Factores clínicos que afectan a la calidad de vida percibida en la reconstrucción artroscópica de las luxaciones acromioclaviculares / Clinical factors that affect perceived quality of life in arthroscopic reconstruction for acromioclavicular joint dislocation

Objetivo. Analizar los resultados de la reparación artroscópica de la luxación acromioclavicular en términos de calidad de vida percibida. Material y método. Estudio prospectivo de pacientes con luxación acromioclavicular grados iii-vde Rockwood, tratados artroscópicamente con un seguimiento medio de 25,4 meses. Se registraron los datos demográficos de la serie y se realizaron evaluaciones antes de la cirugía, a los 3 meses y a los 2 años con los cuestionarios validados Short Form-36 Health Survey (SF-36), escala visual analógica (EVA), The Disabilities of the Arm, Shoulder and Hand (DASH), Constant-Murley Shoulder Outcome Score (Constant) y Walch-Duplay Score (WD). Resultados. Se analizaron 20 pacientes, 17 hombres y 3 mujeres, con una edad media de 36,1 años. Según la clasificación de Rockwood, 3 pacientes fueron grado iii, 3 grado iv y 14 grado v. Se objetivó mejoría tanto funcional como clínica en todos los test clínicos analizados (SF-36, EVA y DASH) tanto a los 3 meses como a los 2 años (p<0,001). El valor final del test de Constant fue de 95,3±2,4 y el WD medio fue de 1,8±0,62. No se encontró que la calidad de vida percibida se viera afectada por ninguna variable a estudio, excepto por la evolución del DASH. Conclusiones. La calidad de vida percibida (valorada mediante el SF-36) en pacientes intervenidos artroscópicamente de luxación acromioclavicular grados iii-v no se ve influida por el sexo, la edad, el grado, el desplazamiento, la lateralidad, la evolución de la EVA, la puntuación del Constant ni por el WD. Sí se correlaciona con la evolución en el DASH (AU)

Objective. To analyse the results of arthroscopic repair of acromioclavicular dislocation in terms of health-related quality of life. Material and method. Prospective study of patients with acromioclavicular dislocation Rockwood grade iii-v, treated arthroscopically with a mean follow up of 25.4 months. The demographics of the series were recorded and evaluations were performed preoperatively, at 3 months and 2 years with validated questionnaires as Short Form-36 Health Survey (SF-36), visual analogue scale (VAS), The Disabilities of the Arm, Shoulder and Hand (DASH), Constant-Murley Shoulder Outcome Score (Constant) and Walch-Duplay Score (WD). Results. Twenty patients, 17 men and 3 women with a mean age of 36.1 years, were analysed. According to the classification of Rockwood, 3 patients were grade iii, 3 grade iv and 14 grade v. Functional and clinical improvement was detected in all clinical tests (SF-36, VAS and DASH) at 3 months and 2 years follow up (P<.001). The final Constant score was 95.3±2.4 and the WD was 1.8±0.62. It was not found that the health-related quality of life was affected by any variable studied except the evolution of DASH. Conclusions. The health-related quality of life (assessed by SF-36) in patients undergoing arthroscopic repair of acromioclavicular joint dislocation grades iii-v was not influenced by gender, age, grade, displacement, handedness, evolution of the VAS, scoring of the Constant or by the WD. However, it is correlated with the evolution in the DASH score (AU)

Clinical factors that affect perceived quality of life in arthroscopic reconstruction for acromioclavicular joint dislocation. / Factores clínicos que afectan a la calidad de vida percibida en la reconstrucción artroscópica de las luxaciones acromioclaviculares.

OBJECTIVE: To analyse the results of arthroscopic repair of acromioclavicular dislocation in terms of health-related quality of life. MATERIAL AND METHOD: Prospective study of patients with acromioclavicular dislocation Rockwood grade iii-v, treated arthroscopically with a mean follow up of 25.4 months. The demographics of the series were recorded and evaluations were performed preoperatively, at 3 months and 2 years with validated questionnaires as Short Form-36 Health Survey (SF-36), visual analogue scale (VAS), The Disabilities of the Arm, Shoulder and Hand (DASH), Constant-Murley Shoulder Outcome Score (Constant) and Walch-Duplay Score (WD). RESULTS: Twenty patients, 17 men and 3 women with a mean age of 36.1 years, were analysed. According to the classification of Rockwood, 3 patients were grade iii, 3 grade iv and 14 grade v. Functional and clinical improvement was detected in all clinical tests (SF-36, VAS and DASH) at 3 months and 2 years follow up (P<.001). The final Constant score was 95.3±2.4 and the WD was 1.8±0.62. It was not found that the health-related quality of life was affected by any variable studied except the evolution of DASH. CONCLUSIONS: The health-related quality of life (assessed by SF-36) in patients undergoing arthroscopic repair of acromioclavicular joint dislocation grades iii-v was not influenced by gender, age, grade, displacement, handedness, evolution of the VAS, scoring of the Constant or by the WD. However, it is correlated with the evolution in the DASH score.

