8 research outputs found
Pseudoaneurismas femorales en fracturas de cadera. 驴Se puede evitar?
Aunque la aparici贸n de un pseudoaneurisma femoral es infrecuente en el contexto del tratamiento
de fracturas pertrocant茅reas, debido a su extrema gravedad y a su posible implicaci贸n en las causas de mortali
-
dad, es necesario realizar un diagn贸stico temprano y un tratamiento adecuado. Presentamos 3 casos en los que
se produjo una lesi贸n de la arteria femoral superficial, y 2 de la arteria femoral profunda, tratados los 3 casos con
stents recubiertos.
Conclusiones
. Se debe tomar en consideraci贸n, recti
fi
car la aducci贸n y rotaci贸n interna de la
extremidad fracturada una vez colocado el implante, el uso de brocas cortas o con un tope para el momento del en
-
cerrojado distal, longitud adecuada de los tornillos, controlar el desplazamiento del troc谩nter menor, o una correcta
colocaci贸n de los cerclajes femorales, para poder disminuir la incidencia de este tipo de lesiones.Although the appearance of a femoral pseudoaneurysm is uncommon in the context of treatment
of trochanteric fractures, due to their extreme gravity and its possible involvement in the causes of death, it is ne
-
cessary for early diagnosis and appropriate treatment. We report 3 cases in which an injury occurred superficial
femoral artery, and 2 of the deep femoral artery, 3 cases treated with stents.
Conclusions.
It should be taken into
consideration, correct adduction and internal rotation of the fractured limb once fitted the implant, the use of short
bits or a cap on the distal locking time, proper length screws, control the displacement of the lesser trochanter , or
the correct placement of the femoral cerclage, to decrease the incidence of these injuries
Luxaci贸n anterior de cadera: presentaci贸n de un caso y revisi贸n de la literatura.
La luxaci贸n anterior de cadera es una lesi贸n poco frecuente y que se produce por traumatismos de
alta energ铆a. Este tipo de luxaci贸n requiere maniobras especiales para su reducci贸n. El tratamiento ortop茅dico puede
dar buenos resultados, aunque en ocasiones es necesaria la reducci贸n abierta y el tratamiento quir煤rgico de lesiones
asociadas. Presentamos el caso de un var贸n de 27 a帽os que presentaba una luxaci贸n anterior de cadera derecha
debido a accidente automovil铆stico. Adem谩s ten铆a lesiones asociadas en pie derecho. Se realiz贸 reducci贸n cerrada y
tratamiento conservador con buenos resultados. El pron贸stico de una luxaci贸n de cadera depende de la gravedad de
la lesi贸n as铆 como del tiempo que se tarda en realizar la reducci贸n, que est谩 relacionando con el riesgo de desarrollo de
necrosis avascular. La luxaci贸n anterior de cadera tiene mejor pron贸stico que la luxaci贸n posterior cuando se realiza
un tratamiento temprano adecuado.The anterior hip dislocation is a little frequent injury and is produced by high energy traumatisms.
This type of dislocation requires special maneuvers for its reduction. The orthopaedic treatment can give good results,
although sometimes it is necessary the open reduction and the surgical treatment of associate injuries. We present a
case of a 27 year-old man who presented an anterior hip dislocation due to automobile accident. He had associated
injuries on right food. He was treated by closed reduction and orthopaedic treatment and he had good results. The
prognosis of a hip dislocation depends on the gravity of the injury as well as the time that takes in realizing the reduction, that it is relating to the risk of development of avascular necrosis. The anterior hip dislocation has better prognosis
than the posterior dislocation when a suitable treatment is early realized
Osteoporosis transitoria migratoria de cadera: a prop贸sito de un caso
La osteoporosis transitoria asociada a la gestaci贸n es una condici贸n poco usual, idiop谩tica y auto
-
limitada. Com煤nmente asociada al tercer trimestre del embarazo y al periodo postparto; cursa con dolor migra
-
torio
en
las
articulaciones
de
carga,
osteopenia
radiogr谩fica
difusa
periarticular
y
patr贸n
de
edema
medular
贸seo
en
la
RMN.
Presentamos
el
caso
cl铆nico
de
una
mujer
de
28
a帽os,
en
la
semana
34
de
gestaci贸n,
que
tras
una
leve
ca铆da
presenta
dolor
y
limitaci贸n
funcional
en
miembro
inferior
derecho.
En
la
RMN
se
evidencia
edema
贸seo
a nivel del extremo proximal de f茅mur derecho. Se trat贸 de forma conservadora, mediante reposo y marcha con
andador
en
descarga,
program谩ndose
fijaci贸n
profil谩ctica
en
quir贸fano.
