Papers by Servicio Traumatología HUPEC
Intra articular knee injuries in the pediatric age, classically considered as rarer than those oc... more Intra articular knee injuries in the pediatric age, classically considered as rarer than those occurring in adulthood, has seen a rise in consultations due especially to an increased participation of children in «extreme sports» and an improved diagnosis of these injuries. There are few studies that establish the prevalence of knee injuries prior to maturity; however, arthroscopic studies have found a heightened frequency of anterior cruciate ligament (ACL) ruptures, meniscal tears and osteochondral fractures secondary to patellofemoral instability. The authors in this study update these pathologies and provide their experience in diagnostic and treatment of meniscal lesions in pediatric age. The most frequent meniscal injuries are the traumatic tears, but discoid meniscus, cysts and hipermobility are also discussed.
A comparative study was made of tro- chanteric fractures treated with the extramedullary DHS of A... more A comparative study was made of tro- chanteric fractures treated with the extramedullary DHS of AO (Synthes ® ) plate with sliding screw and se- cond-generation intramedullary Gamma nail (Howmedica ® ) from 1996 to July 1998. A retrospective study was made of 95 patients treated with these sys- tems (56 patients with Gamma and 39 with DHS), in a total of 250 clinical records reviewed. The purpose of this clinical study was to corrobora- te in clinical practice the biomechanical results obser- ved by studying both techniques by finite-element analysis. In comparison with the DHS system, the Gamma nail achieved similar results in stable fractures. In unstable fractures, the Gamma nail made earlier walking possi- ble. However, inherent technical difficulties and errors with the static Gamma nail lead to a higher incidence of complications in the evolution of the cephalic nail.
El complejo articular del hombro esta sometido a solicitaciones mecanicas en la mayoria de las mo... more El complejo articular del hombro esta sometido a solicitaciones mecanicas en la mayoria de las modalidades deportivas; asi el 10-15% de los traumatismos sufridos por los atletas afectan a esta articulacion (1). La "patologia reina" del hombro del deportista es la inestabilidad, por su frecuencia, importantes implicaciones funcionales y tratamiento problematico. Por el contrario, las roturas musculares y tendinosas del hombro son lesiones poco frecuentes en el deportista pero no por ello irrelevantes, pues pueden provocar una gran incapacidad para seguir desempenando el mismo deporte y al mismo nivel de competicion si no se hace un tratamiento correcto, a pesar del cual a veces los resultados no son satisfactorios. Es decir, pueden representar el "principio del fin" de la actividad deportiva. Tibone y cols. (2) en un estudio realizado sobre tratamiento quirurgico de roturas del manguito de los rotadores en atletas, encuentran que solo el 32% de los jugadores de ba...
Revista de Osteoporosis y Metabolismo Mineral, 2010
Over the last decade vertebroplasty and kyphoplasty have become popular as therapeutic options fo... more Over the last decade vertebroplasty and kyphoplasty have become popular as therapeutic options for the treatment of vertebral fractures. In fact, numerous no...
Post-operative autologous transfusion (PAT) and pre-donated autologous blood transfusion (PABT) a... more Post-operative autologous transfusion (PAT) and pre-donated autologous blood transfusion (PABT) are methods widely used to avoid homologous transfusion (HT) in programmed orthopaedic surgery. The PABT presents frequent li-mitations lin
Fracture of the polyethylene liner of uncemented acetabular components is rarely mentioned in the... more Fracture of the polyethylene liner of uncemented acetabular components is rarely mentioned in the literature. One case of fracture of the polyethylene liner is uncementeed his arthroplasty is described and we review 15 cases previously reported. The purpose of the report is to alert about this rare complication.
espanolHemos realizado un estudio epidemiologico de las fracturas de femur proximal en personas m... more espanolHemos realizado un estudio epidemiologico de las fracturas de femur proximal en personas mayores de 50 anos, atendidas en nuestro Hospital durante los anos 1990-92. Se valoraron un total de 355 casos. En el periodo estudiado se observo que las fracturas mas numerosas fueron la cervicales, no encontrando diferencias significativas en los ingresos segun el periodo estacional. La edad media de presentacion fue de 81 anos. La tasa de incidencia fue muy semejante a las otras provincias espanolas y menor que la encontrada en los paises del Norte de Europa, Inglaterra y Estados Unidos. EnglishWe have performed an epidemiologic study on the incidence of proximal femoral fractures in patients older than 50 years, all reviewed in our Hospital from 1990 to 1992. We included 355 patients. Femoral neek fractures were the most frequent lesions. No significant differences in the hospital admissions were found during all the year's seasons. The mean age of presentation was 81 years. The ...