Reparación artroscópica anatómica de las luxaciones agudas acromio-claviculares / Arthroscopic anatomic repair of acute acromioclavicular joint dislocations

Objetivo: Describir la técnica quirúrgica asistida por artroscopia para el tratamiento de las lesiones agudas acromio-claviculares (AC), basada en la reconstrucción anatómica córaco-clavicular (CC), y presentar los resultados clínicos preliminares. Material y método: Fueron tratados 12 pacientes de luxación AC, con edad media de 31 (19-45) años, con técnica artroscópica mediante reconstrucción con doble dispositivo de suspensión córaco-clavicular (Zip-tight). Seguimiento de entre tres y 12 meses. El tiempo medio entre lesión y cirugía fue de ocho días. Tres luxaciones fueron tipo III de Rockwood, dos tipo IV y siete tipo V. El diagnóstico se basó en radiografías ántero-posteriores y Alexander outlet. La evaluación clínica funcional se realizó con test SF-36, DASH y escala visual analógica (EVA) para el dolor. Resultados: Se obtuvo mejoría en todos los valores estudiados: DASH 79,4 (556 - 89) pre a 3,8 (1,9 - 9,5) post, SF36-físico 29,9 (17 - 43) pre a 56,1 (53 -60) post, SF36-mental 44,2 (27 - 52) pre a 55,4 (44 - 57) post. EVA 8,1 (6-9) pre a 1,3 (0-2) post. El grado de satisfacción fue de 8,5 sobre 10. Los resultados radiográficos fueron satisfactorios en 11 casos, en otro había pérdida de reducción menor al 50% sin repercusión clínica. No se presentaron complicaciones. Conclusión: La técnica presentada para estabilización de luxaciones AC en fase aguda mediante dos dispositivos de suspensión córaco-clavicular anatómicos es una técnica artroscópica segura, con alta demanda para el cirujano y baja tasa de complicaciones que obtiene óptimos resultados a corto plazo en pacientes seleccionados (AU)

Objective: Describe the arthroscopically assisted surgical technique to treat acute acromio-clavicular injuries based on anatomic coracoclavicular (CC) reconstruction and present the preliminary clinical results. Material and methods: After AC dislocation, 12 patients were treated with the anatomic arthroscopic reconstruction technique using a dual coracoclavicular suspension device. Follow-up was from 3 to 12 months 8Xip-tight). The mean time between injury and surgery was 8 days. Three dislocations were Rockwood type III, 2 type IV and 7 type V. The mean age was 31 years (19-45). Diagnosis included antero-posterior and Alexander outlet radiographs. Clinical evaluation was performed with the SF-36 test, DASH and the visual analog scale (VAS) for pain. Results: Improvement was observed in all values studied. DASH 79.4 (556-89) pre to 3.8 (1.9-9.5) post, SF36- physical 29.9 (17-43) pre to 56.1 (53-60) post, SF36- mental 44.2 (27-52) pre to 55.4 (44-57) post. VAS 8.1 (6-9) pre to 1.3 (0-2) post. The degree of satisfaction was 8.5 over 10. Radiographic results were satisfactory in 11 cases. In one case, there was a loss of reduction of less than 50% that had no clinical impact. No complications such as tunnel fractures, infection or intolerance of material occurred. Conclusion: The technique for stabilization of acute AC dislocations with two anatomically configured CC suspension devices is safe but demanding. However, the complication rate is low and short-term results are optimum in selected patients (AU)

Luxación de los tendones extensores de la mano a nivel de la articulación metacarpofalángica / Luxation of the hand extensor tendons around the metacarpophalangeal joint

Objetivo. La luxación de los tendones extensores sobre la cabeza de los metacarpianos, constituye una entidad poco frecuente en pacientes que no presentan una artritis reumatoide. Sin embargo, con el incremento de actividades deportivas, especialmente aquellas que exigen un contacto físico permanente, el número de casos ha ido aumentando. Método. En cuanto al tratamiento se refiere, hay que distinguir los casos agudos (menos de tres semanas de evolución) de los crónicos, pues en los primeros casos suele ser suficiente la inmovilización, mientras que en los segundos es necesario practicar algún tipo de intervención quirúrgica. Resultados. En el presente trabajo se dan a conocer los resultados obtenidos sobre tres pacientes con dicha patología y a los cuales se procedió a la centralización quirúrgica del tendón mediante técnica de Kilgore (AU)

Objectives: Dislocation of the extensors over the head of the metacarpals constitutes a rare condition in patients who do not present rheumatoid arthritis. Nevertheless, with the increase in sport activities and especially those that demand a permanent physical contact, the number of cases has been increasing. Methods: As far as treatment its goes, it is necessary to distinguish the acute cases (less than three weeks evolution) from the chronic ones as immobilization is usually sufficient in the first case. On the other hand, it is necessary to practice some type of operation in the second case. Results: In the present work, the results obtained on three patients with this pathology on whom surgical centralization of the tendon by means of the Kilgore technique is made known (AU)