Pub Date : 2021-04-01DOI: 10.37315/sotocav20212865635
A. MONÍS GARCÍA, I. Miranda Gómez, I. OLMO VALERIANO, M. MORENO VADILLO, J. Colado Domínguez, M.J. Sangüesa Nebot, J. DOMÉNECH FERNÁNDEZ
Introduction: hydatid cysts are produced by the Echinococcus granulosus parasite. The single location in the muscles is rare. The cystic mass can be confirmed by ultrasound or magnetic resonance imaging (MRI) and its differential diagnosis may be difficult. Material and method: We present a case with a tumorous mass in thigh with MRI report: "encapsulated cystic lesion dependent on the biceps femoris, which contacts the sciatic neurovascular bundle, being the 1st diagnostic possibility hydatid cyst". Mebendazole was prescribed and after a month the tumor was excised, which was not located within the muscle but rather pushing it, attached to the sciatic nerve. Diagnosis after anatomopathological study was sciatic schwannoma. Discussion and conclusion: on MRI, schwannomas are usually seen as a mass adhered and eccentric to a nerve, but they can present cystic degeneration mimicking hydatidic cyst; Faced with a single muscular or perimuscular cystic tumor, close to the neurovascular bundle, with negative systemic tests for parasite disease, the schwannoma should be taken into account in the differential diagnosis.
{"title":"TUMORACIÓN QUÍSTICA EN EL MUSLO: SCHWANNOMA DEL NERVIO CIÁTICO CON DIAGNÓSTICO INICIAL DE QUISTE HIDATÍDICO, UN CASO CLÍNICO","authors":"A. MONÍS GARCÍA, I. Miranda Gómez, I. OLMO VALERIANO, M. MORENO VADILLO, J. Colado Domínguez, M.J. Sangüesa Nebot, J. DOMÉNECH FERNÁNDEZ","doi":"10.37315/sotocav20212865635","DOIUrl":"https://doi.org/10.37315/sotocav20212865635","url":null,"abstract":"Introduction: hydatid cysts are produced by the Echinococcus granulosus parasite. The single location in the muscles is rare. The cystic mass can be confirmed by ultrasound or magnetic resonance imaging (MRI) and its differential diagnosis may be difficult. Material and method: We present a case with a tumorous mass in thigh with MRI report: \"encapsulated cystic lesion dependent on the biceps femoris, which contacts the sciatic neurovascular bundle, being the 1st diagnostic possibility hydatid cyst\". Mebendazole was prescribed and after a month the tumor was excised, which was not located within the muscle but rather pushing it, attached to the sciatic nerve. Diagnosis after anatomopathological study was sciatic schwannoma. Discussion and conclusion: on MRI, schwannomas are usually seen as a mass adhered and eccentric to a nerve, but they can present cystic degeneration mimicking hydatidic cyst; Faced with a single muscular or perimuscular cystic tumor, close to the neurovascular bundle, with negative systemic tests for parasite disease, the schwannoma should be taken into account in the differential diagnosis.","PeriodicalId":202353,"journal":{"name":"Revista Española de Cirugía Osteoarticular","volume":"57 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126088093","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}
Pub Date : 2021-01-01DOI: 10.37315/sotocav20212855613
C. Sánchez Losilla, P. BADÍA FERRANDO, F. JARA GARCÍA
Triplan distal tibial fractures are a complex type of bone injury that occurs in adolescence, prior to closure of the distal tibial physis. They correspond to 6 to 10% of adolescent epiphyseal fractures; and 5 to 10% of intra-articular tibial injuries in pediatrics. The objective of this work is to present a case of triplanar fracture of the distal tibial epiphysis treated with cannulated screws.
