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Language Revista española de cirugía osteoarticular, 2017, vol. 52, no. 272
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- Músculo ancóneo epitroclear. Una infrecuente causa de neuropatía cubital del codo(2017) Cortés Tronch, V.; Aguilella, L.The entrapment neuropathy of the ulnar nerve at the elbow is a frequent pathology with a variety of etiologies. One of them is the presence of an accessory muscle, such as the anconeus epitrochlearis. Although this muscle is frequently found in the general population, it is a rare cause of nerve compression. Despite its similarity to the idiopathic form, there are certain features that may suggest that the compression is due to this accessory muscle. This work reports a representative case in which the anconeus epitrochlearis was discovered during the surgical intervention.
- Osteocondritis disecante de localización troclear : a propósito de un caso.(2017) Honrubia Escribano, C. J.; López Lozano, Raúl; Silvestre Muñoz, Antonio; Pino Almero, L.; Mínguez Rey, María FeOsteochondritis dissecans of the knee represents a complex pathology which is very frequently diagnosed late. It is therefore a challenge for the orthopaedic surgeon to avoid such delay in the diagnosis, and to provide a suitable early treatment for the patient. We present the case of a patient with osteochondritis dissecans of trochlear grove localization, which is characterized by the uncommon location of the pathology (approximately 1% according to the series consulted). The patient is a 13-year-old male suffering from pain and repetition spills in his left knee of more than 2 years of evolution, which doesn?t allow normal sports activity. Even though the literature related to the osteochondritis dissecans of the knee located in the medial femoral condyle is abundant and its treatment and rehabilitation algorithms are clear, they are not for the rest of its much less frequent locations
- Experiencia con test de artrografía intraoperatoria para valorar la rotura de la sindesmosis tibioperonea(2017) Aguilar González, J. C.; Copete González, I.; Balfagón Ferrer, A.; Barrés Carsi, MarianoAnkle fractures frequently associate tibiofibular syndesmosis injuries, whose diagnosis allows intraoperative treatment that can prevent mid-long term complications. There are several clinical diagnostic tests and specific projections but they are difficult to interpret and standardize. The objective of the study is to evaluate a recently described intraoperative diagnostic test. We conducted the test by intraarticular contrast injection in ten patients with fractures type Weber B or C. The test was valuable in 8 cases and the result coincided with the other clinical test used. We detected a fracture in one case that had gone undetected and resulted in a change of treatment. There were no complications. Using a reproducible, cheap and safe test, we can obtain an easily interpretable image that complements the rest of clinical tests to support the surgeon in the decision to fix the sindesmosis in ankle fractures.
- Tratamiento de defectos óseos sépticos masivos femorales mediante artroplastia total de fémur(2017) Correa González, N. C.; Alguacil Pinel, J.; Baeza Oliete, J.Asociado al aumento en la frecuencia de artroplastia primaria, la cirugía protésica de recambio, en el contexto de un déficit de stock óseo es un escenario clínico cada vez más frecuente. En este tipo de pacientes, la artroplastia total de fémur aparece como una alternativa terapéutica válida, aunque no exenta de complicaciones. Presentamos 5 casos intervenidos de artroplastia total de fémur en nuestro centro entre los años 2012 y 2016. Todos los casos corresponden a pacientes que presentaban infección de artroplastia de cadera o rodilla, en quienes el déficit de stock óseo impedía una nueva cirugía de recambio. Fueron intervenidos 3 hombres y 2 mujeres con una media de edad de 60 años. El tiempo de seguimiento varió entre 6 y 67 meses. Tuvimos 3 casos de infección del implante femoral y un caso de luxación. El nivel de funcionalidad postoperatoria de los pacientes se midió con el score MSTS. El valor medio obtenido fue de 18,75 sobre un máximo de 30 puntos. Los mejores resultados se observaron en los apartados dolor y estado emocional. Por el contrario, los niveles más bajos resultaron de la necesidad de todos los pacientes, de utilizar algún dispositivo de ayuda para deambular. A pesar de la alta tasa de complicaciones obtenida, el nivel de satisfacción de los pacientes fue elevado. La mayoría de ellos refería estar muy contento con la intervención y no estar arrepentido de haberse operado
- Medidas para la prevención de la infección en la artroplastia de rodilla : prácticas habituales y evidencias(2017) Climent Peris, Vicente; Mifsut Miedes, Damian; Álvarez Llanas, A.; Strauch, M.; Baeza Oliete, J.; Valero Queralt, M.A.; Ferraro Esparza, L.; Martínez Algarra, J.C; Gilabert, E.; Gargallo, E.Infection after knee arthroplasty is one of the most feared complications and routine measures are applied to prevent it. The objective of this study is to identify which are the measures applied by the surgeons of the Valencian Community (CV) and know if the scientific evidence supports them or not. Methods. A descriptive cross-sectional observational study based on a survey of 64 surgeons and bibliographic searches on the aspects included in the survey were conducted. Results. 18.8% of the surgeons perform screening for SARM carriers and decolonization. 98.4% use cefazoline and 1.6% cefuroxime as antibiotic prophylaxis. With respect to the duration of antibiotic prophylaxis, 51% of surgeons administer three doses (24 hours prophylaxis), 23.4% use 2 doses and 17.2% of them use only one dose. 67.2% use 2% alcoholic chlorhexidine gluconate solution for surgical site preparation and 71.9% use adhesive incision drapes. Routine cement with antibiotics is used by 65.6% of respondents. The current scientific evidence supports antibiotic prophylaxis as performed by 100% of respondents; however there is no evidence for the superiority of the preparation of the skin with alcoholic chlorhexidine versus other antiseptics. There is also no evidence to support the use of adhesive incision drapes or the use of cement with antibiotics in a routine manner. Conclusions. It would be advisable for the CV surgeons to avoid the use of incision adhesive drapes and the application of cement with antibiotics in all cases. The preparation of the skin with alcoholic chlorhexidine does not seem to be more effective than other antiseptics in orthopaedic surgery. The screening of SAMR carriers and their decolonization seems to reduce the infection rate; its use can be recommended today, but studies with the largest number of patients that confirm their benefit are needed.
- Recidivas tras tratamiento con colagenasa : estudio histológico(2017) Sanjuan Cerveró, R.; Montaner Alonso, Daniel; Carrera Hueso, Francisco Javier; Vaquero Pérez, Manuelrecurrences following CCH treatment of Dupuytren?s disease are controversial and sometimes normal pathological anatomy is distorted. Our study aims to evaluate the presence of possible alterations of the disease at pathological level on samples of recurrence of Dupuytren?s disease (CCH vs fasciectomy). Methods: prospective, blind study for pathological and statistical analysis of patients who underwent fasciectomy due to recurrence of Dupuytren?s disease after previous treatment with collagenase or previous fasciectomy. Pathological study with H / E and immunohistochemistry. Results: a total of 8 patients were included (4 with previous treatment with CCH and 4 with fasciectomy). There were no significant differences in anatomopathological or inmonuhistochemical analysis. Conclusions: histologically, recurrences of Dupuytren Disease after fasciectomy or collagenase treatment are indistinguishable. The presentation of macroscopic forms other than those seen in fasciectomy is possible.
