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Revista Española de Cirugía Osteoarticular最新文献

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Liberación endoscópica del nervio ciático en el síndrome del espacio subglúteo: técnica quirúrgica y serie de casos clínicos. 臀下间隙综合征坐骨神经内镜释放:手术技术及临床病例系列。
Pub Date : 2023-01-01 DOI: 10.37315/sotocav202229257109
MOLINA PÉREZ, FERNÁNDEZ GARCÍA, LLOPIS SANJUAN
Objectives: To describe the surgical technique for an endoscopic sciatic nerve release in deep gluteal syndrome and to evaluate its results. Study design and Methods. Retrospective observational study of a consecutive case series that underwent endoscopic surgery by the Arthroscopy Unit from our hospital. All of them were diagnosed clinically and radiologically (using magnetic resonance imaging) of sciatic nerve entrapment. Results. Eight patients underwent surgery with a mean age of 44 years old and a majority of women. The mean duration of surgery was 55 minutes with a mean hospital stay of one day. Anatomical muscular alterations were found in six cases and fibrovascular bands in two. Pain, assessed by Visual Analogue Scale (VAS), decreased from 8'00 to 2'25. The patients were on average quite satisfied. One complication was described and just one case required salvage surgery. Conclusions. Sciatic nerve release is an effective technique in patients with subgluteal space syndrome due to sciatic entrapment, since it improves the patient's symptoms. The use of endoscopy provides added value, as it allows visualization of the nerve using minimally invasive techniques.
目的:介绍臀深综合征的内窥镜坐骨神经松解术的手术技术并评价其效果。研究设计与方法。对我院关节镜科接受内窥镜手术的连续病例系列进行回顾性观察研究。所有患者均经临床和影像学(磁共振成像)诊断为坐骨神经卡压。结果。8例患者接受了手术,平均年龄44岁,大多数为女性。平均手术时间为55分钟,平均住院时间为1天。6例发现解剖性肌肉改变,2例发现纤维血管带。通过视觉模拟评分(VAS)评估疼痛,从8分下降到2分25分。患者总体上都很满意。一例并发症被描述,只有一例需要抢救手术。结论。坐骨神经松解术是治疗由坐骨压迫引起的臀下间隙综合征的有效方法,可改善患者的症状。内窥镜的使用提供了额外的价值,因为它允许使用微创技术可视化神经。
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引用次数: 0
Quiste gigante acromioclavicular en paciente mayor. Hasta cuando tratar la causa. 老年患者肩锁骨巨大囊肿。直到什么时候治疗病因。
Pub Date : 2023-01-01 DOI: 10.37315/sotocav202229257134
PARDO COELLO, CALATRAVA ROMERO, MADROÑERO MELO, LÓPEZ MONTES, NIEVES HERNÁNDEZ, RABADÁN PÉREZ, CASTELLANOS ROBLES
Introduction: Acromioclavicular joint cysts are a rare entity, generally present in elderly patients with chronic injuries or arthropathies of the rotator cuff. There are several causes of cyst formation, there are generally two of the most frequent, which we will talk about in this article. Clinical case: We present the case of an 82-year-old male patient with a giant acromioclavicular cyst, more than 20 cm in diameter, with rapid growth in recent months and with associated rotator cuff tendon injury. Discussion: These cysts are not very frequent injuries, mainly caused by degeneration of the acromioclavicular joint, most of the cases associated with rotator cuff injuries. Diagnosis is based on clinical examination, ultrasound and magnetic resonance imaging. Treatment by cyst aspiration and corticosteroid infiltration is not usually very effective and has a high recurrence rate, so surgical removal of the cyst is more indicated. Conclusions: The surgical indication for these cysts is pain, sometimes associated with resection of distal fragments of the clavicle; when a rotator cuff injury is present, reverse shoulder arthroplasty can be an alternative; however, in patients with poor symptoms, simple excision of the cyst can be an effective treatment.
