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1.
Rev. esp. cir. ortop. traumatol. (Ed. impr.) ; 67(2): 139-143, Mar-Abr. 2023. ilus, tab
Article in English | IBECS | ID: ibc-217114

ABSTRACT

Objective: The purpose of this study is to evaluate the clinical outcomes and complications of percutaneous achilles tendon repair with absorbable sutures. Material and methods: A prospective cohort study including patients treated for an achilles tendon rupture from January 2016 to March 2019 was conducted. Inclusion criteria: ≥18 years of age, non-insertional (2–8cm proximal to insertion) achilles tendon ruptures. Open or partial ruptures were excluded. The diagnosis was based on clinical criteria and confirmed by ultrasonography in all patients. Epidemiological data, rupture and healing risk factors, previous diagnosis of tendinopathy, pre-rupture sport activity, job information, mechanism of rupture and the time in days between lesion and surgery were collected. Patients were assessed using visual analogue scale (VAS) at the 1, 3, 6 and 12-month follow-up. The achilles tendon rupture score (ATRS) were assessed at the 6 and 12 month follow-up. Ultrasound was performed at the 6-month follow-up. The re-rupture rate and postoperative complications were also collected. Conclusions: In our experience, percutaneous achilles tendon repair with absorbable sutures in patients with an acute achilles tendon rupture has shown good functional results but with a high incidence of complications. Although most complications were transitory sural nerve symptoms, this complication would be avoided in patients treated conservatively. For this reason, conservative treatment associated with an early weightbearing rehabilitation protocol should be considered a viable option for patients with achilles tendon ruptures, mainly in cooperative young patients.(AU)


Objetivo: El propósito de este estudio es evaluar los resultados clínicos y las complicaciones de la reparación percutánea del tendón de Aquiles con suturas reabsorbibles. Material y métodos: Se realizó un estudio de cohorte prospectivo que incluye pacientes tratados por una rotura del tendón de Aquiles desde enero de 2016 hasta marzo de 2019. Criterios de inclusión: ≥18años de edad, roturas del tendón de Aquiles no insercionales (de 2 a 8cm proximales a la inserción). Se excluyeron roturas abiertas o parciales. El diagnóstico se basó en criterios clínicos y se confirmó mediante ecografía en todos los pacientes. Se recogieron datos epidemiológicos, factores de riesgo de rotura y cicatrización, diagnóstico previo de tendinopatía, actividad deportiva previa a la rotura, información laboral, mecanismo de rotura y tiempo en días entre la lesión y la cirugía. Los pacientes fueron evaluados utilizando la escala analógica visual (VAS) en el seguimiento de 1, 3, 6 y 12meses. La puntuación de rotura del tendón de Aquiles (ATRS) se evaluó a los 6 y 12meses de seguimiento. La ecografía se realizó a los 6meses de seguimiento. También se recogieron la tasa de re-ruptura y las complicaciones postoperatorias. Conclusiones: En nuestra experiencia, la reparación percutánea del tendón de Aquiles con suturas reabsorbibles en pacientes con rotura aguda del tendón de Aquiles ha mostrado buenos resultados funcionales pero con una alta incidencia de complicaciones. Aunque la mayoría de las complicaciones fueron síntomas transitorios del nervio sural, esta complicación se evitaría en pacientes tratados de forma conservadora. Por esta razón, el tratamiento conservador asociado a un protocolo de rehabilitación con carga temprana debe considerarse una opción viable para pacientes con roturas del tendón de Aquiles, principalmente en pacientes jóvenes colaboradores.(AU)


Subject(s)
Humans , Male , Female , Middle Aged , Sutures , Suture Techniques , Achilles Tendon/surgery , Conservative Treatment , Rupture , Cohort Studies , Prospective Studies
2.
Rev. esp. cir. ortop. traumatol. (Ed. impr.) ; 67(2): T139-T143, Mar-Abr. 2023. ilus, tab
Article in Spanish | IBECS | ID: ibc-217115

ABSTRACT

Objective: The purpose of this study is to evaluate the clinical outcomes and complications of percutaneous achilles tendon repair with absorbable sutures. Material and methods: A prospective cohort study including patients treated for an achilles tendon rupture from January 2016 to March 2019 was conducted. Inclusion criteria: ≥18 years of age, non-insertional (2–8cm proximal to insertion) achilles tendon ruptures. Open or partial ruptures were excluded. The diagnosis was based on clinical criteria and confirmed by ultrasonography in all patients. Epidemiological data, rupture and healing risk factors, previous diagnosis of tendinopathy, pre-rupture sport activity, job information, mechanism of rupture and the time in days between lesion and surgery were collected. Patients were assessed using visual analogue scale (VAS) at the 1, 3, 6 and 12-month follow-up. The achilles tendon rupture score (ATRS) were assessed at the 6 and 12 month follow-up. Ultrasound was performed at the 6-month follow-up. The re-rupture rate and postoperative complications were also collected. Conclusions: In our experience, percutaneous achilles tendon repair with absorbable sutures in patients with an acute achilles tendon rupture has shown good functional results but with a high incidence of complications. Although most complications were transitory sural nerve symptoms, this complication would be avoided in patients treated conservatively. For this reason, conservative treatment associated with an early weightbearing rehabilitation protocol should be considered a viable option for patients with achilles tendon ruptures, mainly in cooperative young patients.(AU)


