Pub Date : 2026-01-01DOI: 10.1016/j.recot.2025.04.016
C. López-Orosa , P. Álvarez-Losada , A.N. Toro-Ibarguen
Background and objective
Non-surgical management of intracapsular hip fractures is rare and reserved for fragile patients with co-morbidities that contraindicate surgery. The aim of the study is to determine the mortality rate in intracapsular hip fractures managed non-surgically.
Material and methods
Retrospective series of patients who received non-surgical management between January 2004 and December 2023 included, minimum follow-up 1 year. Periprosthetics or secondary-to-tumor fractures, polytraumatized and surgically treated intracapsular hip fractures were excluded. Mortality was recorded during admission, at 30 days, 6 months and one year.
Results
Non-surgical management was indicated in 54 patients (frequency 7.56%), the most common reason was low functionality (Barthel index < 20 points) associated with non-ambulation and/or neurological disease/dementia. Two patients were excluded due to loss of follow-up. During admission, 3 patients died (5.8%), at 30 days 8 patients (15.4%), at 6 months 23 patients had died (44.2%) and in the first year 30 patients (57. 7%). It was observed that the deceased patients were older (mean age 89.7 years versus 83 years); and association between mortality at one year and Barthel index (p: 0.019) and mobility 30 days after the fracture (p: 0.006).
Conclusion
We present a high one-year mortality (57.7%), higher than published for surgery, so we believe that in fragile patients we must either improve multidisciplinary outpatient follow-up or consider other palliative care, without reaching harsh therapeutic treatment.
{"title":"Manejo no operatorio en fracturas intracapsulares de cadera. Características generales en una serie monocéntrica","authors":"C. López-Orosa , P. Álvarez-Losada , A.N. Toro-Ibarguen","doi":"10.1016/j.recot.2025.04.016","DOIUrl":"10.1016/j.recot.2025.04.016","url":null,"abstract":"<div><h3>Background and objective</h3><div>Non-surgical management of intracapsular hip fractures is rare and reserved for fragile patients with co-morbidities that contraindicate surgery. The aim of the study is to determine the mortality rate in intracapsular hip fractures managed non-surgically.</div></div><div><h3>Material and methods</h3><div>Retrospective series of patients who received non-surgical management between January 2004 and December 2023 included, minimum follow-up 1 year. Periprosthetics or secondary-to-tumor fractures, polytraumatized and surgically treated intracapsular hip fractures were excluded. Mortality was recorded during admission, at 30 days, 6 months and one year.</div></div><div><h3>Results</h3><div>Non-surgical management was indicated in 54 patients (frequency 7.56%), the most common reason was low functionality (Barthel index <<!--> <!-->20 points) associated with non-ambulation and/or neurological disease/dementia. Two patients were excluded due to loss of follow-up. During admission, 3 patients died (5.8%), at 30 days 8 patients (15.4%), at 6 months 23 patients had died (44.2%) and in the first year 30 patients (57. 7%). It was observed that the deceased patients were older (mean age 89.7 years versus 83 years); and association between mortality at one year and Barthel index (p: 0.019) and mobility 30 days after the fracture (p: 0.006).</div></div><div><h3>Conclusion</h3><div>We present a high one-year mortality (57.7%), higher than published for surgery, so we believe that in fragile patients we must either improve multidisciplinary outpatient follow-up or consider other palliative care, without reaching harsh therapeutic treatment.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"70 1","pages":"Pages 1-7"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145963121","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 : 2026-01-01DOI: 10.1016/j.recot.2025.04.018
M.B. Spinelli , V.M. Cafruni , N. Lucero Viviani , A.C. Parise , C. Rodriguez , N. Satera , M.G. Santini Araujo
Introducction
Diabetic foot (DF) is a common and serious complication of diabetes mellitus (DM), especially in patients with chronic kidney disease (CKD) undergoing renal replacement therapy (RRT). This study aimed to assess the prevalence of DF and associated conditions in DM patients receiving RRT at a tertiary care hospital in Argentina.
Materials and methods
We conducted a cross-sectional observational study between December 2022 and September 2024. A total of 54 patients with type 1 or type 2 DM undergoing either hemodialysis (HD) or peritoneal dialysis (PD) were included. History of DF, active or pre-ulcerative lesions, neuropathy, peripheral vascular disease, and associated risk factors were evaluated through physical examination and medical record review.
Results
DF was present in 40.7% of patients, with a higher proportion in HD (48.6%) compared to PD (26.3%). Pre-ulcerative lesions were found in 61.1%, and active ulcers in 9.3%. A history of amputation was reported in 31.4% of cases. Diabetic neuropathy (87%) and peripheral vascular disease (81.5%), both closely related to DF development, were key findings. Significant differences were observed in smoking (42.1% PD vs. 11.4% HD, p = 0.016), which may impair microcirculation, and obesity (63.2% PD vs. 25.7% HD, p = 0.016), which increases plantar pressure and contributes to foot deformities.
