Revista Espanola de Cirugia Ortopedica y Traumatologia最新文献

{"title":"Pendiente tibial en reconstrucción de ligamento cruzado anterior: ¿cuándo debe corregirse?","authors":"T. Pineda,&nbsp;D.H. Dejour","doi":"10.1016/j.recot.2025.11.032","DOIUrl":"10.1016/j.recot.2025.11.032","url":null,"abstract":"<div><div>The tibial slope has been identified as a key anatomical factor influencing anteroposterior knee stability. Increased slope values have been linked to greater anterior tibial translation, higher stress on the anterior cruciate ligament and an elevated risk of graft failure following reconstruction. This review aims to examine the current evidence and ongoing controversies regarding the clinical relevance of tibial slope, measurement methods, and surgical correction indications.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"70 4","pages":"Pages 348-351"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147784523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Translated article] Soft tissue infections during a climate emergency: Impact of the October 2024 cut-off low (DANA) event in Valencia","authors":"A. Amaya Franco,&nbsp;L. Pelegrín Dura,&nbsp;D. Torres-Perez,&nbsp;J. Tecles Peydró,&nbsp;D. Martínez López,&nbsp;J. Antonio Blas Dobón,&nbsp;J. Luis Rodrigo Pérez","doi":"10.1016/j.recot.2026.03.019","DOIUrl":"10.1016/j.recot.2026.03.019","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introduction&lt;/h3&gt;&lt;div&gt;The objective of this study is to provide an epidemiological description of soft tissue infections caused by traumatic injuries treated at a tertiary hospital in Valencia during the floods resulting from the cut-off low (&lt;em&gt;depresión aislada en niveles altos&lt;/em&gt; [DANA]) that occurred in October 2024. The study also addresses the therapeutic approach and associated complications.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Materials and methods&lt;/h3&gt;&lt;div&gt;We conducted a retrospective, single-centre, descriptive study evaluating musculoskeletal soft tissue infections in patients with an emergency department diagnosis of “DANA-related injury” who required hospitalisation in the Department of Orthopedic Surgery and Traumatology of a tertiary care hospital. The study period extended from October 30th to November 14th, 2024.&lt;/div&gt;&lt;div&gt;A total of 41 admissions (14%) were recorded out of the 289 patients treated in the trauma emergency department for wounds and closed fractures. Patients who were admitted with fractures only, without associated wounds, were excluded, resulting in a final sample of 31 patients.&lt;/div&gt;&lt;div&gt;All patients underwent emergency surgical intervention, including wound debridement in the operating room, with intraoperative collection of multiple samples sent to the Microbiology Department for etiological identification of micro&lt;/div&gt;&lt;div&gt;organisms, as well as analysis of their antibiotic susceptibility and resistance patterns. Until antibiogram results were available, all patients received empirical broad-spectrum intravenous antibiotic therapy.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Of the 41 admitted patients, 10 were excluded due to the absence of open wounds (closed fractures), resulting in a final cohort of 31 patients with soft tissue injuries, 10 of whom (32%) also presented with long bone fractures. Among the 31 patients, 21 were male (67%) and 10 female, with a mean age of 54.7 years. The most frequent anatomical location of the wounds was the lower extremities. The most commonly isolated microorganisms in culture were &lt;em&gt;Aeromonas hydrophila&lt;/em&gt; (7 cases), &lt;em&gt;Escherichia coli&lt;/em&gt; (7 cases), and &lt;em&gt;Klebsiella pneumoniae&lt;/em&gt; (5 cases), with 56.5% of cases presenting polymicrobial infections.