατομικών πλακών τύπου DARKO αποτελούν
μια αξιόπιστη λύση στη χειρουργική του άκρου πόδα. Το χαμηλό τους προφίλ και το υλικό κατασκευής
(τιτάνιο) την καθιστούν εύκολη στη χρήση ακόμα και στον μη πεπειραμένο χειρουργό. Προσφέρουν
εξαιρετική σταθερότητα η οποία επιτρέπει την άμεση κινητοποίηση του ασθενή περιορίζοντας πολύ
το ποσοστό αστοχιών και επιπλοκών.
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October
2012
Long term follow-up, of an Inflammatory leiomyosarcoma of the Ankle Joint.
VS Nikolaou, S. Lallos, J. Lazarettos, D. Korres, N. Efstathopoulos
2nd Department of Orthopaedics, Athens University, Konstantopoulio Hospital, Greece
POSTER
Abstract
Inflammatory leiomyosarcoma is a rare variant of smooth muscle cell tumor more often found in
the trunk, extremities and retroperitoneoum. We present a case of inflammatory leiomyosarcoma
arising in the ankle joint of a 55 year old white male. Immunohistochemistry, electron microscopy,
and cytogenetics is useful in the differentiation of this rare variant of leiomyosarcoma from other
tumors. Ten years after surgical excision of the lesion, patient is disease-free, with no symptoms
and good limb function. Prognosis of this variant seems to be favourable when treated with wide
excision of the tumor.
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Conference
RECURRENT INTRA-ARTICULAR OSTEOID OSTEOMA OF THE HIP AFTER RADIOFREQUENCY
ABLATION. LONG TERM FOLLOW UP.
N. Efstathopoulos , L. Roumeiotis, E. Brilakis, VS Nikolaou,
2nd Department of Orthopaedics, Athens University, Konstantopoulio Hospital, Greece
POSTER
Abstract
We present a case of a 53-year-old woman with recurrent intra-articular osteoid osteoma of the
hip 6 months after initial treatment with percutaneous radiofrequency ablation. En bloc surgical
excision of the osteoid osteoma and prophylactic internal fixation for impending stress fracture was
performed. The patient is pain free, has returned to normal function and there is no sign of recurrence
at the 9-year follow-up. Intra – articular osteoid osteoma, present a diagnostic challenge and often
they are misdiagnosed. Minimally invasive ablation techniques can fail in significant percentage
and then surgical excision with histological confirmation remains the definitive treatment of choice.
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2012
Morton’s Neuroma:
A clinical versus radiological diagnosis
Philip Pastides, Sameh El-Sallakh, Charalambos Charalambides
The Whittington Hospital, London, UK
Aims: The aim of our study was to compare the clinical versus radiological diagnosis of patients
suffering from a Morton’s neuroma.
Methods: Clinical assessments and pre-operative radiological imaging of patients who had excision
of a Morton’s neuromas were retrospectively compared.
Results: 43 neuromas were excised from 36 patients over 68 months. The commonest clinical
symptoms were tenderness on direct palpation (100%), pain on weight bearing (91%) which was
relieved by rest (81%). The most sensitive clinical sign was a Mulder’s click. Clinical assessment had a
sensitivity of 98% (42/43). Ultrasonography had a sensitivity of 90% (28/31) and magnetic resonance
imaging had a sensitivity of 88% (14/16).
Conclusion: There is no absolute requirement for imaging patients who clinically have a Morton’s
neuroma. The two main indications for imaging are (a) an unclear clinical assessment and (b) cases
when more than one web space is affected. Ultrasonography should be the investigation of choice.
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Conference
SUTURE FIXATION OF AKIN OSTEOTOMY: CLINICAL RESULTS AND COST ANALYSIS OF A PROSPECTIVE STUDY
Philip Pastides, Ahmad K Malik, Bhupinder Mann, Charalambos Charalambides
, Charalambos Charalambides
The Whittington Hospital, London, UK
Aims: In his original work, Akins did not describe the use of any metal work for his osteotomy. Today
the osteotomy is most commonly held and fixed with either a staple or screw, however we describe
the results obtained with a simple suture technique.
Methods: Data was prospectively collected on 125 consecutive patients undergoing an Akin osteotomy. The hallux valgus (HV) and intermetatarsal (IM) angles pre and postoperatively were recorded.
Patients were reviewed at 6 week follow up to assess their function and alignment. A cost analysis
was also performed comparing different fixation methods.
Results: 111 of the patients were female and the average age at time of surgery was 49 years. 104 cases
were in conjunction with hallux valgus correction while 21 cases were for hallux interphalangeus.