{"title":"FRACTURAS TRIPLANAS DE TOBILLO. A PROPÓSITO DE UN CASO","authors":"C. Sánchez Losilla, P. BADÍA FERRANDO, F. JARA GARCÍA","doi":"10.37315/sotocav20212855613","DOIUrl":"https://doi.org/10.37315/sotocav20212855613","url":null,"abstract":"Triplan distal tibial fractures are a complex type of bone injury that occurs in adolescence, prior to closure of the distal tibial physis. They correspond to 6 to 10% of adolescent epiphyseal fractures; and 5 to 10% of intra-articular tibial injuries in pediatrics. The objective of this work is to present a case of triplanar fracture of the distal tibial epiphysis treated with cannulated screws.","PeriodicalId":202353,"journal":{"name":"Revista Española de Cirugía Osteoarticular","volume":"134 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123212219","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}
Pub Date : 2021-01-01DOI: 10.37315/sotocav20212855616
JF GARRIDO FERRER, L. Marco Díaz, J. Diranzo García, L. Castillo Ruipérez, L. Hernández Ferrando
We present a case of a 58 years old woman who presents a low-anterior dislocation with vascular and total nerve injury secondary to a fall with the shoulder extended and abducted (90º). In this situation, it was fixed with closed reduction. After 6 weeks, the ENG and the EMG showed brachial plexopathy. Disruptions were not detected in NMR. She gradually improved with rehabilitation, not having new vascular symptoms. Age, obesity, the delay until the reduction and associated fractures are risk factors to completed brachial plexus palsy, being more common in low energy traumas. Axilar nerve is the most affected element, followed by radial, ulnar and median, in this order. EMG/ENG is the gold standard technique for the diagnosis after one month. MNR will be essential to check the state of the nerve. Rehabilitation is key in the treatment, and the surgery can be postponed. Neurolysis showed encouraging results in the first semester. Functional recovery is slow (six months - one year), being faster in the EMG results. Acute vascular affection is a traumatology emergency. The third section of the axillar nerve is the most common affected. Suspected diagnosis is important, even when the radial pulse is detected. After closed reduction, ECO-Doppler and CT Angiography are the diagnosis test indicated. Suspecting neurovascular injury is mandatory. Systematic exploration and urgent treatment decrease complications and they can improve the patient prognosis.
{"title":"AFECTACIÓN NEUROVASCULAR TRAS LUXACIÓN GLENO-HUMERAL: A PROPÓSITO DE UN CASO","authors":"JF GARRIDO FERRER, L. Marco Díaz, J. Diranzo García, L. Castillo Ruipérez, L. Hernández Ferrando","doi":"10.37315/sotocav20212855616","DOIUrl":"https://doi.org/10.37315/sotocav20212855616","url":null,"abstract":"We present a case of a 58 years old woman who presents a low-anterior dislocation with vascular and total nerve injury secondary to a fall with the shoulder extended and abducted (90º). In this situation, it was fixed with closed reduction.\u0000After 6 weeks, the ENG and the EMG showed brachial plexopathy. Disruptions were not detected in NMR. She gradually improved with rehabilitation, not having new vascular symptoms. Age, obesity, the delay until the reduction and associated fractures are risk factors to completed brachial plexus palsy, being more common in low energy traumas. Axilar nerve is the most affected element, followed by radial, ulnar and median, in this order. EMG/ENG is the gold standard technique for the diagnosis after one month. MNR will be essential to check the state of the nerve. Rehabilitation is key in the treatment, and the surgery can be postponed. Neurolysis showed encouraging results in the first semester. Functional recovery is slow (six months - one year), being faster in the EMG results. Acute vascular affection is a traumatology emergency. The third section of the axillar nerve is the most common affected. Suspected diagnosis is important, even\u0000when the radial pulse is detected. After closed reduction, ECO-Doppler and CT Angiography are the diagnosis test indicated. Suspecting neurovascular injury is mandatory. Systematic exploration and urgent treatment decrease complications and they can improve the patient prognosis.","PeriodicalId":202353,"journal":{"name":"Revista Española de Cirugía Osteoarticular","volume":"34 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115276115","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}