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;Soft tissue infections secondary to traumatic injuries sustained during the flooding caused by the October 2024 DANA event posed a significant clinical challenge to Orthopedic and Trauma Surgery Services. Flood-related soft tissue infections are characterised by a high prevalence of polymicrobial infections, frequently involving Gram-negative and multidrug-resistant pathogens. These findings underscore the need for early diagnosis and the initiation of broad-spectrum antimicrobial therapy to reduce the risk of complications and the need for multiple surgical interventions. This study highlights the importance of prompt, multidisciplinary, and protocol-driven responses to extreme weather ","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"70 4","pages":"Pages T309-T314"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147784555","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Translated article] Mid- to long-term radiological and functional outcomes after calcaneoplasty with Achilles tendon reinsertion for insertional tendinopathy","authors":"C. López-Hernández,&nbsp;M. González-Alonso,&nbsp;R. Vázquez-Crespo,&nbsp;J. Zhang-Chen,&nbsp;S. Tejero","doi":"10.1016/j.recot.2026.03.006","DOIUrl":"10.1016/j.recot.2026.03.006","url":null,"abstract":"<div><h3>Background</h3><div>Insertional Achilles tendinopathy (IAT) significantly impairs function and quality of life, particularly in young athletes. When conservative treatment fails, surgical options include Zadek osteotomy and calcaneoplasty with tendon reinsertion. Although certain preoperative radiological parameters, such as calcaneal inclination and tuberosity length, may influence functional outcomes, comprehensive studies analyzing their impact on calcaneoplasty results remain limited.</div></div><div><h3>Objectives</h3><div>To evaluate the mid- and long-term effectiveness of calcaneoplasty with Achilles tendon reinsertion in patients with refractory IAT and to assess the relationship between preoperative radiological parameters (calcaneal inclination) and postoperative functional outcomes.</div></div><div><h3>Methods</h3><div>A retrospective analysis was conducted on 38 patients who underwent calcaneoplasty with reinsertion between 2011 and 2024. Mean follow-up was 22 months (IQR: 71) with a median age of 55 years (IQR: 10). Preoperative radiological parameters (Ruch, Fowler-Phillips, CLA, BRINK angles, among others) and functional scales (VAS, AOFAS, EFAS, VISA-A, Tegner) were assessed before and after surgery.</div></div><div><h3>Results</h3><div>Significant postoperative improvement was observed across all functional scales (<em>p</em> <!-->&lt;<!--> <!-->.001, Wilcoxon signed-rank test). Mean VAS pain scores decreased from 8.75<!--> <!-->±<!--> <!-->1.27 to 1.71<!--> <!-->±<!--> <!-->2.02, while AOFAS scores increased from 38.36<!--> <!-->±<!--> <!-->14.55 to 88.82<!--> <!-->±<!--> <!-->11.95. EFAS and VISA-A scores improved by 16.46 and 45.59 points, respectively. Tegner scores showed an increase of 50.48 points in athletic capacity. Two complications (5.26%) were reported: one suture granuloma and one case of lateral plantar nerve neuralgia, both successfully managed conservatively. No significant correlation was found between calcaneal inclination or tuberosity length and postoperative functional outcomes. Strengths of the study include a comprehensive functional assessment and consistent follow-up, while limitations include the retrospective design and use of two reinsertion techniques (single- and double-row), with no significant differences in outcomes.</div></div><div><h3>Conclusion</h3><div>Calcaneoplasty with Achilles tendon reinsertion is effective for refractory insertional Achilles tendinopathy, providing sustained mid- and long-term benefits. Preoperative radiological parameters were not significantly associated with postoperative functional outcomes.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"70 4","pages":"Pages T289-T295"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147784601","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Eficacia a corto y medio plazo de las ondas de choque extracorpóreas frente a las infiltraciones de corticoides en el tratamiento del dedo en resorte: estudio comparativo prospectivo no aleatorizado","authors":"A.H. Suárez Cabañas,&nbsp;M. Ramírez Sánchez,&nbsp;A. Álvarez Jiménez,&nbsp;M. Santana Bañolas,&nbsp;J.M. González Martín,&nbsp;J.M. García Castellano","doi":"10.1016/j.recot.2025.12.005","DOIUrl":"10.1016/j.recot.2025.12.005","url":null,"abstract":"<div><h3>Background and objective</h3><div>Trigger finger is a common condition managed through various conservative approaches. This study aimed to compare the short- and mid-term efficacy of radial extracorporeal shock wave therapy (rESWT) versus corticosteroid injection (INF) in patients with moderate trigger finger.