Conclusions
DM patients on RRT have a high prevalence of DF and related risk factors. Early detection and multidisciplinary follow-up are essential to prevent complications such as ulcers and amputations.
糖尿病足（DF）是糖尿病（DM）常见且严重的并发症，特别是在接受肾脏替代治疗（RRT）的慢性肾脏疾病（CKD）患者中。本研究旨在评估阿根廷一家三级医院接受RRT治疗的糖尿病患者中DF及相关疾病的患病率。材料和方法我们在2022年12月至2024年9月进行了一项横断面观察研究。共纳入54例接受血液透析（HD）或腹膜透析（PD）的1型或2型糖尿病患者。通过体格检查和病历回顾评估DF病史、活动性或溃疡前期病变、神经病变、周围血管疾病及相关危险因素。结果40.7%的患者存在df， HD患者的比例（48.6%）高于PD（26.3%）。溃疡前病变占61.1%，活动性溃疡占9.3%。31.4%的病例有截肢史。糖尿病神经病变（87%）和周围血管疾病（81.5%）与DF的发展密切相关，是主要发现。吸烟（42.1% PD vs. 11.4% HD, p = 0.016）可能损害微循环，肥胖（63.2% PD vs. 25.7% HD, p = 0.016）会增加足底压力并导致足部畸形，两者存在显著差异。结论接受RRT治疗的sdm患者有较高的DF患病率及相关危险因素。早期发现和多学科随访对于预防溃疡和截肢等并发症至关重要。
{"title":"Prevalence of diabetic foot in patients with diabetes mellitus undergoing dialysis treatment in a tertiary-level hospital in Argentina","authors":"M.B. Spinelli , V.M. Cafruni , N. Lucero Viviani , A.C. Parise , C. Rodriguez , N. Satera , M.G. Santini Araujo","doi":"10.1016/j.recot.2025.04.018","DOIUrl":"10.1016/j.recot.2025.04.018","url":null,"abstract":"<div><h3>Introducction</h3><div>Diabetic foot (DF) is a common and serious complication of diabetes mellitus (DM), especially in patients with chronic kidney disease (CKD) undergoing renal replacement therapy (RRT). This study aimed to assess the prevalence of DF and associated conditions in DM patients receiving RRT at a tertiary care hospital in Argentina.</div></div><div><h3>Materials and methods</h3><div>We conducted a cross-sectional observational study between December 2022 and September 2024. A total of 54 patients with type 1 or type 2 DM undergoing either hemodialysis (HD) or peritoneal dialysis (PD) were included. History of DF, active or pre-ulcerative lesions, neuropathy, peripheral vascular disease, and associated risk factors were evaluated through physical examination and medical record review.</div></div><div><h3>Results</h3><div>DF was present in 40.7% of patients, with a higher proportion in HD (48.6%) compared to PD (26.3%). Pre-ulcerative lesions were found in 61.1%, and active ulcers in 9.3%. A history of amputation was reported in 31.4% of cases. Diabetic neuropathy (87%) and peripheral vascular disease (81.5%), both closely related to DF development, were key findings. Significant differences were observed in smoking (42.1% PD vs. 11.4% HD, <em>p</em> <!-->=<!--> <!-->0.016), which may impair microcirculation, and obesity (63.2% PD vs. 25.7% HD, <em>p</em> <!-->=<!--> <!-->0.016), which increases plantar pressure and contributes to foot deformities.</div></div><div><h3>Conclusions</h3><div>DM patients on RRT have a high prevalence of DF and related risk factors. Early detection and multidisciplinary follow-up are essential to prevent complications such as ulcers and amputations.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"70 1","pages":"Pages 8-12"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145963124","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 : 2026-01-01DOI: 10.1016/j.recot.2025.05.006
M. Galán-Olleros, S. Martínez-Álvarez, I. Martínez-Caballero
{"title":"La reducción no es necesaria en fracturas metafisarias de radio distal en bayoneta en niños prepuberales","authors":"M. Galán-Olleros, S. Martínez-Álvarez, I. Martínez-Caballero","doi":"10.1016/j.recot.2025.05.006","DOIUrl":"10.1016/j.recot.2025.05.006","url":null,"abstract":"","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"70 1","pages":"Pages 88-90"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145963181","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 : 2026-01-01DOI: 10.1016/j.recot.2025.05.005
A.N. Toro-Ibarguen , E. Sánchez Benito , J.M. Cortés Villar
Background and objective
The primary objective is to evaluate the clinical and functional outcomes of tape reinforcement in anterior cruciate ligament (ACL) reconstructions, recording complications, as well as the rate of reinterventions and graft failure.
