Orthopedics and Traumatology

• Shoulder and elbow: osteoarthritis, shoulder instability and dislocation, shoulder fractures, clavicle fracture, epicondylitis (tennis elbow), epitrochleitis (golfer's elbow).
• Hand and wrist: Dupuytren's disease, trigger finger, De Quervain's tendonitis, rhizoarthrosis (arthrosis of the base of the thumb), carpal tunnel syndrome.
• Hip: coxarthrosis (arthrosis of the hip), traumatic and sports injuries, proximal femur fractures, post-traumatic problems and complications of hip surgery.
• Knee: articular cartilage injuries, primary and secondary gonarthrosis (knee arthrosis), anterior cruciate ligament injuries, meniscal injuries.
• Foot and ankle: forefoot pathologies, hindfoot pathologies, ankle pathologies, diabetic foot, complex trauma.
• Trauma: polytrauma and posttraumatic problems.
  

Shoulder and elbow pathologies

• Conservative therapy in the acute phase (brace).
• Rehabilitative treatments.
• Surgical treatments performed in open, minimally invasive or arthroscopic technique according to the pathology to be treated.
• Surgery to replace the joint with a prosthesis in cases of symptomatic arthrosis and when all attempts at conservative treatment do not lead to the desired success.

Hand and wrist pathologies

Hand surgery is used to treat degenerative joint diseases and rheumatologic conditions, such as infections, trauma, and tumors. Treatment options can be conservative or surgical. Hand surgeries are performed on an outpatient basis, and for more complex procedures, an evaluation visit with the specialist is conducted first.

• Surgical treatment of Dupuytren's Disease.
  Consists of removing, partially or completely, the palmar fascia with the aim of recovering extensibility of the fingers. The surgery can be performed under loco-regional or general anesthesia; it usually lasts 1 to 2 hours.
• Treatment of trigger finger
  Therapies range from the use of a night position brace, to courses of physiotherapy, local cortisone infiltration, and antiphlogistic medical therapy. In advanced stages, surgical treatment immediately resolves the problem while preventing progressive damage to the tendons. The surgery, lasting only a few minutes, is performed under local anesthesia.
• Treatment of De Quervain's tendonitis
  Conservative treatment with position brace and possibly cortisone infiltration. Surgical treatment of the hand, when necessary, is performed under local anesthesia. After surgery a splint is maintained for one week in order to protect the wound but the tip of the thumb is left free so as to allow full mobility of the wrist and fingers with immediate recovery of activities of daily living.
• Treatment of rhizoarthrosis
  Rehabilitation treatment with fabrication of custom-made braces and physiotherapy. Arthroscopic surgical treatment of the hand when necessary. Postoperatively, a thumb splint will be made that leaves the other fingers free.
• Diagnosis and treatment of carpal tunnel
  Diagnosis is made on the basis of clinical history and with the help of electromyography (EMG) examination, in addition to radiographic examination of the wrist. In the early stages, symptoms can often be resolved by changing a particular work gesture, use of a rigid brace or an armed wrist brace, and medical anti-inflammatory therapy. Surgical treatment of the hand, when necessary, is of short duration and is usually performed under local anesthesia and on a day-hospital basis. In selected cases, it can also be performed endoscopically. Full use of the operated hand is usually recovered within 4-6 weeks.

Hip pathologies

Servizio di Ortopedia e Traumatologia EOC is recognized as a national training center for minimally invasive anterior hip surgery.

• Primary total hip prostheses in anterior minimally invasive technique (AMIS): surgical access with small incision and innovative surgical technique with state-of-the-art implants.
• Revision prostheses: replacement of implants, reconstruction of bone or tissue defects.
• Treatment of traumatic and sports injuries of young people and athletes conservative intervention (e.g. osteotomy).
• Treatment of post-traumatic problems after fractures of the pelvis, hip, or femur.
• Treatment of complications of hip surgery.
• Surgical treatment of femur fractures: interventions aimed at reducing pain symptoms and ensuring early mobilization, starting physiotherapy sessions from the first postoperative day.

Knee pathologies

Cartilage regeneration
Infiltrative therapy (cortisone, hyaluronic acid, and platelet-enriched plasma-PRP), Arthroscopic surgical therapies, Microfractures, Abrasion, Autologous chondrocyte transplantation, Autologous osteochondral transplantation, Osteochondral transplantation with allograft (fresh allograft), Synthetic scaffolds, Stem cells and tissue engineering.

