Acta ortopedica mexicana最新文献

{"title":"[Revision surgery of anterior cruciate ligament plasty].","authors":"J M Busto-Villarreal, J G Prado-Peláez, J D Alfaro-Meza","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>anterior cruciate ligament injuries (ACL) continue increasing in frecuency in the general population and sportmen who practice soccer and american football where we can locate 53% of the total of cases, the annual incidence is 70 per 100,000 persons. The incidence of this injuries has being increasing in women probably of the increase of the participation in such sports.</p><p><strong>Objective: </strong>to document the causes of anterior cruciate ligament (ACL) plasty failure, as well as the diagnosis, surgical technique, and postoperative care of a revision ACL plasty surgery.</p><p><strong>Material and methods: </strong>a search for relevant information, original research articles, clinical trials, and reviews in indexed journals was performed.</p><p><strong>Results: </strong>anterior cruciate ligament injuries continue to increase among the general population and athletes who play soccer and American soccer mainly, in this population group we found 53% of the total cases. The gold standard for treatment is arthroscopic reconstruction of the ligament. ACL reconstruction surgery has good results, with an estimated 75-90% success rate. Long-term failures of anterior cruciate ligament repair represent 5-25%. Among the factors associated with this failure are technical errors, traumatic antecedents, biological factors, among others.</p><p><strong>Conclusions: </strong>in ACL revision surgery good results can be achieved with respect to graft stability, return to play and functional stability of the knee, but the results are generally inferior to those of primary ACL reconstruction.</p>","PeriodicalId":101296,"journal":{"name":"Acta ortopedica mexicana","volume":"38 2","pages":"105-108"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141089580","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":"Volar dislocation of the metacarpophalangeal joint of the thumb: open reduction and repair of the ulnar collateral ligament. A case report.","authors":"R Maroto-Rodríguez, M Tibau-Alberdi, J Sánchez-González","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>metacarpophalangeal dislocations of the thumb are not very frequent injuries, it is necessary to know the anatomy of the region to know possible causes of interposition that prevent a closed reduction of this pathology.</p><p><strong>Case presentation: </strong>we present the case of a 75-year-old woman with a post-traumatic metacarpophalangeal dislocation of the thumb that required open reduction and surgical repair. In this procedure, we performed reduction of the dislocation, mobilization of the interposed structures, repair of the capsule and reinsertion of the ulnar collateral ligament. The early mobilization protocol helped to obtain very good results.</p><p><strong>Conclusion: </strong>it is imperative to consider possible associated injuries during the acute phase to achieve optimal short, medium, and long-term outcomes for our patients. A comprehensive and proactive approach to diagnosis and treatment is vital in effectively addressing this pathology and minimizing its potential sequelae.</p>","PeriodicalId":101296,"journal":{"name":"Acta ortopedica mexicana","volume":"38 2","pages":"119-122"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141089599","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":"[Treatment of osteitis pubis: arthrodesis with a new technique regarding two cases and review of the literature].","authors":"J Olucha-Puchol, J R Rodríguez-Collell, P Renovell-Ferrer","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>pain in the pubic symphysis, even if studied in athletes, still sets out diagnostic and therapeutic challenges in other patient groups. Within this context, refractory osteorthritis of the pubic symphysis presents itself as an issue lacking clear therapeutic consensus.</p><p><strong>Material and methods: </strong>two women over 65 years old and presenting osteoarthritis of the pubic symphysis were evaluated. Following unsuccessful conventional therapies, arthrodesis via subpubic plate, wire suture and autologous graft from the iliac crest was performed.</p><p><strong>Results: </strong>after a one-year of following, both patients experienced clinical and radiographic improvement. Bone arthrodesis was achieved without significant complications, proving to be a viable surgical option.</p><p><strong>Conclusion: </strong>this study supports the medium and long-term efficacy of arthrodesis of the pubic symphysis in refractory cases of osteoarthrisis. Therefore, the technique can be considered a surgical option in the management of said condition.</p>","PeriodicalId":101296,"journal":{"name":"Acta ortopedica mexicana","volume":"38 2","pages":"123-128"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141089594","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":"[Partial exchange of components in chronic hip infection].","authors":"W F Martínez, F Tillet, E J Bochatey, F A Lopreite","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>one- or two-stage total revision is considered the gold standard for the treatment of hip arthroplasty with chronic infection. However, during the removal of a fixed prosthetic component, the host bone may be damaged, making definitive prosthetic reimplantation difficult.</p><p><strong>Objective: </strong>we present a series of patients treated for chronic periprosthetic hip infection with preservation of one fixed component.</p><p><strong>Material and methods: </strong>this study included 12 patients with hip arthroplasty and chronic periprosthetic infection scheduled for one or two-stage partial replacement with retention of a fixed component between June 2015 and January 2021. The minimum follow-up period was 2 years (mean, 4.08 years). None of the 12 patients in this series was lost to follow-up. We evaluated the evolution through clinical examination, Harris Hip Score, laboratory and radiological studies.