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Language Revista española de cirugía osteoarticular, 2023, vol. 58, no. 293
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- Enfermedad de Van Neck-Odelberg: presentación clínica y actitudes diagnósticas a evitar(Engloba Grupo de Comunicación, 2023) Lapeña Martínez, A; Sevilla Monllor, A; Moril Peñalver, L.La enfermedad de Van Neck Odelberg es una entidad infrecuente y benigna. Sin embargo, puede comprometer la realización de pruebas diagnósticas agresivas dado su desconocimiento y similitud con enfermedades más graves. El objetivo de este trabajo es presentar el caso de un varón de 13 años con enfermedad de Van Neck Odelberg, así como su dificultoso diagnóstico y consecuencias ante el desconocimiento de esta patología.
- Fractura-luxación de Chopart en edad pediátrica(Engloba Grupo de Comunicación, 2023) Lapeña Martínez, A; Salom Taverner, M.; Martínez Gil, J L; Cucó Sanz, L; Enguídanos Sánchez, C.Chopart's fracture-dislocation is an extremely rare pathology in the pediatric age. High-energy trauma with the foot in the plantarflexed and inverted position seems to be the origin of dislocations produced in the midfoot as described in the bibliography. A fast reduction and fixation are necessary in order to preserve the state of the soft tissues and avoid fatal complications on the extremity.The aim of this paper is to present the case of an 11-year-old patient with Chopart's fracture-dislocation, as well as the recommendations based on our experience and found in the literature.
- Perfusión de baclofeno intratecal para el tratamiento de la espasticidad. Rotura del cateter. Caso clínico(Engloba Grupo de Comunicación, 2023) Ledesma Galey, L.; Méndez López, J.MIntrathecal therapy with baclofen is used for the treatment of severe spasticity, either of central or spinal origin. The system has an infusion pump and a catheter through which the administration of baclofen is allowed within the subarachnoid space, both spinal cord and brain. This therapy is indicated when there is an insufficient response to oral medication, and the dose cannot be further increased due to undesirable side effects. This method is associated with a number of complications. Depending on the series, the incidence ranges from 25% to 30%. The highest being those related to the catheter, reaching up to 16.5%. These range from its malfunction to the time of its replacement. The latter being the one that will be exposed in the clinical case.
- Osificación heterotópica en isquion. Localización infrecuente(Engloba Grupo de Comunicación, 2023) Ledesma Galey, L.; Méndez López, J.MHeterotopic ossifications (HO) are an alteration characterized histologically and radiographically by the formation of normal bony bone in soft tissues where its formation does not normally correspond. The pathology can affect the bones or the joints. It can originate in any extraskeletal location, where undifferentiated mesenchymal cells are found. Multifactorial etiology and cause still completely unknown. They can be found associated with arthroplasty, burns and a wide group of neurological injuries, including spinal cord injury, traumatic brain injury, anoxic brain injuries, cerebrovascular accidents, etc... In patients with central nervous system (CNS) damage, HO is a common complication, ranging from 11% to 76% of cases. In spinal cord injury, the frequency of HO varies from 5% to 60% depending on the study and whether the diagnosis is based on clinical symptoms or standard radiographic results. Symptomatic HO develops in approximately 10% of patients. The most commonly affected joint is the hip. Next in frequency is the knee, with a medial location (54.7%). It can also appear in other places such as the elbow, spine... less frequently. The appearance in the ischium is much less frequent. The indication for surgical treatment will only be in case of mobility restriction, hygiene or clothing limitation and risk of ulceration. This is going to be the case.
- Diagnóstico y tratamiento del pulgar en Z en edad pediátrica, a propósito de un caso(Engloba Grupo de Comunicación, 2023) Carratalá Pérez, Carla; Gómez Barbero, Patricia; Villar Blanco, Alfredo; Esteban y Peña, Mª MercedesIntroducción: La deformidad en ?Z? del pulgar supone una flexión de la articulación metacarpofalángica y una hiperextensión de la articulación interfalángica. Se trata de una deformidad típica de la artritis reumatoide, aunque en edad pediátrica suele ser de carácter congénito. Material y métodos: Presentamos el caso de un varón de 15 años que es diagnosticado de pulgar en ?Z? en estadio leve y tratado quirúrgicamente mediante liberación volar de partes blandas y retensado del tendón del extensor pollicis longus, según la técnica de Iwamoto. Discusión y conclusión: Para el correcto tratamiento de este tipo de lesiones, es fundamental diferenciar entre una deformidad reductible y una fija, así como valorar el estado de la articulación con las pruebas de imagen. En estadios precoces con deformidades reductibles, el tratamiento se basa en la reconstrucción del aparato extensor. En estadios más avanzados, se deberá recurrir a la artroplastia o a la artrodesis
- Tratamiento de la sinovitis villonodular pigmentada difusa de rodilla: sinovectomía artroscópica seguida de sinoviortesis radioisotópica(Engloba Grupo de Comunicación, 2023) Martínez López, D; Villar Blanco, Alfredo; Colomina Laiz, T; López López, S.; Rodrigo Pérez, José LuisPigmented villonodular synovitis (SNVP) is a benign but locally aggressive disease of synovial proliferation that can occur in all joints, tendon sheaths and bursae, with a predilection for the knee. The etiology of PVNS remains unclear. Magnetic Resonance Imaging (MRI) is the best diagnostic method to establish suspected SNVP, although synovial biopsy is the gold standard for diagnosis. Initial treatment is based on synovectomy, open or arthroscopic. After surgery, there is a high rate of recurrence.1 Radioisotope synoviotrosis as an adjunct to surgical synovectomy appears to decrease the rate of local recurrence. Management of a case of knee SNVP by arthroscopic synovectomy and adjuvant radiosynoviordesis is presented.
- Influencia de los trastornos del movimiento en la necesidad de recambio de prótesis total de rodilla primaria(Engloba Grupo de Comunicación, 2023) Gutiérrez Pereira, J; Madrigal Quevedo, A.; Martín Magaña, L; Ferrer Ferrando, J; de Anta Díaz, BIntroducción: Valoramos cómo influyen los Trastornos del Movimiento en la supervivencia de los implantes de prótesis total de rodilla primaria. Métodos: Estudio retrospectivo observacional analizando los pacientes intervenidos de prótesis total de rodilla primaria en nuestro centro que requirieron cirugía de revisión. Resultados: Encontramos una prevalencia mayor a la esperada por edad de Trastornos del Movimiento en el grupo de prótesis total de rodilla primaria que precisaron revisión por aflojamiento aséptico. Conclusión: Los Trastornos del Movimiento parecen influir en la supervivencia de los implantes de prótesis total de rodilla primaria.
- Lesiones por arma de fuego. Serie de casos y revisión sistemática(Engloba Grupo de Comunicación, 2023) Garrido Ferrer, J.F; Marco Diaz, L; Bertó Martí, X.; Gázquez Gázquez, G.; Hernández Ferrando, L.Background: gunshot wounds are a challenging task for the surgeon. Armed conflicts have decreased in Western World, but a review of the basic concepts is required because of the current situation in West Europe. Case report: seven cases about gunshot wounds are reported. From soft tissue injury to polytraumatized patients. Discussion: four mean topics are presented in this review. Soft and bone tissue, as well as vascular and neurological injury. Treatment is a disputed issue. It is important to know when debridement is required, how to deal with neurological o vascular lesion and how to fix a fracture in a damage control surgery. Conclusions: gunshot wounds show different clinical presentations and they have several treatment options. it is mandatory to train a multydisciplinary team in the emergency room.