Materials and methods
Retrospective analysis of ACL reconstructions with hamstring (HS) autograft that were reinforced with high-strength tape. We included patients in whom we obtained a graft of HS < 8 mm or ≥ 8 mm of poor quality. Age, sex, body mass index (BMI), and previous activity were recorded. Clinical and functional evaluation were made and postoperative range of motion (ROM), pain, and Lysholm functional scale were recorded. Complication rate, graft failure rate, and reintervention rate were analyzed.
Results
A total of 160 patients were included, with a mean age of 29.19 years. Of these, 98 were male and 62 female, with a mean BMI of 23.5. The mean follow-up period was 31.7 months. The average ROM was 137.2°, the mean pain level was 0.8, and the average Lysholm score was 95.1. The complication rate was 11%, with 5% requiring reoperation. The graft failure rate was 1.3%. A graft diameter < 8 mm was associated with females with Fisher's exact test of P<.0001. In the other parameters, no statistically significant differences were found between patients with grafts < 8 mm and those with grafts ≥8 mm.
Conclusions
This study demonstrates that tape reinforcement in ACL reconstruction is a safe procedure, offering excellent clinical and functional outcomes with low reinterventions and graft failure rates.
{"title":"Análisis de los resultados de la reconstrucción del ligamento cruzado anterior asociado al refuerzo con cinta de alta resistencia (material de polietileno trenzado de ultra alto peso molecular)","authors":"A.N. Toro-Ibarguen , E. Sánchez Benito , J.M. Cortés Villar","doi":"10.1016/j.recot.2025.05.005","DOIUrl":"10.1016/j.recot.2025.05.005","url":null,"abstract":"<div><h3>Background and objective</h3><div>The primary objective is to evaluate the clinical and functional outcomes of tape reinforcement in anterior cruciate ligament (ACL) reconstructions, recording complications, as well as the rate of reinterventions and graft failure.</div></div><div><h3>Materials and methods</h3><div>Retrospective analysis of ACL reconstructions with hamstring (HS) autograft that were reinforced with high-strength tape. We included patients in whom we obtained a graft of HS <<!--> <!-->8<!--> <!-->mm or ≥<!--> <!-->8<!--> <!-->mm of poor quality. Age, sex, body mass index (BMI), and previous activity were recorded. Clinical and functional evaluation were made and postoperative range of motion (ROM), pain, and Lysholm functional scale were recorded. Complication rate, graft failure rate, and reintervention rate were analyzed.</div></div><div><h3>Results</h3><div>A total of 160 patients were included, with a mean age of 29.19 years. Of these, 98 were male and 62 female, with a mean BMI of 23.5. The mean follow-up period was 31.7 months. The average ROM was 137.2°, the mean pain level was 0.8, and the average Lysholm score was 95.1. The complication rate was 11%, with 5% requiring reoperation. The graft failure rate was 1.3%. A graft diameter <<!--> <!-->8<!--> <!-->mm was associated with females with Fisher's exact test of <em>P</em><.0001. In the other parameters, no statistically significant differences were found between patients with grafts <<!--> <!-->8<!--> <!-->mm and those with grafts ≥8<!--> <!-->mm.</div></div><div><h3>Conclusions</h3><div>This study demonstrates that tape reinforcement in ACL reconstruction is a safe procedure, offering excellent clinical and functional outcomes with low reinterventions and graft failure rates.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"70 1","pages":"Pages 20-27"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145963179","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 : 2026-01-01DOI: 10.1016/j.recot.2025.11.006
P. González-Herranz, N. Penelas-Abelleira, M.L. Rodríguez-Rodríguez, M. Goday-Etxebarria
Introduction
Early diagnosis of DDH, ultrasonography and treatment with Pavlik arnais have provided an improvement of the results. However, always appear children more than 3 months until 24-months old with late diagnosis or failure with Pavlik treatment requiring closed reduction and spica cast treatment as standard management.
Material and method
The authors reviewed retrospectively DDH cases treated all patients treated with spica cast in human position during 3 months. The minimum follow-up was 5 years. It was considered good result when DDH reduced, remained stable, concentric, without AVN and not required surgery for sequels. All demographics, clinical and radiological parameters were statistically analyzed.