Al
cabo
de
dos
semanas
de
su
ingreso,
sin
haber
sido
intervenida
a煤n,
inicia
dolor
en
cadera
contralateral.
Se
realiza
nueva
RMN
donde
se
observa
edema
en
cabeza
y
regi贸n
intertrocant茅rica
izquierda,
con
mejor铆a
de
los
hallazgos
previos
en
la
cadera
derecha.
Se
suspende
tratamiento
quir煤rgico
y
se
indica
reposo
absoluto
con
manejo
expectante.
A
las
9
semanas
de
inicio
del
cuadro y 8 semanas postparto la paciente se encuentra asintom谩tica y realiza su actividad diaria sin limitaciones.
Un alto 铆ndice de sospecha y un diagn贸stico precoz son la clave para evitar una fractura como resultado de la
osteoporosis
transitoria.
La
resonancia
magn茅tica
es
la
mejor
herramienta
no
invasiva
para
las
mujeres
embara
-
zadas con dolor en la cadera. La detecci贸n temprana puede prevenir las complicaciones y evitar cirug铆as mayoreTransient osteoporosis of the hip is a rare condition, idiopathic and self-limiting disease. This
malady
(complaint,
disorder)
is
more
common
in
the
third
trimester
of
pregnancy
and
postpartum.
Characterized
by
migratory
pain
in
bearing
joints,
periarticular
osteopenia
and
diffuse
radiographic
pattern
of
bone
marrow
edema
on
MR.
We
report
the
case
of
a
woman
28
years
old,
in
the
34th
week
of
her
pregnancy,
who
after
a
fall,
presents
pain
and
functional
limitation
in
her
right
leg.
The
MR
showed
bone
edema
at
the
proximal
right
femur.
She
was
treated
with
rest
and
a
walker,
and
she
was
scheduled
for
prophylactic
fixation
in
the
operating
room
in
a
few
weeks.
Two
weeks
after
hospital
admission,
left
hip
started
aching.
A
new
MR
showed
edema
in
the
head
and
intertrochanteric
region
of
the
left
hip,
with
improvement
of
previous
findings
in
the
right
hip.
Surgical
treatment
was
cancelled
and
bed
rest
was
suggested
as
expectant
management.
At
9
weeks
of
onset
of
symptoms
and
8
weeks
postpartum,
the
patient
was
asymptomatic
and
performs
daily
activities
without
limitations.
High
index
of
suspicion
and
early
diagnosis
is
the
key
to
avoid
fracture
as
a
result
of
transient
osteoporosis.
Magnetic
resonance imaging is the best non-invasive tool for pregnant women with hip pain. Early detection of the disease
can
avoid
complications
and
major
surgeries
Bifosfonatos y fracturas femorales de baja energ铆a: la experiencia en nuestro centro
Los bifosfonatos son f谩rmacos de uso com煤n para la prevenci贸n de fracturas osteopor贸ticas. En los
煤ltimos a帽os ha sido relacionado su consumo prolongado con la aparici贸n de fracturas de baja energ铆a en f茅mur con
un trazo caracter铆stico transverso. Para evaluar esta relaci贸n hemos analizado las fracturas de f茅mur de baja energ铆a
atendidas en nuestro centro durante 2 a帽os y relacion谩ndolas con el consumo previo de bisfosfonatos. En fracturas
subtrocant茅ras no se observan diferencias significativas; en diafisarias, las fracturas trazo transverso t铆pico se presentan
en pacientes de menor edad y significativamente asociados al consumo previo de bifosfonatos (6 de las 8 fracturas
de este tipo pensaban historia de consumo prolongado de estos f谩rmacos). Como conclusi贸n, aunque se han
publicado numerosos art铆culos en los 煤ltimos a帽os con series de casos que relacionan este tipo de fracturas con el consumo
previo de bifosfonatos, el tama帽o muestral de los estudios y las dificultades de evaluar el consumo de un f谩rmaco
retrospectivamente hacen necesarios estudios aleatorizados y prospectivos para dejar evidencia de la posible relaci贸nBisphosphonates are commonly used drugs for the prevention of osteoporotic fractures. In recent years,
consumption has long been linked with the emergence of low-energy fractures of the femur with a characteristic transverse
line. To evaluate this relationship we have analyzed the femur fractures treated low energy in our center for 2
years and related to the prior use of bisphosphonates. In subtrochanteric fractures, no significant differences were
found; in diaphyseal fractures are typically transverse line is present in younger patients and significantly associated
with prior use of bisphosphonates (6 of 8 thought this type fractures history of prolonged use of these drugs). In conclusion,
although there have been numerous articles in the last years series of cases this type of fracture associated
with prior use of bisphosphonates, the sample size of studies and the difficulties of assessing a drug consumption
retrospective studies are needed prospective randomized to leave evidence of the possible association
Fijador externo como tratamiento definitivo de fractura de di谩fisis femoral en Enfermedad de Paget
