[Lateral osteotomy of the calcaneus in the treatment of Müller-Weiss disease]. / Osteotomía lateral de calcáneo en el tratamiento de la enfermedad de Müller-Weiss.

INTRODUCTION: The deforming condition of the navicular bone known as Müller-Weiss disease (MWD) is a rare disease. Patients present with chronic pain in the talonavicular joint and a paradoxical flat foot with a varo hindfoot. OBJECTIVE: To analyze the clinical results of a lateral osteotomy of calcaneus applied to patients with MWD. MATERIAL AND METHODS: Retrospective observational study carried out in two hospitals. The series consists of nine cases in eight patients, all of them with symptomatic Müller-Weiss disease, treated by lateral osteotomy of the calcaneus between 2012 and 2017, obtaining an average follow-up of 4 years (2-6). The mean age was 62 years (50-75). In all patients, Costa-Bartani angles (CB), Kite angle and Calcaneal Inclination (CI) were measured. In addition, the Manchester Oxford Scale (MO) to measure the post-surgical satisfaction of patients. RESULTS: All patients report having improved their pain by obtaining a postoperative score on the mean Manchester Oxford scale of 32.54 points (15.62-53.75). In 66% of patients the CB angle improves, the Kite angle in 89% and the CI in 33%. CONCLUSION: The improvement in the pain of the patients in our series is not accompanied by radiological changes in the same proportion, it is a simple and uncomplicated technique in our follow-up.

INTRODUCCIÓN: La afección deformante del hueso navicular conocida como enfermedad de Müller-Weiss (EMW) es una enfermedad rara. Los pacientes presentan dolor crónico en la articulación talonavicular y un pie plano paradójico con retropié varo. OBJETIVO: Analizar los resultados clínicos de la osteotomía valguizante de calcáneo aplicada a pacientes con EMW. MATERIAL Y MÉTODOS: Estudio observacional, retrospectivo, realizado en dos centros hospitalarios. La serie consta de nueve casos en ocho pacientes, todos ellos con enfermedad de Müller-Weiss sintomática, fueron tratados mediante osteotomía valguizante de calcáneo entre 2012 y 2017, con un seguimiento medio de cuatro años (dos a seis). La edad media fue de 62 años (50-75). En todos los pacientes se midieron los ángulos de Costa-Bartani (CB), el ángulo de Kite y la inclinación calcánea (IC). Además, se utilizó la escala Manchester Oxford (MO) para medir la satisfacción postquirúrgica de los pacientes. RESULTADOS: Todos los pacientes refieren haber mejorado en su dolor, obteniendo una puntuación postoperatoria media de 32.54 puntos (15.62-53.75) en la escala Manchester Oxford. En 66% de los pacientes el ángulo CB mejoró, al igual que en el ángulo de Kite en 89% y la IC en 33%. CONCLUSIÓN: La mejoría en el dolor de los pacientes de nuestra serie no está acompañada por cambios radiológicos en la misma proporción, es una técnica sencilla y sin complicaciones en nuestro seguimiento.

[Comparative clinical study of 2 surgical techniques for trapeziometacarpal osteoarthritis]. / Estudio clínico comparativo de 2 técnicas quirúrgicas de rizartrosis del pulgar.

OBJECTIVE: In trapeziometacarpal osteoarthritis (or rhizarthrosis), there is great controversy over the surgical technique to choose: simple trapeziectomy, resection-interposition arthroplasty, interposition arthroplasty suspension-or arthroplasty with implant or prosthesis. These latter 2 are the most used without consensus in the literature on the technique to choose and without sufficient comparative studies. The objective is to compare the 2 techniques most used today: suspension-interposition arthroplasty and arthroplasty with prosthesis. MATERIAL AND METHOD: A prospective study was conducted on 15 patients diagnosed with grade 2-3 rhizarthrosis treated with interposition arthroplasty-suspension (group 1) and 15 with prosthesis (group 2) showing clinical outcomes, advantages and disadvantages of each. The study variables were the visual analogue scale (VAS), the DASH questionnaire, the grip strength, the strength of end to end and end-lateral clamp, the joint balance adduction-abduction and preemption-retropositioning, and the opposition. The 2 groups are from 2 different hospitals operated on by a hand surgeon from the Hand Unit. The follow-up time for all patients included in the study was 12 months. RESULTS: The VAS, DASH and grip strength at 12 months did not show significant differences. As regards the strength of end to end and end-lateral clamp, group 2 showed the highest values in all follow-up periods with statistically significant differences. CONCLUSIONS: Patient selection and surgical experience is essential, given the satisfactory results of both techniques. Arthroplasty prosthesis is reserved for grades 2 and 3, middle-aged patients, good trapezium architecture, and experienced surgeons.