Objetivo: El propósito de este estudio es evaluar los resultados clínicos y las complicaciones de la reparación percutánea del tendón de Aquiles con suturas reabsorbibles. Material y métodos: Se realizó un estudio de cohorte prospectivo que incluye pacientes tratados por una rotura del tendón de Aquiles desde enero de 2016 hasta marzo de 2019. Criterios de inclusión: ≥18años de edad, roturas del tendón de Aquiles no insercionales (de 2 a 8cm proximales a la inserción). Se excluyeron roturas abiertas o parciales. El diagnóstico se basó en criterios clínicos y se confirmó mediante ecografía en todos los pacientes. Se recogieron datos epidemiológicos, factores de riesgo de rotura y cicatrización, diagnóstico previo de tendinopatía, actividad deportiva previa a la rotura, información laboral, mecanismo de rotura y tiempo en días entre la lesión y la cirugía. Los pacientes fueron evaluados utilizando la escala analógica visual (VAS) en el seguimiento de 1, 3, 6 y 12meses. La puntuación de rotura del tendón de Aquiles (ATRS) se evaluó a los 6 y 12meses de seguimiento. La ecografía se realizó a los 6meses de seguimiento. También se recogieron la tasa de re-ruptura y las complicaciones postoperatorias. Conclusiones: En nuestra experiencia, la reparación percutánea del tendón de Aquiles con suturas reabsorbibles en pacientes con rotura aguda del tendón de Aquiles ha mostrado buenos resultados funcionales pero con una alta incidencia de complicaciones. Aunque la mayoría de las complicaciones fueron síntomas transitorios del nervio sural, esta complicación se evitaría en pacientes tratados de forma conservadora. Por esta razón, el tratamiento conservador asociado a un protocolo de rehabilitación con carga temprana debe considerarse una opción viable para pacientes con roturas del tendón de Aquiles, principalmente en pacientes jóvenes colaboradores.(AU)


Subject(s)
Humans , Male , Female , Middle Aged , Sutures , Suture Techniques , Achilles Tendon/surgery , Conservative Treatment , Rupture , Cohort Studies , Prospective Studies
3.
Rev. esp. cir. ortop. traumatol. (Ed. impr.) ; 67(1): 56-61, Ene-Feb. 2023.
Article in English | IBECS | ID: ibc-214355

ABSTRACT

Background and objective: The purpose of this study is to evaluate the clinical outcomes and complications of percutaneous Achilles tendon repair with absorbable sutures. Material and methods: Prospective cohort study including 52 patients treated for Achilles tendon ruptures (January 2016 to March 2019). Inclusion criteria: ≥18 years of age, non-insertional Achilles tendon ruptures. Diagnosis based on clinical criteria, confirmed by ultrasonography. Assessment using Visual Analogue Scale (VAS), Achilles Tendon Rupture Score (ATRS) and ultrasound. Re-rupture rate and postoperative complications were collected. Results: VAS scoring (SD) at 1, 3, 6 and 12 months follow-up (FU) were 2.63 (0.83), 1.79 (1.25), 0.69 (1.09) and 0.08 (0.39), respectively. Mean (SD) ATRS score was 92.45 points at 6 months (6.27) and 94.04 points at 12 months FU (4.59). Three re-ruptures (5.77%) occurred with a mean time between surgery and re-rupture of 108.75 days (SD 28.4), all of them within 4-month FU. No ruptures at the time to return to sports activity. Thirteen complications (25%) (3 re-ruptures, 1 superficial wound infection and 9 transitory sural nerve injuries). Conclusions: Percutaneous Achilles tendon repair with absorbable sutures in patients with acute Achilles tendon ruptures has shown good functional results but with a high incidence of complications. Although most complications were transitory sural nerve symptoms, these would be avoided with conservative treatment. Conservative treatment associated with an early weight-bearing rehabilitation protocol should be considered a viable option for patients with Achilles tendon ruptures, specially in cooperative young patients.(AU)


Antecedentes y objetivo: El propósito es evaluar los resultados clínicos y complicaciones de la reparación percutánea del tendón de Aquiles con suturas reabsorbibles. Material y métodos: Estudio de cohorte prospectivo incluyendo 52 pacientes tratados por rotura del tendón de Aquiles (enero 2016-marzo 2019). Criterios de inclusión: ≥18 años de edad, roturas no insercionales del tendón de Aquiles. Diagnóstico clínico y confirmado por ecografía. Evaluación mediante Escala Analógica Visual (EVA), puntuación de rotura del tendón de Aquiles (ATRS) y ecografía. Recopilación de tasas de re-rotura y complicaciones postoperatorias. Resultados: Puntuación EVA (DE) al mes, 3, 6 y 12 meses de seguimiento: 2,63 (0,83), 1,79 (1,25), 0,69 (1,09) y 0,08 (0,39). Media (DE) de la puntuación ATRS: 92,45 puntos a los 6 meses (6,27) y 94,04 puntos a los 12 meses (4,59). 3 re-roturas (5,77%) con tiempo medio entre cirugía y re-rotura de 108,75 días (DE 28,4), todas durante los 4 meses de seguimiento. No roturas a la reincorporación a la actividad deportiva. 13 complicaciones (25%) (3 re-roturas, 1 infección de herida superficial y 9 lesiones transitorias del nervio sural). Conclusiones: La reparación percutánea del tendón de Aquiles con suturas reabsorbibles en pacientes con rotura aguda del tendón de Aquiles muestra buenos resultados funcionales; con alta incidencia de complicaciones. La mayoría de complicaciones fueron síntomas transitorios del nervio sural, que se evitarían en pacientes tratados conservadoramente. Asociado a un protocolo temprano de rehabilitación con carga, debe considerarse una opción, especialmente en pacientes jóvenes cooperadores.(AU)


