Log In 
Language Revista española de cirugía osteoarticular, 2002, vol. 37, no. 210
Permanent URI for this collection
Browse
Recent Submissions
- Variación rotacional de la pierna tras la artroplastia de rodilla(2002) Anchuela Ocaña, Javier; Dankloff Mora, ConcepciónTras la artoplastia de rodilla se produce un nuevo equilibrio axial en el plano horizontal cuya calibración es difícil tanto antes, como durante la cirugía y después de la misma, y cuyas consecuencias son de gran trascendencia para el futuro articular. Este estudio toma como referencia rotacional de la extremidad el ángulo de marcha, el cual constituye la suma global de los ángulos de rotación de los elementos óseos y articulares del miembro, analizando su evolución durante el primer año tras la cirugía. Se pudo observar que este ángulo no varió tras la cirugía en el miembro intervenido ni en el control, manteniendo el valor presente en la gonartrosis y dentro del rango de la normalidad, lo que evidencia la fiabilidad de la técnica quirúrgica actual en la ubicación de los implantes para el equilibrio axial, no sólo en el plano coronal, sino también en el horizontal, donde las referencias anatómicas y las medidas clínicas y radiológicas habituales son menos precisas.
- Severa complicación neurológica tras vertebroplastia percutánea(2002) Ramos Galea, Rafael; Paredes Herrero, Elena; Calero Aguilar, Hermógenes; Sánchez López, J. M.; García Alonso, Manuel FranciscoThe technique of percutaneous vertebroplasty for osteoporotic fractures and spine tumors was develop an important increase because there were a lot of publications with good results and low rate of complications. This fact was done a fast developing of instruments and new PMMA cements to simplify this technique and decreased the rate of complications. In our opinion the percutaneous vertebroplasty is a high demand technique and have a high potential of major neurological complications if it is not performed with use of appropriate safeguards, but the purpose of this article is not to condemn the technique because we have had a good results using it in this pathologies and the majority of publications have shown a high rate of excellent results.
- Fractura de Bennet con luxación metacarpofalángica del pulgar asociada(2002) Martínez Martín, Angel Antonio; Cuenca Espiérrez, Jorge; Herrera Rodríguez, Antonio; Pérez Serrano, LuisWe report a rare case of simultaneous Bennett's fracture and metacarpophalangeal open volar dislocation of the thumb. The Bennett's fracture was treated by percutaneous pinning. The open volar dislocation was reduced and the collateral ligaments, the extensor tendons, and the dorsal capsule, were surgically repaired. An infection of the metacarpophalangeal joint appeared four weeks later, which was treated by surgical drainage and antibiotic therapy. The resultant damage of this joint was treated by arthrodesis with an external fixator.
- Cicatrización meniscal: Estudio experimental en oveja(2002) Torrero Muñoz, José Ignacio; Gomar Sancho, Francisco; Sala Cuartero, DiegoLas características vasculares del menisco dificultan la cicatrización en las zonas más internas. Para su reconstrucción es necesario realizar técnicas que aumenten el aporte vascular a esa zona. Una de las técnicas propuestas es conectar la lesión interna con la zona periférica vascular a través de incisiones transversales. En 24 ovejas adultas de raza merina se realizaron incisiones longitudinales en la zona "rojo-blanca" del menisco interno, completándolos con un trazo transversal comunicado con el paramenisco, procediendo posteriormente a la sutura. Los animales fueron sacrificados a las 3, 6, 12, 26, 32 y 52 semanas, cuatro animales en cada periodo de tiempo. Los meniscos fueron extraídos al sacrificio y estudiados con microscopia óptica, técnicas de inmunohistoquimia para la colágena tipo II, y espectometría de absorción para glicosominoglicanos. La cicatrización fue incompleta en el 91% de los casos en la vertiente anterior de la herida y en el 81% de los casos en la vertiente posterior. La cicatriz inicial era rica en colágeno II, disminuyendo progresivamente hasta los mismos niveles del tejido meniscal normal. Los glicosominoglicanos aumentaron progresivamente en la cicatriz hasta duplicar los niveles del menisco normal. El estudio histológico de la cicatrización de la rotura meniscal no confirmaron los aparentes buenos resultados observados en artroscopia.
- Tratamiento quirúrgico de fracturas toracolumbares por vía posterior con instrumentación y fusión bisegmentaria(2002) Baños Clemente, A.; Ramírez Villaescusa, José Vicente; Martínez Castroverde Pérez, Jesús; Martínez Arnáiz, Francisco Javier; Portero Martínez, Eloy; Andrés González, José MaríaWe evaluate retrospectively the clinical, radiologic and functional outcomes of patients admitted to our hospital with unstable vertebral fractures with or without neurologic lesion treated with posterior fusion and transpedicular instrumentation of the upper and lower segment to the fractured vertebra. Thirty patients with unstable vertebral fracture of the thoracolumbar segment surgically managed between January 1993 and December 2000 are studied. The surgical approach was posterior in all cases, with posterolateral fusion with autologous corticocancellous graft. In 8 patients the fractured vertebra was also included. In two cases with neurologic impairment, a posterolateral decompression and laminectomy were associated. The Smiley-Webster score was used for the clinical and functional outcome with excellent results in 22 patients. The preoperative sagittal index was 14,4 degrees and improved to 4,2 degrees after surgery. The mean of vertebral body height was 46% preoperatively, and 78% postoperatively. The results obtained with this fixation are similar to other devices which require longer fusion and instrumentation or a second procedure to remove the hardware.
- Fracturas del pilón tibial: Resultados del tratamiento quirúrgico(2002) Gracia Rodríguez, Indalecio; Andrés González, José María; Jiménez Ortega, PlácidoA retrospective study was made of 50 fractures of the tibial plateau treated surgically. The fractures were classified according the Rüedi and Allogöwer. The treatment was open reduction and osteosynthesis in 35 cases and osteotaxis and minimal osteosynthesis in 15. The clinical results were satisfactory in 80% fractures type I and no satisfactory in 83% fractures type III. Better clinical results were obtained when the articular reduction was good and the degree of fracture displacement and collapse was small.
- Remodelación ósea en artroplastia total de cadera: Estudio con elementos finitos de la influencia del diseño(2002) Seral García, Belén; García Aznar, José Manuel; Doblaré Castellano, Manuel; Seral Iñigo, FernandoRemodelling of periprosthetic femoral bone after total hip arthroplasty is being studied extensively. Finite element analysis and computer-simulated remodelling theory have predicted that femoral bone-mineral density decreases after total hip arthroplasty. There is an important controversy about the clinical consequences of bone remodelling. It could decrease the bone strength, produce a cement mantle fracture, an aseptic loosening of the implant, or a periprosthetic fracture. So that it could be decline the survival of the hip prosthesis. The status of periprosthetic bone stock is an important concern when revision total hip arthroplasty is undertaken. This study has been conducted to evaluate the periprosthetic bone-mineral density following primary total hip arthroplasty by finite elements analysis and computer simulation. We have compared two cemented stems with different designs: Exeter (Howmedica International) and SHP (Biomet International) to study the phenomenon of femoral stress-shielding. We have found that with the best mechanical conditions and with the same materials, the prothesis design determined a different periprosthetic bone remodelling.
