K L Quinto-González, A Espinosa-Gutiérrez, E Hernández-Méndez-Villamil, A E Borjón-Cisneros
{"title":"[Glomus tumor of subungual presentation in the thumb and use of ultrasound in its diagnosis. Case report and literature review].","authors":"K L Quinto-González, A Espinosa-Gutiérrez, E Hernández-Méndez-Villamil, A E Borjón-Cisneros","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>the glomus tumor is a benign neoplasm originated in the smooth muscle cells of the vascular glomus. Approximately 80% of lesions are located on the upper extremity and, of these, the majority are in the subungual area. The diagnosis must include imaging tests, among which ultrasound stands out, being a good alternative due to its low cost and accessibility.</p><p><strong>Objective: </strong>we present a case of late diagnosis of surgically managed glomus tumor, as well as a review of the existing literature for diagnosis, treatment, and prognosis of this uncommon pathology.</p><p><strong>Clinical case: </strong>the case of a 52-year-old female patient who reported chronic, burning pain, radiating to the distal phalanx of the thumb with no history of trauma, of 2 years of evolution and which limited her daily life activities, is presented. The exploration with interphalangeal Doppler ultrasound is complemented, being an excellent alternative due to its easy accessibility. A glomus tumor was diagnosed in the interphalangeal thumb. An \"H\" approach was performed on the interphalangeal fold with subungual dissection with resection of the tumor piece and follow-up by an outpatient clinic where a surgical wound with adequate healing was found. Physical examination with capacity for the mobilization of the distal interphalangeal joint (IFJ) and visual analogue scale (VAS) 1 point. The updated pathological evaluation of the existence of a glomus tumor.</p><p><strong>Conclusions: </strong>ultrasound is an excellent aid in the diagnosis, as well as in the surgical planning for the treatment of the glomus tumor; for being accessible, low cost and highly effective. The anatomopathological study is the gold standard.</p>","PeriodicalId":101296,"journal":{"name":"Acta ortopedica mexicana","volume":"37 6","pages":"368-371"},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140103098","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}
{"title":"Bone tuberculosis, in patients with no prior history of tuberculosis.","authors":"D Portman-Santos, I Baley-Amiga, S Jasqui-Remba","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>There are different types of infection caused by Mycobacterium tuberculosis, the pulmonary variety is the most common of them; infection of the bone secondary to joint replacement, is usually caused by a previous lung infection that has been disseminated. However primary bone infection is very rare and little reported, which makes information on the matter very scarce. A female patient is presented with a history of congenital hip dysplasia, who underwent multiple surgical interventions, including total hip arthroplasty (THA), afterwards she presented a fistula and persistent serous exudate; a biopsy was performed where acid-fast bacilli were detected. The delay in the diagnosis of osteoarticular tuberculosis (OATB) can lead to negative consequences, affecting the quality of life of the patient. Conventional diagnostic methods may be insufficient for the diagnosis of OATB.</p>","PeriodicalId":101296,"journal":{"name":"Acta ortopedica mexicana","volume":"37 6","pages":"372-375"},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140103141","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}
M Cristiani-Winer, P Nicolás-Ortiz, D Orosco-Falcone, J H Guimbard-Pérez, J C Carabajal
{"title":"[The morbidity of the posterior iliac crest bone graft harvesting could be an overestimated fact. Study in patients with open posterolateral lumbar fusion].","authors":"M Cristiani-Winer, P Nicolás-Ortiz, D Orosco-Falcone, J H Guimbard-Pérez, J C Carabajal","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>spinal fusion is used to treat, among other pathologies, the degenerative intervertebral disc disease. Autologous iliac crest bone grafting is the golden standard treatment for increasing the rate of fusion; however, it isn't free of complications.</p><p><strong>Objectives: </strong>to investigate whether patients who have posterior iliac crest graft harvesting and are blinded to the donor site, can identify from which side the graft was harvested, and whether the intensity of this pain is related to the amount of graft obtained.</p><p><strong>Material and methods: </strong>prospective, experimental, randomized and comparative, single-blind study. Adult patients who underwent primary instrumented open posterolateral lumbar fusion with autologous iliac crest bone graft between July 2019 and April 2020 were included. Patients were divided into two randomized groups. The amount of graft to be harvested was according to surgical needs. The patients were asked about pain according to the visual analogue scale in the first, third and sixth months after surgery, always requesting that the most painful side be identified.</p><p><strong>Results: </strong>a total of 44 patients (n = 23 right crest, n = 21 left crest) were analyzed. Most patients were unable to identify the side from which the bone graft was harvested, with a statistically significant difference (p-value 0.0001).</p><p><strong>Conclusion: </strong>iliac crest bone graft harvesting is an effective and safe procedure that improves the rates of fusion without increasing the patient's morbidity.</p>","PeriodicalId":101296,"journal":{"name":"Acta ortopedica mexicana","volume":"37 6","pages":"338-343"},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140103101","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}