</div></div><div><h3>Material and methods</h3><div>A non-randomized prospective comparative study was conducted with 42 patients diagnosed with Quinnell grade<!--> <!-->II-III trigger finger, assigned to treatment groups (rESWT vs INF) by sequential sampling. The following outcomes were assessed at baseline, 6<!--> <!-->weeks, and 6<!--> <!-->months: pain (VAS), functionality (QuickDASH and Roles &amp; Maudsley), stiffness/severity (Quinnell), and grip strength (hand dynamometry). The primary variable was main pain improvement at 6<!--> <!-->months. Statistical analysis included nonparametric tests (Wilcoxon, Mann-Whitney U), chi-square/Fisher tests for qualitative variables, and paired regression for temporal changes (α<!--> <!-->=<!--> <!-->0.05).</div></div><div><h3>Results</h3><div>Both groups showed significant improvements in all evaluated parameters. At short-term follow-up (6 weeks), INF achieved a faster pain reduction, whereas at mid-term (6<!--> <!-->months), rESWT demonstrated sustained benefits in pain, stiffness, and functionality, with a higher proportion of «excellent-good» outcomes on the Roles &amp; Maudsley scale (<em>P</em> <!-->&lt;<!--> <!-->.05). Grip strength increased similarly in both groups. No major adverse events were reported.</div></div><div><h3>Conclusions</h3><div>rESWT and INF are both effective treatments for trigger finger. INF may be preferred for rapid pain relief, while rESWT provides longer-lasting benefits and represents a useful non-invasive alternative for patients with contraindications to corticosteroids.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"70 4","pages":"Pages 339-347"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147784611","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fracturas de olécranon Mayo IIA tratadas con sutura transósea de alta resistencia: resultados clínicos y radiológicos a largo plazo","authors":"R. García-Elvira,&nbsp;J.A. López Tello,&nbsp;D. Martín Barreda,&nbsp;J. Ríos Guillermo,&nbsp;Á. Fernández-Reinales,&nbsp;A. Combalia,&nbsp;P. Torner","doi":"10.1016/j.recot.2025.11.026","DOIUrl":"10.1016/j.recot.2025.11.026","url":null,"abstract":"<div><h3>Introduction</h3><div>Olecranon fractures are common injuries, especially in the elderly population, in whom conventional osteosynthesis with tension band wiring (TBW) or plating (PF) is associated with high reoperation rates for hardware removal due to intolerance (up to 80% of surgically treated patients in the TBW group and 25% in those treated with PF). High-strength transosseous suture (TBS) has been proposed as an alternative to reduce these complications associated with conventional techniques, although few studies with long-term follow-up exist. The aim of this study was to assess, in the long term, the need for reoperation after the use of TBS in Mayo type IIA olecranon fractures in elderly patients, as well as their clinical and radiological outcomes.</div></div><div><h3>Materials and methods</h3><div>In 2022, a previously published cohort of 29 patients operated on between 2010–2018 using TBS was contacted. The sex distribution was 26 women (89.7%) and 3 men (10.3%). Of these, 19 could be evaluated (12 in person and 7 by telephone), with a mean follow-up of 7.41 years (range: 4,1–11,8 years). The need for hardware removal, joint function using the Oxford Elbow Score (OES) and the Mayo Elbow Performance Score (MEPS), elbow mobility, and radiological findings were analyzed.</div></div><div><h3>Results</h3><div>The mean age of patients at follow-up was 79 years. No patient required hardware removal. Three patients (15.8%) reported mild discomfort, but without functional impact or desire for reoperation. In the patients assessed in person, the mean range of motion was 132° flexion and 5° extension; the mean OES was 47 points and the mean MEPS was 97.1 points, with 83.3% rated as excellent outcomes. All these patients showed radiographic union without signs of post-traumatic osteoarthritis.