BIBLIOTECA

ARTÍCULOS MÉDICOS

BIBLIOTECA

ARTÍCULOS MÉDICOS

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    Tendinopatía rotuliana: una guía práctica de consenso para la elección del mejor tratamiento

    La tendinopatía rotuliana cursa como un cuadro de dolor anterior de rodilla localizado fundamentalmente en el polo inferior de la patela. La causa principal de esta condición degenerativa son los movimientos repetitivos que generan una carga excesiva del tendón, particularmente durante los deportes que impliquen cambios rápidos de dirección, saltos y carreras, como voleibol, baloncesto o fútbol. Representa hasta un 30-45% de las lesiones que sufren los atletas involucrados en deportes de salto, con tiempos de inactividad que pueden alcanzar los 6 meses. Aunque se acepta que el manejo conservador debe suponer la primera línea de tratamiento, existen diferentes alternativas dentro de este, con mecanismos de acción y duración heterogéneos, así como efectividad y niveles de evidencia variables. Asimismo, es difícil encontrar protocolos de tratamiento que sirvan de guía para el manejo de esta patología durante la práctica clínica. Cuando fracasa el tratamiento conservador, se ha descrito la cirugía tanto abierta como artroscópica para el tratamiento de esta patología, con técnicas variables y resultados consistentes. El objetivo de este trabajo es realizar una revisión narrativa para exponer las alternativas de tratamiento más habituales, su mecanismo de acción, así como detallar el nivel de evidencia disponible para su aplicación y, finalmente, emitir un grado de recomendación para cada uno de ellos. Se pone de manifiesto que la terapia física basada en un programa de ejercicios supervisados ha de suponer la base del tratamiento; no obstante, cuando esta fracasa, parece indicado proporcionar al paciente una técnica invasiva orientada a favorecer los mecanismos de reparación tendinosos, reservando la cirugía para aquellos casos recalcitrantes, puesto que se carece de estudios comparativos de calidad que permitan universalizar su uso.

    In the Treatment of Lateral Epicondylitis by Percutaneous Perforation, Injectables Have No Added Value

    No single injection therapy has been proven to be superior in the treatment of lateral epicondylitis. In most studies, the injection technique is not standardized, which makes it challenging to compare outcomes.

    Clinical Faceoff: Strategies for Management of Suspected Scaphoid Fractures

    In the United Kingdom, guidelines issued by the National Institute for Health and Clinical Research (NICE) suggest the routine use of MRI when a scaphoid fracture is suspected based on interview, examination findings, and normal scaphoid-specific radiographs [5]. This clinical scenario is often referred to as a “suspected scaphoid fracture” [16]. An alternative strategy for managing suspected scaphoid fractures is based on the management of other fractures that predictably heal (such as metacarpal fractures and isolated nondisplaced or minimally displaced radial head fractures) and is premised on the idea that if a fracture is likely to heal without serious sequelae, then overtreatment represents a risk as great as undertreatment. The alternative pathway for the care of patients who present to emergency departments with a history, signs, and symptoms potentially consistent with scaphoid fracture involves providing patients with information about the expected course of recovery and specific instructions about how to seek more care if desired.

    The effects of length and width of the stem on proximal humerus stress shielding in uncemented primary reverse total shoulder arthroplasty

    To preserve humeral bone during RTSA, stems have been made shorter and cement avoided whenever possible. However, with the increased use of uncemented RTSA, a phenomenon comparable to the stress shielding of the hip has been described for the proximal humerus. The aim of this study was to investigate the influence of stem length and width on proximal humeral bone resorption after primary uncemented RTSA.

    The ‘Holy Grail’ of shoulder dislocations: a systematic review on traumatic bilateral luxatio erecta; is it in reality a once-in-a-lifetime experience for an orthopaedic surgeon?

    Even though shoulder dislocation is thought to be the most common dislocation treated in the Emergency Department, inferior ones, known as Luxatio Erecta, comprise only 0.5% of them. Taking into consideration the rareness of unilateral Luxatio Erecta, bilateral cases should be even fewer. The purpose of this paper is to identify the reported number of cases of Traumatic Bilateral Luxatio Erecta in the literature over the last 100 years and to summarize the mechanism of injury, the initial management, and the complications of these patients.

    Is restoration of vertebral body height after vertebral body fractures and minimally-invasive dorsal stabilization with polyaxial pedicle screws just an illusion?

    Thoracolumbar spine fractures often require surgical treatment as they are associated with spinal instability. Optimal operative techniques and treatment are discussed controversially. Aim of our prospective cohort study was to investigate the sagittal alignment after reduction, the secondary loss of reduction and the subjective outcome as well as the causal correlation of these parameters after minimally invasive stabilization of thoracic and lumbar fractures with polyaxial pedicle screws.