Subject(s)
Humans , Male , Female , Achilles Tendon , Sutures , Conservative Treatment , Sural Nerve , Prospective Studies , Cohort Studies
4.
Rev. esp. cir. ortop. traumatol. (Ed. impr.) ; 67(1): T56-T61, Ene-Feb. 2023. ilus, tab
Article in Spanish | IBECS | ID: ibc-214356

ABSTRACT

Antecedentes y objetivo: El propósito es evaluar los resultados clínicos y complicaciones de la reparación percutánea del tendón de Aquiles con suturas reabsorbibles. Material y métodos: Estudio de cohorte prospectivo incluyendo 52 pacientes tratados por rotura del tendón de Aquiles (enero 2016-marzo 2019). Criterios de inclusión: ≥18 años de edad, roturas no insercionales del tendón de Aquiles. Diagnóstico clínico y confirmado por ecografía. Evaluación mediante Escala Analógica Visual (EVA), puntuación de rotura del tendón de Aquiles (ATRS) y ecografía. Recopilación de tasas de re-rotura y complicaciones postoperatorias. Resultados: Puntuación EVA (DE) al mes, 3, 6 y 12 meses de seguimiento: 2,63 (0,83), 1,79 (1,25), 0,69 (1,09) y 0,08 (0,39). Media (DE) de la puntuación ATRS: 92,45 puntos a los 6 meses (6,27) y 94,04 puntos a los 12 meses (4,59). 3 re-roturas (5,77%) con tiempo medio entre cirugía y re-rotura de 108,75 días (DE 28,4), todas durante los 4 meses de seguimiento. No roturas a la reincorporación a la actividad deportiva. 13 complicaciones (25%) (3 re-roturas, 1 infección de herida superficial y 9 lesiones transitorias del nervio sural). Conclusiones: La reparación percutánea del tendón de Aquiles con suturas reabsorbibles en pacientes con rotura aguda del tendón de Aquiles muestra buenos resultados funcionales; con alta incidencia de complicaciones. La mayoría de complicaciones fueron síntomas transitorios del nervio sural, que se evitarían en pacientes tratados conservadoramente. Asociado a un protocolo temprano de rehabilitación con carga, debe considerarse una opción, especialmente en pacientes jóvenes cooperadores.(AU)


Background and objective: The purpose of this study is to evaluate the clinical outcomes and complications of percutaneous Achilles tendon repair with absorbable sutures. Material and methods: Prospective cohort study including 52 patients treated for Achilles tendon ruptures (January 2016 to March 2019). Inclusion criteria: ≥18 years of age, non-insertional Achilles tendon ruptures. Diagnosis based on clinical criteria, confirmed by ultrasonography. Assessment using Visual Analogue Scale (VAS), Achilles Tendon Rupture Score (ATRS) and ultrasound. Re-rupture rate and postoperative complications were collected. Results: VAS scoring (SD) at 1, 3, 6 and 12 months follow-up (FU) were 2.63 (0.83), 1.79 (1.25), 0.69 (1.09) and 0.08 (0.39), respectively. Mean (SD) ATRS score was 92.45 points at 6 months (6.27) and 94.04 points at 12 months FU (4.59). Three re-ruptures (5.77%) occurred with a mean time between surgery and re-rupture of 108.75 days (SD 28.4), all of them within 4-month FU. No ruptures at the time to return to sports activity. Thirteen complications (25%) (3 re-ruptures, 1 superficial wound infection and 9 transitory sural nerve injuries). Conclusions: Percutaneous Achilles tendon repair with absorbable sutures in patients with acute Achilles tendon ruptures has shown good functional results but with a high incidence of complications. Although most complications were transitory sural nerve symptoms, these would be avoided with conservative treatment. Conservative treatment associated with an early weight-bearing rehabilitation protocol should be considered a viable option for patients with Achilles tendon ruptures, specially in cooperative young patients.(AU)


Subject(s)
Humans , Male , Female , Achilles Tendon , Sutures , Conservative Treatment , Sural Nerve , Prospective Studies , Cohort Studies
5.
Rev Esp Cir Ortop Traumatol ; 67(2): T139-T143, 2023.
Article in English, Spanish | MEDLINE | ID: mdl-36529423

