Revista Colombiana de Ortopedia y Traumatología最新文献

Paget's disease of bone is a metabolic alteration due to an imbalance between osteoclastic and osteoblastic activity, leading to an inefficient remodeling process that results in changes in bone structure. Although in many cases it can be asymptomatic, it is associated with severe complications such as fractures, skeletal deformities, bone neoplasms and symptoms due to compression of nerve structures at the skull and spine. This pathology occurs more frequently in male patients and in the United Kingdom, as well as in countries with a British immigrant population; however, it is very infrequent in Latin American countries. We present the case of a 72-year-old patient diagnosed with Paget's disease according to imaging and laboratory findings, treated with zoledronic acid for symptomatic management.

Introduction

About 200 million people in the world has osteoporosis. On average, a fracture occurs every three seconds and its prevalence has been increasing exponentially in the last decade. Despite being a public health issue in Colombia, we lack statistics that show de magnitude of the disease.

Materials and Methods

It's a cross-sectional descriptive study with an analytical component in patients with fragility fractures treated in the Emergency Department. The incidence has been calculated and the population characteristics described. We identified statistical significance associations between different variables.

Results

An incidence of 10.7 FF/100 fractures / year and 1.02 FF/100 patients treated at the ED/year was found. There was a higher incidence of fractures at 57 years old, 80% in women, mainly unemployed. Distal radius fracture had a higher prevalence, followed by hip and proximal humerous. 85% of the patients did not had osteoporosis previously. Statistically significant associations were found between age and location, sex and age, and sex and location.

Discussion

With population aging, the incidence of FF has been increasing, we found demographic data like those reported in the literature; a higher frequency in women and mainly compromising the distal radius. Due to the methodological limitations of the study, it allows for new questions and hypothesis based on the associations we found. We consider important the identification, diagnosis, and early treatment in these patients since the risk of new falls, associated morbidity and mortality is reduced.

Evidence Level

III: Descriptive- analytic study.

Introduction

The development of foot ulcers in the diabetic foot (DF) can result in amputation of lower extremities and even generate a great impact in morbidity of diabetic patients. Considering the former, this study pretends to evaluate patient's characteristics during hospitalization in a regional Hospital.

Material and methods

One hundred twenty-one patients were included in this retrospective cohort study between amputated and non-amputated subjects provided from the hospital's database since January 2013 until January 2018. Demographic data, as well as related factors were analysed through a bi- and multivariate logistic regression in relation to lower limb amputation as independent variable, thus calculating odds ratio (OR) with confidence intervals of 95%. Such information was analysed using STATA.

Results

Eighty-one patients required lower limb amputation. In the bivariate logistic regression, there were 3 related factors to amputation [Wagner (p < 0.05, 95% CI), leukocytosis (p < 0.05, 95% CI) and vascular occlusion reported in arterial Doppler (p < 0.05, 95% CI)], nonetheless, multivariate regression only related vascular occlusion reported in arterial Doppler as statistically significant in relation to lower limb amputation (p < 0.05, 95% CI).

Conclusion

Three factors were statistically relevant in relation to lower limb amputation in patients with DF (Wagner, leukocytosis, and vascular occlusion), showing the importance of an early diagnosis and an adequate management as a key factor in the management of this pathology.

Introduction

Slipped capital femoral epiphysis (SCFE), is a pathology with no consensus in its treatment and with variable complication rates depending on the technique.

Materials and methods

Description of the clinical and radiographic outcomes of an SCFE patients cohort treated in our hospital between 2012 and 2015. We evaluated the association between clinical characteristics and avascular necrosis of the femoral head (AVN) using raw RR and Mantel-Haenszel adjusted RR.

Results

71 patients were included, mean age was 13.1 years, pre-surgical Southwick angle was 46.9° (12°-100°). Sixteen cases were mild (22.5%), 38 moderate (53.5%) and 17 severe (23.9%). We found six cases of AVN after surgical dislocation (23% or 24%) and one case after percutaneous techniques (2,2%) (p=0,05).

Conclusion

We did not find association between the variables age, BMI and sex with AVN. There is an association between this outcome and the surgical technique.