El tratamiento de las fracturas en la enfermedad de Paget presenta dificultades para el cirujano,
debido a las caracter铆sticas patol贸gicas del hueso en este tipo de pacientes. La opci贸n terap茅utica de elecci贸n
en fracturas de di谩fisis femoral es el enclavado endomedular, pero a menudo encontramos en esta enfermedad
complicaciones que dificultan la t茅cnica quir煤rgica. Presentamos el caso de una paciente con fractura de di谩fisis
femoral en hueso con caracter铆sticas pag茅ticas, en el que por la estrechez del canal y la dureza de las corticales no
fue posible realizar en enclavado endomedular, y se opt贸 por el fijador externo como tratamiento definitivo, con
buenos resultados radiogr谩ficos y funcionales. Tras el primer a帽o de evoluci贸n, observamos una buena consoli
-
daci贸n 贸sea en la radiograf铆a, y la paciente deambula sin ayuda.The treatment of fractures in Paget's disease presents difficulties for the surgeon because of the
pathological features of bone in these patients. The treatment of choice for femoral shaft fractures is intrame
-
dullary nailing, but often found in this disease, complications that hinder the surgical technique. We report the
case of a patient with femoral shaft fracture in bone with pagetic characteristics, in which because of the narrow
canal and the hardness of the cortical, intamedullary nailing was not possible. We opted for the external fixator as
definitive treatment, with good radiographic and functional results. After the first year of follow up, we see good
bone healing on X-ray and the patient ambulate without help
Experiencia con test de artrograf铆a intraoperatoria para valorar la rotura de la sindesmosis tibioperonea
Ankle fractures frequently associate tibiofibular syndesmosis injuries, whose diagnosis allows intraoperative treatment that can prevent mid-long term complications. There are several clinical diagnostic tests and specific projections but they are difficult to interpret and standardize. The objective of the study is to evaluate a recently described intraoperative diagnostic test. We conducted the test by intraarticular contrast injection in ten patients with fractures type Weber B or C. The test was valuable in 8 cases and the result coincided with the other clinical test used. We detected a fracture in one case that had gone undetected and resulted in a change of treatment. There were no complications. Using a reproducible, cheap and safe test, we can obtain an easily interpretable image that complements the rest of clinical tests to support the surgeon in the decision to fix the sindesmosis in ankle fractures
Orchidectomy increases beta-adrenoceptor activation-mediated neuronal nitric oxide and noradrenaline release in rat mesenteric artery
Background/aims: A previous study has demonstrated that endogenous male sex hormones do not alter neuronal nitric oxide (NO) release in rat mesenteric artery. However, the regulatory role of endogenous male sex hormones on noradrenaline (NA) release in rat mesenteric artery is not known. The present study was designed to analyze whether endogenous male sex hormones influence the NA release induced by electrical field stimulation (EFS), as well as the possible modification in NA and neuronal NO release by presynaptic beta-adrenoceptor activation.
Methods: For this purpose, mesenteric arteries from control and orchidectomized male Sprague-Dawley rats were used. Basal and EFS-induced neuronal NO and NA release, as well as the contractile effect induced by EFS, was measured.
Results: Basal and EFS-induced neuronal NO and NA release were similar in arteries from control and orchidectomized rats. The beta-adrenoceptor agonist clenbuterol did not modify EFS-induced neuronal NO and NA release in arteries from control rats. In contrast, in arteries from orchidectomized animals, clenbuterol increased both neuronal NO and NA release; this increase was prevented by incubation with the beta-adrenoceptor antagonist propranolol. However, the contractile response elicited by EFS was not modified by clenbuterol in either group of rats.
Conclusions: These results show that orchidectomy does not alter the EFS-induced NA release. What is more, activation of presynaptic beta-adrenoceptors does not modify EFS-induced NA and neuronal NO release in arteries from control rats although it increases the release of both neurotransmitters in arteries from orchidectomized rats. Despite these modifications, the EFS-induced contractile response is preserved in arteries from orchidectomized rats.Depto. de Biolog铆a CelularFac. de Odontolog铆aTRUEpu