ABSTRACT

OBJECTIVE: The purpose of this study is to evaluate the clinical outcomes and complications of percutaneous achilles tendon repair with absorbable sutures. MATERIAL AND METHODS: A prospective cohort study including patients treated for an achilles tendon rupture from January 2016 to March 2019 was conducted. INCLUSION CRITERIA: ≥18 years of age, non-insertional (2-8cm proximal to insertion) achilles tendon ruptures. Open or partial ruptures were excluded. The diagnosis was based on clinical criteria and confirmed by ultrasonography in all patients. Epidemiological data, rupture and healing risk factors, previous diagnosis of tendinopathy, pre-rupture sport activity, job information, mechanism of rupture and the time in days between lesion and surgery were collected. Patients were assessed using visual analogue scale at the 1, 3, 6 and 12-month follow-up. The achilles tendon rupture score were assessed at the 6 and 12 month follow-up. Ultrasound was performed at the 6-month follow-up. The re-rupture rate and postoperative complications were also collected. CONCLUSIONS: In our experience, percutaneous achilles tendon repair with absorbable sutures in patients with an acute achilles tendon rupture has shown good functional results but with a high incidence of complications. Although most complications were transitory sural nerve symptoms, this complication would be avoided in patients treated conservatively. For this reason, conservative treatment associated with an early weightbearing rehabilitation protocol should be considered a viable option for patients with achilles tendon ruptures, mainly in cooperative young patients.


Subject(s)
Achilles Tendon , Orthopedic Procedures , Tendon Injuries , Humans , Achilles Tendon/diagnostic imaging , Achilles Tendon/surgery , Prospective Studies , Ultrasonography , Orthopedic Procedures/methods , Tendon Injuries/surgery , Sutures , Rupture/surgery , Suture Techniques , Treatment Outcome
6.
Rev Esp Cir Ortop Traumatol ; 67(1): T56-T61, 2023.
Article in English, Spanish | MEDLINE | ID: mdl-36265782

ABSTRACT

BACKGROUND AND OBJECTIVE: The purpose of this study is to evaluate the clinical outcomes and complications of percutaneous Achilles tendon repair with absorbable sutures. MATERIAL AND METHODS: Prospective cohort study including 52 patients treated for Achilles tendon ruptures (January 2016 to March 2019). INCLUSION CRITERIA: ≥18 years of age, non-insertional Achilles tendon ruptures. Diagnosis based on clinical criteria, confirmed by ultrasonography. Assessment using Visual Analogue Scale (VAS), Achilles Tendon Rupture Score (ATRS) and ultrasound. Re-rupture rate and postoperative complications were collected. RESULTS: VAS scoring (SD) at 1, 3, 6 and 12 months follow-up (FU) were 2.63 (0.83), 1.79 (1.25), 0.69 (1.09) and 0.08 (0.39), respectively. Mean (SD) ATRS score was 92.45 points at 6 months (6.27) and 94.04 points at 12 months FU (4.59). Three re-ruptures (5.77%) occurred with a mean time between surgery and re-rupture of 108.75 days (SD 28.4), all of them within 4-month FU. No ruptures at the time to return to sports activity. Thirteen complications (25%) (3 re-ruptures, 1 superficial wound infection and 9 transitory sural nerve injuries). CONCLUSIONS: Percutaneous Achilles tendon repair with absorbable sutures in patients with acute Achilles tendon ruptures has shown good functional results but with a high incidence of complications. Although most complications were transitory sural nerve symptoms, these would be avoided with conservative treatment. Conservative treatment associated with an early weight-bearing rehabilitation protocol should be considered a viable option for patients with Achilles tendon ruptures, specially in cooperative young patients.


Subject(s)
Achilles Tendon , Ankle Injuries , Orthopedic Procedures , Plastic Surgery Procedures , Tendon Injuries , Humans , Achilles Tendon/surgery , Achilles Tendon/injuries , Prospective Studies , Orthopedic Procedures/methods , Rupture/surgery , Tendon Injuries/surgery , Sutures , Suture Techniques , Treatment Outcome
7.
Rev Esp Cir Ortop Traumatol ; 67(1): 56-61, 2023.
Article in English, Spanish | MEDLINE | ID: mdl-35809780

ABSTRACT

BACKGROUND AND OBJECTIVE: The purpose of this study is to evaluate the clinical outcomes and complications of percutaneous Achilles tendon repair with absorbable sutures. MATERIAL AND METHODS: Prospective cohort study including 52 patients treated for Achilles tendon ruptures (January 2016 to March 2019). INCLUSION CRITERIA: ≥18 years of age, non-insertional Achilles tendon ruptures. Diagnosis based on clinical criteria, confirmed by ultrasonography. Assessment using Visual Analogue Scale (VAS), Achilles Tendon Rupture Score (ATRS) and ultrasound. Re-rupture rate and postoperative complications were collected. RESULTS: VAS scoring (SD) at 1, 3, 6 and 12 months follow-up (FU) were 2.63 (0.83), 1.79 (1.25), 0.69 (1.09) and 0.08 (0.39), respectively. Mean (SD) ATRS score was 92.45 points at 6 months (6.27) and 94.04 points at 12 months FU (4.59). Three re-ruptures (5.77%) occurred with a mean time between surgery and re-rupture of 108.75 days (SD 28.4), all of them within 4-month FU. No ruptures at the time to return to sports activity. Thirteen complications (25%) (3 re-ruptures, 1 superficial wound infection and 9 transitory sural nerve injuries). CONCLUSIONS: Percutaneous Achilles tendon repair with absorbable sutures in patients with acute Achilles tendon ruptures has shown good functional results but with a high incidence of complications. Although most complications were transitory sural nerve symptoms, these would be avoided with conservative treatment. Conservative treatment associated with an early weight-bearing rehabilitation protocol should be considered a viable option for patients with Achilles tendon ruptures, specially in cooperative young patients.


