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Language Revista española de cirugía osteoarticular, 2022, vol. 57, no. 290
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- Características de los pacientes con fracturas periprotésicas de artroplastia total de rodilla y cadera(Engloba Grupo de Comunicación, 2022) Lapeña Martínez, A; Pérez Aznar, Alfonso T.; Sebastiá Forcada, Emilio; González Navarro, Blanca; Martín Grandes, Rosario; Mahiques Segura, GerardIntroduction: The objective was to analyze whether patient-dependent characteristics were consistent or not in periprosthetic fractures of total knee arthroplasty (TKA) and hip arthroplasty (THA). Methods: A retrospective study of periprosthetic fracture was performed in 20 patients after TKA and 40 after THA. Results: The overall mean age was 75.9 years, with 65% females, without significant differences between groups, except for a higher rate of obesity in ATR. The mean presentation of the fractures was 119.7 months after THA, and 40.8 after TKA. A substantial rate of patients in both groups had a defect in the final limb alignment. Conclusion: Most patient-dependent variables were common in both arthroplasties. The main differences were the higher rate of obesity and the earlier appearance of the fracture after TKA. Osteopenia may be an influential factor but it could not be objectively verified in this study. The correct alignment of the components seems important.
- La vitamina-D para la prevención de fracturas osteoporóticas(Engloba Grupo de Comunicación, 2022) Jiménez Olivares, J; Lajara Marco, Francisco; González Navarro, Blanca; Mahiques Segura, Gerard; Martín Grandes, Rosario; Martínez Méndez, DanielIntroduction: The objective of this study was to show the initial results of an oral vitamin-D and calcium supplementation program in patients who had suffered a hip fracture for the prevention of subsequent fractures considered osteoporotic. Method: Prospective comparative cohorts study in patients older than 65 operated for hip fracture. The patients were divided into two groups according to the serum level of vitamin-D at admission: 1) hypovit-D group, 58 patients who were prescribed oral vitamin-D and calcium at discharge; 2) control group, 13 patients with a normal level of vitamin-D who did not have that supplementation. Results: The sample size could not be completed due to the scarcity of patients with normal vitamin-D levels. The subsequent fracture rate in the following two years was 20.7% in the hypovit-D group and 15.4% in control group, with no significant difference (p = 0.664). Conclusion: provisionally, with the available data, oral vitamin-D and calcium supplementation have not shown effectiveness in preventing a subsequent hip fracture.
- Asociación de luxación posterolateral de codo con fractura diafisaria ipsilateral de radio en adultos(Engloba Grupo de Comunicación, 2022) Ortega-Yago, María Amparo; Balfagón Ferrer, A.; Barrés Carsi, MarianoDiaphyseal fractures of the radius with posterolateral dislocation of the ipsilateral elbow are a rare entity with low frequency. The objective of this study was to analyze the diagnosis, treatment and follow-up of these patients and to review the cases described in the literature. We present 3 patients with this association operated on in our centre. The treatment of the dislocation in all three patients was closed. One patient required an external fixator due to a diaphyseal fracture of the humerus. An open reduction with internal fixation of the radius was performed in all three patients using an LCP-type locked plate. Two patients had complete recovery of mobility, and the last patient required arthrolysis of the elbow due to significant limitation in mobility. It is important to determine the stability of the elbow after reducing the dislocation, and perform an early treatment of the radius to try to reduce the time of immobilisation.
- Epidemiología y riesgo de hernia discal lumbar en trabajadores activos(Engloba Grupo de Comunicación, 2022) Chirca Leac, C.M; Martínez Méndez, Daniel; González Parreño, Santiago; González Navarro, Blanca; Mahiques Segura, Gerard; Martín Grandes, RosarioIntroduction: The objective of this study was to analyze the epidemiology of the low back pain and risk factors for lumbar disc herniation in the patient working age. Methods: Cross-sectional retrospective observational study identifying 75 patients with low back pain among active workers assisted by an occupational accident insurance company (73% men, mean age 46 years), of whom 48 (64%) had lumbar disc herniation. Results: Compared with workers without low back pain, only low economic status was a risk factor for low back pain (OR, 2.7; 95% CI, 1.1-7.1). Among patients with low back pain, comparing lumbar disc herniation and not, low economic status was also a risk factor for disc herniation (OR, 4.5; 95% CI, 1.6-12.8). There were no patients who required surgery after one year of follow-up. The average time of temporary incapacity for work was 83 days. Conclusion: Heavy work influences the appearance of disc herniation, but the only significant predisposing factor was low salary. Surgical treatment is infrequent.
- Papel del biovidrio en el tratamiento de la osteomielitis focal crónica(Engloba Grupo de Comunicación, 2022) Ortega-Yago, María Amparo; Argüelles Linares, Francisco; Baeza Oliete, J.Bioactive glass emerges as an alternative to the classic two-stage treatment of chronic focal osteomyelitis. It allows the eradication of the infection in a single surgical act without the need to add a local antibiotic thanks to its mechanism of action, facilitating the filling of the residual bone defect after debridement. A retrospective review of 29 patients treated with bioactive glass was carried out in order to analyze the results and secondary complications. We observed a significant improvement in the analytical parameters, with complete remission of the infection in 80% of the patients. 31% showed wound serum leakage with spontaneous resolution in 55% of patients in the first 7 days after surgery. Therefore, bioactive glass is effective against multiple microorganisms, with good results in recurrence rate and few complications, even though long-term studies are required to confirm these results.
- Comparación del daño tisular entre los abordajes lateral y anterior para la prótesis total de cadera(Engloba Grupo de Comunicación, 2022) de Anta Díaz, B; Martínez Méndez, Daniel; Sebastiá Forcada, Emilio; Pérez Aznar, Alfonso T.; González Navarro, Blanca; González Parreño, SantiagoIntroduction: The objective was to compare the tissue damage caused by the anterior and lateral approaches for a total hip replacement. Methods: Prospective cohort study comparing patients undergoing total hip replacement using an anterior or lateral approach. Tissue damage was assessed by serum levels of interleukin, tumor necrosis factor, and acute-phase reactants, and magnetic resonance imaging. Function was assessed with the Harris hip scale. Results: The parameters of tissue damage were significantly higher early with the lateral approach, although equalizing towards 30 postoperative days. There were no significant differences in functional outcome at 3 and 12 months. Conclusion: Although the lateral approach presents greater tissue damage in the early postoperative period, the functional outcome and speed of recovery in the short-term are similar between both approaches.