</div></div><div><h3>Conclusions</h3><div>The high-strength transosseous suture technique appears to be a good alternative to conventional methods, providing reliable fixation, reducing associated complications, and lowering reoperation rates for hardware removal in elderly patients.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"70 4","pages":"Pages 276-282"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147784645","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Translated article] Tibial slope in ACL reconstruction: When should it be corrected?","authors":"T. Pineda ,&nbsp;D.H. Dejour","doi":"10.1016/j.recot.2026.03.016","DOIUrl":"10.1016/j.recot.2026.03.016","url":null,"abstract":"<div><div>The tibial slope has been identified as a key anatomical factor influencing anteroposterior knee stability. Increased slope values have been linked to greater anterior tibial translation, higher stress on the anterior cruciate ligament and an elevated risk of graft failure following reconstruction. This review aims to examine the current evidence and ongoing controversies regarding the clinical relevance of tibial slope, measurement methods, and surgical correction indications.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"70 4","pages":"Pages T348-T351"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147784606","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":"[Translated article] Diabetes mellitus as a risk factor for infection after posterior lumbar arthrodesis: Multivariate analysis of 356 cases","authors":"J.H. Núñez,&nbsp;J. Diego Montenegro,&nbsp;B. Escudero-Cisneros,&nbsp;I. Omiste,&nbsp;D. Bosch García,&nbsp;C. García Cardona","doi":"10.1016/j.recot.2026.03.008","DOIUrl":"10.1016/j.recot.2026.03.008","url":null,"abstract":"<div><h3>Introduction</h3><div>Lumbar spinal fusion is a widely used technique in the treatment of conditions such as lumbar stenosis and degenerative spondylolisthesis. However, acute postoperative infection remains a significant complication. The aim of this study was to identify risk factors associated with a higher incidence of acute infection following posterior lumbar fusion for degenerative pathology.</div></div><div><h3>Material and methods</h3><div>We conducted an observational, retrospective, and analytical study at a single hospital centre. Patients over 18 years of age who underwent instrumented lumbar fusion for lumbar stenosis or degenerative spondylolisthesis between 2017 and 2022 were included. Demographic, clinical, and surgical variables were analysed. A bivariate analysis was followed by a multivariate logistic regression model to identify independent risk factors for acute postoperative infection.</div></div><div><h3>Results</h3><div>A total of 356 patients were analysed, with a mean age of 60.4<!--> <!-->years; 55.6% were male. The overall incidence of acute postoperative infection was 5.9% (21<!--> <!-->cases). Bivariate analysis revealed significant associations with infection for diabetes mellitus (<em>P</em> <!-->=<!--> <!-->.010), hypertension (<em>P</em> <!-->=<!--> <!-->.042), chronic corticosteroid use (<em>P</em> <!-->=<!--> <!-->.001), and surgical duration<!--> <!-->&gt;<!--> <!-->3<!--> <!-->h (<em>P</em> <!-->=<!--> <!-->.028). In the multivariate model, only diabetes mellitus remained a significant independent risk factor (OR: 3.36; 95% CI: 1.22–9.31; <em>P</em> <!-->=<!--> <!-->.019).</div></div><div><h3>Conclusions</h3><div>Diabetes mellitus was identified as the main independent risk factor for acute postoperative infection. This finding highlights the importance of a thorough preoperative assessment of surgical risk in diabetic patients and the need to provide them with adequate information during the informed consent process.