Subject(s)
Achilles Tendon , Ankle Injuries , Orthopedic Procedures , Plastic Surgery Procedures , Tendon Injuries , Humans , Achilles Tendon/surgery , Achilles Tendon/injuries , Prospective Studies , Orthopedic Procedures/methods , Rupture/surgery , Tendon Injuries/surgery , Sutures , Suture Techniques , Treatment Outcome
8.
Rev Esp Cir Ortop Traumatol ; 67(2): 139-143, 2023.
Article in English, Spanish | MEDLINE | ID: mdl-36096468

ABSTRACT

OBJECTIVE: The purpose of this study is to evaluate the clinical outcomes and complications of percutaneous achilles tendon repair with absorbable sutures. MATERIAL AND METHODS: A prospective cohort study including patients treated for an achilles tendon rupture from January 2016 to March 2019 was conducted. INCLUSION CRITERIA: ≥18 years of age, non-insertional (2-8cm proximal to insertion) achilles tendon ruptures. Open or partial ruptures were excluded. The diagnosis was based on clinical criteria and confirmed by ultrasonography in all patients. Epidemiological data, rupture and healing risk factors, previous diagnosis of tendinopathy, pre-rupture sport activity, job information, mechanism of rupture and the time in days between lesion and surgery were collected. Patients were assessed using visual analogue scale (VAS) at the 1, 3, 6 and 12-month follow-up. The achilles tendon rupture score (ATRS) were assessed at the 6 and 12 month follow-up. Ultrasound was performed at the 6-month follow-up. The re-rupture rate and postoperative complications were also collected. CONCLUSIONS: In our experience, percutaneous achilles tendon repair with absorbable sutures in patients with an acute achilles tendon rupture has shown good functional results but with a high incidence of complications. Although most complications were transitory sural nerve symptoms, this complication would be avoided in patients treated conservatively. For this reason, conservative treatment associated with an early weightbearing rehabilitation protocol should be considered a viable option for patients with achilles tendon ruptures, mainly in cooperative young patients.


Subject(s)
Achilles Tendon , Plastic Surgery Procedures , Tendon Injuries , Humans , Achilles Tendon/diagnostic imaging , Achilles Tendon/surgery , Prospective Studies , Ultrasonography , Tendon Injuries/surgery , Sutures , Rupture/surgery , Suture Techniques , Treatment Outcome
9.
Acta ortop. mex ; 36(6): 373-378, nov.-dic. 2022. tab, graf
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1533534

ABSTRACT

Resumen: Introducción: el calzado ortopédico suele prescribirse en el postoperatorio de cirugía de hallux valgus para proteger la osteotomía y mantener la funcionalidad al paciente. En este sentido, la superioridad del zapato de suela rígida en comparación con el zapato de suela invertida sigue siendo controvertido. El objetivo de este estudio es comparar los resultados clínicos, funcionales y radiológicos entre el uso del zapato de suela rígida (ZSR) y el zapato de suela invertida (ZSI) después de la cirugía de hallux valgus. Material y métodos: un total de 57 pacientes intervenidos de hallux valgus fueron incluidos y analizados retrospectivamente. En un grupo se incluyeron 28 pacientes que usaron el ZSR, mientras que el segundo grupo incluyó a 29 pacientes que usaron el ZSI. El zapato ortopédico se usó durante seis semanas tras la cirugía. Se recogieron datos clínicos (dolor lumbar y articular de las extremidades inferiores, necesidad de muletas y problemas para subir y bajar escaleras), datos radiológicos (AIM, AHV), así como complicaciones postoperatorias (desplazamiento de osteotomía, fractura del primer metatarsiano o seudoartrosis). Resultados: el zapato de suela rígida mostró menor dificultad para subir y bajar escaleras (OR 3.8 (IC 95% 1.2-12.8), p 0.02), sólo para subir (OR 3.2 (IC 95% 1.1-10), p 0.03), así como una disminución de la necesidad de muletas (OR 1.7 (IC 95% 1.04-2.6), p < 0.03). El dolor de columna lumbar o articular de extremidades inferiores no mostró diferencias estadísticas. No se encontraron diferencias estadísticas en los datos epidemiológicos y radiológicos entre los grupos. Conclusiones: el zapato de suela parece aportar más comodidad a los pacientes sin aumentar las complicaciones radiológicas.