J M Hernández-Naranjo, M Vives-Barquiel, M P Camacho-Carrasco, A Carreras-Castañer, M Renau-Cerrillo, B Campuzano-Bitterling
{"title":"[There is no difference in clinical outcomes in patients with distal Neer II and Neer V clavicle fractures treated with or without coracoclavicular augmentation systems].","authors":"J M Hernández-Naranjo, M Vives-Barquiel, M P Camacho-Carrasco, A Carreras-Castañer, M Renau-Cerrillo, B Campuzano-Bitterling","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>the use of coracoclavicular augmentation systems together with locking plates in the treatment of unstable distal clavicle fractures (Neer II and Neer V) is controversial.</p><p><strong>Material and methods: </strong>patients with unstable distal clavicle fractures treated between 2013-2022 were retrospectively reviewed. The patients were divided into two groups: patients treated with locking plates (P group) and patients treated with locking plates and coracoclavicular augmentation systems (PCC group). Postoperative complications, modified preoperative and final coracoclavicular distance (CC), and outcomes on the Visual Analog Scale (VAS) and Quick Disabilities of the Arm, Shoulder, and Hand (Quick DASH) were recorded.</p><p><strong>Results: </strong>16 of 23 patients were treated with plates only, and 7 of 23 were treated with plates and coracoclavicular augmentation systems. One case showed no fracture consolidation, and there was one case of cutaneous infection. The mean final CC distance was 23.7 in the P group and 22.1 in the PCC group. The mean VAS score was 1.3 in both the P and PCC groups, while the mean Quick DASH score was 5.5 in the P group and 8.1 in the PCC group. No significant differences were found in CC distance, VAS or Quick DASH scores.</p><p><strong>Conclusion: </strong>the use of locking plates is likely sufficient in the management of unstable distal clavicle fractures, as there were no significant differences in functional outcomes in this study when coracoclavicular augmentation systems were used together with locking plates.</p>","PeriodicalId":101296,"journal":{"name":"Acta ortopedica mexicana","volume":"37 6","pages":"344-349"},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140103140","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}
{"title":"Direct anterior approach complications for total hip arthroplasty.","authors":"L J Fernández-Palomo, R González-Pola","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The direct anterior approach (DAA) for total hip arthroplasty has been popularized in the last decade as a minimally invasive approach used by many surgeons, including the authors, to preserve the integrity of muscle groups and their insertions and the dynamic hip stability resulting in less surgical trauma and faster recovery process with decreased postoperative pain. This surgical approach is not without a variety of complications and pitfalls. This review aims to identify any potential drawbacks and challenges associated with the DAA in THA and guide surgeons on minimizing and avoiding them.</p>","PeriodicalId":101296,"journal":{"name":"Acta ortopedica mexicana","volume":"37 6","pages":"361-367"},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140103143","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}
{"title":"[Anterior tibialis tendon transfer for the treatment of dynamic supination in patients with clubfoot. Analysis of clinical outcomes and complications].","authors":"F Turazza, E Sanchez, V Allende, J J Masquijo","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>our aim was to evaluate the clinical outcomes and complications of anterior tibialis tendon transfer (ATTT) in children with dynamic supination after clubfoot treatment.</p><p><strong>Material and methods: </strong>children with dynamic supination after initial treatment with Ponseti method or surgery who underwent ATTT between 2008 and 2020 were included for evaluation. Demographic data, previous treatment, associated procedures and fixation method were analyzed. Functional results were evaluated with the grading system described by Thompson. Complications and their treatment were analyzed.</p><p><strong>Results: </strong>a total of 39 patients (57 feet) were analyzed. 70% received previous treatment with Ponseti method, 19.3% underwent surgical posteromedial release, and 10.7% another type of surgical treatment. 