Pub Date : 2021-01-01DOI: 10.37315/sotocav2021285561
L. LAMONEDA-GADEA, L. Moril-Peñalver, M. Fernández-Ruiz, FA LÓPEZ-PRATS
The gold Standard in the treatment of patella fractures is generally the tension band technique.Recently, the treatment of these fractures by means of plate osteosyntehsis has been implemented, obtaining good results, and a low rate of complications and reinterventions. GOAL: Evaluate the clinic, functional and radiologic results in patients with a complex patella fracture, comparing results of plate osteosynthesis treatment versus tension band. MATERIAL AND METHODOLOGY:Retrospective obvervational cohort study. A total of sixty patients with patella fracture were evaluated at Hospital General Universitario de Elche between 2015 and 2020, thirty by tension bands technique and the other thirty with plate osteosynthesis treatment. All the clinic, functional and radiologic results, as well as complication were registered and compared for both groups. RESULTS: The functional scales show no differences (LES p = 0.475, EVA p = 0.888, KOS-ADLS p = 0.327). Differences have been found (p <0.001) in relation to the extraction of osteosynthesis material (EMO) in patients operated on with BT (50% vs 0%). We identified more material failure in BT (37.5%) versus 0% in plate (p = 0.001). The flexion ranges were higher in the plate group (120.42º) compared to BT (110º) without statistically significant differences. There are no differences in relation to scarring, infection, stiffness, pseudoarthrosis, patella magna or low, loss of reduction or deep vein thrombosis. CONCLUSIONS: All the patients with patella fracture that were evaluated presented successful clinic and functional results. However, we found a lower rate of complication and reinterventions on the plate osteosynthesis treatment. In summary, it has been proved that plate osteosynthesis treatment is a successful holding method for complex patella fractures.
治疗髌骨骨折的金标准通常是张力带技术。近年来，采用钢板内固定术治疗这些骨折，取得了良好的效果，并发症和再干预率低。目的:评估复杂髌骨骨折患者的临床、功能和影像学结果，比较钢板固定治疗和张力带治疗的结果。材料和方法:回顾性观察队列研究。2015年至2020年，我们在埃尔切总医院对60例髌骨骨折患者进行了评估，其中30例采用张力带技术，30例采用钢板固定治疗。对两组患者的临床、功能、影像学结果及并发症进行比较。结果:功能量表差异无统计学意义(LES p = 0.475, EVA p = 0.888, KOS-ADLS p = 0.327)。在BT手术患者中，与骨合成材料(EMO)的提取有关(50% vs 0%)发现差异(p <0.001)。我们发现BT组的材料失败率更高(37.5%)，而钢板组为0% (p = 0.001)。钢板组屈曲幅度(120.42º)高于BT组(110º)，但差异无统计学意义。瘢痕、感染、僵硬、假关节、大髌骨或低髌骨、复位丧失或深静脉血栓形成方面没有差异。结论:所有评估的髌骨骨折患者均取得了良好的临床和功能效果。然而，我们发现钢板内固定治疗的并发症和再干预率较低。综上所述，钢板固定治疗是复杂髌骨骨折的一种成功的固定方法。
{"title":"FRACTURAS COMPLEJAS DE RÓTULA:¿OSTEOSÍNTESIS CON BANDA DE TENSIÓN O PLACA BLOQUEADA?","authors":"L. LAMONEDA-GADEA, L. Moril-Peñalver, M. Fernández-Ruiz, FA LÓPEZ-PRATS","doi":"10.37315/sotocav2021285561","DOIUrl":"https://doi.org/10.37315/sotocav2021285561","url":null,"abstract":"The gold Standard in the treatment of patella fractures is generally the tension band technique.Recently, the treatment of these fractures by means of plate osteosyntehsis has been implemented, obtaining good results, and a low rate of complications and reinterventions. GOAL: Evaluate the clinic, functional and radiologic results in patients with a complex patella fracture, comparing results of plate osteosynthesis treatment versus tension band. MATERIAL AND METHODOLOGY:Retrospective obvervational cohort study. A total of sixty patients with patella fracture