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Language Revista española de cirugía osteoarticular, 2006, vol. 41, no. 227
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- Fijación híbrida de componentes en la artroplastia de revisión de rodilla. Resultados clínicos, radiológicos y gammagráficos a medio plazo.(2006) Gómez Vallejo, J.; Seral García, Belén; Blanco Baiges, E.; Seral Iñigo, FernandoBackground: The revision total knee arthroplasty using hybrid stem fixation is one of the most common methods in the prosthesis loosening treatment. Methods: We retrospectively reviewed 19 patients who under- went revision total knee PFC TC-3 Sigma performed between January 2001 to December 2004. The averaged age was 73.4 years at the time of operation. Patients were evaluated clini- cally, radiographic and scintygraphic using the American Knee society score, the Knee Society total knee arthroplasty roent- genographic evaluation modified by Fehring and the SF-36. The average follow-up was two years. Results: The average knee score improved from 27,8 points to 58,4 (11-95). The average functional score improved from 37,4 points to 59,8 (25-100). According to the radiographic study 17 of the 19 femoral implants with cementless stems were considered stable, 2 were categorized as possibly loose requiring close follow up, and none were loose. In the tibial implants only one case were considered possibly loose, the rest was stable. With respect to scintygraphic evaluation the bone scan was posi- tive in 12 cases in tibia and 8 in femur. A estatistical signifi- cance was found between the SF-36 and the KSS score. Conclusion: The PFC TC-3 Sigma system has demonstrated a good midterm results. By means the exploration and the KSS score we have obtained real conclusions on radiographic sta- bility and scintigraphic scan. It will be necessary to consider the long term results of the images studies and the possible relation with the aseptic loosening.
- Clavo Gamma 3 (Stryker) para el tratamiento de fracturas trocantéreas: nuestra experiencia durante el año 2005(2006) Varela Egocheaga, José Ramón; Ferrero Manzanal, F.; Montero Díaz, M.; Fernández Villán, María; González Sastre, VanessaObjetivos: estudiar los resultados del sistema de enclavado Gamma 3 en el tratamiento de las fracturas trocantéreas durante el año 2005. Material y Métodos: 73 pacientes con fractura trocantérea mayores de 60 años tratados mediante enclavado céfalo-medular Gamma 3 durante el año 2005 con un seguimiento de 8 a18 meses. Edad media 80 años, 40% de los pacientes deambulantes de forma independiente previo a la fractura, 50% ASA III y IV. Resultados: tiempo quirúrgico 90 minutos, 54% de pacientes transfundidos con una media de 0,89 concentrados por paciente sin diferencias estadisticamente significativas entre aquellos en lo que se colocó y tapón y los que no; 63% de los pacientes deambulan si ayuda en el pstoperatorio. Conclusiones: el sistema Gamma 3 proporciona resultados fiables y reproducible en cualquier variedad de fractura trocanterea y nos parece un sistema eficaz y válido para el tratamiento de este tipo de fracturas.
- Fracturas por estallido toracolumbares: pasado, presente y futuro.(2006) Escribá Urios, I; Escribá Roca, Ismael; Gomar Sancho, Francisco
- Recambio de platillo de polietileno en prótesis de rodilla integrada. A propósito de un caso(2006) Canillas del Rey, F.M.; Nieto López, Daniel; Carballo Vázquez, F.; Sanjurjo Navarro, J.Presentamos un caso un desgaste de polietileno en una prótesis de rodilla cementada sin signos de aflojamiento. La paciente de 84 años de edad fue intervenida hace catorce años por gonartrosis sintomática. La paciente había empeorando clínicamente y acude a nuestro centro por dolor e inestabilidad. En la radiografía se aprecian signos de un importante desgaste del polietileno sin aflojamiento de los componentes metálicos. El modelo implantado no se fabrica en la actualidad y se decide el tallado de un platillo de polietileno para que se adapte a la bandeja tibial a la cual se cementa. A los dos años de la cirugía la paciente está asintomática, con una buena funcionalidad y sin signos radiológicos de desgaste. Creemos que es el primer caso descrito de esta solución para un problema que puede aparecer cada vez con más frecuencia en la práctica quirúrgica.
- Análisis de los factores de riesgo de las fracturas vertebrales osteoporóticas.(2006) Martorell Meseguer, E.; Renovell Ferrer, Pablo; Blasco Mollá, María Carmen; Gomar Sancho, FranciscoThis prospective cohorts study includes patients who were hospitalized, due to osteoporotic fractures, from October 2004 to April 2005, at the Orthopaedics and Trauma Department at Hospital Clínico Universitario of Valencia. This study is included in GIOS Project (Integral Management Project for patients older than 50 years suffering osteoporotic fracture). A total of 449 patients have been included in the study, 59 patients suffered osteoporotic vertebral fracture and 390 patients suffering non-vertebral osteoporotic fractures, such as hip, distal radius and proximal humerus. The risk fac- tors of both groups have been analyzed and matched by age to be compared. It has been found incidence differences in age between both groups, as well as a greater influence of non-related age factors in the osteoporotic vertebral fracture group. From the results, it can be appreciated that not even a 10% of the patients included in the study, were previously tre- ated against osteoporosis, being desirable to detect patients with a high risk of suffering this type of fracture, in order to reduce the risk factors and start preventive treatment. Due to the growth of elder population, the number of osteoporotic fractures will increase substantially in future years, unless cost-effective control programs as GIOS are implanted.
- Deformación plástica del antebrazo: revisión y caso clínico(2006) Fernández Hernández, O.; Sánchez Herráez, S.; González-Arabio Sandoval, D.; Sánchez Lázaro, Jaime; Lozano Muñoz, A. I.Plastic bowing of a bone is a rare entity that some- times goes unnoticed. It’s a typical injury in children, who have more elastic bones than adults. Most of the plastic bowing of the forearm take place by falls with an outstretched arm, causing deformities, pain and a limitation of pronation and supination. In order to reduce the curvature of the bone, opposing forces to those that produced the injury are needed, maintained for a long time. In children younger than 4 years, with an enormous remodelling capacity, only great deformi- ties >20º should be reduced. For those older than 10 years, with little remodelling capacity, angulations >10-15º must be manipulated. The greatest complication derived from a bad reduction is the limitation of the pronation and supination, which in most cases does not modify the functionality of the extremity.
- Síndrome compartimental en joven con alteración hemática(2006) García Pesquera, J.M.; Gutiérrez Gómez, F. Javier; Alarcón García, L.J.; Fuster Ledesma, A.R.; Blanco Pozo, AgustínEl síndrome compartimental es una patología bien conocida que se produce por un aumento de la presión dentro de un compartimiento miofascial. Presentamos el caso de un paciente con trombopenia que sufrió un traumatismo banal. Necesitó fasciotomía del compartimiento anteroexterno de la pierna y, más tarde, esplenectomía. El diagnóstico y tratamiento tardíos de esta complicación, así como una descomprensión inadecuada, pueden conducir a la pérdida de función en una extremidad.