</p><p><strong>Results: </strong>at a mean follow-up of 4.08 years after prosthetic reimplantation, two of the 12 patients had recurrence of infection (16.6%), and the mean Harris hip score reached 63.6 points at the last follow-up assessment.</p><p><strong>Conclusions: </strong>fixed implant preservation may be an acceptable option for patients with chronic periprosthetic hip infection when removal of the fixed component results in significant bone loss compromising future reimplantation. However, more studies are required on this treatment method.</p>","PeriodicalId":101296,"journal":{"name":"Acta ortopedica mexicana","volume":"38 2","pages":"95-100"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141089576","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 with low grade chondrosarcoma and liposarcoma components. A rare histologic variant. Case report and literature review.","authors":"E Estrada-Villaseñor, R Pichardo-Bahena, A L Cedeño-Garcidueñas, E A Delgado-Cedillo, N Marín-Arriaga, D A Arguelles-Pérez","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>conventional parosteal osteosarcoma is an uncommon malignant bone tumor, comprising 4% of all osteosarcomas. Although rare, parosteal osteosarcoma is the most common type of osteosarcoma of the bone surface. We present the clinical, histological and imaging characteristics of a rare histologic variant of a parosteal osteosarcoma, review the literature and emphasize the importance of radio-pathological correlation as well as the interpretation of a representative biopsy in order to obtain the correct diagnosis.</p><p><strong>Case report: </strong>a 36-year old woman began her condition one year prior to admission to the hospital with increased volume in the left knee and pain. Image studies showed a juxtacortical heterogeneous tumor localized on the posterior surface of the distal femoral metaphysis. An incisional biopsy was performed, with the diagnosis of a Parosteal Osteosarcoma and a wide surgical resection was undertaken. According to the findings of the surgical specimen, the diagnosis of a Parosteal Osteosarcoma with low grade chondrosarcoma and liposarcoma components was made. The knowledge of this rare parosteal osteosarcoma variant can lead the orthopedic oncologists to avoid overlooking the adipose component and provide adequate surgical margins.</p><p><strong>Conclusion: </strong>we present the clinical, histological and imaging characteristics of a Parosteal Osteosarcoma with low grade liposarcoma and chondrosarcoma components.</p>","PeriodicalId":101296,"journal":{"name":"Acta ortopedica mexicana","volume":"38 2","pages":"113-118"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141089598","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":"[Utility of topical vancomycin application in the prevention of surgical site infection of the lumbosacral spine].","authors":"F Revilla-Pacheco, L Rivera-May, S Manrique-Guzmán, T Herrada-Pineda, I Hoyo, J Franco-Granillo, A K Perez-Vazquez, M J Wilches-Dávalos","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>surgical site infections (SSI) remain a significant cause of morbidity and mortality and one of the most representative causes of nosocomial infections. The use of intrawound vancomycin in lumbar spine surgery is a potential prophylactic measure against SSI; however, evidence regarding its efficacy is contradictory. Our study was designed to research if intrawound vancomycin significantly prevents SSI in lumbar spine surgery.</p><p><strong>Material and methods: </strong>this is a randomized, double-blinded, controlled clinical trial; 233 patients who underwent lumbar spine surgery, were randomly assigned to a group in which intrawound vancomycin was instilled in the incision before closure (109), or to a control group (114). The main outcome is the presence of SSI; we determined its prevalence and searched for difference between groups for association between SSI and independent variables.</p><p><strong>Results: </strong>global SSI prevalence was 1.8%, in the experimental group was 0.9%, in the control group was 2.6%. There was no significant difference between these values, p = 0.622. The relative risk of SSI in the experimental group was 0.35 (95% CI 0.037-3.30), that of the control group was 2.87 (95% CI 0.30-27.16). The number needed to treat is 58.3. We did not find a significant association between the independent variables studied and the appearance of SSI.</p><p><strong>Conclusions: </strong>we did not find a significant difference in the prevalence of SSI between groups nor a significant association between SSI and independent variables.</p>","PeriodicalId":101296,"journal":{"name":"Acta ortopedica mexicana","volume":"38 2","pages":"73-81"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141089596","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":"[Evaluation of factors associated with major hemorrhage in patients undergoing primary total hip arthroplasty].","authors":"J Palmero-Picazo, J Lassard-Rosenthal, E A Ríos-Zavala","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>the use of blood transfusions leads to increased hospital costs and an increased risk of medical complications and death. Therefore, it is necessary to study the incidence of major bleeding events and the factors associated with these outcomes in patients undergoing primary total hip arthroplasty (THA).</p><p><strong>Material and methods: </strong>observational, longitudinal and prospective study, carried out at the High Specialty Medical Unit of Traumatology and Orthopedics of Lomas Verdes of the Mexican Institute of Social Security, in the Joint Replacement Service, in the period from March 1, 2020 to July 1, 2020.</p><p><strong>Results: </strong>the incidence of major bleeding in patients undergoing primary THA was 84.8%, when considering two criteria: a decrease in hemoglobin 2 g/dl and the need for transfusion 2 units of red blood cells. This figure increased to 87.1% when also including trans-surgical bleeding at its 75th percentile, equivalent to 500 ml. Transfusion of at least one unit of red blood cells during surgery was performed in 68% of patients. Trans-surgical bleeding reached a maximum of 1,900 ml, with a 75th percentile of 500 ml. Unlike other studies, in our institution, female gender did not prove to be a significant risk factor for major bleeding.