were evaluated at Hospital General Universitario de Elche between 2015 and 2020, thirty by tension bands technique and the other thirty with plate osteosynthesis treatment. All the clinic, functional and radiologic results, as well as complication were registered and compared for both groups. RESULTS: The functional scales show no differences (LES p = 0.475, EVA p = 0.888, KOS-ADLS p = 0.327). Differences have been found (p <0.001) in relation to the extraction of osteosynthesis material (EMO) in patients operated on with BT (50% vs 0%). We identified more material failure in BT (37.5%) versus 0% in plate (p = 0.001). The flexion ranges were higher in the plate group (120.42º) compared to BT (110º) without statistically significant differences. There are no differences in relation to scarring, infection, stiffness, pseudoarthrosis, patella magna or low, loss of reduction or deep vein thrombosis. CONCLUSIONS: All the patients with patella fracture that were evaluated presented successful clinic and functional results. However, we found a lower rate of complication and reinterventions on the plate osteosynthesis treatment. In summary, it has been proved that plate osteosynthesis treatment is a successful holding method for complex patella fractures.","PeriodicalId":202353,"journal":{"name":"Revista Española de Cirugía Osteoarticular","volume":"41 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122219406","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}
Pub Date : 2021-01-01DOI: 10.37315/sotocav20212855622
A. DARÁS BALLESTER, F. Bonilla Enseñat, C. de la Calva Ceinos, M. Fuertes Lanzuela
Our objective is to present a case of proximal tibial osteomyelitis due to Salmonella, which is infrequent in clinical practice, as well as to analyze the procedures carried out for its treatment, and the differential diagnosis of the lesion. Clinical case: A 13-year-old male referred from another Hospital to our Hospital Children's Oncology due to a suspicion of a bone tumor in the tibia. The patient reported two-week history of knee pain associated with fever. In the radiographs taken at his center, a lytic lesion was observed in the proximal metaphysis of the tibia, which led to the performance of a Magnetic Resonance Imaging (MRI). After reviewing the MRI images in our center, the neoplastic nature of the lesion was ruled out and the suspected diagnosis was an Osteomyelitis, after which the patient underwent surgery, being performed a corticotomy and emptying of the abscess and initiating intravenous antibiotic treatment. The patient had an unremarkable postoperative course and in the culture of the extracted material Salmonella group B was obtained. The patient was controlled with oral antibiotic, and was definitively discharged two years after the intervention. However, 3 years after that, he came to Hospital with similar symptoms. After performing some imaging tests, two multiloculated lytic lesions were observed in the proximal tibia with a perilesional inflammatory reaction, suggestive of recurrence of Osteomyelitis, for which he underwent surgery again, performing a bone window and curettage, and filling the cavity with tricalcium sulfate and antibiotic. The cultures taken were again positive for Salmonella B. After the patient's clinical and analytical progress was correct, he was treated with oral antibiotics, and was definitively discharged two years after the intervention. Conclusion: Salmonella osteomyelitis in immunocompetent patients is a rare pathology that can simulate a neoplastic lesion if it is found in an atypical location such as metaphysis. The diagnosis must be clinical, radiological and analytical, although the definitive diagnosis will be achieved by cultures results. The definitive treatment is curettage and filling the lesion, associated with antibiotic therapy, and it is necessary to take into account that the lesion may recur.
