Chronic Achilles tendon rupture associated with rupture of the peroneus brevis tendon. A clinical case. / Rotura crónica del tendón de Aquiles asociada a rotura del tendón peroneus brevis. Caso clínico.

The treatment of a chronic rupture of the Achilles tendon remains difficult. Different techniques such as augmentation or plasties are used for restoring the gap in these ruptures. The combination of Achilles tendon rupture with other tendon ruptures may increase the difficulty in their treatment. We present a rare combination of a delayed Achilles tendon rupture and a peroneus brevis tendon rupture and its management. The importance of the presented case is the combination of both ruptures that adds difficulty to the surgical technique. A thorough analysis should be made of the magnetic resonance findings when planning a tendon transposition. To our knowledge, there are no reports of a simultaneous combination of an Achilles tendon rupture and a peroneus brevis tendon rupture.

Factores de mal pronóstico en la reparación del manguito rotador / Prediction data of poor outcome in shoulder surgery: rotator cuff injury

La patología y la cirugía del manguito rotador han experimentado en los últimos años un gran avance gracias a la artroscopia y a las técnicas de diagnóstico por la imagen que han colaborado así mismo en dicho avance. Sin embargo, no debemos olvidar que la anamnesis y la exploración física siguen siendo fundamentales. El objetivo de nuestro trabajo de revisión es detectar aquellos factores que pueden influir negativamente en la evolución del proceso desde la primera visita al paciente. También es valorada la información que aportan las pruebas complementarias para efectuar un planteamiento terapéutico y/o quirúrgico si procede

Objective: Looking for factors that can have negative influence in the evolution and treatment of the rotator cuff injuries of the shoulder. Material and method: We have done a review of different journal articles following the next parameters. Systemize clinical exploration, requested complementary explorations and a therapeutic planning. Results: The clinical exploration can detect data that indicates a bad evolution as restricted passive and active movement of the shoulder and a lost of strength of the external rotation of the limb. An early diagnose and treatment improve the results in the isolated ruptures of the rotator cuff. Associated instability with partial lessions of the rotator cuff on the joint side must be consider mainly in the young people. In the partial ruptures of the rotator cuff the subacromial decompression is not enough in the long term results. The rerupture of the rotator cuff is the most common complication of the rotator cuff repair