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Language Revista española de cirugía osteoarticular, 2002, vol. 37, no. 212
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- Prótesis unicondílea de rodilla: Valoración clínica preliminar(2002) Ramírez Barragán, A.; Pérez Ochagavía, Federico; Martín Rodríguez, A. P.; Zan Valdivieso, J.; Domínguez Hernández, J.; San Juan Vidal, A.; De Pedro Moro, J. A.Los pacientes afectados de artrosis unicompartimetal de rodilla pueden ser tratados con diferentes métodos quirúrgicos. Los más habituales son la osteonomía tibial en jóvenes y la prótesis total de rodilla en ancianos. Una alternativa que va adquiriendo adeptos es la prótesis unicondílea. Tras un período inicial de gran euforia se pasó a otro de escepticismo, dando los resultados. El propósito del presente estudio es evaluar un nuevo diseño de prótesis de rodilla unicondílea (Alpina, IQL) a corto plazo siguiendo criterios clínicos y de calidad de vida. Se revisan 13 pacientes intervenidos entre Junio de 2000 a Marzo del 2002. Siete eran varones y seis mujeres. La edad media fue de 65 años (r=55-72ª). En doce casos la etiología fue artrosis y en uno necrosis del cóndilo interno. La evaluación clínica se realizó mediante el cuestionario sobre la calidad de vida SF-12. Todos los pacientes consiguieron una flexión de 110º y extensión completa. Sólo un paciente presentó molestias leves.
- Sarcomas de partes blandas. Análisis de 42 casos(2002) Simón Pérez, Clarisa; Martín Ferrero, Miguel Angel; Rodríguez Mateos, J. I.; Almaraz Gómez, Ana; Peral Martínez, José Ignacio; Sánchez Martín, A.The aim of this study is to evaluate the long-term prognosis of a series of patients treated in our hospital with regard to various clinical, diagnostic and therapeutic factors. A total of 123 patients who had been treated for malignant soft tissue tumours between 1979 and 1999 were reviewed. Of these, only 42 fulfilled the requirements to be included in our study. The outcome was evaluated taking into account prognostic variables identified in previously published studies and our own experience, and a statistical study of these factors as carried out with the Kaplan-Meier survival analysis method. The total survival time for all the cases studied was 33+8 (median + SE) months with a 95% confidence interval of 17.49 months. The time free of illness was 9+2 (median + SE) months with a 95% confidence interval of 6.12 months. The time-period until metastasis appeared was 26+5 (median + SE) months with a 95% confidence interval of 17.35 months. At the same time, the bivariant analysis of the many prognostic variables was performed. The high number of variables and the dispersion of the sample group suggest that it would be advisable to carry out more prospective, multicentric studies to reach definitive conclusions about this type of tumour.
- Osteolisis tibial secundaria a un implante ligamentoso de Leeds-Keio: Presentación de un caso(2002) Zafra, M.A.; Ballester, J.; Román, Manuel; Carpintero Benítez, PedroSome years ago the Leed-Keio prosthesis was widely used for anterior cruciate ligament repair. Due to the poor middle and long-term results, this technique has been abandoned. However, synthetic implants are used for other lesions such as knee extensor mechanism rupture and shoulder or lumbar spine instabilities. This paper presents a case of massive osteolysis of the tibial plateau requiring removal of the prosthesis and autologous bone graft, a complication not reported before.
- Quiste subcondral de comportamiento agresivo(2002) Panisello Sebastiá, Juan José; Martínez Martín, Angel Antonio; Cuenca Espiérrez, Jorge; Herrera Rodríguez, Antonio; Herrero Barcos, L.Subchondral bone cysts are rare lesions generally found next to major joints in adult patients. The clinical and radiological appearances are usually enough to allow the diagnosis, and most of them do not need any treatment. In unusual large lesions and in those cases of aggressive behaviour another diagnosis must be ruled-out.
- Tratamiento de las fracturas diafisarias de húmero mediante osteosíntesis con placa(2002) Zamora Rodríguez, J. M.; Modrego Aranda, Francisco Javier; Seral García, Belén; Seral Iñigo, FernandoTwenty-three humeral diaphyseal fractures were treated by open reduction and internal fixation using AO plating technique between 1991 and 1999. All but one fracture healed at an average of 94 days. The results were evaluated according to the criteria of Brumback. The 90 per cent of the cases had excellent or good results. The most important postoperative complication was transient radial-nerve palsy in three cases. All radial nerve palsies recovered between 45 days and 108 days. Internal fixation using plating technique give good results and provide predictable methods for achieving fracture stabilization and ultimate healing.
- Osteosíntesis cervical posterior con placa en lesiones cervicales(2002) Sánchez Martín, Miguel MaríaThe purpose of the present study is to retrospectively assess the long-term clinical outcome of patients with instable lesions of the lower cervical spine treated by internal fixation with Roy-Camille plates and screws on the lateral masses. Patients and methods: Fifteen patients (14 traumatic and 1 non traumatic) with instability who had internal fixation by plates and screws of Rody-Camille were studied. Except for 1 patient who had flexion fracture of the vertebral body, the remainder suffered lesions of the vertebral arc (uni-or bilateral dislocation, fracture-dislocation, separation-fracture of the lateral mass and major ligament sprains). The technique must be accurate to avoid vascular and nervous complications. Results: There was a strong association between clinical outcome and the final radiographic grade, according to Roy-Camille grading scale. The dynamic assessment of the lateral cervical radiographs showed an excellent result in all the lesions of the vertebral arc (13 patients studied). One case of vertebral body fracture had a bad result with flexion deformity, pain and need for material removal. Conclusions: the findings of the present clinical study suggest that the posterior cervical stabilization for unstable arc lesions, whether traumatic or not, is a excellent solution, specially when upper and lower lesions are associated.
- Reflexiones sobre la traumatología y la ortopedia en el nuevo milenio(2002) Sánchez Martín, Miguel MaríaThe present paper aims to focus the state of our discipline from the perspectiva of the clinical practice, academics and research in the new millenium. Orthopaedic surgery must adapt to the modern trends in patients care under the effect of technology, social and politic changes. Our survivorship as professional is to be based upon a methodical flexibility. The physician has to look for the patient's well, beyond his own, to gain respect and trust from the general public. The teaching must change trough interactive and cooperative means about patients issues. The research is becoming more difficult since more time and budget are required and not always available. It is important to assess surgical and also not surgical challenges. Being physicians in first place, and not only operator, will breakaway the taboo about surgical industry and its influence on clinical practice.