Results
Of a total 152 hips were treated, 24 (15.8%) required surgery. In 6 cases (4%) was observed AVN. According IHDI/Tönnis displacement severity, types I and II were success treated in 98.9% and types III/IV in 64%. As bad prognosis factors were identified Ortolani test (+), alfa angle minor than 44°, acetabular index higher than 44° or IHDI/Tönnis types III/IV and factors for a good prognosis types I/II and the early recovery of the acetabular index more than 10° after 5 months of treatment. The age and early treatment of the patients was only important for the hips type III/IV (64 hips), the mean age of patients treated successfully was 5.1 months (64%), comparing with 8.8 months of the surgery group (36%). The incidence of AVN was 4% (6 cases) and in all cases the nucleus of ossification was not present in the X-ray pre-treatment. We cannot find relationship between AVN with previous skin traction, adductor tenotomy or severity of displacement.
Conclusions
Conservative management of DDH with spica cast provide excellent results in almost all cases in types I and II hips (98.9%) and in 64% of types III/IV. An improvement of the acetabular index more than 10°, 5 months after the treatment is the best prognosis factor for a good result.
{"title":"[Translated article] Early recovery of acetabular index in ddh as good prognosis factor after closed reduction and spica cast treatment","authors":"P. González-Herranz, N. Penelas-Abelleira, M.L. Rodríguez-Rodríguez, M. Goday-Etxebarria","doi":"10.1016/j.recot.2025.11.006","DOIUrl":"10.1016/j.recot.2025.11.006","url":null,"abstract":"<div><h3><em>Introduction</em></h3><div>Early diagnosis of DDH, ultrasonography and treatment with Pavlik arnais have provided an improvement of the results. However, always appear children more than 3 months until 24-months old with late diagnosis or failure with Pavlik treatment requiring closed reduction and spica cast treatment as standard management.</div></div><div><h3><em>Material and method</em></h3><div>The authors reviewed retrospectively DDH cases treated all patients treated with spica cast in human position during 3 months. The minimum follow-up was 5 years. It was considered good result when DDH reduced, remained stable, concentric, without AVN and not required surgery for sequels. All demographics, clinical and radiological parameters were statistically analyzed.</div></div><div><h3><em>Results</em></h3><div>Of a total 152 hips were treated, 24 (15.8%) required surgery. In 6 cases (4%) was observed AVN. According IHDI/Tönnis displacement severity, types I and II were success treated in 98.9% and types III/IV in 64%. As bad prognosis factors were identified Ortolani test (+), alfa angle minor than 44°, acetabular index higher than 44° or IHDI/Tönnis types III/IV and factors for a good prognosis types I/II and the early recovery of the acetabular index more than 10° after 5 months of treatment. The age and early treatment of the patients was only important for the hips type III/IV (64 hips), the mean age of patients treated successfully was 5.1 months (64%), comparing with 8.8 months of the surgery group (36%). The incidence of AVN was 4% (6 cases) and in all cases the nucleus of ossification was not present in the X-ray pre-treatment. We cannot find relationship between AVN with previous skin traction, adductor tenotomy or severity of displacement.</div></div><div><h3><em>Conclusions</em></h3><div>Conservative management of DDH with spica cast provide excellent results in almost all cases in types I and II hips (98.9%) and in 64% of types III/IV. An improvement of the acetabular index more than 10°, 5 months after the treatment is the best prognosis factor for a good result.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"70 1","pages":"Pages T36-T42"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145963183","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 : 2026-01-01DOI: 10.1016/j.recot.2025.11.009
P.I. Codesido Vilar , P. Sucasas Hermida , B. Calvete Vázquez , C. Bonome Roel , A. Montero Picallo , M. Goday Etxebarria , A. López González
<div><h3>Introduction</h3><div>The most common tibial plateau fractures are AO 41B3/Schatzker type 2 (external unicondylar lesions with a vertical fracture line). The goal of treatment for these fractures is the satisfactory restoration of mechanical alignment, anatomic reduction of the articular surface, and stable fixation to allow early range of motion. The aim of our study is to determine the factors that most influence long-term functional and quality of life outcomes after surgical treatment by strictly selecting previously healthy patients facing an unexpected external tibial plateau fracture.</div></div><div><h3>Material and method</h3><div>A retrospective study was conducted in our tertiary hospital after obtaining approval from the ethics committee. Data from patients with external tibial plateau fracture hospitalized between 2013 and 2018 with more than 3 years of evolution were analyzed. All patients who met the strict inclusion criteria completed the KOOS, EQ-5D profile and VAS questionnaires. In addition, they underwent a physical examination and radiological study using telemetry and computed tomography (CT). The clinical data collected from the patients were: age, sex, fracture side, implant use, graft use, days elapsed until surgery, years after surgery, ASA, range of motion in extension and flexion. The radiological data were: in the telemetry, the deviation in mm of the load axis with respect to the contralateral limb was analyzed, the MPTA of both limbs and the difference in degrees between them; in the CT, the maximum joint step was measured and the affected area was calculated in cm<sup>2</sup> as well as the largest anteroposterior diameter and maximum width in mm (maximum anteroposterior and transverse diameters).