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"70 4","pages":"Pages T296-T302"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147784456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Translated article] Influence of prosthetic lateralization on tuberosity healing in reverse shoulder arthroplasty for proximal humerus fractures","authors":"D.J. Gómez,&nbsp;C. Bermeo,&nbsp;G. Viollaz,&nbsp;A. Muratore,&nbsp;R. Durán,&nbsp;G. Teruya,&nbsp;A. Tedeschi,&nbsp;D. Moya","doi":"10.1016/j.recot.2026.04.006","DOIUrl":"10.1016/j.recot.2026.04.006","url":null,"abstract":"<div><h3>Introduction</h3><div>To evaluate the effect of prosthetic lateralization on tuberosity healing following reverse shoulder arthroplasty (RSA) for proximal humerus fractures (PHFs) in older adults.</div></div><div><h3>Material and methods</h3><div>This single-center retrospective study included patients aged &gt;65 years with displaced Neer 3- or 4-part PHFs treated with RSA within four weeks of injury. Patients were allocated according to the global lateralization of the prosthesis: very highly lateralized (VHL; 21.4<!--> <!-->mm, Arrow®, <em>n</em> <!-->=<!--> <!-->53) and lateralized (L; 14.7<!--> <!-->mm, Unique®, <em>n</em> <!-->=<!--> <!-->20). Tuberosity healing was assessed radiographically and classified as anatomic, non-anatomic, or failed consolidation. Statistical analysis was performed using Student's <em>t</em>-test or Mann–Whitney <em>U</em> test for continuous variables, and Chi-square or Fisher's exact test for categorical variables.</div></div><div><h3>Results</h3><div>The final cohort consisted of 73 patients (62 women, 11 men) with a mean age of 76.2<!--> <!-->±<!--> <!-->6.9<!--> <!-->years. Overall tuberosity healing occurred in 60 patients (82.2%), while 13 (17.8%) demonstrated failed consolidation. The L group showed a significantly higher overall healing rate (100%) compared with the VHL group (75.5%; <em>p</em> <!-->=<!--> <!-->.020). Anatomic healing was achieved in 55% of the L group and 28% of the VHL group (<em>p</em> <!-->=<!--> <!-->.020). All failures occurred exclusively in the VHL cohort (24.5%). The overall complication rate was 6.8%, with no significant differences between groups.</div></div><div><h3>Conclusion</h3><div>Very high prosthetic lateralization (&gt;20<!--> <!-->mm) is associated with reduced rates of anatomic tuberosity healing and a higher incidence of failed consolidation, likely due to increased mechanical tension that compromises osteointegration in osteoporotic bone.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"70 4","pages":"Pages T332-T338"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147844122","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Análisis radiológico y funcional a medio-largo plazo tras calcaneoplastia con reinserción del tendón de Aquiles en la tendinopatía insercional","authors":"C. López-Hernández,&nbsp;M. González-Alonso,&nbsp;R. Vázquez-Crespo,&nbsp;J. Zhang-Chen,&nbsp;S. Tejero","doi":"10.1016/j.recot.2025.11.028","DOIUrl":"10.1016/j.recot.2025.11.028","url":null,"abstract":"<div><h3>Background</h3><div>Insertional Achilles tendinopathy (IAT) significantly impairs function and quality of life, particularly in young athletes. When conservative treatment fails, surgical options include Zadek osteotomy and calcaneoplasty with tendon reinsertion. Although certain preoperative radiological parameters, such as calcaneal inclination and tuberosity length, may influence functional outcomes, comprehensive studies analyzing their impact on calcaneoplasty results remain limited.</div></div><div><h3>Objectives</h3><div>To evaluate the mid- and long-term effectiveness of calcaneoplasty with Achilles tendon reinsertion in patients with refractory IAT and to assess the relationship between preoperative radiological parameters (calcaneal inclination) and postoperative functional outcomes.</div></div><div><h3>Methods</h3><div>A retrospective analysis was conducted on 38 patients who underwent calcaneoplasty with reinsertion between 2011 and 2024. Mean follow-up was 22 months (IQR: 71) with a median age of 55<!--> <!-->years (IQR: 10). Preoperative radiological parameters (Ruch, Fowler-Phillips, CLA, BRINK angles, among others) and functional scales (VAS, AOFAS, EFAS, VISA-A, Tegner) were assessed before and after surgery.</div></div><div><h3>Results</h3><div>Significant postoperative improvement was observed across all functional scales (<em>P</em> <!