肩锁关节囊肿是一种罕见的实体,通常存在于老年慢性损伤或肩袖关节病患者。囊肿形成的原因有几种,一般有两种最常见,我们将在本文中讨论。临床病例:我们报告一位82岁男性患者,患有巨大肩锁囊肿,直径超过20cm,近几个月快速增长,并伴有肩袖肌腱损伤。讨论:这些囊肿不是很常见的损伤,主要由肩锁关节退行性变引起,多数病例伴有肩袖损伤。诊断基于临床检查、超声和磁共振成像。囊肿抽吸和皮质类固醇浸润治疗通常不是很有效,复发率高,因此手术切除囊肿更有意义。结论:这些囊肿的手术指征是疼痛,有时需要切除锁骨远端碎片;当存在肩袖损伤时,反向肩关节置换术是一种选择;然而,对于症状较差的患者,单纯切除囊肿是一种有效的治疗方法。
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引用次数: 0
Hernia discal dorsal juvenil en un niño de 12 años tras sobresfuerzo, a propósito de un caso clínico. 一名12岁儿童过度用力后的幼年背椎间盘突出,关于一个临床病例。
Pub Date : 2023-01-01 DOI: 10.37315/sotocav20222925795
FAJARDO-SÁNCHEZ, JORDÀ-GÓMEZ, POYATOS-CAMPOS
Introduction: Dorsal disc herniation occurs in approximately 1% of all disc herniations in adults, this frequency is even lower in children, so it is crucial to make a good differential diagnosis. Material and method: We present the clinical case of a 12-year-old male who reported disabling pain after intense exercise accompanied by an acute scoliotic deformity with a left thoracic curve. Imaging studies revealed a right posterolateral dorsal disc herniation at level D9-10, which occupied the lateral recess. The patient was treated conservatively with physiotherapy and analgesics, improving within 2 months. Discussion and conclusion: It is crucial to rule out severe pathologies that may present with similar symptoms. Thereforth the first therapeutic step is conservative treatment consisting in pharmacological treatment and physiotherapy. Red flags must be identified, such as neurological involvement, which may lead to considering surgical treatment as the first option.
简介:成人椎间盘突出的发生率约为1%,儿童椎间盘突出的发生率更低,因此鉴别诊断至关重要。材料和方法:我们提出了一个12岁的男性的临床病例,他报告了剧烈运动后的致残性疼痛,并伴有急性脊柱侧凸畸形和左胸弯曲。影像学检查显示右侧后外侧椎间盘突出,位于D9-10节段,占据外侧隐窝。患者给予物理治疗和镇痛药物保守治疗,2个月内病情好转。讨论和结论:排除可能出现类似症状的严重病理是至关重要的。因此,治疗的第一步是保守治疗,包括药物治疗和物理治疗。必须识别出危险信号,例如神经系统受累,这可能导致将手术治疗作为第一选择。
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引用次数: 0
Evaluación, tratamiento, complicaciones y controversias de las fracturas de calcáneo. Revisión de la literatura. 跟骨骨折的评估、治疗、并发症及争议。这篇文章是我们2011年癌症研究综述的一部分。
Pub Date : 2023-01-01 DOI: 10.37315/sotocav202229257100
GONZÁLEZ ANDREU, SOLAZ ESTEVAN, FAYOS JORDÁN, NAVARRO GIMENO, CARRATALÁ PÉREZ
Calcaneal fractures are a challenge for the orthopedic surgeon. Most of these are intra-articular fractures with complex lines that affect young population of working age. The treatment remains controversial and the continuous technological and scientific improvements have made surgical management the treatment of choice in a high percentage of them. The aim of this update article is to address key points in the diagnosis and treatment of these fractures, as well as understand the complications and points of controversy.