Patients who have unicompartimental knee osteoarthritis can be manager by different surgical tech... more Patients who have unicompartimental knee osteoarthritis can be manager by different surgical techniques. Young people are usually treated by tibial osteotomy and elderly people by total knee replacement. Unicondylar knee prosthesis is becoming an attractive recognized alternative. After a period of enthusiastic regarding this technique, scepticism took place based on the clinical results. The aim of this study is to evaluate, in firs instance, a new knee unicondylar knee prosthesis design (Alpine, IQL) following clinical criteria and quality of life. Thirteen patients, managed in between June 2000 and March 2002, are reviewed. Seven were males and six females. The mean age was 65 years (range 55-77 years). Osteoarthritis was the aetiology in twelve cases and necrosis of the medial condyle in one patient. The clinical evaluation was based on quality of life through a questionnaire SF-12. All patients improved a knee flexion of 110o and a complete extension. Only one patient had sligh...
A case of isolated congenital pseudoar- throsis of the fibula with valgus deviation of the ankle ... more A case of isolated congenital pseudoar- throsis of the fibula with valgus deviation of the ankle was treated by arthrodesis of the distal tibial and fibu- lar metaphyses to detain the progression of the articu- lar deformity.
espanolObjetivos: valorar y comparar los resultados a corto plazo de la artroplastia total de rod... more espanolObjetivos: valorar y comparar los resultados a corto plazo de la artroplastia total de rodilla realizada mediante dos vias de abordaje. Material y metodos: estudio prospectivo comparativo que compara abordaje parapatelar medial (24 pacientes) y transvasto minimamente invasivo (25 pacientes) en artroplastia total de rodilla. Se incluyeron pacientes con gonartrosis grado IV de la clasificacion de Kellgren-Lawrence y se excluyeron aquellos menores de 50 anos, deformidad en varo (> 15o) o valgo (> 10o), artrosis postraumatica, artritis reumatoide, cirugias de revision, osteotomias correctoras previas, IMC > 40 kg/m2, infeccion activa local o sistemica y/o deterioro mental. Resultados: se encontraron diferencias estadisticamente significativas en dolor del primer y segundo dia postoperatorios a favor del abordaje minimamente invasivo (1o dia: 3,8 ± 2,5 vs. 6,7 ± 2,1; p 2o dia: 3 ± 2,1 vs. 6 ± 2; p EnglishAim: Assess and compare short-term outcomes of total knee arthroplas...
Revista Espanola De Cirugia Osteoarticular, 2005
Introducción. La cabeza radial es una estructura intraarticular del codo que participa en los mov... more Introducción. La cabeza radial es una estructura intraarticular del codo que participa en los movimientos de flexoextensión de esta articulación, así como los de pronosupinación del antebrazo. En las fracturas desplazadas o conminutas, cuando la reconstrucción anatómica es imposible habitualmente se realiza la exéresis de la cabeza radial (1-5), sin embargo la aparición de complicaciones a largo plazo como son la migración proximal del radio, disminución fuerza, cambios degenerativos tanto en el codo como en la muñeca así como cubito valgo suponen un inconveniente de dicho tratamiento. Por ello otros autores han propuesto otras opciones terapéuticas como son la fijación interna (6-8), la resección tardía (9) o la sustitución protésica (10,11). Son aún preguntas por resolver: ¿en que fracturas debemos realizar la exéresis?, ¿Cuáles son susceptibles de fijación interna?, ¿Cuándo debemos realizar la sustitución protésica? El objetivo de este trabajo es valorar las consecuencias de la exéresis precoz dependiendo del tipo de fractura tanto a nivel del codo y de la muñeca.
Over the last decade vertebroplasty and kyphoplasty have become popular as therapeutic options fo... more Over the last decade vertebroplasty and kyphoplasty have become popular as therapeutic options for the treatment of vertebral fractures. In fact, numerous non-controlled studies have indicated that both procedures are very efficacious for the control of pain associated with fractures. However, some recently published randomised trials have cast doubt on the true effectiveness of these procedures. On the other hand, certain observations have suggested that the increase in the rigidity which is produced by the injection of metacrylate into a vertebral body could facilitate the collapse of the adjacent vertebra. Therefore, vertebroplasty and kyphoplasty should not be considered as a routine theraputic measure, but should be limited to carefully selected patients, in whom the potential benefits surpass the risks and costs of the procedure. In any case, the patients should be put on a global treatment programme which includes pharmaceutical measures and non-pharmaceutical care to reduce the risk of future vertebral and peripheral fractures. Various clinical trials have recently been published which were supposed to be an important contribution to knowledge regarding the effectiveness of vertebroplasty. The results have been rather contradictory both within themselves, and with earlier observational studies. For this reason it is worth reviewing this questions with the intention of helping clinicians who need to take decisions on the treatment of patients with osteoporotic fractures. We have not dealt with the possible utility vertebroplasty in other processes, such as fractures caused by tumours or by trauma.