-->&lt;<!--> <!-->.001, Wilcoxon signed-rank test). Mean VAS pain scores decreased from 8.75<!--> <!-->±<!--> <!-->1.27 to 1.71<!--> <!-->±<!--> <!-->2.02, while AOFAS scores increased from 38.36<!--> <!-->±<!--> <!-->14.55 to 88.82<!--> <!-->±<!--> <!-->11.95. EFAS and VISA-A scores improved by 16.46 and 45.59 points, respectively. Tegner scores showed an increase of 50.48 points in athletic capacity. Two complications (5.26%) were reported: one suture granuloma and one case of lateral plantar nerve neuralgia, both successfully managed conservatively. No significant correlation was found between calcaneal inclination or tuberosity length and postoperative functional outcomes. Strengths of the study include a comprehensive functional assessment and consistent follow-up, while limitations include the retrospective design and use of two reinsertion techniques (single- and double-row), with no significant differences in outcomes.</div></div><div><h3>Conclusion</h3><div>Calcaneoplasty with Achilles tendon reinsertion is effective for refractory insertional Achilles tendinopathy, providing sustained mid- and long-term benefits. Preoperative radiological parameters were not significantly associated with postoperative functional outcomes.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"70 4","pages":"Pages 289-295"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147784615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mortalidad tras fracturas femorales periprotésicas y periimplante: análisis comparativo según tipo de implante previo","authors":"P. Ulldemolins,&nbsp;D. Mayorga Naranjo,&nbsp;G. Mariscal Ruiz-Rico,&nbsp;M. Bovea Marco,&nbsp;T. Ros Ample","doi":"10.1016/j.recot.2025.11.027","DOIUrl":"10.1016/j.recot.2025.11.027","url":null,"abstract":"<div><h3>Introduction</h3><div>Periprosthetic and peri-implant femoral fractures (PPF) include periprosthetic hip fractures (periPC), periprosthetic knee fractures (periPR), as well as peri-implant fractures associated with an osteosynthesis nail (periCL). Although risk factors for PPF are widely studied, there is scarce evidence on differential risk factors for each subtype. The objective of this study is to compare 30-day and 1-year mortality rates among the three PPF subtypes and identify differential risk factors between them.</div></div><div><h3>Methodology</h3><div>A retrospective cohort study conducted in a tertiary hospital, including 100 patients with PPF between 2019 and 2022, with a minimum follow-up of one year. Demographic, clinical, and surgical data were collected, along with 30-day and 1-year mortality and changes in ambulation capacity. Statistical analysis included intergroup comparison tests and stratified mortality analysis.</div></div><div><h3>Results</h3><div>There were 49 periprosthetic hip fractures, 29 knee fractures, and 22 femoral nail-related fractures. Overall mortality was 12% at 30<!--> <!-->days and 28% at one year, with no differences between subtypes. Mortality was associated with ASA<!--> <!-->&gt;<!--> <!-->III, CCI<!--> <!-->&gt;<!--> <!-->5, systemic complications, intraoperative transfusions, and deterioration of ambulation capacity (<em>P</em> <!-->&lt;<!--> <!-->.05). Stratified analysis identified significant differential associations in periPC (age, CCI<!--> <!-->&gt;<!--> <!-->5, ASA<!--> <!-->&gt;<!--> <!-->III, systemic complications, postoperative ambulatory status) and periPR (ASA, surgical time, systemic and local complications, ambulatory status), with no significant factors in periCL.</div></div><div><h3>Conclusions</h3><div>Elevated ASA index, CCI, and systemic complications are risk factors in all three types of PPF. Surgical time and local complications were associated with worse outcomes in the periPR group. Novel findings include the need for blood transfusions and deterioration of ambulatory status as modifiable risk factors associated with higher mortality.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"70 4","pages":"Pages 283-288"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147784168","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}