跟骨骨折对骨科医生来说是一个挑战。这些大多是复杂线的关节内骨折,影响年轻的工作年龄人口。治疗仍有争议,不断的技术和科学的进步,使手术管理的治疗选择在其中的高比例。这篇更新文章的目的是解决这些骨折的诊断和治疗的关键点,以及了解并发症和争议点。
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引用次数: 0
Inyección intraarticular única de ácido hialurónico en la gonartrosis sintomática: estudio comparativo de la eficacia de dos presentaciones y cambio de protocolo. 单关节内注射透明质酸治疗有症状性gonartrosis:两种表现和方案改变的疗效比较研究。
Pub Date : 2023-01-01 DOI: 10.37315/sotocav202229257121
GARCÍA-BRAVO, PÉREZ-AGUIAR, DÍAZ-GUTIÉRREZ, Rivero, MATEO-MORATINOS, BRAVO-MORENO, Hernández
Introduction: Vicosupplementation with hyaluronic acid in knee osteoarthritis has proven to be a safe and effective treatment. Its effectiveness is maintained for at least 6 months. Few studies have compared the efficacy of two single injection products at 12 months. Objective: To evaluate the efficacy results in patients infiltrated with two single injection hyaluronic acid : Hyalone® (H) and Adant One® (A), at 12 months. Material and methods: A retrospective observational study has been designed on a cohort of patients with knee osteoarthritis. They were treated by intra-articular knee viscosupplementation with two types of single injection hyaluronic acid. Its efficacy was evaluated according to the WOMAC scale and the VAS at 6 and 12 months. Results: 86 patients were treated with single doses of A and 67 with H. A significant improvement was found in the WOMAC assessment at 6 months with A (p = 0.035), while at 12 months the result no longer showed statistical significance (p = 0.184). With H at 12 months the improvement in the WOMAC values continued to be favorable (p = 0.039). Regarding pain control, an improvement in the VAS was observed, which was significant only in the case of H at 12 months (p = 0.020). Conclusions: A single H injection at 12 months was more effective for pain control and improved functionality in patients with knee osteoarthritis compared to A. It is possible to make viscosupplementation protocols for knee osteoarthritis with hyaluronic acid at annual intervals using H.
维柯补充透明质酸治疗膝骨关节炎已被证明是一种安全有效的治疗方法。其有效性至少维持6个月。很少有研究比较两种单次注射产品在12个月时的疗效。目的:评价单次注射两种透明质酸Hyalone®(H)和Adant One®(A)浸润患者12个月的疗效。材料和方法:对一组膝关节骨关节炎患者进行回顾性观察性研究。采用两种透明质酸单次注射膝关节内粘剂治疗。6个月和12个月分别用WOMAC评分和VAS评分评价其疗效。结果:单剂量A治疗86例,h治疗67例,A治疗6个月时WOMAC评分有显著改善(p = 0.035), 12个月时无统计学意义(p = 0.184)。在12个月时,WOMAC值的改善继续有利(p = 0.039)。在疼痛控制方面,观察到VAS的改善,仅在12个月时H的情况下有显著性改善(p = 0.020)。结论:与A相比,在12个月时单次注射H对膝关节骨性关节炎患者的疼痛控制和功能改善更有效。可以使用H每年为膝关节骨性关节炎制定透明质酸的粘胶补充方案。
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引用次数: 0
Resultados de la artroplastia inversa de hombro con vástago corto no cementado en la artropatía por insuficiencia de manguito rotador. 摘要本研究的目的是评估肩袖功能不全的关节病中肩短茎非骨水泥反向置换术的结果。
Pub Date : 2023-01-01 DOI: 10.37315/sotocav202229257116
SEBASTIÁ-FORCADA, MIRALLES-MUÑOZ, DE LA PINTA-ZAZO
Introduction: The reverse shoulder prosthesis has become the treatment of choice in glenohumeral arthropathy due to rotator cuff tear. The aim of the study was to assess the medium-term clinical and mechanical results of the short-stem reverse shoulder prosthesis. Material and methods: A prospective cohort study was carried out with a minimum follow-up of 2 years and a mean age of 72.5 years. The patients were reviewed postoperatively in a protocolized manner at 3, 6, 9, 12 and 24 months of follow-up and assessed with the Constant and DASH tests. Results: All patients improved regarding pain, 86.7% had no pain and the remaining 13.3% had mild pain. Postoperatively, both external and internal rotation improved globally in all patients. Conclusion: The uncemented short-stem reverse shoulder prosthesis presents satisfactory results regarding function, mobility and pain reduction.
