Revista española de cirugía osteoarticular, 1998, vol. 33, no. 193

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    Parálisis del nervio interóseo posterior tras luxación posterolateral de codo
    (1998) Asenjo Siguero, J.J.; López-Oliva Muñoz, Felipe
    We report an uncommon case of posterior interosseus nerve palsy in association with an elbow dislocation. The authors discuss about the mechanism and anatomical basis of this lesion.
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    Tratamiento quirúrgico de las fracturas de meseta tibial: Estudio de 53 casos
    (1998) Sanz Reig, J.; Cebrián Gómez, Román; Lizaur Utrilla, Alejandro; Gracia Rodríguez, Indalecio
    A review of 53 fractures of the tibial plateau treated with open reduction and internal fixation is presented. The average follow-up was 14 months. Attending to Schatzker's classification, we found 5 fractures type I, 3 type II, 24 type III, 6 type IV, 8 type V and 7 type VI. The results were excellent or good in 76%. In our study, results do not correlate with type of fracture, type of internal fixation or period of immobilization, but do with the articular step-off. The results deteriorated when the step-off was more than 3 mm.
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    ¿Interesa la creación de grupos interdisciplinarios para el tratamiento integral del anciano con fractura de cadera?
    (1998) Moleón Camacho, M.; Millares Lorenzo, J. L.
    Las personas mayors de 65 años con fractura de cadera suelen tener antecedents de fracturas vertebrales o de muñeca, así como presentar patologías crónicas de cierta importancia (enfermedades cardiovasculares, insuficiencia respiratoria, alteraciones metabólicas, etc.) y, una vez presentada la fractura, complicaciones postquirúrgicas (mortalidad entre el 11-20%, descompensación de patologías crónicas previas, etc.). En nuestro trabajo encontramos que para disminuir las complicaciones es necesaria la intervención de grupos interdisciplinarios de profesionales (Cirujano ortopédico, anestesista, médico internista o geriatra, rehabilitador, enfermeras, asistentes y trabajadores sociales, médico de atención primaria o de cabecera, siendo discutible la creación de Equipos de atención domiciliaria) para el tratamiento integral e integrado de los pacientes con fractura de cadera.
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    Nuestra experiencia con la enfermedad de Freiberg
    (1998) Montero Furelos, Luis Angel; Pombo, S.; Gómez Canedo, Juan Manuel; Irisarri, C.
    We analyze a series of 34 patients, 9 males and 25 females, with Freiberg's disease, detailing their location and severity at moment of the diagnosis. Clinically the severity of disease was variable, and frequently discordant with the radiological image. Only in 5 patients was necessary the surgical treatment. There was no etiologic factor clearly found in any of the cases, with and without traumatic precedents. We describe the radiological pattern of this disease. The MRI permits at early stage detection of bone anomalies.
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    Masa pélvica tras una artroplastia total de cadera: Una complicación rara del polietileno
    (1998) Seral García, Belén; García Pequerul, José Manuel; Castiella Muruzabal, Tomás; Seral Iñigo, Fernando
    La osteólisis producida por partículas tras una artroplastia total de cadera (ATC) es un fenómeno bien conocido y documentado. Pero la existencia de una tumoración de partes blandas tras una ATC es un hecho poco frecuente. Nosotros presentamos un caso poco habitual de fracaso del polietileno (PE) tras una artroplastia de cadera no cementada: una masa intrapélvica íntimamente relacionada con el psoasilíaco, al año de implantarle una prótesis no cementada tipo Mont-Blanc.
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    Hemangioma intramuscular de la infancia simulando rabdomiosarcoma
    (1998) Panisello Sebastiá, Juan José; Martínez Martín, Angel Antonio; Domingo Cebollada, Luis Javier; Alvarez Alegret, Ramiro; Martínez Tello, Ana Mª
    Se presenta un caso de hemangioma intramuscular de la infancia en una paciente de 14 meses de edad en quien la historia, examen clínico y técnicas de imagen sugerían un rabdomiosarcoma. El tratamiento plateado fue la escisión en bloque, y la anatomía patológica reveló la verdadera naturaleza de la lesión. Se revisan las características de este raro tumor y los elementos que lo hacen semejante a lesiones malignas.
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    Osteotomía valguizante de tibia con placa atornillada de angulación variable (VCO)
    (1998) Panisello Sebastiá, Juan José; Lecina Galve, F.; Maurain Viloria, Ana Isabel; Clavero Vicente, Enrique; Martínez Martín, Angel Antonio; González Agudo, José Alberto
    We report a retrospective analysis of 28 patients presenting varus deformity treated by proximal tibial opening-wedge osteotomy and using a screwed plate of variable angle. This device provides the desired correction, a steady and secure assembly allowing early knee movement. The average follow-up was 15 months. At that time, the period of functional recovery, mobility and need of functional rehabilitation were assessed. Short-term clinical and radiographic findings were similar to other series using selection criteria for suitable patients. The need of functional rehabilitation was markedly lower.
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    La artroplastia de Neer en las fracturas complejas del húmero proximal
    (1998) Francés Borrego, A.; García López, A.; Pérez, M. J.; León, A.; Marco Martínez, Fernando; López-Duran Stern, Luis
    We study the results obtained after acute treatment of a group of 32 patients diagnosed of four-fragment fracture of the proximal humerus in whom a Neer I hemiarthroplasty was used. The patients were assessed with clinic and radiological parameters, and for the evaluation of the results Neer criteria were used. The global results obtained were 69% of good and fair and 31% of bad results. The tuberosities attachment concentrate the great complication index, that together with other complications acconist for 18% of the cases. The success of the attachment had a positive correlation with functional results (p=0.0019). A meticulous technique joined with a good rehabilitation program is pointed as essential for being successful.
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    Técnicas de ahorro de sangre en cirugía ortopédica
    (1998) Llau Pitarch, Juan V.; Aguilar, G.; Mínguez Rey, María Fe; Reina, C.; Belda, J.; Gomar Sancho, Francisco
    Technique in orthopaedic surgery requires frequently transfusion of homologous blood which entails several risks. Nowadays, the importance of the decrease of both transfusion and overtransfusion has been proposed for this type of surgery. This aim can be reached by using different blood saving techniques including either the use of antologous blood or methods to minimize perioperative bleeding. The highest efficacy in order to diminish homologous blood transfusion combines several savings techniques as autotransfusion programs, controlled hypotension, and the use of new drugs such as erytropoyetin and aproinin. Restrictive criteria have to be established according to the more recent guidelines for blood transfusion.