</div></div><div><h3>Results</h3><div>A total of 27 patients were analysed, with a mean age of 53.3 years and a mean evaluation time since the fracture of 4.8 years. We found statistically significant correlations (<em>p</em> <!--><<!--> <!-->.05) between: days until surgery and size of the area in cm<sup>2</sup> (<em>p</em> <!-->=<!--> <!-->.042) and step in mm (<em>p</em> <!-->=<!--> <!-->.028), that is, the more days of delay, the greater the area and the greater the step; being a man presented a positive correlation with having a greater step (<em>p</em> <!-->=<!--> <!-->.025), greater area (<em>p</em> <!-->=<!--> <!-->.007) and greater slope (<em>p</em> <!-->=<!--> <!-->.039) compared to women. A statistically significant relationship was observed between the area of residual fracture and the values of KOOS symptoms (<em>p</em> <!-->=<!--> <!-->.015), KOOS function (<em>p</em> <!-->=<!--> <!-->.012), EQ-5D profile (<em>p</em> <!-->=<!--> <!-->.038) and VAS (<em>p</em> <!-->=<!--> <!-->.049); the greater the affected area, the worse the patient's condition. We also detected significant correlations between increased joint step and KOOS symptoms (<em>p</em> <!-->=<!--> <!-->.005), KOOS pain (<em>p</em> <!-->
{"title":"[Translated article] External tibial plateau fracture (AO 41B3/Schatzker 2): Analysis of clinical radiological factors in long-term functional and quality of life outcomes after surgical treatment","authors":"P.I. Codesido Vilar , P. Sucasas Hermida , B. Calvete Vázquez , C. Bonome Roel , A. Montero Picallo , M. Goday Etxebarria , A. López González","doi":"10.1016/j.recot.2025.11.009","DOIUrl":"10.1016/j.recot.2025.11.009","url":null,"abstract":"<div><h3>Introduction</h3><div>The most common tibial plateau fractures are AO 41B3/Schatzker type 2 (external unicondylar lesions with a vertical fracture line). The goal of treatment for these fractures is the satisfactory restoration of mechanical alignment, anatomic reduction of the articular surface, and stable fixation to allow early range of motion. The aim of our study is to determine the factors that most influence long-term functional and quality of life outcomes after surgical treatment by strictly selecting previously healthy patients facing an unexpected external tibial plateau fracture.</div></div><div><h3>Material and method</h3><div>A retrospective study was conducted in our tertiary hospital after obtaining approval from the ethics committee. Data from patients with external tibial plateau fracture hospitalized between 2013 and 2018 with more than 3 years of evolution were analyzed. All patients who met the strict inclusion criteria completed the KOOS, EQ-5D profile and VAS questionnaires. In addition, they underwent a physical examination and radiological study using telemetry and computed tomography (CT). The clinical data collected from the patients were: age, sex, fracture side, implant use, graft use, days elapsed until surgery, years after surgery, ASA, range of motion in extension and flexion. The radiological data were: in the telemetry, the deviation in mm of the load axis with respect to the contralateral limb was analyzed, the MPTA of both limbs and the difference in degrees between them; in the CT, the maximum joint step was measured and the affected area was calculated in cm<sup>2</sup> as well as the largest anteroposterior diameter and maximum width in mm (maximum anteroposterior and transverse diameters).</div></div><div><h3>Results</h3><div>A total of 27 patients were analysed, with a mean age of 53.3 years and a mean evaluation time since the fracture of 4.8 years. We found statistically significant correlations (<em>p</em> <!--><<!--> <!-->.05) between: days until surgery and size of the area in cm<sup>2</sup> (<em>p</em> <!-->=<!--> <!-->.042) and step in mm (<em>p</em> <!-->=<!--> <!-->.028), that is, the more days of delay, the greater the area and the greater the step; being a man presented a positive correlation with having a greater step (<em>p</em> <!-->=<!--> <!-->.025), greater area (<em>p</em> <!-->=<!--> <!-->.007) and greater slope (<em>p</em> <!-->=<!--> <!-->.039) compared to women. A statistically significant relationship was observed between the area of residual fracture and the values of KOOS symptoms (<em>p</em> <!-->=<!--> <!-->.015), KOOS function (<em>p</em> <!-->=<!--> <!-->.012), EQ-5D profile (<em>p</em> <!-->=<!--> <!-->.038) and VAS (<em>p</em> <!-->=<!--> <!-->.049); the greater the affected area, the worse the patient's condition. We also detected significant correlations between increased joint step and KOOS symptoms (<em>p</em> <!-->=<!--> <!-->.005), KOOS pain (<em>p</em> <!-->","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"70 1","pages":"Pages T28-T35"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145963208","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 : 2026-01-01DOI: 10.1016/j.recot.2025.11.011
A. Gargantilla Vázquez , M.J. Pérez Úbeda
A natural disaster is a phenomenon causing significant human, material, economic, and environmental losses, exceeding the capacity of the affected community or country to respond with its own resources. These events progress through phases: hyperacute, acute, subacute, chronic, and rehabilitation/recovery. Orthopedic surgeons play a vital role in each phase, from initial rescue to long-term rehabilitation.