简介:反向肩关节假体已成为治疗肩袖撕裂引起的肩关节病的首选方法。本研究的目的是评估短柄反向肩关节假体的中期临床和力学结果。材料和方法:前瞻性队列研究,随访时间最短2年,平均年龄72.5岁。在术后3、6、9、12和24个月的随访中,按照协议方式对患者进行复查,并使用Constant和DASH测试进行评估。结果:所有患者疼痛改善,86.7%无疼痛,13.3%轻度疼痛。术后,所有患者的外旋和内旋均得到改善。结论:非骨水泥短柄反向肩关节假体在功能、活动和减轻疼痛方面具有满意的效果。
{"title":"Resultados de la artroplastia inversa de hombro con vástago corto no cementado en la artropatía por insuficiencia de manguito rotador.","authors":"SEBASTIÁ-FORCADA, MIRALLES-MUÑOZ, DE LA PINTA-ZAZO","doi":"10.37315/sotocav202229257116","DOIUrl":"https://doi.org/10.37315/sotocav202229257116","url":null,"abstract":"Introduction: The reverse shoulder prosthesis has become the treatment of choice in glenohumeral arthropathy due to rotator cuff tear. The aim of the study was to assess the medium-term clinical and mechanical results of the short-stem reverse shoulder prosthesis. Material and methods: A prospective cohort study was carried out with a minimum follow-up of 2 years and a mean age of 72.5 years. The patients were reviewed postoperatively in a protocolized manner at 3, 6, 9, 12 and 24 months of follow-up and assessed with the Constant and DASH tests. Results: All patients improved regarding pain, 86.7% had no pain and the remaining 13.3% had mild pain. Postoperatively, both external and internal rotation improved globally in all patients. Conclusion: The uncemented short-stem reverse shoulder prosthesis presents satisfactory results regarding function, mobility and pain reduction.","PeriodicalId":202353,"journal":{"name":"Revista Española de Cirugía Osteoarticular","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128058430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Fractura de estrés sucesiva bilateral del 5th metatarsiano, en niño con metatarso aducto. 双侧连续应力性第五跖骨骨折,儿童内收跖骨。
Pub Date : 2023-01-01 DOI: 10.37315/sotocav202229257127
FERNÁNDEZ GABARDA, BALLESTA MORATALLA, VALVERDE VÁZQUEZ
Stress fractures of the lateral column of the foot are rare and almost always in the context of competitive sports. Stress fractures in children are even less frequent and are most often seen in cases of associated foot deformities, especially pes cavus varus or metatarsal adductus. We present the case of an 11-year-old boy with stress fractures of the fifth metatarsal of both feet with bilateral metatarsus adductus deformity. We recall the relative frequency of residual metatarsus adductus deformity in the older child, the greatly increased risk of stress fractures of the external column of the foot associated with this deformity, as well as refractures and nounion. Finally, to recall the signs and symptoms of metatarsus adductus deformity, as well as the radiographic aspects related to this fracture considering its rarity in children.
足侧柱应力性骨折是罕见的,几乎总是在竞技体育的背景下。儿童应力性骨折的发生率更低,最常见于足部畸形,尤其是足腔内翻或跖内收。我们提出的情况下,一个11岁的男孩与应力性骨折的第5跖双侧跖骨内收畸形。我们回顾了在年龄较大的儿童中残留跖骨内收畸形的相对频率,与此畸形相关的足外柱应力性骨折以及骨折和脱位的风险大大增加。最后,回顾一下跖内收畸形的体征和症状,以及考虑到其在儿童中的罕见性,与此骨折相关的影像学方面。
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引用次数: 0
Realidad mixta en Hololens 2 como sistema de asistencia intraoperatoria en cirugía de escoliosis idiopática del adolescente: un caso clínico. Hololens 2作为青少年特发性脊柱侧弯手术术中辅助系统的混合现实:一个临床案例。
Pub Date : 2022-10-01 DOI: 10.37315/sotocav20222915780
FERRÀS TARRAGÓ, SÁENZ GAMBOA, DOMÉNECH FERNÀNDEZ
Virtual reality has been one of the main technological revolutions in trauma in the last decade. This allows us to perform intraoperative assistance in a simple way, without the use of physical anchors and with a quick and accessible image preparation process. We present the use of this technology in surgical assistance for the correction of the deformity in adolescent idiopathic scoliosis. Material and methods: using C++ code and the Unity platform, a virtual planning tool was generated and the optimal positioning and size of the implants were designed at the apex of the deformity. Subsequently, the image was fixed in the ptaient and the holographic image was used for surgical assistance. Results: the positioning and size of the implants were identical to those planned using this technology. The planning time was low and the surgeon's satisfaction was high regarding the practicality of its use and the result obtained. Conclusions: virtual reality is a simple technology that allows improving intraoperative assistance in spinal surgery, this being one of the first cases described for its intraoperative use.
