Acta ortopedica mexicana最新文献

{"title":"Arthrodilation: a treatment algorithm as a conservative management option for adhesive capsulitis.","authors":"A Flores-Villalobos, F Cruz-López, G Cuevas-Rodríguez, J Hernández-León","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>the management of adhesive capsulitis (AC) remains a topic of debate among orthopedic surgeons, with a wide variation in the literature. Conservative treatment relies as the first-line option as clinical studies report positive outcomes. However, there is variability in the effectiveness of different treatment modalities.</p><p><strong>Material and methods: </strong>this study aimed to analyzed functional and clinical outcomes of patients with AC who underwent the arthrodilation protocol, including three ultrasound-guided injections administered on a weekly basis: two corticosteroid injections and one injection of hyaluronic acid combined with corticosteroids. Additionally, patients received a specific rehabilitation therapy. Visual analogue scale (VAS), the university of California-Los Angeles shoulder score (UCLA) and Constant-Murley score were assessed before treatment and after 3-month follow-up period.</p><p><strong>Results: </strong>23 patients were included, receiving the same treatment protocol with a mean onset of symptoms of 4.9 ± 1.7 months. Among these patients, there was a clear predominance of females (65.2%). Age distribution ranged from 39 to 74 years (mean = 56) indicating that individuals in their mid-50s were more susceptible to developing this condition. Furthermore, a slight majority (52.2%) exhibited AC in their right shoulder. VAS significantly decreased (-6.09 ± 1.9 [p 0.05]). Similarly, UCLA score (10.9 ± 2.9 to 31.7 ± 2.2) and Constant-Murley score (22.3 ± 6.1 to 62.0 ± 6.2) improved significantly. Pre-to-post treatment evaluation showed improvement in both UCLA (mean = 20.8 ± 2.9 [p 0.05]) and Constant-Murley (mean = 39.7 ± 9 [p 0.05]).</p><p><strong>Conclusion: </strong>arthrodilation protocol demonstrated promising results, with patients achieving good to excellent outcomes and safely resuming their regular daily activities within a short-term follow-up period. These findings provide support for arthrodilation as a viable conservative management option and contribute valuable insights to the ongoing research aimed at identifying optimal treatment approaches for adhesive capsulitis.</p>","PeriodicalId":101296,"journal":{"name":"Acta ortopedica mexicana","volume":"37 5","pages":"255-263"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139934997","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":"Superior pubic ramus fixation with titanium elastic nails-surgical technique.","authors":"M A Altamirano-Cruz, L Baldini-García, P Jorba-Elguero, S Q Rodríguez-Lara","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Superior pubic rami fractures are commonly associated with a posterior pelvic ring disruption. It has been shown that fixing both the anterior pelvic arch and the posterior ring increases stability and enhances clinical results. Several techniques for fixing the superior pubic rami exist, and multiple studies showed that minimally invasive methods decrease wound-related complications, with the advantage of preserving soft tissues. We describe a surgical procedure to treat simple pubic rami fractures associated with posterior pelvic ring disruptions by placing an intramedullary elastic titanium nail (TEN). We propose this technique as an alternative fixation method for superior pubic rami fractures.</p>","PeriodicalId":101296,"journal":{"name":"Acta ortopedica mexicana","volume":"37 5","pages":"276-282"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139934998","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":"[Clinical experience on the management of post-traumatic bone defects of long bones treated with the membrane induction technique].","authors":"J Quiroz-Williams, S Gaytán-Fernández, R G Barragán-Hervella, S Morgan-Padrón, O Rojas-Durán, J P Martínez-Asención, I O Castillo-Ramírez","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>bone defects drastically alter the patient's quality of life, and can produce serious sequelae such as dysfunctional shortening, angular deformity, joint stiffness and irreversible gait disorder.</p><p><strong>Objective: </strong>to describe the experience of managing post-traumatic bone defects of long bones treated with the membrane induction technique.</p><p><strong>Material and methods: </strong>retrospective observational study of patients with bone defects greater than 3 cm in diaphyseal pseudoarthrosis of long bones, who underwent the Masquelet technique. Period taken from January 2019 to January 2021. All patients underwent vigorous debridement and stabilization of the fracture, to then place the cement spacer. Spacer removal was at 4-6 weeks. The degree of consolidation was assessed, as well as the evolution of the treatment.