Acta ortopedica mexicana最新文献

Introduction: The cavus foot is a musculoskeletal pathology with an increase of the medial arch of the concavity of the foot. The etiology of the cavus foot is still enigmatic, it is related with neurologic conditions, Charcot-Marie-Tooth disease, Friedreich's ataxia, and cerebral palsy. The aim of this research was to analyze the plantar pressure distribution of the feet on young athletes with cavus foot.

Material and methods: Eighty-three young athletes between nine and 20 years old, that presented cavus feet pathology were recruited. The mass and height average were 56.9 ± 12.36 kg and 1.61 ± 0.10 m respectively. Plantar pressure distribution of the feet was recorded during static conditions. The hindfoot and forefoot pressure were compared in each foot.

Results: The plantar pressure distribution were categorized in three groups. In the first group the participants presented higher pressure in the hindfoot than forefoot, in the second group, the athletes showed similar pressure in the posterior and anterior region of the feet and in the last one, the subjects revealed higher pressure in the forefoot. To be considered in one of the three groups, the difference of pressure between the posterior and anterior part of the foot was established at 16%.

Conclusion: Many musculoskeletal disorders in the human body are biomechanical in origin and related with foot anatomy. The cavus foot is a pathology with high prevalence in athletes and it is related with the mechanical forces over the feet during dynamic conditions.

Objective: Clinical and functional evaluation of patients with Lisfranc lesion without work or sport cause and treated in our center.

Material and methods: Thirteen patients with Lisfranc lesion without occupational or sports causes were divided into two groups, high-energy and low-energy injuries. Were analyzed the return to work and sports activity prior to the injury and the use of footwear and insoles after the injury. Also were assessed AOFAS and EVA postoperative score and posterior complications after lesion recovery.

Results: High-energy group included 7 patients who underwent surgery on an average of 7.3 days. Of the total of patients, 4 presented post-surgical sequelae. Of these patients, one patient was unable to return to their previous work activity and two patients were unable to practice the usual sports activity. The AOFAS was 79.4 and EVA 2.8. In the low energy group, we found six patients operated on 5.6 days on average. All of them were able to return to their previous work and sports activity. The AOFAS were 84.8 and the EVA 1.6. Statistically significant differences were not observed in any of the variables studied.

Conclusion: Patients with Lisfranc injury out of laboral or sports background present good clinical and functional results.

Introduction: The hallux valgus is a very frequent and complex orthopedic pathology. It involves the bone and soft tissue structures of the first toe. There are multiple techniques described for the alignment of the first toe. All technics aim to restore the normal angulation of the toe while using a stable osteotomy through a painless surgical procedure. The minimal invasive techniques have been growing in acceptance since the year 2000, as a viable surgical alternative to treat this pathology.

Material and methods: We included patients with a diagnostic of mild or moderate hallux valgus on whom a minimal invasive procedure was performed to correct the deformity of the first toe. We performed a distal Reverdin/Isham osteotomy on the first metatarsal and an akin osteotomy in the proximal phalanx, a lateral capsular release and a abductor tenotomy. These patients were followed for 24 months after their surgery.

Results: Our patients had an adequate correction angular correction, for a distal osteotomy. They had a good pain control, with an adequate mobility in the postoperative period. The patients presented an adequate personal satisfaction, 87% of them had good results. We found an important and statistically significant improvement in the Kitaoka scale.

Conclusion: The minimal invasive technics for the correction of mild or moderated hallux valgus are a good alternative. Our patients are satisfied with the functional, and cosmetic results.

No Abstract available.

Comprehensive geriatric assessment impacts on the preservation of functionality , affecting the quality of life of the patient. Low muscle mass, expressed as low grip strength, is a common condition that has shown great utility in predicting mortality, days of hospital stay, and early mobilization.

Objective: To describe the usefulness of grip strength as a predictor of functional loss in patients older than 60 years with hip fracture.

Material and methods: A prospective, observational, analytical, longitudinal cohort study in 60-year-old hospitalized patients with hip fracture, the grip strength was evaluated with a hydraulic dynamometer at admission and after surgery, with a follow-up at 30 days.

Results: The patients presented a significant decrease in grip strength at admission compared to grip strength at discharge (20.79 ± 4.75 vs. 15.45 ± 4.17 respectively). When evaluating muscle strength, it was found that those patients with functional loss had a higher score of grip strength at admission (21.42 ± 5.26, p = 0.04), and grip strength at discharge (16.14 ± 4.52 p = 0.013). For each day of hospital stay, 0.493 kg of muscle strength decreases.

