Triple osteotomía del ilíaco en patología de cadera / Triple iliac osteotomy in hip disease

OBJETIVO: Se presenta nuestra experiencia en el tratamiento de la displasia residual de cadera en adolescentes y adultos jóvenes, utilizando la técnica de triple osteotomía del ilíaco descrita por Tönnis. MATERIAL Y MÉTODO: Se han revisado las historias clínicas y los protocolos quirúrgicos de siete casos intervenidos entre 1994 y 1997 utilizando la mencionada técnica. RESULTADOS: La etiología fue displasia del desarrollo de la cadera en cinco casos, enfermedad de Perthes en uno y artrosis en otro. En ninguno de los casos fue necesaria una inmovilización postoperatoria, comenzando la marcha al tercer día de la intervención. En cuatro casos se habían realizado uno o más procedimientos quirúrgicos asociados. Radiográficamente se demuestra una mejoría de la cobertura acetabular. Los resultados han sido buenos en cinco casos, regular en uno y malo en otro. CONCLUSIÓN: Se trata de una técnica quirúrgica compleja que requiere una planificación cuidadosa, pero los resultados pueden ser prometedores para la mejoría de caderas problemáticas en el tratamiento de displasias residuales de cadera del adolescente (AU)

[Quality of prescription at an on-demand clinic: a preliminary examination]. / Calidad de prescripción en consulta a demanda de pediatría: examen preliminar.

OBJECTIVES: To analyse the qualitative composition of medication prescribed to paediatric patients, in function of the intrinsic value of the medication and active principles used, and to evaluate risks run by children through being exposed to medication. DESIGN: An observational, descriptive, crossover study. SETTING: Paediatrics service of Puerto de la Torre Health Centre (Málaga); serving a fundamentally urban population, with rural areas round about. PARTICIPANTS: All the patients seen during two consecutive weeks of November 1994. 15 cases of the 457 seen were excluded. The unit of analysis was a visit. MAIN MEASUREMENTS: Age, reason for consultation and medication prescribed at each attendance were recorded. Four age groups were defined: A (0-12 months), B (12-36 months), C (36-60 months) and D (> 60 months). On the basis of the initial records, the following quantitative variables per visit were broken down: number of drugs; number of drugs with high intrinsic value (HIV); number of drugs with low intrinsic value (LIV); number of active principles; number of HIV active principles; and number of LIV active principles. RESULTS AND CONCLUSIONS: The incidence of medical prescription in the attendance sample was 85.1%. It was highest in group C and lowest in group A. Average medication per attendance was 1.36 +/- 0.08. Group C was identified as the group with the highest average of drugs prescription, HIV drugs, active.

Internal fixation of ulnar fractures by locking nail.

Fractures and dislocations of the forearm are commonly observed in trauma clinics. With time, there will probably be significant increases in fractures of the forearm associated with traffic and sports. The efficacy of the treatment of ulnar fractures by a new locking nail, developed by Lefevre in Strasbourg, was tested in 20 patients. The fractures were severely displaced ulnae or both bones of the forearm. The minimum follow-up period was six months. The average age of the patients was 33.5 years (range, 14-77 years). The nail is placed into the ulna proximally. Locking is achieved by two screws placed at the proximal and distal end of the nail. The healing time for the fractures of both bones of the forearm ranged from 75 days to 20 weeks, with an average of 15 weeks. Healing time for the ulnar fractures ranged from eight to 20 weeks, with an average of ten weeks. The advantages of this nail were easy closed technique, compression effects at the fracture site, and enough stability so that an external support and tourniquet, in isolated ulnar fractures, were not necessary.