Short run "rebound effect" of COVID on the transport carbon footprint.

The COVID-19 pandemic completely transformed the mobility of cities. The restrictions on movement led to "empty cities" throughout the world, with some environmental effects in terms of clean air and the reduction of CO2 emissions. This research considers how COVID-19 mobility restrictions have affected the carbon footprint of four medium-sized Chilean cities (Coronel, Temuco, Valdivia, and Osorno) that have environmental problems and are highly dependent on motorized systems. The study uses data from 2400 household surveys at three distinct times: pre-pandemic - T0 (winter 2019), the time of implementation of restrictive mobility policies to contain the pandemic - T1 (winter 2020), and six months later when those restrictions were gradually lifted - T2 (summer 2021). The analysis suggests that CO2 emissions actually went up, declining in the winter 2020, but then increasing with the greater use of cars in the summer 2021 due to the temporary effects of commuting to work, ultimately reaching levels higher than the pre-pandemic values, known as the "rebound effect."

Simultaneous Clavicle Fracture and Acromioclavicular Joint Dislocation: Novel Surgical Technique: A Case Report.

CASE: A 41-year-old man sustained a midshaft clavicle fracture with associated type IV ipsilateral acromioclavicular joint (ACJ) dislocation. The clavicle was fixed with a locking plate and ACJ stabilized with a novel technique: 2 metal anchors with preloaded suture fixed at the coracoid process, looping the sutures over the clavicle, and passing through the plate holes without clavicle bone drilling. Excellent functional outcomes for range of motion, pain, and functional scores persisted 2 and a half years after surgery. CONCLUSION: The described surgical technique achieved exceptional short-term outcomes, sparing clavicle bone stock and allowing an early return to sports.

Two-Stage Anterior Cruciate Ligament Reconstruction Revision Surgery for Severe Bone Defects With Anterolateral Ligament Reconstruction Technique.

Anterior cruciate ligament revision surgery poses a number of specific difficulties. These include the lack of bone mass to enable effective fixation of the reconstruction, morbidity of the donor area when bone autograft is used to fill the tunnels, and absence of the semitendinosus and gracilis homolateral tendons in cases in which they have already been used in the primary surgical procedure. To address all these problems, we describe a 2-stage revision technique that uses bone allograft for tunnel filling and Achilles allograft for ligament reconstruction. In addition, the intervention includes an extra-articular phase in which the anterolateral ligament is reinforced to increase the rotational stability of the knee, thus improving the prognosis of operation.

Late-Onset Recurrent Femoral Cyst Formation 10 Years after ACL Reconstruction: A Case Report and Literature Review.

Synovial fistula and cyst formation after anterior cruciate ligament (ACL) reconstruction is very unusual and almost always affects the tibia. Only 3 cases originating in the femur have been reported. We present a rare case of late-onset femoral cyst formation related to ACL reconstruction. Ten years after successful ACL reconstruction surgery, effusion and pain at the lateral aspect of the lateral femoral condyle appeared. Symptoms persisted despite initial percutaneous drainage and conservative treatment. Surgery was carried out, with drainage and graft-fixation pin device removal, with recurrent cyst formation after the intervention. Total recovery of the patient was achieved after carrying out revision surgery consisting in bone tunnel filling using autologous bone graft and occlusion of cortical bone defect with local fascial flap. The development of this unusual complication was related to lack of absorption of the fixation device, bone burn due to drilling, and persistent synovial fluid in the femoral bone tunnel, combined with the absence of bone ingrowth.

Prospective analysis of radiofrequency denervation in patients with chronic low back pain.

BACKGROUND: To analyse the effectiveness of lumbar rhizolysis in patients with facet joint-related chronic low back pain and to study the influence of various variables on the results. Facet joints are thought to be responsible for up to 15% of all cases of chronic low back pain. Although radiofrequency denervation of these joints is a common procedure, there is currently no solid evidence to allow the selection of patients who may be candidates for this technique to be selected or the effectiveness and safety thereof to be demonstrated. METHODS: A prospective analytical study of 100 patients treated with lumbar rhizolysis at the Hospital Universitario de Cabueñes (Gijón, Spain) between 2016 and 2019. Various demographic variables, the evolution of the visual analogue scale (VAS), the Oswestry Disability Index (ODI) and consumption of analgesics pre- and postoperatively was analysed at 2, 6, 12 and 24 months. RESULTS: The mean age of our sample was 57.8 years (27.0-85.5), with a BMI of 27.09 (16.14-46.22), and 63.8% of subjects were female. The mean duration of the symptoms prior to the intervention was 8.7 years, with 28.7% of subjects having a history of spinal surgery. The intervention resulted in a significant reduction in analgesics consumption. Moreover, a statistically significant reduction in pure low back pain, radiating pain and in the ODI in the short to medium term was observed with respect to baseline. We found that being female, having a history of prior low back surgery, the time to progression and the analgesic level consumed by the patient were related to a greater disability. CONCLUSIONS: Lumbar rhizolysis results in a significant reduction in pain and functional disability in patients with chronic low back pain in both the short- and medium-term, and reduces the need for analgesics consumption.

