Percutaneous achilles tendon repair with absorbable suture: Outcomes and complications / Reparación percutánea del tendón de Aquiles con sutura reabsorbible: resultados y complicaciones

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)

Reparación percutánea del tendón de Aquiles con sutura reabsorbible: resultados y complicaciones / Percutaneous Achilles tendon repair with absorbable suture: Outcomes and complications

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)

Percutaneous Achilles tendon repair with absorbable suture: Outcomes and complications / Reparación percutánea del tendón de Aquiles con sutura reabsorbible: resultados y complicaciones

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)

[Artículo traducido] Reparación percutánea del tendón de Aquiles con sutura reabsorbible: resultados y complicaciones / Percutaneous Achilles tendon repair with absorbable suture: Outcomes and complications

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)

Percutaneous achilles tendon repair with absorbable suture: Outcomes and complications.

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.

Percutaneous Achilles tendon repair with absorbable suture: Outcomes and complications.

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.

Percutaneous Achilles tendon repair with absorbable suture: Outcomes and complications. / [Artículo traducido] Reparación percutánea del tendón de Aquiles con sutura reabsorbible: resultados y complicaciones.

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.

Percutaneous achilles tendon repair with absorbable suture: Outcomes and complications. / Reparación percutánea del tendón de Aquiles con sutura reabsorbible: resultados y complicaciones.

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.

Zapato de suela rígida versus zapato de suela invertida en la cirugía de hallux valgus: análisis clínico, funcional y radiológico / Rigid sole shoe versus inverted sole shoe in hallux valgus surgery: clinical, functional and radiological analysis

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.

[Rigid sole shoe versus inverted sole shoe in hallux valgus surgery: clinical, functional and radiological analysis]. / Zapato de suela rígida versus zapato de suela invertida en la cirugía de hallux valgus: análisis clínico, funcional y radiológico.

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.

Compresión medular metastásica: incidencia, epidemiología y factores pronóstico / Metastatic spinal cord compression: incidence, epidemiology and prognostic factors

Introducción: La compresión medular metastásica (CMM) es una complicación severa en pacientes con cáncer cuya incidencia es difícil de estimar con exactitud. El objetivo del presente estudio es describir la incidencia, las características epidemiológicas y el pronóstico de la compresión medular metastásica en pacientes con cáncer. Material y métodos: Analizamos una cohorte con un total de 1.736 pacientes con diagnóstico de cáncer de cualquier origen ingresados en una unidad de cuidados paliativos. De los pacientes con diagnóstico de CMM, se recogieron datos epidemiológicos, signos y síntomas, tiempo medio hasta el diagnóstico, régimen de tratamiento, respuesta al tratamiento y mortalidad. Resultados: De un total de 1.736 pacientes, se identificaron 28 (1,6%) casos de CMM. La edad promedio fue de 67,2 (DE: 12,7) años siendo el cáncer de pulmón el tumor primario más frecuente (42,8%). La columna torácica fue la localización más afectada (42,8%; n=12) y el dolor el síntoma predominante (46,4%, n=13). La mediana de supervivencia después del diagnóstico de CMM fue de 84,5 días. Conclusiones: Hemos obtenido una incidencia del 1,6% (N=28) de CMM en una cohorte de 1.736 pacientes con cáncer. La CMM es un marcador de mal pronóstico con una supervivencia media menor de 3 meses desde el diagnóstico y una mortalidad intrahospitalaria del 32,4%

Background: Metastatic spinal cord compression (MSCC) is a severe complication in patients with cancer, and its incidence rate is difficult to accurately estimate. The aim of this study is to report the incidence and epidemiological and prognostic characteristics of MSCC in patients with cancer. Material and methods: We analysed a cohort of 1736 patients diagnosed with cancer of any origin who were hospitalised in a palliative care unit. We collected epidemiological data, signs and symptoms, mean time to diagnosis, treatment regimen, response to treatment and mortality for the patients diagnosed with MSCC. Results: In the 1736 patients, we identified 28 (1.6%) cases of MSCC. The average age was 67.2 (SD, 12.7) years, and lung cancer was the most common primary tumour (42.8%). The thoracic spine was the most affected location (12 cases, 42.8%), and pain was the predominant symptom (13 cases, 46.4%). The median survival after the MSCC diagnosis was 84.5 days. Conclusions: We observed an incidence rate of 1.6% (N=28) for MSCC in a cohort of 1736 patients with cancer. MSCC is a marker of poor prognosis, with a mean survival of less than 3 months from diagnosis and a hospital mortality of 32.4%

Metastatic spinal cord compression: Incidence, epidemiology and prognostic factors. / Compresión medular metastásica: incidencia, epidemiología y factores pronóstico.

BACKGROUND: Metastatic spinal cord compression (MSCC) is a severe complication in patients with cancer, and its incidence rate is difficult to accurately estimate. The aim of this study is to report the incidence and epidemiological and prognostic characteristics of MSCC in patients with cancer. MATERIAL AND METHODS: We analysed a cohort of 1736 patients diagnosed with cancer of any origin who were hospitalised in a palliative care unit. We collected epidemiological data, signs and symptoms, mean time to diagnosis, treatment regimen, response to treatment and mortality for the patients diagnosed with MSCC. RESULTS: In the 1736 patients, we identified 28 (1.6%) cases of MSCC. The average age was 67.2 (SD, 12.7) years, and lung cancer was the most common primary tumour (42.8%). The thoracic spine was the most affected location (12 cases, 42.8%), and pain was the predominant symptom (13 cases, 46.4%). The median survival after the MSCC diagnosis was 84.5 days. CONCLUSIONS: We observed an incidence rate of 1.6% (N=28) for MSCC in a cohort of 1736 patients with cancer. MSCC is a marker of poor prognosis, with a mean survival of less than 3 months from diagnosis and a hospital mortality of 32.4%.

Surgical technique and outcomes for bilateral humeral lengthening for achondroplasia: 26-year experience.

BACKGROUND: Elongation in patients with achondroplasia provides better overall skeletal proportionality and significantly improves such individuals' access to their perineal region to self-manage personal hygiene. This paper describes our surgical technique and outcomes for bilateral humeral lengthening in achondroplasia patients over 26 years. METHODS: Ours was a retrospective study of 55 patients with achondroplasia-related short stature, in whom bilateral humeral lengthening was performed from 1990 to 2016. We describe the surgical technique and analyze mean gain in humeral length, days using an external fixator, mean percentage of lengthening, external fixation index, type of callus, and complications. Pre- and postoperative radiographic measurements were obtained. Patients also were contacted by telephone and asked about their ability to perform peri-anal self-hygiene and about their overall satisfaction. RESULTS: In total, 110 humeri were lengthened (28 males and 27 females) with medium elongation of 9.5 cm on the right and 9.6 cm on the left, while averaging 220 days in an external fixator. We observed 14 minor complications. There was no significant association between pin position and type of callus, and elongation most often external and in the presence of a straight callus. Before elongation, 77.1% of patients reported difficulties with perineal hygiene and 85.4% could not put their hands in their pockets. Upon completion of lengthening, 100% could perform both tasks and 94.5% were very satisfied. CONCLUSIONS: Bilateral humeral elongation yields significant improvements in patient autonomy, with a relatively low complication rate and very high patient satisfaction.

Tratamiento de la leucemia mieloide crónica e infección por el virus de inmunodeficiencia humana / Chronic myeloid leukemia treatment and human immunodeficiency virus infection

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