{"title":"OSTEOMIELITIS DE TIBIA PROXIMAL POR SALMONELLA GRUPO B EN UN PACIENTE JOVEN INMUNOCOMPETENT","authors":"A. DARÁS BALLESTER, F. Bonilla Enseñat, C. de la Calva Ceinos, M. Fuertes Lanzuela","doi":"10.37315/sotocav20212855622","DOIUrl":"https://doi.org/10.37315/sotocav20212855622","url":null,"abstract":"Our objective is to present a case of proximal tibial osteomyelitis due to Salmonella, which is infrequent in clinical practice, as well as to analyze the procedures carried out for its treatment, and the differential diagnosis of the lesion. Clinical case:\u0000A 13-year-old male referred from another Hospital to our Hospital Children's Oncology due to a suspicion of a bone tumor in the tibia. The patient reported two-week history of knee pain associated with fever. In the radiographs taken at his center, a lytic lesion was observed in the proximal metaphysis of the tibia, which led to the performance of a Magnetic Resonance Imaging (MRI). After reviewing the MRI images in our center, the neoplastic nature of the lesion was ruled out and the suspected diagnosis was an Osteomyelitis, after which the patient underwent surgery, being performed a\u0000corticotomy and emptying of the abscess and initiating intravenous antibiotic treatment. The patient had an unremarkable postoperative course and in the culture of the extracted material Salmonella group B was obtained. The patient was\u0000controlled with oral antibiotic, and was definitively discharged two years after the intervention. However, 3 years after that, he came to Hospital with similar symptoms. After performing some imaging tests, two multiloculated lytic lesions were observed in the proximal tibia with a perilesional inflammatory reaction, suggestive of recurrence of Osteomyelitis, for which he underwent surgery again, performing a bone window and curettage, and filling the cavity with tricalcium sulfate and antibiotic. The cultures taken were again positive for Salmonella B. After the patient's clinical and analytical progress\u0000was correct, he was treated with oral antibiotics, and was definitively discharged two years after the intervention. Conclusion: Salmonella osteomyelitis in immunocompetent patients is a rare pathology that can simulate a neoplastic lesion if it is found in an atypical location such as metaphysis. The diagnosis must be clinical, radiological and analytical, although the definitive diagnosis will be achieved by cultures results. The definitive treatment is curettage and filling the lesion, associated with antibiotic therapy, and it is necessary to take into account that the lesion may recur.","PeriodicalId":202353,"journal":{"name":"Revista Española de Cirugía Osteoarticular","volume":"24 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115466721","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}
Pub Date : 2021-01-01DOI: 10.37315/sotocav2021285569
Juan Ramon Rodriguez-Collell, D. Mifsut-Miedes
Femoro-patellar complications after TKA despite improvements in implant designs and surgical technique remain an unsolved problem. Among these complications is lateral femoro-patellar impingement, being the reason for surgical revision in 0.33%. The objective of this work is to present a clinical case of femoro-patellar impingement after total knee replacement, treated by facectomy arthroscopic lateral.
{"title":"TRATAMIENTO ARTROSCÓPICO DEL PINZAMIENTO PATELO-FEMORAL LATERAL TRAS ARTROPLASTIA TOTAL DE RODILLA","authors":"Juan Ramon Rodriguez-Collell, D. Mifsut-Miedes","doi":"10.37315/sotocav2021285569","DOIUrl":"https://doi.org/10.37315/sotocav2021285569","url":null,"abstract":"Femoro-patellar complications after TKA despite improvements in implant designs and surgical technique remain an\u0000unsolved problem. Among these complications is lateral femoro-patellar impingement, being the reason for surgical\u0000revision in 0.33%. The objective of this work is to present a clinical case of femoro-patellar impingement after total knee\u0000replacement, treated by facectomy arthroscopic lateral.","PeriodicalId":202353,"journal":{"name":"Revista Española de Cirugía Osteoarticular","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121100669","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}
Pub Date : 2020-10-01DOI: 10.37315/sotocav202028455119
Juan Ramon Rodriguez-Collell, Damián Mifsut Miedes
Periprosthetic patella fractures are much more common in knee prostheses in which the patella has been replaced. The aetiology of periprosthetic patella fractures has a traumatic origin in 12% of cases and atraumatic secondary to avascular necrosis in the remaining 88%. Peri-implant fractures, in which the patella has been replaced and the implant is stable with an integral extensor mechanism, resolve with conservative treatment. In cases of stable implant, with a displaced fracture of the upper or lower pole of the patella, the implant is left in situ and the extensor apparatus is repaired according to standard techniques. If there is disruption of the extensor apparatus with an unstable implant, the patellar button should be removed and continuity of the extensor apparatus repaired with a patellectomy. In these cases, internal fixation with wire cerclages is discouraged. In cases where the extensor mechanism is intact and the implant is unstable, the removal of the patellar button is sufficient. The risk of infection after surgery for a periprosthetic patella fracture is high.