</p><p><strong>Result: </strong>25 patients were included in the study; the mean age was 36.8 ± 8.9 years. Diameter of bone losses was 3 to 10 cm (84%) and > 10 cm (16%). Bone consolidation occurred in patients with a defect < 10 cm (16%). 32% of patients presented some complication.</p><p><strong>Conclusions: </strong>bone union was achieved only in a few patients with defects smaller than 10 cm, requiring alternative procedures in most cases. Proper selection of patients is required.</p>","PeriodicalId":101296,"journal":{"name":"Acta ortopedica mexicana","volume":"37 5","pages":"264-269"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139935028","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":"[Arthroscopic biceps tenodesis with a «relaxed» technique.Clinical and radiological results of a prospective cohort].","authors":"N Zanolli, N Bernal, N Rojas, A Calvo, P Valenti, F Reinare","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>in the treatment the long head of the biceps tendon (LHBT) pathology, the «relaxed tenodesis» is an arthroscopic articular suprapectoral tenodesis that seeks to lower the tension on the LHBT, and therefore, theoretically avoid persistent pain.</p><p><strong>Objective: </strong>to assess clinical and radiological results of «relaxed» tenodesis in a prospective cohort of patient with work related illness.</p><p><strong>Material and methods: </strong>prospective cohort, 54 shoulders with «relaxed» tenodesis performed with an intra-articular interference screw by the same surgeon, from October 2014 to 2018, in a level 1 trauma center. Demographic, clinical, functional and radiologic results were analyzed. On 6 months follow-up, a sonographic and clinical assessment was performed.</p><p><strong>Results: </strong>mean age 49 ± 9, mean follow-up 16 ± 4 months. The main diagnosis was a rotator cuff tear in 79%, primary biceps pathology in 10% and other pathologies in 11%. At the end of follow-up, the cohort showed active anterior elevation 157.7 ± 22.7, external rotation 47 ± 16.6, median internal rotation T12, Constant Score 83 ± 12.05 points, subjective shoulder value 83 ± 12.97% and pain visual analogue scale 1.4 ± 1.7 points. One patient had a biceps tear and two had cosmetic arm asymmetry. On ultrasound 98% had the LHBT in situ and 10% had inflammatory changes on the bicipital groove. There were complications in 21% of the sample.</p><p><strong>Conclusions: </strong>«relaxed biceps tenodesis» is a technique that shows good clinical, functional and sonographic results, with low failure rate.</p>","PeriodicalId":101296,"journal":{"name":"Acta ortopedica mexicana","volume":"37 5","pages":"283-289"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139935025","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":"[Bibliographic review of the efficacy of platelet-rich plasma treatment in lumbar disc herniation].","authors":"A L Guerrero-Molina, M G Cruz-Álvarez, S Tenopala-Villegas","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Platelet-rich plasma (PRP) is an autologous blood product containing growth factors and proteins, widely employed in the clinical setting for tissue repair. Robust evidence in basic science literature has facilitated clinical research involving PRP for patients with disc disease and lumbar pain. Degenerative disc disease (DDD) has been identified as a significant contributor to lower back pain, with approximately 40% of patients under 30 and 90% of those over 50 experiencing lumbar pain showing MRI findings consistent with degenerative changes in intervertebral discs. Regenerative medicine within the disc has primarily been studied in patients with chronic, untreatable lumbar pain. <b>Objective:</b> to understand the available evidence regarding the efficacy of PRP in lumbar disc herniation. By understanding the scientific evidence supporting PRP as a lumbar disc herniation treatment, a research project can be developed, providing the theoretical foundation for implementing this therapy in the Mexican population. A search was conducted using PUBMED, ClinicalKey (Elsevier), Medscape, Science Direct, and Google Scholar databases. <b>Conclusions:</b> despite promising results in several studies on intradiscal PRP injection, small sample sizes and non-standardized graft preparation procedures have hindered these research efforts.