In the acute phase, their responsibilities include triaging and managing injuries such as fractures (commonly in the lower limbs), wound infections, and crush injuries. Effective treatment is crucial to minimizing morbidity and mortality. Coordination between emergency medical teams (EMTs) and local authorities is essential for an efficient response, while poor organization can hinder relief efforts.
Orthopedic surgeons must adapt to limited resources, respect cultural contexts, and address socio-economic realities. Their role is increasingly critical due to the rising frequency of natural disasters linked to climate change, emphasizing the need for preparation and collaboration.
{"title":"[Artículo traducido] El papel del cirujano ortopédico en los desastres naturales","authors":"A. Gargantilla Vázquez , M.J. Pérez Úbeda","doi":"10.1016/j.recot.2025.11.011","DOIUrl":"10.1016/j.recot.2025.11.011","url":null,"abstract":"<div><div>A natural disaster is a phenomenon causing significant human, material, economic, and environmental losses, exceeding the capacity of the affected community or country to respond with its own resources. These events progress through phases: hyperacute, acute, subacute, chronic, and rehabilitation/recovery. Orthopedic surgeons play a vital role in each phase, from initial rescue to long-term rehabilitation.</div><div>In the acute phase, their responsibilities include triaging and managing injuries such as fractures (commonly in the lower limbs), wound infections, and crush injuries. Effective treatment is crucial to minimizing morbidity and mortality. Coordination between emergency medical teams (EMTs) and local authorities is essential for an efficient response, while poor organization can hinder relief efforts.</div><div>Orthopedic surgeons must adapt to limited resources, respect cultural contexts, and address socio-economic realities. Their role is increasingly critical due to the rising frequency of natural disasters linked to climate change, emphasizing the need for preparation and collaboration.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"70 1","pages":"Pages T59-T63"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145963172","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 : 2026-01-01DOI: 10.1016/j.recot.2025.11.008
M. Fa-Binefa, M. Valera Pertegás, A. Peiró Ibañez, L. Trullols Tarragó, P. Machado Granados, I. Gracia Alegría
Managing chronic periprosthetic infections in patients who have undergone limb-salvage surgery following a malignant bone tumor with megaprosthesis often involves a two-stage revision surgery with the use of a cement-spacer. This paper show details the preparation of a self-made intramedullary metal-stabilized mega-cement spacer for patients needing a two-stage revision surgery due to infection after oncologic bone tumor resection and limb-salvage surgery with megaprosthesis and present 2 clinical cases treated with this technique. The report provides a practical surgical technique to create a cement hip mega-spacer using readily available tools in most orthopedic surgical settings.
{"title":"[Artículo traducido] ¿Cómo crear un megaespaciador personalizado para una cirugía de revisión en 2 tiempos de megaprótesis de cadera después de una cirugía de salvamento de extremidad por causa oncológica? Técnica quirúrgica y reporte de 2 casos","authors":"M. Fa-Binefa, M. Valera Pertegás, A. Peiró Ibañez, L. Trullols Tarragó, P. Machado Granados, I. Gracia Alegría","doi":"10.1016/j.recot.2025.11.008","DOIUrl":"10.1016/j.recot.2025.11.008","url":null,"abstract":"<div><div>Managing chronic periprosthetic infections in patients who have undergone limb-salvage surgery following a malignant bone tumor with megaprosthesis often involves a two-stage revision surgery with the use of a cement-spacer. This paper show details the preparation of a self-made intramedullary metal-stabilized mega-cement spacer for patients needing a two-stage revision surgery due to infection after oncologic bone tumor resection and limb-salvage surgery with megaprosthesis and present 2<!--> <!-->clinical cases treated with this technique. The report provides a practical surgical technique to create a cement hip mega-spacer using readily available tools in most orthopedic surgical settings.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"70 1","pages":"Pages T84-T87"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145963180","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 : 2026-01-01DOI: 10.1016/j.recot.2025.11.012
M.B. Spinelli , V.M. Cafruni , N. Lucero Viviani , A.C. Parise , C. Rodriguez , N. Satera , M.G. Santini Araujo
Introducction
Diabetic foot (DF) is a common and serious complication of diabetes mellitus (DM), especially in patients with chronic kidney disease (CKD) undergoing renal replacement therapy (RRT). This study aimed to assess the prevalence of DF and associated conditions in DM patients receiving RRT at a tertiary care hospital in Argentina.