88% of cases required associated procedures including Achilles tendon lengthening or tenotomy, plantar fasciotomy, tibial osteotomy, lateral column shortening, posterior release. The predominant type of fixation was the pull-out button method (96.5%). The average follow-up was 31.5 months. According to the Thompson grading system, 52 patients presented good results, two fair and three poor. 98.2% of the feet showed active contraction of the transferred tibialis anterior tendon. There were four complications: plantar irritation, synovial cyst in the dorsum of the foot and deep infection. Two feet required unplanned surgery.</p><p><strong>Conclusion: </strong>anterior tibialis tendon transfer is an effective technique to correct residual dynamic supination in patients with clubfoot.</p>","PeriodicalId":101296,"journal":{"name":"Acta ortopedica mexicana","volume":"37 6","pages":"324-330"},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140103096","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}
F Pauletti, M Carabajal-Mattar, L Marangoni, J J Masquijo
{"title":"[Clinical results and complications of meniscal repair in children and adolescents].","authors":"F Pauletti, M Carabajal-Mattar, L Marangoni, J J Masquijo","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>there is scarce information on meniscal repair in the paediatric population in terms of outcomes of this technique. The aim of this study was to evaluate the clinical outcomes and complications of meniscal repair in paediatric population with isolated lesions, associated with ACL rupture and discoid meniscus with unstable lesions.</p><p><strong>Material and methods: </strong>data from 78 patients 18 years of age, with arthroscopic diagnosis of isolated meniscal lesion, associated with ACL tear or discoid meniscus, in whom arthroscopic repair was performed, were retrospectively analyzed for demographic characteristics, surgical technique, and perioperative complications. Functional results were assessed with the Lysholm and Pedi-IKDC scales. Time to repair failure was defined as the interval between meniscal repair and revision (re-repair or subtotal meniscectomy).</p><p><strong>Results: </strong>mean age was 14 years (SD 3.1, range 3-19). The patients in group C were significantly younger (15.4 years in group A vs 14.9 in group B vs 12.1 in group C, p = 0.001). The average follow-up was 33.8 months. The mean Lysholm score and Pedi-IKDC were 96.1 points (range, 76-100) and 93.8 points (range, 59.8-100), respectively. The overall failure rate was 14.1% (11/78). There were 4 (13%) failures in group A, 3 failures (12%) in group B, and 5 failures (17%) in group C (p = 0.429). We found a tendency towards a greater number of failures in bucket handle injuries (p = 0.08) and a significant association when 4 sutures were used (p = 0.041).</p><p><strong>Conclusion: </strong>in this series, meniscal repair demonstrated a clinical success rate of 85.9%. Patients with discoid meniscus, bucket handle injuries, and those who required a greater number of sutures had a higher risk of failure. Repair should be considered the first surgical treatment option for most meniscal injuries in children and adolescents.</p>","PeriodicalId":101296,"journal":{"name":"Acta ortopedica mexicana","volume":"37 6","pages":"356-360"},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140103097","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}
E G E Araujo, G Corral, N Ochoa, D Torres, M Gutiérrez
{"title":"Clinical improvement after intraarticular and intraosseous injections of platelet rich plasma combined with hyaluronic acid for knee osteoarthritis. Case series.","authors":"E G E Araujo, G Corral, N Ochoa, D Torres, M Gutiérrez","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>knee osteoarthritis (KOA) is known as the most common form of osteoarthrosis with a 6% prevalence in people over 30 years old, and more than 40% in the population over 70 years old. The use of PRP led to diverse results and this disparity can be attributed to the dissimilar methods of PRP preparation. This study aims to assess the functional effects of intraosseous (IO) and intraarticular (IA) injections of platelet rich plasma (PRP) followed by IA injections of hyaluronic acid (HA).</p><p><strong>Objectives: </strong>this study aimed to assess the functional effects of intraosseous (IO) and intraarticular (IA) injections of platelet rich plasma (PRP) followed by IA injections of hyaluronic acid (HA), administered 3 and 4 weeks after the initiation of treatment in 33 patients with grade II-III (Ahlback scale) knee osteoarthritis (KOA).</p><p><strong>Material and methods: </strong>retrospectively, 33 patients were assessed using the Western Ontario and McMaster Universities (WOMAC) osteoarthritis index and visual analogue scale (VAS) score. They were followed-up for 12.92 months on average. Patients were divided into three groups based on age and four groups based on the follow-up period.</p><p><strong>Results: </strong>the pre-operative mean of the WOMAC index was 44.35 ± 20.20 and the post-operative mean was 22.81 ± 17.25 (p < 0.001). The pre-operative and post-operative mean of the VAS scores were 5.79 ± 2.01 and 2.41 ± 1.43 (p < 0.001), respectively. The largest improvement in WOMAC (from 42.86 to 13.69) was observed in the youngest patients (44 to 55 years old) and the largest reduction in VAS (from 6.89 to 2.22) was seen in patients aged 56 to 70 years.</p><p><strong>Conclusion: </strong>the combination of IO and IA plasma rich in growth factor (PRGF) treatment with the IA-HA treatment yielded excellent results, diminishing pain and improving motor functionality in patients with KOA.</p>","PeriodicalId":101296,"journal":{"name":"Acta ortopedica mexicana","volume":"37 6","pages":"350-355"},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140103142","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}