</p><p><strong>Conclusion: </strong>it is advisable to analyze the procedures and particularities of THA surgery that may be associated with a lower risk of bleeding in older patients.</p>","PeriodicalId":101296,"journal":{"name":"Acta ortopedica mexicana","volume":"38 2","pages":"88-94"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141089589","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":"[Epiphyseal fracture of the second metatarsal in adolescents: report of two cases].","authors":"G A Pons-Carrera, R Capdevila-Leonori, G Fraind-Maya","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Epiphyseal fractures of the metatarsal head are a rare entity specially as an isolated injury and is rarely seen in patients with skeletal immaturity. Due lack of documentation for this type of fracture, the treatment of choice is uncertain. The purpose of the present study is to present two cases and treatment of epiphyseal fracture of the second metatarsal head, to our knowledge there are no publications for this injury.</p>","PeriodicalId":101296,"journal":{"name":"Acta ortopedica mexicana","volume":"38 2","pages":"109-112"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141089587","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":"[National competitive bidding analysis of osteosynthesis materials in pediatric patients with femur fractures].","authors":"A D Navarro-Vergara, A S Portillo-Candia, C L Sánchez-Silva, R A Arréllaga-Alonso, A A Portillo-Vanni","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>health promotion policy requires the identification of barriers to the adoption of public policies. Paraguay's national healthcare system is inequitable, expensive, and inefficient. The Ministry of Public Health and Social Welfare (MSPyBS) is the entity responsible for covering the needs of a significant portion of the population. In January 2022, the MSPyBS financed the purchase of titanium elastic nails through a National Public Tender for Osteosynthesis Materials (LPN 02/22) to provide them for free in the pediatric service. Using research as a tool, we seek to analyze the impact of the implementation of LPN 02/22 at the Trauma Hospital, believing that this action would help streamline administrative and bureaucratic processes, making them more efficient with the assistance of the hospital's human resources.</p><p><strong>Material and methods: </strong>a retrospective, analytical, and comparative study conducted at a high-complexity trauma center in Asunción, Paraguay. Patients aged 4 to 14 years with an indication for stabilization with elastic nails were included. Demographic data, the mechanism of injury, time elapsed from hospital arrival to surgical treatment, length of hospital stay, and the average hospital cost were analyzed based on the daily expense of pediatric patient hospitalization.</p><p><strong>Results: </strong>52 patients, divided into 25 cases in 2021 before implementation and 27 cases after implementation. The time elapsed from hospital arrival to definitive treatment was six days in the pre-implementation period, with an average stay from admission to discharge of 7.4 days. After implementation, the time from hospital arrival to definitive treatment was 4.3 days, and the average discharge time for the Post group was six days. The potential savings per patient amount to 332 dollars, offset by the institution's implant supply cost of 197 dollars, resulting in an approximate savings of 135 dollars per patient for the ministry.</p><p><strong>Conclusions: </strong>we view the implementation of free titanium elastic nails for pediatric femur fracture patients positively. We encourage the institution to continue with similar policies and strive to achieve even greater benefits for users.</p>","PeriodicalId":101296,"journal":{"name":"Acta ortopedica mexicana","volume":"38 1","pages":"10-14"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140858192","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":"[Medial discoid meniscus in a pediatric patient. Case report and review of the literature].","authors":"I F Rodríguez-Rodríguez, P Navarro-Torres-Arpi, A Dryjanski-Lerner, J G Gómez-Mont-Landerreche, G A Levy-Holden, F Gil-Orbezo","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Discoid meniscus is a congenital morphological variant of the meniscus, which tends to occur more frequently in its lateral form than in the medial form. This anomaly is characterized by central hypertrophy of the meniscus and a larger diameter than the normal meniscus, resulting in an abnormal shape and greater coverage of the tibial plateau. The clinical presentation of this condition varies depending on the stability of the meniscus. In pediatric patients, in particular, it is common to experience progressive and atraumatic symptoms, such as pain and limited mobility. Diagnosis is based on imaging studies, with magnetic resonance imaging being the preferred tool, where the \"bowtie sign\" is a classic finding. Surgery is recommended for symptomatic patients, with a focus on preserving the peripheral portion of the meniscus. Saucerization is the most commonly used technique, followed by stability assessment to determine if additional procedures are required. In this case, a 9-year-old patient with a medial discoid meniscus presented symptoms following trauma. Despite this atypical presentation, a successful outcome was achieved through arthroscopic surgery, underscoring the importance of accurate diagnosis and proper management of this condition in pediatric patients. Understanding the anatomical and pathophysiological characteristics of the discoid meniscus is essential for an effective therapeutic approach.</p>","PeriodicalId":101296,"journal":{"name":"Acta ortopedica mexicana","volume":"38 1","pages":"52-56"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140868908","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}