Knee Arthroplasty
Total prostheses with three-dimensional CT study to allow customized sizing of components and dedicated bone resection masks; surgical technique by computer navigation to allow better precision. Monocompartmental prostheses, partial prosthetic implants that replace only the diseased portion of the knee.

Foot and ankle pathologies

Management and treatment of injuries and trauma of the foot and ankle, both acute and the subsequent states after trauma; chronic, degenerative or syndromic/evolutionary pathologies.

Pathologies of the forefoot

• Hallux valgus
  • Osteotomy, arthrodesis (fusion of a joint).
• Hammer toe
  • Conservative treatment with shoe fitting.
  • Surgical treatment with temporary fixation.
• Hallux rigidus
  • Conservative treatment with shoe adaptation.
  • Surgical treatment with exostosis resection (cheilectomy).
  • Arthrodesis (fusion of the joint).
• Morton's neurinoma (Inflammation and enlargement of the interdigital nerve).
  • Conservative therapy with cortisone infiltration.
  • Surgical treatment with nerve resection.

Pathologies of the hindfoot

• Flat foot
  • Conservative treatment with orthotics.
  • Surgical treatment with osteotomy (bone cutting) of the calcaneus and transfer of the long tendon of the toes.
  • Triple arthrodesis (fusion of multiple joints).
• Hollow (and varus) foot
  • Correction hindfoot axis with osteotomy (cutting of bone) of the calcaneus.
  • Plantar fasciitis (inflammation of the insertion of the fascia at the sole of the foot).
  • Conservative therapy, physiotherapy, infiltrations.
  • Surgical treatment with release (cut and release) of the fascia and possible decompression of peripheral nerves.
• Tarsal tunnel
  • Conservative therapy.
  • Surgical treatment with release (isolation and release) of the tibial nerve.

Ankle pathologies

• Ligament injuries/sprain of the ankle.
  • Conservative therapy in the acute phase.
  • Surgical treatment in conventional technique (with possible correction of varus).
  • Surgical treatment in arthroscopic technique (with possible correction of varus).
• Osteochondral lesions (lesions of cartilage and underlying bone).
  • Conservative therapy.
  • Arthroscopic surgical treatment and removal of small fragments of cartilage.
  • Arthroscopic surgical treatment and microfracture (small holes in bone).
  • Surgical treatment of lesion replacement and axis modification Arthrodesis (fusion).
• Arthrosis of the ankle
  • Conservative therapy.
  • Axis modification.
  • Prosthesis.
  • Arthrodesis (fusion).
• Malleolar fractures.
  • Conservative therapy with cast or brace in case of compound fractures.
  • Surgical treatment with osteosynthesis (internal fixation using metal plates, screws or wires).
• Achilles tendon rupture
  • Conservative therapy with Künzli shoe.
  • Surgical treatment with minimally invasive technique.
  • Surgical treatment with conventional technique.
• Achilles tendon tendinopathy
  • Conservative therapy with physiotherapy and shock waves (insertional and noninsertional tendinopathy).
  • Surgical treatment with exostosis resection, debridement (cleaning) of the tendon and reinsertion, ev. reinforcement with other tendon (insertional tendinopathy).
  • Surgical treatment with debridement (cleaning) (noninsertional tendinopathy).
    

Trauma

Servizio di Ortopedia e Traumatologia EOC is the cantonal referral center for complex orthopaedics and is one of twelve Swiss centers for the care of polytrauma patients (Highly Specialized Medicine - MAS).

The multidisciplinary care of the polytrauma patient is designed so that the surgeon can coordinate the different specialist figures that may be involved (neurosurgeons, anesthesiologists, interventional radiologists...) to quickly achieve the optimal evaluation and treatment of the patient. Standardized protocols and procedures make it possible to optimize time and implement the correct and life-saving therapies, according to the most up-to-date criteria of international trauma societies.

Search

The research of the Traumatology and Orthopedics Unit is divided into clinical research (clinical trials) and translational research (laboratory).

Regarding clinical research, we conduct several clinical trials in order to discriminate and choose which is the best therapeutic approach for the individual patient, basing our choice on the most modern and up-to-date literature. On the other hand, as far as translational research is concerned, through our regenerative medicine laboratory, we delve into different topics related to the most frequent orthopedic and traumatological pathologies in order to have the best and latest techniques available.