[Developmental dysplasia of the hip in children with a psychomotor disorder. A risk factor for a poor outcome?]. / Displasia del desarrollo de la cadera en niños con trastorno psicomotor. ¿Factor de riesgo para un mal resultado?

INTRODUCTION: Orthopaedic treatment of developmental dysplasia of the hip (DDH) has a high success rate in cases that are diagnosed early. However, the outcomes of these patients are not really known when they are subsequently diagnosed with some type of cerebral impairment. MATERIALS AND METHODS: A retrospective observational study was conducted on cases of DDH with a poor outcome after orthopaedic treatment, being unknown if they had any type of psychomotor disorder. The patients were clinically and radiologically assessed, and afterwards received neurological valuation by the Child Neurology Unit. RESULTS: Of the 325 cases of DDH diagnosed in 293 patients, 10 patients (3%) with 16 hips with DDH were diagnosed of any cerebral impairment. All them were initially treated orthopedically. Clinical and radiologically evolution was succesful only in 4 cases (25%) being necessary any surgical procedure in the remaining 12 cases. After surgical treatment we got an improvement in the Acetabular Index (p=0.005) and Reimers Extrusion Index (p=0.042). Neck-shaft angle and Wiberg CE angle also improved but this difference was not statically significant. Cerebral impairment was diagnosed at 2,5 years of age and the begining of walking was delayed at 2.4 years of age. CONCLUSIONS: Cerebral impairment can lead to an unfavourable outcome in the treatment of DDH, with the relative risk of a poor outcome being 7.2 times higher in these patients. An unfavourable outcome with conventional treatment of DDH must make us suspect the presence of some type of neurological disorder, particularly if there is a delay in walking.

Displasia del desarrollo de la cadera en niños con trastorno psicomotor. ¿Factor de riesgo para un mal resultado? / Developmental dysplasia of the hip in children with a psychomotor disorder. A risk factor for a poor outcome?

INTRODUCCIÓN: El tratamiento ortopédico de la displasia del desarrollo de la cadera (DDC) presenta un alto porcentaje de éxito en casos diagnosticados precozmente o en los primeros meses de vida. Sin embargo, se desconoce qué resultados presentan estos pacientes cuando posteriormente son diagnosticados de un trastorno psicomotor. MATERIAL Y MÉTODOS: Se realiza un estudio observacional retrospectivo de los casos de DDC con mala evolución tras tratamiento ortopédico, desconociéndose si presentaban algún tipo de trastorno psicomotor. Los pacientes fueron valorados clínica y radiológicamente, y por la Unidad de Neurología Infantil. RESULTADOS: De los 325 casos de DDC diagnosticados en 293 pacientes, 10 pacientes (3%) con 16 caderas con DDC fueron diagnosticados de algún tipo de trastorno psicomotor. Todos los casos inicialmente fueron tratados ortopédicamente. La evolución tanto clínica como radiológica en estos casos fue favorable sOlo en 4 (25%). En los 12 restantes se indicó quirúrgica para su resolución (75%). Hubo mejoría tras tratamiento quirúrgico en el índice acetabular (p = 0,005) y en el índice de extrusión de Reimers (p = 0,042). El ángulo cÉrvico-diafisario y el ángulo CE de Wiberg también mejoraron, pero su diferencia no fue estadísticamente significativa. El diagnóstico del trastorno psicomotor se realizó a los 2,5 años de edad. El inicio de la deambulación de estos pacientes estaba retrasado, iniciándose a los 2,4 años. CONCLUSIONES: El trastorno psicomotor puede condicionar una tórpida evolución en el tratamiento conservador de la DDC; el riesgo relativo de presentar un mal resultado es 7.2 veces mayor en estos pacientes. Ante una mala respuesta al tratamiento convencional de una DDC, debe sospecharse la existencia de un posible trastorno neurológico de base, especialmente si hay un retraso en la deambulación

INTRODUCTION: Orthopaedic treatment of developmental dysplasia of the hip (DDH) has a high success rate in cases that are diagnosed early. However, the outcomes of these patients are not really known when they are subsequently diagnosed with some type of cerebral impairment. MATERIALS AND METHODS: A retrospective observational study was conducted on cases of DDH with a poor outcome after orthopaedic treatment, being unknown if they had any type of psychomotor disorder. The patients were clinically and radiologically assessed, and afterwards received neurological valuation by the Child Neurology Unit. RESULTS: Of the 325 cases of DDH diagnosed in 293 patients, 10 patients (3%) with 16 hips with DDH were diagnosed of any cerebral impairment. All them were initially treated orthopedically. Clinical and radiologically evolution was succesful only in 4 cases (25%) being necessary any surgical procedure in the remaining 12 cases. After surgical treatment we got an improvement in the Acetabular Index (p = 0.005) and Reimers Extrusion Index (p = 0.042). Neck-shaft angle and Wiberg CE angle also improved but this difference was not statically significant. Cerebral impairment was diagnosed at 2,5 years of age and the begining of walking was delayed at 2.4 years of age. CONCLUSIONS: Cerebral impairment can lead to an unfavourable outcome in the treatment of DDH, with the relative risk of a poor outcome being 7.2 times higher in these patients. An unfavourable outcome with conventional treatment of DDH must make us suspect the presence of some type of neurological disorder, particularly if there is a delay in walking