</p>","PeriodicalId":101296,"journal":{"name":"Acta ortopedica mexicana","volume":"37 5","pages":"290-295"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139935027","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":"[Parosteal osteosarcoma of the femur and salvage surgery with intercalary prosthesis. Experience in a third level unit and surgical technique].","authors":"M Vilchis-Ramírez, F A Álvarez-Martínez, M E Tena-Sanabria, G Fuentes-Herrera","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>parosteal osteosarcoma is an extramedullary malignant bone tumor in which cells produce osteoid, represents less than 5% of all osteosarcomas, it occurs predominantly in women between the second and fourth decade of life. It is often located in the distal region of the femur and proximal tibia. Clinically it presents with increased volume and thigh or knee pain. Due to its low incidence and clinical features, a clinical case of femoral parosteal osteosarcoma is presented, with description of the surgical technique performed.</p><p><strong>Case report: </strong>a 14-year-old female presented with a 6-month history of increased volume and right thigh pain. Radiological studies revealed a bone lesion with malignant characteristics, for which she was sent to third-level hospital where oncology study protocol was set up; consisting in two percutaneous biopsies of the lesion with Jamshidi needle, which were histopathology reported as negative for malignant cells. The pulmonary high-resolution computed tomography showed metastasis and a Tc-99m MDP bone scintigraphy showed increased osteoblastic activity in the right femoral shaft. Given the results, is confirmed the need of en-bloc resection and intercalary prosthesis implantation with adjuvant chemotherapy.</p><p><strong>Conclusion: </strong>the intercalary prosthesis is a suitable therapeutic option in limb-salvage surgery for patients with femoral parosteal osteosarcoma.</p>","PeriodicalId":101296,"journal":{"name":"Acta ortopedica mexicana","volume":"37 5","pages":"309-313"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139934994","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":"[Reconstruction of painful neuroma of superficial branch of radial nerve after first dorsal compartment release: presentation of two cases].","authors":"J L Martínez-Peniche, E Hernández-Méndez-Villamil, P J Haquet-Guerrero, A J Espinosa-Gutiérrez","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>nerve lesions are potentially catastrophic injuries. They can cause motor loss, severe pain and neuroma formation. The superficial branch of the radial nerve is at risk during first dorsal compartment release, its injury can cause neuroma formation. Autologous nerve reconstruction is the gold standard for treatment of small nerve gaps.</p><p><strong>Cases presentation: </strong>we present two cases of adult women (F/47 y F/51) with a prior history of first dorsal compartment release in another institution. Both patients developed debilitating neuropathic pain, as well as allodynia in the surgical site. They were diagnosed with superficial radial nerve neuroma. Oral medication and physical therapy was attempted without success. Surgical exploration and autologous nerve reconstruction was performed. Both patients had excellent relief of pain from visual analogue scale (VAS 9-10 to VAS 1-2). Postoperatively, both patients recovered partial sensitivity to pain in the zones distal to the repair.</p><p><strong>Conclusions: </strong>neuromas are feared complications that occur with unrecognized nerve lesions during surgery, they are difficult to treat and require multidisciplinary management. These two cases demonstrate that autologous nerve reconstruction is an excellent option for recovering function in small gaps of nerve tissue.</p>","PeriodicalId":101296,"journal":{"name":"Acta ortopedica mexicana","volume":"37 5","pages":"314-317"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139934996","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":"[Dislocation due to injury with trajectory in the scaphoid-trapezoid-trapezoid periscaphoid-perisemilunar bones. Case report and literature review].","authors":"G R Gutiérrez-Grajales, J G Herrera-Tenorio, G H Córdoba-Olivares","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>dislocations of carpal bones without associated fractures are considered a rare injury, the most common mechanism of injury being axial loading with wrist in extension plus ulnar deviation. The literature reports a wide variety of complex carpal injuries, even so, it is possible to identify previously undescribed injuries.</p><p><strong>Objective: </strong>to present an atypical case of a patient with an injury to the midcarpal stabilizing mechanism and the stabilizing mechanism of the proximal row of the wrist following trauma to the hand that required carpectomy as definitive surgical treatment.