The mean preoperative HV angle was 33.3 degrees (range 22 to 53), and the IM angle 13.3 degrees
(range 9 to 25). At the 6 week follow up all patients had shown signs of radiological union. The postoperative HV angle was 12.4 degrees (range 7 to 17) and the IM angle 6.4 degrees (range 5 to 11)
Conclusion: This method is a quick, easy, implant free method of fixing the Akin osteotomy, with
no need for removal of metalwork. In addition it is a cost effective method which is clinically just as
effective as methods requiring a staple or screw
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October
2012
MINIMALLY INVASIVE CHEILECTOMY FOR THE TREATMENT OF LOW GRADE HALLUX RIGIDUS:
A PROSPECTIVE STUDY REPORTING ON PATIENT OUTCOME
Philip Pastides, Sameh El-Sallakh, Charalambos Charalambides
The Whittington Hospital, London, UK
Introduction: Hallux rigidus is a benign condition that can cause significant restriction of everyday
function and activities. It can lead to significant restriction of everyday function and recreational
activities.
Methods: 41 patients (54 feet) with grade I to III hallux rigidus underwent minimally invasive cheilectomy over a twenty month period. The mean age was 43 years. Outcomes were quantified using
the American Orthopaedic Foot and Ankle Society Hallux Metatarso-Interphalangeal scoring system.
Results: At six weeks, AOFAS-HMI scores improved from 88.2 to 71.2 (p<0.001). Improvements were
noted in pain, function, footwear and range of movement (p<0.002). Most of the patients returned
to clinic in their own shoes at two weeks and all of them at six weeks. Thirty patients (73%) had
returned to sporting activities by six weeks. Isolated cases of painful scars and altered sensation
completely resolved by three to six months.
Conclusion: Minimally invasive cheilectomy is a joint preserving procedure that produces good
short to mid term results, with minimal disruption to the soft tissues around the hallux. We advocate the use of this procedure in patients with grade I to III hallux rigidus and no pain during mid
range of movement.
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Conference
DEBRIDEMENT AND MICROFRACTURE IN THE TREATMENT OF LATE STAGE FREIBERG’S DISEASE
Philip Pastides, Sameh El-Sallakh, Charalambos Charalambides
The Whittington Hospital, London, UK
Background: Freiberg’s disease is an uncommon condition of anterior metatarsalgia that involves the
head of metatarsals. Several operative techniques have been described to treat late stage disease.
Methods: We retrospectively reviewed a consecutive series of patients who presented to our institution who did not respond to conservative methods. These patients were treated surgically with
an operative technique involving microfracture of the metatarsal head and reattachment of the
cartilage flap.
Results: Mean follow up was 49 post operative months (18-96). At six months, mean visual analogue
pain score at rest and on mobilising was 2.1 (0-3) and 3.1 (0-5) respectively (p<0.05). All 11 patients
had reported a satisfactory outcome and return to acceptable activity levels.
Conclusion: This operative technique is a safe and feasible treatment option for patients suffering
from late stage Freiberg’s disease. It is advantageous as is not causing shortening or other anatomical abnormalities in the area.
All of our patients reported a significant reduction of pain in their feet and all were able to walk
and run almost pain free. There were no reported cases of severe restriction of movement or fixed
deformity of the toe. We conclude that our technique is a successful alternative operative technique
for late stage Freiberg’s disease.
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October
2012
The Organizing Commitee would like to thank the following
companies for their contribution:
Main Sponsors:
AstraZeneca / Alector Pharmaceuticals
Eurobank EFG Cyprus
Orthofix Srl
Sponsors:
Bayer Health Care / Novagem
Marios Theocharides Ltd
Pfizer Hellas (Cyprus Branch)
Unimed (Cyprus) Ltd
Vouros Healthcare Ltd
Supporters:
A. Constantinides Pharmaceuticals
Aegis Ltd
Anatomic Help
Boehringer Ingelheim / CPO
George Petrou Ltd
Heraeus Hellas
Lifepharma Ltd - Member of MSJ Group of Companies
MSD
Mundipharma Pharmaceuticals Ltd
Remedica
The Star Medicines Importers Co Ltd
Traumatonic Ltd
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18
17
LIFT
EXHIBITION PLAN
20
16
15
14
13
1
2
3
4
5
12
11
10
9
8
7
6
26-28
October
2012
Booths:
1
Aegis Ltd
3
Mundipharma Pharmaceuticals Ltd
4
MSD
5
Traumatonic Ltd
6
AstraZeneca/Alector Pharmaceuticals
7
Remedica Ltd
9&10
Anatomic Help
11
The Star Medicines Importers Co Ltd
13
George Petrou Ltd
14
Orthofix Srl
15&16 Bayer Health Care/Novagem.
17
Unimed (Cyprus) Ltd
18
Marios Theocharides Ltd
19
Pfizer Hellas (Cyprus Branch)
20
Vouros Healthcare Ltd
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