Abstract: Introduction: the orthopedic shoe is usually prescribed during postoperative care after hallux valgus surgery to protect the osteotomy and provide functional comfort to the patient. In this regard, the superiority of rigid sole shoe (RSS) compared to the reverse camber shoe (RCS) remains controversial. The aim of this study is to compare the clinical, functional and radiological outcomes from using the rigid sole shoe (RSS) vs. the reverse camber shoe (RCS) after hallux valgus surgery. Material and methods: fifty-seven hallux valgus surgery patients were included and analyzed retrospectively. The 1st group included 28 patients using the RSS and the 2nd group included 29 patients using the RCS. The orthopedic shoe was used for six weeks postoperatively. Clinical data (lumbar and lower limb pain, need of crutches and problems with going up and down stairs), radiological data (IMA, HVA) and postoperative complications (displacement of osteotomy, metatarsal fracture or non-union) were collected. Results: the RSS showed less difficulty going up and down stairs (OR 3.8 (CI 95% 1.2-12.8), p 0.02), only going upstairs (OR 3.2 (CI 95% 1.1-10), p 0.03), as well as a decreased need for crutches (OR 1.7 (CI 95% 1.04-2.6), p < 0.03). Lumbar spine or lower limb pain did not show any statistical differences. No statistical differences in the epidemiological and radiological data were found between the groups. Conclusions: the RSS seems to provide more comfort to the patients without worsening the radiological results.

10.
Acta Ortop Mex ; 36(6): 373-378, 2022.
Article in Spanish | MEDLINE | ID: mdl-37669657

ABSTRACT

INTRODUCTION: the orthopedic shoe is usually prescribed during postoperative care after hallux valgus surgery to protect the osteotomy and provide functional comfort to the patient. In this regard, the superiority of rigid sole shoe (RSS) compared to the reverse camber shoe (RCS) remains controversial. The aim of this study is to compare the clinical, functional and radiological outcomes from using the rigid sole shoe (RSS) vs. the reverse camber shoe (RCS) after hallux valgus surgery. MATERIAL AND METHODS: fifty-seven hallux valgus surgery patients were included and analyzed retrospectively. The 1st group included 28 patients using the RSS and the 2nd group included 29 patients using the RCS. The orthopedic shoe was used for six weeks postoperatively. Clinical data (lumbar and lower limb pain, need of crutches and problems with going up and down stairs), radiological data (IMA, HVA) and postoperative complications (displacement of osteotomy, metatarsal fracture or non-union) were collected. RESULTS: the RSS showed less difficulty going up and down stairs (OR 3.8 (CI 95% 1.2-12.8), p 0.02), only going upstairs (OR 3.2 (CI 95% 1.1-10), p 0.03), as well as a decreased need for crutches (OR 1.7 (CI 95% 1.04-2.6), p < 0.03). Lumbar spine or lower limb pain did not show any statistical differences. No statistical differences in the epidemiological and radiological data were found between the groups. CONCLUSIONS: the RSS seems to provide more comfort to the patients without worsening the radiological results.


INTRODUCCIÓN: el calzado ortopédico suele prescribirse en el postoperatorio de cirugía de hallux valgus para proteger la osteotomía y mantener la funcionalidad al paciente. En este sentido, la superioridad del zapato de suela rígida en comparación con el zapato de suela invertida sigue siendo controvertido. El objetivo de este estudio es comparar los resultados clínicos, funcionales y radiológicos entre el uso del zapato de suela rígida (ZSR) y el zapato de suela invertida (ZSI) después de la cirugía de hallux valgus. MATERIAL Y MÉTODOS: un total de 57 pacientes intervenidos de hallux valgus fueron incluidos y analizados retrospectivamente. En un grupo se incluyeron 28 pacientes que usaron el ZSR, mientras que el segundo grupo incluyó a 29 pacientes que usaron el ZSI. El zapato ortopédico se usó durante seis semanas tras la cirugía. Se recogieron datos clínicos (dolor lumbar y articular de las extremidades inferiores, necesidad de muletas y problemas para subir y bajar escaleras), datos radiológicos (AIM, AHV), así como complicaciones postoperatorias (desplazamiento de osteotomía, fractura del primer metatarsiano o seudoartrosis). RESULTADOS: el zapato de suela rígida mostró menor dificultad para subir y bajar escaleras (OR 3.8 (IC 95% 1.2-12.8), p 0.02), sólo para subir (OR 3.2 (IC 95% 1.1-10), p 0.03), así como una disminución de la necesidad de muletas (OR 1.7 (IC 95% 1.04-2.6), p < 0.03). El dolor de columna lumbar o articular de extremidades inferiores no mostró diferencias estadísticas. No se encontraron diferencias estadísticas en los datos epidemiológicos y radiológicos entre los grupos. CONCLUSIONES: el zapato de suela parece aportar más comodidad a los pacientes sin aumentar las complicaciones radiológicas.


Subject(s)
Hallux Valgus , Metatarsal Bones , Humans , Hallux Valgus/diagnostic imaging , Hallux Valgus/surgery , Retrospective Studies , Shoes , Foot , Pain , Treatment Outcome , Metatarsal Bones/surgery
11.
J Neonatal Perinatal Med ; 11(1): 61-64, 2018.
Article in English | MEDLINE | ID: mdl-29689744