Materials and methods
We conducted a cross-sectional observational study between December 2022 and September 2024. A total of 54 patients with type 1 or type 2 DM undergoing either hemodialysis (HD) or peritoneal dialysis (PD) were included. History of DF, active or pre-ulcerative lesions, neuropathy, peripheral vascular disease, and associated risk factors were evaluated through physical examination and medical record review.
Results
DF was present in 40.7% of patients, with a higher proportion in HD (48.6%) compared to PD (26.3%). Pre-ulcerative lesions were found in 61.1%, and active ulcers in 9.3%. A history of amputation was reported in 31.4% of cases. Diabetic neuropathy (87%) and peripheral vascular disease (81.5%), both closely related to DF development, were key findings. Significant differences were observed in smoking (42.1% PD vs. 11.4% HD, p = 0.016), which may impair microcirculation, and obesity (63.2% PD vs. 25.7% HD, p = 0.016), which increases plantar pressure and contributes to foot deformities.
Conclusions
DM patients on RRT have a high prevalence of DF and related risk factors. Early detection and multidisciplinary follow-up are essential to prevent complications such as ulcers and amputations.
糖尿病足（DF）是糖尿病（DM）常见且严重的并发症，特别是在接受肾脏替代治疗（RRT）的慢性肾脏疾病（CKD）患者中。本研究旨在评估阿根廷一家三级医院接受RRT治疗的糖尿病患者中DF及相关疾病的患病率。材料和方法我们在2022年12月至2024年9月进行了一项横断面观察研究。共纳入54例接受血液透析（HD）或腹膜透析（PD）的1型或2型糖尿病患者。通过体格检查和病历回顾评估DF病史、活动性或溃疡前期病变、神经病变、周围血管疾病及相关危险因素。结果40.7%的患者存在df， HD患者的比例（48.6%）高于PD（26.3%）。溃疡前病变占61.1%，活动性溃疡占9.3%。31.4%的病例有截肢史。糖尿病神经病变（87%）和周围血管疾病（81.5%）与DF的发展密切相关，是主要发现。吸烟（42.1% PD vs. 11.4% HD, p = 0.016）可能损害微循环，肥胖（63.2% PD vs. 25.7% HD, p = 0.016）会增加足底压力并导致足部畸形，两者存在显著差异。结论接受RRT治疗的sdm患者有较高的DF患病率及相关危险因素。早期发现和多学科随访对于预防溃疡和截肢等并发症至关重要。
{"title":"[Artículo traducido] Prevalencia de pie diabético en pacientes con diabetes mellitus en tratamiento con diálisis en un hospital de tercer nivel en Argentina","authors":"M.B. Spinelli , V.M. Cafruni , N. Lucero Viviani , A.C. Parise , C. Rodriguez , N. Satera , M.G. Santini Araujo","doi":"10.1016/j.recot.2025.11.012","DOIUrl":"10.1016/j.recot.2025.11.012","url":null,"abstract":"<div><h3>Introducction</h3><div>Diabetic foot (DF) is a common and serious complication of diabetes mellitus (DM), especially in patients with chronic kidney disease (CKD) undergoing renal replacement therapy (RRT). This study aimed to assess the prevalence of DF and associated conditions in DM patients receiving RRT at a tertiary care hospital in Argentina.</div></div><div><h3>Materials and methods</h3><div>We conducted a cross-sectional observational study between December 2022 and September 2024. A total of 54 patients with type 1 or type 2 DM undergoing either hemodialysis (HD) or peritoneal dialysis (PD) were included. History of DF, active or pre-ulcerative lesions, neuropathy, peripheral vascular disease, and associated risk factors were evaluated through physical examination and medical record review.</div></div><div><h3>Results</h3><div>DF was present in 40.7% of patients, with a higher proportion in HD (48.6%) compared to PD (26.3%). Pre-ulcerative lesions were found in 61.1%, and active ulcers in 9.3%. A history of amputation was reported in 31.4% of cases. Diabetic neuropathy (87%) and peripheral vascular disease (81.5%), both closely related to DF development, were key findings. Significant differences were observed in smoking (42.1% PD vs. 11.4% HD, <em>p</em> <!-->=<!--> <!-->0.016), which may impair microcirculation, and obesity (63.2% PD vs. 25.7% HD, <em>p</em> <!-->=<!--> <!-->0.016), which increases plantar pressure and contributes to foot deformities.</div></div><div><h3>Conclusions</h3><div>DM patients on RRT have a high prevalence of DF and related risk factors. Early detection and multidisciplinary follow-up are essential to prevent complications such as ulcers and amputations.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"70 1","pages":"Pages T8-T12"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145963125","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 : 2026-01-01DOI: 10.1016/j.recot.2025.11.002
M.R. Sánchez-Crespo , H. Ayala-Gutiérrez , F.J. del Canto-Alvarez , J. Couceiro-Otero , M. Holgado Fernández , M. Vázquez-Sánchez , A. Lamagrande-Obregón , E. Gallardo-Agromayord , R. Landeras-Alvaro
Introduction
Scaphotrapeziotrapezoid (STT) joint osteoarthritis may influence the outcome after trapeziometacarpal prosthesis (TMP) implantation. The literature regarding its clinical and radiological assessment is unclear. The aim of our study was to determine by means of a pre- and post-intervention CT study whether the degree of STT involvement influences the clinical–functional or radiological results after TMP implantation, and to establish whether or not STT osteoarthritis could be a contraindication for the use of these implants.
