Technical aspects and complications in the surgical treatment of poliomyelitis-affected lower limb fractures. / Aspectos técnicos y complicaciones en el tratamiento de las fracturas de los miembros inferiores con secuelas de poliomielitis.

OBJECTIVE: Post-polio patients present problems such as small and deformed bones, with narrow intramedullary canal and osteoporosis, affecting surgical treatment. The aim of this article is to describe the main preoperative and intraoperative complications of the surgical treatment of fractures in this population. MATERIAL AND METHODS: A retrospective analysis was conducted between 1995 and 2014. Data obtained from the medical records included patient age, fracture pattern (AO/OTA), device used, technical aspects of the surgery that changed compared to a standard procedure, and the presence of intraoperative skeletal complications. RESULTS: Sixty-four patients with 78 fractures were included in the study. Forty-seven percent of the fractures were at the proximal femur. The main complications of hip arthroplasty (14 patients) were absent hip abductors and intraoperative instability (3), bad cup fixation (3) and intraoperative periprosthetic fracture (2). The main problems of intramedullary nailing were due to a narrow canal and previous bone deformity. Main problems reported when plating included difficulty to fit a precontoured plate, and oversized hardware. CONCLUSION: Given the large number of intraoperative complications, in preoperative planning we must include nails of small diameter and length, locking plates and external fixators, and, in the case of hip arthroplasty, long and thin stems and restrictive or dual mobility acetabular systems.

Radioprotección en quirófanos de traumatología: ¿en qué situación estamos? / Radiation safety in orthopaedic operating theatres. what is the current situation?

Objetivo. Analizar la exposición a radiaciones ionizantes por parte de dos cirujanos ortopédicos en su práctica diaria y revisar las principales recomendaciones nacionales e internacionales al respecto. Material y método. Se efectúo un estudio retrospectivo de la actividad quirúrgica con uso de fluoroscopia realizado por dos cirujanos ortopédicos en un año. Se calculó la radiación recibida basándose en mediciones por procesos publicados en la bilbliografía. Revisión bibliográfica de recomendaciones y normativas internacionales. Resultado. La radiación recibida en un año por los dos cirujanos ortopédicos no sobrepasó el límite de la legislación actual ni el de las nuevas recomendaciones europeas e internacionales. La exposición fue asimétrica, siendo las manos la zona más radiada. Las nuevas recomendaciones rebajan los niveles permitidos de radiación en ojos. Discusión. La estimación de radiación recibida hace necesario proteger y vigilar especialmente las manos y los ojos. Son necesarios conocimientos del funcionamiento del fluoroscopio y de las medidas de radioprotección (AU)

Objective. To analyse the exposure of two Orthopaedic Surgeons to ionizing radiations in their daily work, and to review the main national and international recommendations on this subject. Material and methods. A retrospective study was conducted on the surgical treatments that use fluoroscopy performed by two Orthopaedic Surgeons during a one year period. An evaluation was made of the radiation received, based on measurements of the processes published in the bibliography section. A literature review of international recommendations and regulations is also presented. Results. The radiation received by the two Orthopaedic Surgeons during one year did not exceed the limits of present-day legislation or the new European and international recommendations. The exposure was asymmetrical, with the hands being the most radiated part. The new recommendations reduce the permitted level of radiation on eyes. Discussion. The evaluation of the radiation received demonstrates the need for radiation protection, paying particular attention to the hands and eyes. Good knowledge of operating a fluoroscope and radiation safety measures are also essential (AU)

[Radiation safety in orthopaedic operating theatres. What is the current situation?]. / Radioprotección en quirófanos de traumatología: ¿en qué situación estamos?

OBJECTIVE: To analyse the exposure of two Orthopaedic Surgeons to ionizing radiations in their daily work, and to review the main national and international recommendations on this subject. MATERIAL AND METHODS: A retrospective study was conducted on the surgical treatments that use fluoroscopy performed by two Orthopaedic Surgeons during a one year period. An evaluation was made of the radiation received, based on measurements of the processes published in the bibliography section. A literature review of international recommendations and regulations is also presented. RESULTS: The radiation received by the two Orthopaedic Surgeons during one year did not exceed the limits of present-day legislation or the new European and international recommendations. The exposure was asymmetrical, with the hands being the most radiated part. The new recommendations reduce the permitted level of radiation on eyes. DISCUSSION: The evaluation of the radiation received demonstrates the need for radiation protection, paying particular attention to the hands and eyes. Good knowledge of operating a fluoroscope and radiation safety measures are also essential.