Conclusion: There is a positive correlation between the days of hospital stay with the decrease in muscle strength in addition to a positive correlation between the Barthel score and grip strength, which proposes that this parameter is an important factor to evaluate in the adult functionality approach.

Introduction: Chondrosarcoma is the second most frequent primary malignant bone tumor, is characterized by the formation of a chondroid matrix, is more frequent in advanced ages and its prognosis is directly related to the histological subtype and tumor grade. The objective of this article is to present the demographic and treatment profile in a reference center.

Material and methods: A retrospective, descriptive, observational, analytical cohort-type study was conducted in a reference center between January 1, 2005 and December 31, 2019, the demographic variables were analyzed and contrasted with the outcome variables that were overall survival and disease-free period.

Results: 85 patients were included, the mean age of presentation was 43.3 years, the clinical stage at the time of presentation was mostly IIa and IIb covering 54.1%. 35 patients had metastases with clinical stage IV. The main site of metastasis was the lung in 32 patients (37.6%). Thirty-six patients (42.3%) had specific mortality. 35 patients (41.2%) died as a result of metastatic disease to lung or other organs, one patient died from direct extension of the tumor in the cervical spine.

Conclusion: The important prognostic factors found in our series that influence global survival are: the presence of metastases and axial localization.

Introduction: The tibial plateau fractures due to high-energy mechanisms are serious injuries that occur on a load bearing joint. These are difficult to approach because, also affect the bone structure of the leg, they usually have associated soft tissue injuries.

Objective: To evaluate the radiological and functional results of high-energy tibial plateau fractures with a minimum follow-up of one year.

Material and methods: Retrospective, observational and multicenter study. Analysis of radiological and functional outcomes in the treatment of high-energy tibial plateau fractures, treated by open reduction and internal fixation (ORIF) between 2014 and 2019.

Results: 54 fractures treated by ORIF. Follow-up one year. 98.1% consolidation in 13 weeks on average. 83.4% without alterations of the axis in the coronal plane. 74% without postoperative joint widening. Functional scores: Lysholm 82.1 average points and Oxford Knee Score (OKS) 39.5 average points.

Conclusion: The joint range of motion was reduced after a high-energy tibial plateau fracture, but with good functional results. The less off axis and less post-operative radiographic widening, the better results are obtained.

Injuries in the metatarsophalangeal joint complex of the hallux are seen with greater frequency in athletes, their importance lies in the functional limitation it generates. Early diagnosis and treatment can reduce the sequelae, however, the recognition of chronic lesions and with it the implementation of adequate therapeutic management generate improvements in quality of life. This document records a case of inveterate dislocation of the metatarsophalangeal joint of the hallux of more than one year of evolution with involvement of the intersesamoid ligament which was corrected with arthrodesis achieving immediate satisfactory results, in the medium and long term with the subsequent functional recovery and total reduction of pain.

A historical review of the development of hip arthroplasty is made. The work was divided into five stages: bioarthroplastic, pre-alloarthroplastic, early development of endoprosthetic alloarthroplasty, transitional stage and contemporary alloarthroplasty. The most important documentary history was located in relation to the events that marked milestones in its development from the end of the 19th century to the present time. The purpose of this manuscript was to make a reflective analysis analyzing what have been its successes, its failures and the lessons it has left us. Likewise, it was considered transcendent not only to review its historical development, but also to locate ourselves in the present and towards where we should direct our efforts to continue innovating this therapeutic resource, taking advantage of the lessons of the past and the attitudes of the present and the route to the future. Given the length of the manuscript, it was divided into parts. In this first part, we will review from the bioarthroplastic stage to the current arthroplastic stage.

Introduction: The aim of this study was to describe the epidemiology and to estimate the direct medical costs of hip fracture among elderly patients in Mexico.

Material and methods: An observational, cross sectional and retrospective study was undertaken. Hospital discharge and surgical procedures for the period 2013-2018 were the databases used for the analysis, and obtained from General Directorate of Health Information. Variables included were sex, federal entity, age, year of discharge, and fracture type according to the CIE-10; and also, the supplies needed for the surgical procedures.

Results: A total of 16,829 patients with hip fracture were discharge, 69% were women, and the mean for age was 79 years old and for the hospital stay length was nine days. The most frequent fracture type was the femur neck with 77% and the average medical costs was USD$45,122,228.00.

Conclusion: Falling risks increase with age, especially in patients among 80-89 years of age, hence, is expected that this type of pathology increases in the following years. The medical costs for treatment of hip fracture represents an economic impact on health services. For that reason, the implementation of prevention strategies, risk of falling for example, is the one of most efficient approach.