Methods
Prospective study of 60 patients with trapeziometacarpal osteoarthritis grade III–IV operated between 2017 and 2022. The Van Cappelle functional test, pain, strength and mobility were evaluated. Simple radiology study and CT scan evaluating STT pre and post-surgery. The results were analysed in relation to the joint space. Recording of complications and statistics.
Results
A total of 50 patients completed the study, mean age 59 years, mean follow-up 56 months, 36 Isis® and 14 Touch® were implanted. Significant improvement was observed in all variables. The STT joint space didn’t change after the intervention, and no statistical association was found between the STT joint space and the different clinical–functional variables. Three cases (6%) suffered STT pain and none required surgical revision. No infections, dislocations or loosening. Four De Quervain's tenosynovitis and two perimplant ossifications were observed. Survival of the implants was 100%.
Conclusions
The use of TMP in patients with trapeziometacarpal osteoarthritis has excellent short and medium-term results, regardless of STT involvement, so it should not be a contraindication for osteoarthritis at this level.
{"title":"[Translated article] Influence of the scaphotrapeziotrapezoid joint on the results of total trapeziometacarpal prostheses","authors":"M.R. Sánchez-Crespo , H. Ayala-Gutiérrez , F.J. del Canto-Alvarez , J. Couceiro-Otero , M. Holgado Fernández , M. Vázquez-Sánchez , A. Lamagrande-Obregón , E. Gallardo-Agromayord , R. Landeras-Alvaro","doi":"10.1016/j.recot.2025.11.002","DOIUrl":"10.1016/j.recot.2025.11.002","url":null,"abstract":"<div><h3>Introduction</h3><div>Scaphotrapeziotrapezoid (STT) joint osteoarthritis may influence the outcome after trapeziometacarpal prosthesis (TMP) implantation. The literature regarding its clinical and radiological assessment is unclear. The aim of our study was to determine by means of a pre- and post-intervention CT study whether the degree of STT involvement influences the clinical–functional or radiological results after TMP implantation, and to establish whether or not STT osteoarthritis could be a contraindication for the use of these implants.</div></div><div><h3>Methods</h3><div>Prospective study of 60 patients with trapeziometacarpal osteoarthritis grade III–IV operated between 2017 and 2022. The Van Cappelle functional test, pain, strength and mobility were evaluated. Simple radiology study and CT scan evaluating STT pre and post-surgery. The results were analysed in relation to the joint space. Recording of complications and statistics.</div></div><div><h3>Results</h3><div>A total of 50 patients completed the study, mean age 59<!--> <!-->years, mean follow-up 56<!--> <!-->months, 36 Isis® and 14 Touch® were implanted. Significant improvement was observed in all variables. The STT joint space didn’t change after the intervention, and no statistical association was found between the STT joint space and the different clinical–functional variables. Three cases (6%) suffered STT pain and none required surgical revision. No infections, dislocations or loosening. Four De Quervain's tenosynovitis and two perimplant ossifications were observed. Survival of the implants was 100%.</div></div><div><h3>Conclusions</h3><div>The use of TMP in patients with trapeziometacarpal osteoarthritis has excellent short and medium-term results, regardless of STT involvement, so it should not be a contraindication for osteoarthritis at this level.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"70 1","pages":"Pages T13-T19"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145963127","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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