    Validity of leg length measurement in the supine and standing position compared with pelvic survey X-ray after total hip arthroplasty

    The correct adjustment of leg length is a major goal in the implantation of total hip replacements (THRs). Differences in leg length can lead to functional impairment and patient dissatisfaction. By determining leg length at an early stage, before the patient is discharged from hospital, compensatory measures such as the production of special insoles or orthopaedic footwear can be initiated promptly if there is a difference in leg length. Due to shortening of the period of time spent in hospital, the traditional measurement of leg length in a standing position may be increasingly subject to error. A protective posture immediately after surgery or the presence of a twisted pelvis, for example, due to scoliotic spinal misalignments, falsifies the measurement result in the standing position. Here, the measurement of leg length in the supine position may prove to be accurate immediately postoperatively, regardless of potential sources of error, and is to be compared with measurement in the standing position versus radiological measurement on the AP pelvic survey.

    Chopart dislocations: a review of diagnosis, treatment and outcomes

    Chopart injuries can be allocated into 4 broad groups, ligamentous injury with or without dislocation and fracture with or without dislocation, which must occur at the talonavicular joint (TNJ) and/or calcaneocuboid joint (CCJ). Chopart dislocations are comprised of pure-dislocations and fracture-dislocations. We aim to review the literature, to enable evidence-based recommendations.

    Complications associated using the reamer–irrigator –aspirator (RIA) system: a systematic review and meta-analysis

    Complications associated with the application of the Reamer–irrigator–Aspirator (RIA) system are described in the literature. However, to date a systematic review and meta-analysis to assess prevalence of complications associated with the use of the RIA system have not been conducted.

    Complications following surgical treatment of posterior malleolar fractures: an analysis of 300 cases

    The treatment of ankle fractures and fracture-dislocations involving the posterior malleolus (PM) has undergone considerable changes over the past decade. The aim of our study was to identify risk factors related to the occurrence of complications in surgically treated ankle fractures with PM involvement.

    Is new always better: comparison of the femoral neck system and the dynamic hip screw in the treatment of femoral neck fractures

    Hip fractures in the elderly population are common and the number of patients is rising. For young and geriatric patients with undisplaced fractures osteosynthesis is the primary type of treatment. The dynamic hip screw (DHS) is around for many years and proved its value especially in displaced fractures. Since 2018 the femoral neck system (FNS) is available as an alternative showing promising biomechanical results. The aim of this study is to evaluate clinical results of the FNS and compare it to the DHS.

    The role of cerclage wiring in the management of subtrochanteric and reverse oblique intertrochanteric fractures: a meta-analysis of comparative studies

    Subtrochanteric and reverse oblique intertrochanteric fractures are challenging and often difficult to reduce. While intramedullary nailing (IMN) is considered the standard treatment, achieving anatomic reduction prior to fixation is essential. This study aimed to assess the impact of cerclage wiring with IMN on the outcomes and complication rate in treating subtrochanteric and reverse oblique intertrochanteric fractures.

    Complications after surgical treatment of pelvic fractures: a five‑year follow‑up of 194 patients

    Surgical treatment of pelvic fractures is an advanced intervention associated with multiple complications. The primary aim of this study was to investigate the rate of unplanned reoperations after pelvic fracture surgery. Secondary aims included occurrence of other adverse events and mortality.

    Heterotopic ossification in primary total hip arthroplasty: risk factor analysis

    Aim is to identify if age, sex, type of posterolateral approach (mini vs standard), surgical time and time from surgery to drainage removal were independent risk factors for heterotopic ossifications after total hip arthroplasty.

    Reinfection rates after one- and two-stage revision surgery for hip and knee arthroplasty: a systematic review and meta-analysis

    Revisions for periprosthetic joint infection of knee and hip arthroplasty can be performed following one- or two-stage treatment protocols. Current literature is inconclusive whether one protocol is superior to the other, as prior literature reported similar reinfection rates for both treatment options. We aimed to provide a systematic review and meta-analysis of current literature on septic arthroplasty revisions.

    How effective are physiotherapy interventions in treating people with sciatica? A systematic review and meta-analysis

    Physiotherapy interventions are prescribed as first-line treatment for people with sciatica; however, their effectiveness remains controversial. The purpose of this systematic review was to establish the short-, medium- and long-term effectiveness of physiotherapy interventions compared to control interventions for people with clinically diagnosed sciatica.

    Sección del ligamento transverso del carpo de forma percutánea ecoguiada vs. cirugía abierta para el tratamiento quirúrgico del síndrome del túnel del carpo (STC)

    El gold standard del tratamiento del síndrome del túnel carpiano (STC) es la sección del ligamento transverso del carpo, siendo la técnica más común la incisión cutánea palmar. Se han desarrollados técnicas percutáneas, aunque su relación riesgo/beneficio sigue siendo controvertida.

    Balance Espinopélvico (Artículo y Vídeos)

    Buenas tardes, hoy os dejamos un artículo interesante sobre el balance espinopélvico y su relación con la artroplastia de cadera y sus resultados así como un par de vídeos relacionados con el tema. Esperemos que sean de vuestro interés.

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