{"title":"Actualización en osteonecrosis y fractura de rótula tras prótesis total de rodilla.","authors":"Juan Ramon Rodriguez-Collell, Damián Mifsut Miedes","doi":"10.37315/sotocav202028455119","DOIUrl":"https://doi.org/10.37315/sotocav202028455119","url":null,"abstract":"Periprosthetic patella fractures are much more common in knee prostheses in which the patella has been replaced. The aetiology of periprosthetic patella fractures has a traumatic origin in 12% of cases and atraumatic secondary to avascular necrosis in the remaining 88%. Peri-implant fractures, in which the patella has been replaced and the implant is stable with an integral extensor mechanism, resolve with conservative treatment. In cases of stable implant, with a displaced fracture of the upper or lower pole of the patella, the implant is left in situ and the extensor apparatus is repaired according to standard techniques. If there is disruption of the extensor apparatus with an unstable implant, the patellar button should be removed and continuity of the extensor apparatus repaired with a patellectomy. In these cases, internal fixation with wire cerclages is discouraged. In cases where the extensor mechanism is intact and the implant is unstable, the removal of the patellar button is sufficient. The risk of infection after surgery for a periprosthetic patella fracture is high.","PeriodicalId":202353,"journal":{"name":"Revista Española de Cirugía Osteoarticular","volume":"20 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121722055","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}
Pub Date : 2020-10-01DOI: 10.37315/sotocav202028455131
E. Ferrando Meseguer, F. SEGURA LLOPIS, F. Almeida Herrero, Alberto TEJEDA GÓMEZ, Damián Mifsut Miedes
Septic non union has still been a challenge for orthopedic surgeons. Its resolution is complex and has hight morbility. It needs a multidisciplinary approach. Distal tibia is a common location due its poor vascularity and soft tissues. We present a patient with pseudoarthrosis of the tibia treated with resection and bone transport. Contact was achieved at the docking site at 5 months. Bone grafting and freshening of fracture ends was performed. At 12 months the frame was removed after complete consolidation. As the only complication, the patient suffered two episodes of cellulitis that were resolved with antibiotic therapy.
{"title":"Pseudoartrosis séptica de tibia por pseudomona aeruginosa. Tratamiento mediante transporte óseo.","authors":"E. Ferrando Meseguer, F. SEGURA LLOPIS, F. Almeida Herrero, Alberto TEJEDA GÓMEZ, Damián Mifsut Miedes","doi":"10.37315/sotocav202028455131","DOIUrl":"https://doi.org/10.37315/sotocav202028455131","url":null,"abstract":"Septic non union has still been a challenge for orthopedic surgeons. Its resolution is complex and has hight morbility. It needs a multidisciplinary approach. Distal tibia is a common location due its poor vascularity and soft tissues. We present a patient with pseudoarthrosis of the tibia treated with resection and bone transport. Contact was achieved at the docking site at 5 months. Bone grafting and freshening of fracture ends was performed. At 12 months the frame was removed after complete consolidation. As the only complication, the patient suffered two episodes of cellulitis that were resolved with\u0000antibiotic therapy.","PeriodicalId":202353,"journal":{"name":"Revista Española de Cirugía Osteoarticular","volume":"33 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116166357","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}
Pub Date : 2020-10-01DOI: 10.37315/sotocav202028455136
G. CRIADO ALBILLOS, A. M. MARTIN RODRIGUEZ, L. MENDIETA DIEZ, M. MILLAN CID, A. Delgado González
Introduction: Gas gangrene, also known as clostridial myonecrosis, is an acute, potentially life-threatening infection of muscular and soft tissues caused by pathogens in the Clostridium genus. Clinical case: We present the case of spontaneous gas gangrene caused by C. Perfringens in a patient with no history of trauma. Discussion: The treatment of gas gangrene consists of prompt surgical debridement combined with antibiotic therapy. Emergency surgical debridement is especially important for patient survival, preserving the limb and preventing complications. If C. Perfringens is confirmed, the antibiotic therapy should consist of penicillin (3-4 million units intravenously every 4h) with clindamycin (900 mg intravenously every 8h) or tetracycline (500 mg intravenously every 6h). Even when we encounter a patient with no history of trauma, gastrointestinal pathology, neutropenia or immunodeficiencies, we should quickly suspect this diagnosis when there is extreme pain in a limb, with or without fever. This suspicion is important due to the need for rapid and aggressive treatment to save the limb and life of the patient and to prevent complications.
