COVID-19 y fractura por fragilidad de la cadera. Recomendaciones conjuntas de la Sociedad Española de Fracturas Osteoporóticas y la Sociedad Española de Geriatría y Gerontología / COVID-19 and fragility hip fracture. Joint recommendations of the Spanish Society of Osteoporotic Fractures and the Spanish Society of Geriatrics and Gerontology

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La neurólisis del nervio mediano en el paciente anciano: evaluación a largo plazo / Neurolysis of the median nerve in the elderly: a long term evaluation

Objetivos. La descompresión del nervio mediano mediante la apertura del retináculo flexor se considera un tratamiento satisfactorio en pacientes afectos del síndrome del túnel carpiano. No obstante, diversos factores como la edad, pueden influir en los resultados postoperatorios. Presentamos los resultados a largo plazo de la cirugía de descompresión del nervio mediano en la muñeca en pacientes de edad avanzada. Métodos. Se trata de un estudio prospectivo histórico, a largo plazo, sobre 52 pacientes intervenidos a una edad de 65 años o superior del síndrome del túnel carpiano. Hemos llevado a cabo una valoración clínico-funcional (cuestionario de Levine et al.), electromiográfica y dinamométrica de los pacientes estudiados, referida a un tiempo postoperatorio medio de 10 años. Resultados. Los valores del cuestionario de Levine revelaron resultados favorables en el postoperatorio, a un seguimiento medio de 10,35 años, con una mejoría media en la escala clínica del cuestionario de 1,93 puntos (intervalo de confianza [IC] del 95%: 1,72-2,17) y en la escala funcional de 0,83 puntos (IC del 95%: 0,68-0,99). De igual modo, los valores electromiográficos presentaron una mejoría significativa respecto a sus valores preoperatorios (mejoría media de velocidad sensitiva 8,43m/s, IC del 95%: 8,17-11,63; mejoría media de latencia motora 1,65ms, IC del 95%: 1,24-2,25). Los datos de fuerza de presión manual no alcanzaron significación estadística. Conclusiones. En pacientes de edad avanzada, la sección completa del ligamento transverso del carpo permite mantener diferencias favorables en la mayoría de los parámetros estudiados tras 10 años desde la cirugía, siendo el tratamiento quirúrgico una opción recomendable(AU)

Purpose. Carpal tunnel release by opening the flexor retinaculum is considered a satisfactory treatment. However, several factors, like ageing, may influence postoperative results. We present the long term outcomes in elderly patients. Methods. This is an historical prospective long term study of 52 patients who received surgical treatment of carpal tunnel syndrome when they were 65 or older. We have carried out a clinical-functional (with the Levine questionnaire), electromyographic and dynamometric valuation of the patients studied, up to ten years from the surgery. Results. The results of Levine's questionnaire, revealed favourable data for a mean follow-up of 10.35 years, with a mean improvement in the clinical score of 1.93 points (95% confidence interval [CI]: 1.72-2.17) and in the functional score of 0.83 points (95% CI: 0.68-0.99). Similarly, the electromyographic values showed a significant improvement compared to preoperative ones (mean difference of sensory velocity of 8.43m/s, 95% CI: 8.17-11.63; mean difference of motor latency of 1.65ms, 95% CI: 1.24-2.25). The data on grip strength did not reach statistical significance. Conclusions. In elderly patients, complete section of the carpal transverse ligament, allows maintaining favourable differences in most of the parameters studied, ten years after surgery, making the surgical treatment a recommendable option(AU)

[Neurolysis of the median nerve in the elderly: a long term evaluation]. / La neurólisis del nervio mediano en el paciente anciano: evaluación a largo plazo.

PURPOSE: Carpal tunnel release by opening the flexor retinaculum is considered a satisfactory treatment. However, several factors, like ageing, may influence postoperative results. We present the long term outcomes in elderly patients. METHODS: This is an historical prospective long term study of 52 patients who received surgical treatment of carpal tunnel syndrome when they were 65 or older. We have carried out a clinical-functional (with the Levine questionnaire), electromyographic and dynamometric valuation of the patients studied, up to ten years from the surgery. RESULTS: The results of Levine's questionnaire, revealed favourable data for a mean follow-up of 10.35 years, with a mean improvement in the clinical score of 1.93 points (95% confidence interval [CI]: 1.72-2.17) and in the functional score of 0.83 points (95% CI: 0.68-0.99). Similarly, the electromyographic values showed a significant improvement compared to preoperative ones (mean difference of sensory velocity of 8.43m/s, 95% CI: 8.17-11.63; mean difference of motor latency of 1.65ms, 95% CI: 1.24-2.25). The data on grip strength did not reach statistical significance. CONCLUSIONS: In elderly patients, complete section of the carpal transverse ligament, allows maintaining favourable differences in most of the parameters studied, ten years after surgery, making the surgical treatment a recommendable option.