ABSTRACT

BACKGROUND: The incidence of clavicle fracture in the newborn population ranges from 0.2 to 3.5% with an associated rate of obstetric brachial palsy (OBP) ranging from 4 to 13% . METHODS: The aim of this study was to describe the anatomical location of the fracture in the clavicle and its possible correlation with OBP. We retrospectively reviewed all perinatal clavicle fractures diagnosed at our institution over thirteen years. RESULTS: A total of 155 clavicle fractures were identified among 23508 live newborns representing an incidence of 0.67% . Fracture location was categorized according to the Allman classification. The most frequent location was the mid-shaft (Allman I) (92.90%), followed by the medial third (Allman III) (5.81%) and finally by the lateral third (Allman II) (1.29%). 17 cases had an associated OBP (10.97%). 13 of these cases (76.47%) involved the medial third, 4 involved the midshaft (23.53%) whilst none of the cases with a clavicle fracture involving the lateral third was associated to OBP. We could determine a significant association between the occurrence of OBP and fracture of the clavicle medial third (Allman type III) (p < 0.05). CONCLUSIONS: To the best of our knowledge this is the first study describing the anatomical location of the fracture in the clavicle and its possible association with OBP. A fracture involving the medial clavicle third in a newborn might alert of the possible event of OBP. Nevertheless, more studies with larger samples will be necessary to confirm these results.


Subject(s)
Birth Injuries/epidemiology , Brachial Plexus Neuropathies/epidemiology , Clavicle/injuries , Fractures, Bone/epidemiology , Apgar Score , Birth Injuries/complications , Brachial Plexus Neuropathies/etiology , Diaphyses/injuries , Dystocia/epidemiology , Female , Fractures, Bone/complications , Humans , Incidence , Infant, Newborn , Pregnancy , Retrospective Studies , Risk Factors
12.
Acta Ortop Mex ; 27(2): 119-22, 2013.
Article in Spanish | MEDLINE | ID: mdl-24701764

ABSTRACT

UNLABELLED: Ischial osteomyelitis is a bone infection that is very infrequent during childhood and is diagnosed by excluding other more frequent conditions. The definitive diagnosis is made with puncture biopsy, which allows instituting targeted antibiotic therapy. We present herein two clinical cases of two children who had a favorable course. In both cases the findings of the initial X-rays were unremarkable. The physical exam did not show total limitation of the coxofemoral joint but it did show ischial tenderness. The MRI showed images compatible with ischial osteitis. The ischial puncture biopsy was diagnostic in both cases. At the 24-month follow-up both children are leading a normal life. CONCLUSIONS: Ischial osteomyelitis is an entity to consider in children with coxalgia once other more frequent conditions have been ruled out. The diagnosis is possible with a thorough iconographic study toget.


Subject(s)
Ischium/pathology , Osteomyelitis/diagnosis , Staphylococcal Infections/diagnosis , Streptococcal Infections/diagnosis , Adolescent , Anti-Bacterial Agents/therapeutic use , Arthralgia/etiology , Bacteremia/complications , Bacteremia/microbiology , Child , Cutaneous Fistula/etiology , Fever/etiology , Humans , Ischium/diagnostic imaging , Ischium/microbiology , Magnetic Resonance Imaging , Osteomyelitis/complications , Osteomyelitis/diagnostic imaging , Osteomyelitis/drug therapy , Osteomyelitis/microbiology , Osteomyelitis/pathology , Positron-Emission Tomography , Staphylococcal Infections/drug therapy , Staphylococcal Infections/microbiology , Staphylococcal Infections/pathology , Streptococcal Infections/drug therapy , Streptococcal Infections/pathology , Streptococcus pyogenes/isolation & purification
13.
Patol. apar. locomot. Fund. Mapfre Med ; 3(3): 173-179, jul.-sept. 2005. ilus, tab
Article in Es | IBECS | ID: ibc-047478

ABSTRACT

Estudio de una serie prospectiva y consecutiva de 24 pacientes,que fueron tratados quirúrgicamente por coccigodíniay en los que se practicó la resección del cóccix. Los pacientesfueron operados durante un período de 10 años (1992-2002).El promedio de edad fue de 40,3 años, siendo 19 las mujeres y5 los varones. Inicialmente en todos ellos se intentaron diversostratamientos no quirúrgicos que no resolvieron el cuadrodoloroso, realizando posteriormente la exéresis del cóccix.Los pacientes fueron objeto de seguimiento clínico duranteun mínimo de un año después de la cocciguectomía, con una valoraciónindependiente a los 3 meses y al año. A los dos años serecogieron datos, para valorar el resultado final, mediante encuestatelefónica. En el último control a los dos años 19 pacientesfueron catalogados de excelentes o buenos (80%). Dos seconsideraron como un resultado moderado, dos no mejoraron yotro decía estar mucho peor. La tasa de complicaciones fue muybaja. En dos ocasiones hubo una dehiscencia de la sutura que seresolvió por cierre por segunda intención.A tenor de los resultados se recomienda la exéresis del cóccixpara el tratamiento de la coccigodínia


Estudio de una serie prospectiva y consecutiva de 24 pacientes,que fueron tratados quirúrgicamente por coccigodíniay en los que se practicó la resección del cóccix. Los pacientesfueron operados durante un período de 10 años (1992-2002).El promedio de edad fue de 40,3 años, siendo 19 las mujeres y5 los varones. Inicialmente en todos ellos se intentaron diversostratamientos no quirúrgicos que no resolvieron el cuadrodoloroso, realizando posteriormente la exéresis del cóccix.Los pacientes fueron objeto de seguimiento clínico duranteun mínimo de un año después de la cocciguectomía, con una valoraciónindependiente a los 3 meses y al año. A los dos años serecogieron datos, para valorar el resultado final, mediante encuestatelefónica. En el último control a los dos años 19 pacientesfueron catalogados de excelentes o buenos (80%). Dos seconsideraron como un resultado moderado, dos no mejoraron yotro decía estar mucho peor. La tasa de complicaciones fue muybaja. En dos ocasiones hubo una dehiscencia de la sutura que seresolvió por cierre por segunda intención.A tenor de los resultados se recomienda la exéresis del cóccixpara el tratamiento de la coccigodínia


