RESUMEN
We report on three cases with congenital brachymetatarsia, one with bilateral affectation, together with the results of a lengthening of the short metatarsal bones by progressive axial distraction using an external minifixator. The method proved to be easy to implement, permitting immediate functionality of the ankle and early load bearing. The immediate results (cosmetic) and later findings (functional) were excellent in all three cases.
Asunto(s)
Huesos Metatarsianos/anomalías , Adolescente , Adulto , Alargamiento Óseo/métodos , Niño , Femenino , Humanos , Huesos Metatarsianos/cirugíaRESUMEN
The authors describe two cases of intrathoracic migration of Kirschner wires used for fixation of unstable Allman grade III sternoclavicular dislocation. The wires continue their migration after 10 years despite the risk and the need to treat such complications.
Asunto(s)
Hilos Ortopédicos , Migración de Cuerpo Extraño/etiología , Luxaciones Articulares/complicaciones , Mediastino , Articulación Esternoclavicular/lesiones , Adulto , Anciano , Femenino , Estudios de Seguimiento , Migración de Cuerpo Extraño/diagnóstico por imagen , Humanos , Luxaciones Articulares/diagnóstico por imagen , Luxaciones Articulares/cirugía , Masculino , Mediastino/diagnóstico por imagen , Radiografía , Articulación Esternoclavicular/diagnóstico por imagen , Articulación Esternoclavicular/cirugía , Factores de TiempoRESUMEN
Using a series of miniature piezoelectric transducers constructed by the authors, a study was made of the effect of anterior displacement of the tuberosity of the tibia on the distribution of pressures in the patellofemoral joint. Proportionally, the most efficient displacements are those set at 1 cm; after this, and as advancement of the tuberosity is increased, the overall pressure continues to decrease progressively (although more slowly) because there are zones that, according to their situation, receive increased instead of decreased pressures. Consequently, values even higher than those of the original situation are reached. This is the case of the proximal part of the patella, particularly on its lateral facet. This situation can affect the results in cases where the lesion is preferentially located on the proximal part. In these cases it may be enough to advance 1 cm with which overall decompressions close to 50% of the pressure that initially affected the patellofemoral joint are obtained. In very evolved cases or when the lesions are located centrally or distally, it may be worthwhile to advance maximally in spite of the possible complications, seeking the greatest decompression effect that intense advancements can achieve.
Asunto(s)
Articulación de la Rodilla/fisiología , Fenómenos Biomecánicos , Humanos , Técnicas In Vitro , Presión , Valores de ReferenciaRESUMEN
Based on Allman's classification, the authors conducted a critical study on the results of treatment of 17 sternoclavicular dislocations, 14 anterior and 3 posterior. They propose conservative treatment for subluxations and operative treatment for total dislocations, particularly when posterior. Tomography was required for precise diagnosis. The advantages of open reduction are stressed and the complication of intra-thoracic migration of crossed Kirschner wires used to stabilise reduction and capsular suturing is described.