{"title":"Shock séptico asociado a gangrena gaseosa - Miositis necrotizante por Clostridium.","authors":"G. CRIADO ALBILLOS, A. M. MARTIN RODRIGUEZ, L. MENDIETA DIEZ, M. MILLAN CID, A. Delgado González","doi":"10.37315/sotocav202028455136","DOIUrl":"https://doi.org/10.37315/sotocav202028455136","url":null,"abstract":"Introduction: Gas gangrene, also known as clostridial myonecrosis, is an acute, potentially life-threatening infection of muscular and soft tissues caused by pathogens in the Clostridium genus. Clinical case: We present the case of spontaneous gas gangrene caused by C. Perfringens in a patient with no history of trauma. Discussion: The treatment of gas gangrene consists of prompt surgical debridement combined with antibiotic therapy. Emergency surgical debridement is especially important for patient survival, preserving the limb and preventing complications. If C. Perfringens is\u0000confirmed, the antibiotic therapy should consist of penicillin (3-4 million units intravenously every 4h) with clindamycin (900 mg intravenously every 8h) or tetracycline (500 mg intravenously every 6h). Even when we encounter a patient with no\u0000history of trauma, gastrointestinal pathology, neutropenia or immunodeficiencies, we should quickly suspect this diagnosis when there is extreme pain in a limb, with or without fever. This suspicion is important due to the need for rapid and aggressive treatment to save the limb and life of the patient and to prevent complications.","PeriodicalId":202353,"journal":{"name":"Revista Española de Cirugía Osteoarticular","volume":"3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124101234","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}
Pub Date : 2020-10-01DOI: 10.37315/sotocav202028455140
Isabel MIÑANO MARTINEZ
Plantar fasciitis is a very common pathology. Over time, some aspects of this entity have generated controversy, so our objective is to group the latest available scientific evidence. Plantar fasciitis has its origin in a degenerative process resulting from repetitive microtrauma. In addition, multiple risk factors are involved that contribute to its overload the fascia and its collagen degeneration. Its diagnosis is clinical, reserving the performance of complementary tests to perform differential diagnosis with other entities, which may originate in the plantar fascia or adjacent structures, paying special attention to nerve entrapments. There are numerous treatments that have proven effectiveness, obtaining better results by individualizing each patient and with a combination of treatments.
{"title":"Actualización en el diagnóstico y tratamiento de la Fascitis plantar.","authors":"Isabel MIÑANO MARTINEZ","doi":"10.37315/sotocav202028455140","DOIUrl":"https://doi.org/10.37315/sotocav202028455140","url":null,"abstract":"Plantar fasciitis is a very common pathology. Over time, some aspects of this entity have generated controversy, so our objective is to group the latest available scientific evidence. Plantar fasciitis has its origin in a degenerative process resulting from repetitive microtrauma. In addition, multiple risk factors are involved that contribute to its overload the fascia and its collagen degeneration. Its diagnosis is clinical, reserving the performance of complementary tests to perform differential diagnosis with other entities, which may originate in the plantar fascia or adjacent structures, paying special\u0000attention to nerve entrapments. There are numerous treatments that have proven effectiveness, obtaining better results by individualizing each patient and with a combination of treatments.","PeriodicalId":202353,"journal":{"name":"Revista Española de Cirugía Osteoarticular","volume":"62 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126396152","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}
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