</p><p><strong>Presentation of case: </strong>a 48 year old male patient is presented who is admitted to our hospital unit after presenting injury to the left hand after being run over by a motor vehicle, with axial load mechanism, presenting deformity in the left thoracic extremity, fracture of the proximal metaphysis of the second phalanx of the third finger as well as dislocation of the proximal interphalangeal joint, with traumatic amputation of the second phalanx of the fourth finger plus extensor injury in zone V of the fifth finger with loss of skin coverage of the fourth and fifth finger, attending our hospital unit 24 hours after the injury.</p><p><strong>Conclusions: </strong>carpal bone dislocations are an orthopedic emergency, with 20% going unnoticed in trauma centers. Early closed reduction is the initial treatment to avoid severe complications, however, surgical treatment is the gold standard for fixation. Carpectomy is considered a mostly adequate sequelae management treatment, however it is well accepted for complex injuries to the wrist stabilization mechanisms, as it can be performed in a short surgical time and early rehabilitation can be initiated and functional ranges of motion can be achieved with low sequelae.</p>","PeriodicalId":101296,"journal":{"name":"Acta ortopedica mexicana","volume":"37 5","pages":"296-301"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139934992","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":"[Association of morphological variables of acromion type with rotator cuff lesions by nuclear magnetic resonance].","authors":"C Murillo-Nieto, L A Valverde-Galindo, J Meza-Flores","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>the acromion is a small portion of the scapula that extends towards the anterior region from the spine of the scapula. Traditionally, the acromion is classified by the shape of its inferior surface in a sagittal plane. Acromial morphology has been found to be related to rotator cuff injury.</p><p><strong>Objective: </strong>to determine the association between the type of acromion with a higher incidence of rotator cuff rupture. Study population: patients who come to the Traumatology and Orthopedics Service of a third level hospital at Monterrey, Mexico, due to a painful shoulder and who have undergone a simple magnetic resonance of the shoulder.</p><p><strong>Material and methods: </strong>a cross-sectional, retrospective and descriptive study was carried out, in which 273 magnetic resonance studies were reviewed in patients who met the inclusion criteria. The type of acromion was reported according to the morphological classification in type I to IV and the state of the rotator cuff: without rupture, partial rupture or complete rupture, making a comparison between right and left shoulder.</p><p><strong>Results: </strong>in this study we found a value of p = 0.473 which concludes that there is no relation between the type of acromion and the injury of the rotator cuff.</p><p><strong>Conclusion: </strong>in the present study, unlike what has been published in the literature, it was found that type II acromion was the one that was associated in most cases with a rotator cuff tear.</p>","PeriodicalId":101296,"journal":{"name":"Acta ortopedica mexicana","volume":"37 4","pages":"203-206"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139907273","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":"[Atlantoid assimilation: malformation, compensation or deformity. Is it part of basilar invagination?]","authors":"J M Alemán-Iñiguez, P D Astudillo-Pacheco, J S De la Torre","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>atlas assimilation can occur alone or in association with other craniocervical junction malformations and deformities. The etiological and pathological mechanisms are not clear.</p><p><strong>Case presentation: </strong>patient in her sixth decade of life, who was treated at the \"Eugenio Espejo\" Hospital, with asymmetric pyramidal symptoms after a low-energy kinetic fall. The condition completely reverted with conservative management. The patient is currently under periodic observation.</p><p><strong>Conclusion: </strong>the atlas assimilation, a congenital malformation, often asymptomatic; it is part of an embryological compensation when it is associated with other malformations. The appearance of deformity is necessary to reach atlantoaxial instability that it is not early. The knowledge of the concepts and distinction of the craniocervical junction abnormalities allows to indicate the best treatment in order to obtain the most suitable results with the individualization of each case.</p>","PeriodicalId":101296,"journal":{"name":"Acta ortopedica mexicana","volume":"37 4","pages":"237-243"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139907274","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}