RESUMO
La fabela es un hueso sesamoideo presente en un 30% de la población que, en la mayoría de las ocasiones, se encuentra en el vientre proximal del gastrocnemio lateral y se articula con el cóndilo femoral posterolateral. El síndrome de la fabela es una entidad poco frecuente que debe considerarse ante un dolor en el ángulo posterolateral de la rodilla que se exacerba a la extensión. Dada su rareza e infradiagnóstico, en la literatura se recogen escasos artículos sobre su manejo terapéutico. En los artículos revisados, el tratamiento conservador presenta altas recidivas, si bien la exéresis quirúrgica de la fabela es el tratamiento más eficaz para la remisión definitiva de los síntomas. La experiencia documentada del tratamiento quirúrgico en deportistas de alto nivel es excepcional. Presentamos el caso de un nadador de élite de 21 años que, tras la exéresis quirúrgica de la fabela, presentó una recuperación completa y una rápida incorporación a la competición
The fabella is a sesamoid bone present in 30% of the population and, in the majority of cases, it is shown in the proximal head of the lateral gastrocnemius articulating with the lateral femoral condyle. Fabella syndrome is an uncommon disease and it must be considered when dealing with posterolateral pain that increases with extension of the knee. Because of its rarity and underdiagnosis, the literature reports few articles relating to its therapeutic management. The articles reviewed demonstrate that conservative treatment has high recurrence rates, surgical excision being the most effective treatment to eradicate symptoms. We found exceptional articles in the literature related to the surgical treatment of fabella syndrome in professional athletes. In this article we report the surgical experience of a 21-year-old elite swimmer who achievedcomplete pain relief and fast recovery after surgical excision of the fabella
Assuntos
Humanos , Masculino , Adulto Jovem , Ossos Sesamoides/lesões , Traumatismos do Joelho/cirurgia , Natação/lesões , Resultado do Tratamento , Recuperação de Função Fisiológica , Desempenho Atlético/estatística & dados numéricosRESUMO
The fabella is a sesamoid bone present in 30% of the population and, in the majority of cases, it is shown in the proximal head of the lateral gastrocnemius articulating with the lateral femoral condyle. Fabella syndrome is an uncommon disease and it must be considered when dealing with posterolateral pain that increases with extension of the knee. Because of its rarity and underdiagnosis, the literature reports few articles relating to its therapeutic management. The articles reviewed demonstrate that conservative treatment has high recurrence rates, surgical excision being the most effective treatment to eradicate symptoms. We found exceptional articles in the literature related to the surgical treatment of fabella syndrome in professional athletes. In this article we report the surgical experience of a 21-year-old elite swimmer who achievedcomplete pain relief and fast recovery after surgical excision of the fabella.
Assuntos
Articulação do Joelho/anormalidades , Articulação do Joelho/cirurgia , Ossos Sesamoides/anormalidades , Ossos Sesamoides/cirurgia , Atletas , Humanos , Masculino , Natação , Síndrome , Adulto JovemRESUMO
An investigation of the therapeutic effect of a once daily dose of captopril was carried out on 19 patients with essential hypertension. Captopril was administered at a dose of 50 mg/day for 2 weeks. If blood pressure was not reduced to less than 160/95 mm Hg in that time, the dose was increased to 100 mg/day for a further 2 weeks (5 patients). If blood pressure remained high, 50 mg chlorthalidone/day was added (4 patients). Only 1 patient was not controlled. The drugs were administered in the morning. Blood pressure and serum angiotensin converting enzyme activity (SACE) were measured 24 hours after the last dose, and patients were followed up to 3 months. The basal SACE decreased 24 hours after the first captopril dose but 3 months later, when blood pressure was controlled, the mean level was back to baseline values. Our results show that once-daily captopril is efficacious in hypertension and its hypotensive effect appears to be independent of ACE inhibition.