在过去的十年里,虚拟现实一直是创伤治疗领域的主要技术革命之一。这使我们能够以一种简单的方式进行术中辅助,而无需使用物理锚,并且具有快速且易于访问的图像准备过程。我们提出了使用这种技术的手术辅助矫正畸形在青少年特发性脊柱侧凸。材料与方法:利用c++代码和Unity平台生成虚拟规划工具,在畸形顶点处设计种植体的最佳位置和尺寸。随后,将图像固定在患者体内,并将全息图像用于手术辅助。结果:植入物的位置和大小与使用该技术计划的相同。计划时间短,外科医生对其使用的实用性和获得的效果满意度高。结论:虚拟现实是一种简单的技术,可以改善脊柱手术中的术中辅助,这是第一个描述其术中使用的案例之一。
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引用次数: 0
Luxación trapecio-metacarpiana aislada: a propósito de un caso. 孤立斜方-掌骨脱位:关于一个病例。
Pub Date : 2022-10-01 DOI: 10.37315/sotocav20222915786
Chiappe, ROSELLÓ AÑÓN, VALVERDE VÁZQUEZ, SANGÜESA NEBOT, DOMÉNECH FERNÀNDEZ
Isolated trapezius-metacarpal dislocation is a rare lesion. Although it is usually easily reducible, the high risk of secondary instability poses a major challenge in the management of this type of injury.There is controversy over what the treatment of choice is. Most of the authors opt for conservative treatment by closed reduction and immobilization with the antebrachial splint, using the stabi-lization of the joint with Kirschner needles (AK) if necessary. On the other hand, surgical treat-ment with ligamentoplasty has also been described.The objective of this paper is to present a clinical case of trapezius-metacarpal dislocation and its definitive treatment with repair with suture anchors (Mini TightRope), as well as to review the literature.
孤立的斜方肌-掌骨脱位是一种罕见的病变。虽然它通常很容易复位,但继发性不稳定的高风险对这类损伤的处理构成了重大挑战。关于选择的治疗方法存在争议。大多数作者选择保守治疗,闭式复位和前臂夹板固定,必要时使用克氏针(AK)固定关节。另一方面,手术治疗的韧带成形术也有描述。本文的目的是报道一例斜方肌-掌骨脱位的临床病例,以及用缝合锚钉(Mini TightRope)修复斜方肌-掌骨脱位的最终治疗方法,并复习文献。
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引用次数: 0
Enfisema subcutáneo benigno: un caso raro y revisión de la literatura. 良性皮下肺气肿:罕见病例及文献综述。
Pub Date : 2022-10-01 DOI: 10.37315/sotocav20222915783
Lucia FURIÓ SANCHIS, Alberto ESCRIVÀ LLORET, Esther PASTOR FERNÁNDEZ, D. Mifsut-Miedes
A 73-year-old woman who came to the emergency department referred by her gp doctor due a finding of crepitus and local temperature increase, on the examination of the left upper limb. She has a wound on her left elbow, in the process of healing by secondary intention, after a fall 4 days ago. She associates not feeling good at all, chills and even some fever peak. Laboratory findings reveal slightly elevated inflammatory markers. Computed tomography shows subcutaneous emphysema and some bubbles between muscle planes. Given the possible emergency situation, it decided to put the patient nil by mouth to go to theatre as soon as possible and be admitted to the ward with intravenous antibiotic treatment. However, the patient was stable at all times and with the good evolution during the time she was in the ward, presenting clinical improvement and analytical stability, it was decided to discharge her after 3 days.
一个73岁的妇女谁来到急诊科由她的全科医生转介,由于发现匍匐和局部体温升高,在检查左上肢。她的左肘部有一个伤口,在4天前跌倒后正在愈合。她将感觉不舒服、发冷甚至高烧联系起来。实验室结果显示炎症标志物轻微升高。计算机断层扫描显示皮下肺气肿和肌肉平面之间的一些气泡。考虑到可能出现的紧急情况,医院决定尽快将患者送入手术室,并接受抗生素静脉注射治疗。然而,患者在住院期间病情一直稳定,进展良好,临床改善,分析稳定,决定在3天后出院。
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引用次数: 0
期刊
Revista Española de Cirugía Osteoarticular
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