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Language Revista española de cirugía osteoarticular, 2020, vol. 55, no. 282
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- Lesión compleja del codo pediátrico: fractura de cóndilo externo asociada a luxación posteromedial de codo.(2020) Darás Ballester, A; Jover Jorge, N.; Doménech, P.Background and aim: External humeral condyle fracture associated with a posteromedial elbow dislocation is a very rare entity, of which there are very few cases published. Our objective is to present a complex case treated in our Hospital, the diagnosis, the treatment we chose, and the follow-up at 9 weeks after the intervention. Clinical case: 5-year-old boy with a posteromedial elbow dislocation associated with an external humeral condyle fracture, which was diagnosed by CT and treated surgically using an anterior approach over the elbow, open reduction, and osteosynthesis with K-wires. Results: clinical and radiological results 9 weeks after the intervention were excellent, presenting a radiographic consolidation of the fracture and an excellent range of joint mobility. Conclusion: early diagnosis and surgical treatment through open reduction and osteosynthesis of the external condyle is the gold standard on treatment for these injuries, since a bad reduction leads to poor long-term results.
- Fracturas de radio distal. ¿Progresa el desplazamiento entre la segunda y la sexta semana?.(2020) Capó Soliveres, Irina; Picazo Gabaldón, Benito R.; Orenga, S.; Gracia Ochoa, M.; Escribano Zacarés, S; Villanueva Dolcet, C.Las fracturas de radio distal son las más frecuentes en nuestra especialidad. El tratamiento conservador con inmovilización, basado en una serie de parámetros radiológicos, sigue siendo el más utilizado hoy en día. El objetivo de nuestro estudio ha sido evaluar el desplazamiento secundario de estas fracturas entre la segunda y sexta semana de evolución. Para ello hemos evaluado las fracturas de radio distal tratadas de forma conservadora en nuestro Servicio, durante el año 2016. De un total de 53 fracturas de muñeca tratadas de forma conservadora, un 49% de los casos presentó algún tipo de desplazamiento, si bien la mayor parte de estos tuvieron lugar antes de la segunda semana. Nuestros resultados fueron similares a los revisados en la literatura, en cuanto a datos demográficos y tasa de desplazamiento. Por lo que recomendamos intercalar algunos controles radiográficos semanales en aquellas fracturas que presenten desde el inicio algún parámetro de inestabilidad.
- Infección periprotésica aguda de rodilla por fusobacterium nucleatum. Revisión de la literatura a propósito de un caso.(2020) Català de las Marinas, J.; Antequera Cano, J.M.; Ferràs Tarragó, Joan ; Jordá Gómez, P.; Tasias, María; Baeza Oliete, J.Fusobacterium Nucleatum is an anaerobic commensal microorganism present in the oral cavity and some mucous membranes with great capacity to form biofilm. In the literature, only one case of acute periprosthetic infection of the knee by Fusobacterium Nucleatum has been reported, providing the second case. A 72-year-old man presented with an acute periprosthetic infection by fusobacterium nucleatum after a second time of a prosthetic knee replacement. Debridement and spacer changes were performed up to 4 times, associating parenteral antibiotic treatment. After ensuring the absence of infection, a modular revision knee prosthesis with stems was placed, with a satisfactory evolution after two years. Currently he has preserved ambulation, joint balance of 0º-50º and is free of infection. Fusobacterium Nucleatum infection is very rare, but aggressive and difficult to resolve, recommending two-stage replacement in acute infection and adequate antibiotic treatment to offer curative treatment.
- Deformidad tipo Checkrein del Hállux y dedos menores del pie sin fractura previa asociada.(2020) Rodríguez, J.R.; Blasco Serra, Arantxa; Rodriguez Pino, L; Mifsut Miedes, DamianWe present a bibliographic review and a description of the surgical technique in checkrein deformity of the hallux and lesser toes. This dynamic deformity causes a significant difficulty in walking and prevents patients from practicing any sport, since in the stance phase of gait toes are forced into maximum plantar flexion and end up trapped under the foot. In cases in which this is not associated with a bone fracture, the clinical suspicion causing the injury is a subclinical compartment syndrome. Treatment described in this work consists of a Z-plasty and the application of a pulvertaft suture in the flexor hallux longus. In the rest of the toes, any additional surgical procedure is not needed, as the deformity is corrected at the retromalleolar level.
- Infección periprotésica en pacientes ancianos tratados mediante hemiartroplastia de cadera tras fractura intracapsular ¿Es el uso de cemento impregnado con altas dosis de antibiótico es un factor asociado a su disminución?.(2020) Novoa, C.; Hurtado Cerezo, J.; Morales Rodríguez, J.; Rodrigo Pérez, José Luis; Blas Dobón, J.A.; Pelayo de Tomás, José ManuelObjective: to study whether the use of cement with a high dose of antibiotics is a factor associated with a lower infection rate in hip hemiarthroplasty after femoral neck fracture.Material and methods: a retrospective cohort study of 144 consecutive patients treated surgically for a cervical hip fracture with cemented hip hemiarthroplasty between February 2015 and February 2017. In 88 (61.1%) high dose antibiotic cement was used, defined as a concentration ? 5% of the total weight (Group 1) and in 56 (38.9%) cement without antibiotics was used (Group 2). The primary outcome variable was periprosthetic infection.Results: there were 2 (1.38%) infections that were classified as deep, both in group 1. One of patients had a superficial infection in group 2. We did not find differences in the rate of infections between the two groups. Among the intra-surgical complications, we found two failures of the cement-prosthesis interface (non-adherence of the cement to the stem at the end of the setting time), both cases occurred in group 1. There was no allergic or toxic reaction. The mean survival time of all operated patients was 2.7 years (95% CI: 2.4-2.9) at the end of follow-up. We found no differences in survival when stratified by the use or not of antibiotics in cement, p = 0.874.Conclusion:In our experience, in patients undergoing hip hemiarthroplasties the use of cement with a high dose of antibiotic is not associated with lower infection rate when intravenous antibiotic prophylaxis is correct.
- Micropartículas de PLLA y CHT como andamiaje para la regeneración del cartílago articular : modelo animal.(2020) Zurriaga Carda, J.; Mata Roig, Manuel; Sancho-Tello Valls, María; Milián Medina, Lara; Antolinos Turpín, Carmen Mª; Peregrín Nevado, I.; Gómez Ribelles, J.L.; Carda Batalla, María del CarmenThe avascular nature of cartilaginous tissue has historically lead to bad prognosis in osteochondral injuries. One of the possible treatment options of these injuries is the use of scaffolds, being superior to other options that obtain a fibrous cartilage as a result. We have elaborated PLLA and CHT microspheres as a scaffold for the treatment of osteochondral injuries carried out in albine New Zealand rabbits. They were distributed into groups with different proportions of microspheres, having also a control group with untreated injuries. Native cartilage of the contralateral knees was also analysed. Samples were evaluated in order to establish the quality of the cartilage obtained (using de macroscopic ICRS, microscopic ICRS II scales and a histomorphometric study).The groups with microspheres obtained a regeneration cartilage with hyaline characteristics, a good cell distribution and regular surface. The control group resulted in a cartilage with worse organization and an irregular surface.