A R Lizcano-Suárez, M A Clara-Altamirano, S Velázquez-Rodríguez, H Martínez-Said, S V Villavicencio-Valencia, D Y García-Ortega
{"title":"[Surgical margins as prognostic factor in pelvis chondrosarcoma. Cohort study in a sarcoma unit].","authors":"A R Lizcano-Suárez, M A Clara-Altamirano, S Velázquez-Rodríguez, H Martínez-Said, S V Villavicencio-Valencia, D Y García-Ortega","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>chondrosarcoma is the second most common primary malignant tumor, constitutes approximately one quarter of all primary bone sarcomas. Surgical margins in pelvic chondrosarcoma have a direct impact as a prognostic factor, both on overall survival and on recurrence-free survival of this disease.</p><p><strong>Objectives: </strong>to analyze the impact of surgical margins as a prognostic factor in pelvic chondrosarcoma.</p><p><strong>Material and methods: </strong>a retrospective database cohort with prospective follow-up of sarcomas in patients diagnosed with primary pelvic chondrosarcoma who underwent surgical treatment. Clinical-demographic variables were obtained, a descriptive analysis of each variable was performed, and these were contrasted with the outcome variables.</p><p><strong>Results: </strong>seventeen patients were included, of which nine were female. The median age was 41 years, ranging from 23 to 65 years. The average tumor size was 20.9 cm (range 5 to 46 cm). The average surgical margin was 5.3 mm, ranging from 1 to 30 mm, with 58% positive margins. The average overall survival was 64 months (range 7 to 108 months). The distribution of pelvic involvement was as follows: zone I in nine patients (52.9%), zone II in two (11.8%), a combination of zones I-III in two (11.8%), I+II in one (5.9%), II+III in one (5.9%), I-III plus sacrum in one (5.9%) and I plus sacrum in one (5.9%). Tumor grades were classified as low in seven patients (41.2%), intermediate in sven (41.2%), high in two (11.8%), and dedifferentiated in one (5.9%). Regarding the type of resection, 12 patients (70.6%) underwent internal hemipelvectomy and five (29.4%) external hemipelvectomy. Recurrence was recorded in five cases (29.4%), metastasis in three (17.6%), and mortality in four (23.5%).</p><p><strong>Conclusions: </strong>this series represents the largest cohort reported in Latin America of primary pelvic chondrosarcomas. A more favorable prognosis was observed in patients with surgical margins greater than 1 mm. The presence of chondrosarcoma in multiple pelvic zones was associated with a worse oncological prognosis. Additionally, a higher incidence of positive surgical margins and local recurrence rates were identified in pelvic chondrosarcomas compared to those located in the extremities.</p>","PeriodicalId":101296,"journal":{"name":"Acta ortopedica mexicana","volume":"37 6","pages":"331-337"},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140103100","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}
A Dryjanski-Lerner, G Vera-Valencia, C Trueba-Vasavilbaso, H Morales-Domínguez
{"title":"[Posttraumatic osteoarthrosis in a patient with chronic anterior cruciate ligament rupture. Case report and review of the literature].","authors":"A Dryjanski-Lerner, G Vera-Valencia, C Trueba-Vasavilbaso, H Morales-Domínguez","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Anterior cruciate ligament (ACL) rupture is a very important epidemiological pathology in our environment. It has a peak incidence between 16 to 39 years of age. It is estimated that between 70-84% of ACL injuries are non-contact. The \"no return\" position describes the knee in valgus, femoral external rotation, tibial internal rotation and semiflexion, promoting injury to this ligament. Geometric measurements of the knee have been associated with an increased probability of non-contact ACL injury. The management of ACL tears is divided into two: conservative treatment and surgical management. Early OA (osteoarthritis) is the most common consequence of an ACL tear. We present the case of a 35-year-old patient with an inveterate ACL rupture of 10 years of evolution. With conservative management initially that progresses to knee instability and pain in the medial and lateral joint line as well as increased volume and functional limitation. After diagnostic studies, it was decided to perform diagnostic-therapeutic arthroscopy and continued close follow-up for associated pathology.</p>","PeriodicalId":101296,"journal":{"name":"Acta ortopedica mexicana","volume":"37 5","pages":"302-308"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139934995","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}