Rev. Esp. de …, 1991
En 1963, Lyman Smith y cols. (1) demostraron que la inyección experimental de quimopapaína en los... more En 1963, Lyman Smith y cols. (1) demostraron que la inyección experimental de quimopapaína en los discos intervertebrales producía la destrucción selectiva de su núcleo pulposo. En 1964, el mismo autor publicó los primeros resultados clínicos de la técnica, rese
Revista española de …, 2002
Resumen: El objetivo de este estudio es valorar el pronóstico a largo plazo de una serie de pacie... more Resumen: El objetivo de este estudio es valorar el pronóstico a largo plazo de una serie de pacientes tratados en nuestro hospital en relación con diversos factores clínicos, diagnósticos y terapéuticos que podrían condicionarlo. Se revisaron 123 pacientes ...
Revista Panamericana de Salud Pública, 2002
Objective. Great efforts have been made to find effective treatments for back pain. Nevertheless,... more Objective. Great efforts have been made to find effective treatments for back pain. Nevertheless, the effectiveness of a particular treatment can depend on patient compliance. The objective of this study was to prospectively investigate whether patients' demographic factors, clinical factors, external barriers in following the treatment, and perceptions of disability, quality of life, depression, and control over health were predictive of compliance with a physical therapy program carried out with patients with low back pain. Methods. This was an exploratory prospective cohort study that was carried out in New York City during 1999. All study participants answered a questionnaire at the initial clinical evaluation by a physical therapist and were followed during the treatment. The study assessed compliance with the three treatment regimens that were prescribed for every patient: attending scheduled physical therapy sessions, following a program of home exercises, and watching back-education videotapes. Depending on the individual patient, the planned treatment program could last from 2 to 6 weeks. The study employed a battery of instruments to measure patient characteristics that included perceived functional limitations, perceived quality of life, depression, and their beliefs about their health. Student's t tests and chi-square tests were used to determine if non-and low-compliant patients differed significantly from high-compliant patients. Logistic regression was used to estimate adjusted odds ratios expressing the association of selected variables with compliance. Results. We found that 51% of the patients were either noncompliant or low-compliant overall with the low back pain treatment program. There were differences in compliance behavior among the three treatment regimens, with compliance being highest for watching the back-education videotapes and lowest for doing the home exercises. Poor compliance overall was positively associated with the expectation of barriers in following the proposed treatment, with comorbidity, and with longer duration of treatment in this program. Conclusions. The findings of our study indicate that patient compliance with back pain treatment is a serious and complex problem. Nevertheless, while this study was only an exploratory one, we believe that the results of this study can be used by care providers to identify patients likely to become noncompliant and also by researchers to plan specific studies on the effectiveness of treatment programs for patients with low back pain. Low back pain, therapeutics, patient compliance, health behavior, patient education.
Rev Esp Cir …, 1995
Resumen.-Revisamos retrospectivamente una serie de 86 pacientes portadores de 110 prótesis totale... more Resumen.-Revisamos retrospectivamente una serie de 86 pacientes portadores de 110 prótesis totales modulares de rodilla colocadas como tratamiento de la gonartrosis. Se analizan los resultados obtenidos en los pacientes a los que se le realizó una fijación híbrida cementada (componente femoral no cementado y componente tibial y patelar cementado) respecto a los que se le realizó una prótesis de anclaje biológico sin ningún tipo de cementación. El análisis de la función clínica, movilidad de la rodilla, estudio radiológico y complicaciones de ambas series no demuestran diferencias significativas entre ambos grupos con un periodo de seguimiento de 45 meses (r=12-60). COMPARATIVE STUDY OF THE FIXATION OF TOTAL KNEE PROSTESIS WITH AND WHITOUT CEMENT Summary.-We have retrospectively review 86 patients with 110 total knee arthroplasty for the treatment of osteoarthrosis. We have analyzed the results obtained in a group of patients with partial fixation with cement and another group fixated without any cement. Clinical and radiological results and complications in both groups were similar without significant differences with an average follow-up of 45 months (12-60).
Resumen. Objetivo: Analizar las comunicaciones a congresos nacionales e internacionales de grupos... more Resumen. Objetivo: Analizar las comunicaciones a congresos nacionales e internacionales de grupos multidisciplinarios españoles, y realizar un metaanálisis para estimar el posible beneficio de la autotransfusión predepósito (ATPD) en nuestro entorno. Material y Métodos: Se han revisado los resúme
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Papers by Servicio Traumatología HUPEC