Subject(s)
Male , Female , Adult , Aged , Middle Aged , Humans , Spinal Diseases/surgery , Low Back Pain/surgery , Coccyx/surgery , Prospective Studies , Low Back Pain/etiology , Postoperative Complications/epidemiology , Coccyx/injuries
14.
Patol. apar. locomot. Fund. Mapfre Med ; 3(1): 3-11, ene.-mar. 2005. ilus, tab
Article in Es | IBECS | ID: ibc-047405

ABSTRACT

Objetivo: Evaluación retrospectiva de los resultados clínicosobtenidos en 7 pacientes acondroplásicos intervenidosquirúrgicamente por presentar síntomas neurológicos de estenosisespinal.Material y método: La serie está compuesta por cinco mujeresy dos hombres con una edad media de 33 años. El períodomínimo de seguimiento después de la cirugía fue de 30 meses.Todos los pacientes tenían una cifosis toracolumbar , regular encinco y angular en dos. Clínicamente presentaban dolor, claudicacióny parestesias y en tres casos existían déficits neurológicosobjetivos. La tomografía axial computarizada (TAC) y la ResonanciaNuclear Magnética (RNM) mostraban que el área de mayorconflicto se encontraba entre las vértebras T11 y L3. La cirugíaconsistió en laminectomía en seis casos, asociándose fusiónanterior en un caso de cifosis angular. En otro caso de cifosis angularse practicó una fusión doble anterior y posterior sin laminectomía.Para evaluar los resultados clínicos se utilizó la escalafuncional de Weinstein.Resultados: Se obtuvieron dos resultados excelentes, unobueno, dos regulares y dos malos .La puntuación media del preoperatoriomejoró en 22,2 puntos (p<0,05) tras la cirugía. Losmejores resultados se lograron en los casos en que la descompresiónquirúrgica se realizó antes de que hubieran aparecidolos síntomas neurológicos deficitarios.Conclusión: En el paciente acondroplásico con síntomas clínicosde estenosis espinal el tratamiento de elección es la cirugíadescompresiva, que debe efectuarse de forma precoz, con el finde prevenir, la aparición de síntomas neurológicos graves. Si haycifosis angular, se debe asociar a la descompresión una fusión dobleanterior y posterior


Objective: Retrospective evaluation of the clinical outcomein seven achondroplastic patients who underwent spinal surgerybecause of spinal stenosis.Material and methods: The subset was composed of fivewomen and two men, and the average age was 33 years. Minimunfollow-up was 30 months. All patients had a thoracolumbarkyphosis. Five patients had a uniform thoracolumbarkyphosis and two had an angular thoracolumbar kyphosis.Syntomatology in all patients consisted in pain, claudicationand paresthesias and objective neurological deficit in three patients.CT scan and MRI demonstrated that the area of maximalspinal canal stricture was located between T11 and L3 inall cases. Six cases underwent decompressive laminectomy,supplemented with anterior fusion in one case of angularkyphosis. Another case of angular kyphosis underwent anteriorand posterior fusion without decompression. Clinical outcomeassessment was made using the Weinstein functionalanalysis form.Results: Two patients rated excellent, one good, two fairand two poor. The score in the back analysis form increased22,2 points after surgery. The best results were observed in thegroup of patients who did not have preoperative neurologicaldeficits.Conclusion: Surgical decompression should be performedearly in the achondroplastic patient presenting symptoms ofspinal stenosis in order to prevent progression of neurologicalsymptomatology. In the event of angular thoracolumbarkyphosis, combined anterior and posterior fusion must be associatedto decompression


Subject(s)
Male , Female , Adult , Adolescent , Middle Aged , Humans , Achondroplasia/surgery , Spinal Stenosis/surgery , Laminectomy/methods , Kyphosis/surgery , Decompression, Surgical/methods , Recovery of Function
15.
Rev. ortop. traumatol. (Madr., Ed. impr.) ; 46(3): 267-270, jun. 2002. ilus
Article in Es | IBECS | ID: ibc-18566

ABSTRACT

Se presentan 2 casos de deportistas jóvenes, que tras un traumatismo agudo sufrieron lesiones muy poco habituales: una fractura del núcleo de osificación epifisario y, el otro, una fractura-avulsión del platillo vertebral. La radiología fue poco significativa en los 2 casos y el diagnóstico se realizó mediante exploraciones complementarias, siendo especialmente útil en ambas ocasiones la tomografía axial computerizada. El tratamiento conservador fue eficaz en el primer caso, pero la fracturaavulsión del platillo requirió intervención quirúrgica para realizar la exéresis del fragmento. (AU)


Subject(s)
Adolescent , Adult , Male , Humans , Athletic Injuries/diagnosis , Back Pain/etiology , Epiphyses, Slipped/complications , Spinal Injuries/complications
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