Fractura Supracondílea de Humero en Niños: (estudio de la Rigidez Postquirúgica del Codo en 100 Casos Intervenidos a través de un Abordaje Posterior)

El tratamiento de las fracturas supracondíleas de húmero desplazadas en niños mediante reducción abierta y fijación interna es un procedimiento poco utilizado y que no goza del favor de la mayoría de los cirujanos ortopédicos, debido principalmente a la pérdida permanente de movilidad en el codo que se atribuye a esta técnica. Según algunos autores ésta pérdida es mayor aún si se utiliza un abordaje posterior. Se presenta una importante casuística (100 casos) de fracturas muy desplazadas que han sido tratadas mediante reducción abierta y fijación por vía posterior y revisadas a largo plazo. La rigidez postquirúrgica encontrada es en general leve, e inferior si se utiliza un abordaje quirúrgico que respete la integridad anatómica del músculo tríceps.Treatment of displaced supracondylar fractures of the humerus in children by open reduction and internal fixation is a little-used therapeutic method and ill-advised by many authors owing to permanent stiffness of the elbow using this procedure. An important series of 100 very displaced fractures treated by open reduction and fixation from a posterior approach and is slight and less using a surgical approach which respects the anathomic of triceps muscle

Osteoma osteoide sobre callo de fractura

Se comunica un caso de osteoma osteoide de localización tibial en un hombre de 23 años, cuya particularidad ha sido su manifestación clínica después de un largo intervalo libre y de haberse desarrollado sobre el lugar mismo del foco de una fractura cerrada tibial sucedida hacía 4 años. El diagnóstico se realizó por la clínica dolorosa de ritmo nocturno, por el estudio radiológico convencional, por tomografía axial computarizada (TAC) y Resonancia Nuclear Magnética (IRM). Su confirmación se hizo por estudio anatomopatológico. El tratamiento consistió en exéresis quirúrgica de la tumoración tras la cual desapareció el dolor no existiendo residuos después de un año. Aunque numerosas publicaciones han sido consagradas al osteoma osteoide, nos ha parecido interesante publicar esta observación particular de esta tumoración en razón de la rareza de su asiento sobre el lugar mismo del callo de una fractura.We report a case of osteoid osteoma in the tibial region in a 23 year old male, whose interest resides in its clinical appearance following a long period without pain and having developed in the same location of a closed tibial fracture that occured some 4 years ago. The diagnosis was performed in addition to the night-time pain experienced, by means of conventional Radiographic study, and Nuclear Magnetic Resonance Diagnostic. Its confirmation was carried out by pathological study. Treatment consisted in surgical exeresis of the tumour. Pain disappeared, after exeresis, not existing tumour ral tissue after one year follow-up. Although numerous publications have been made concerning the osteoide osteoma, it seems interesting to publish this particular case, because of the rarity of its occurrence in the same location of the callus of a fracture

Identification of a Topological Characteristic Responsible for the Biological Robustness of Regulatory Networks

Attribution of biological robustness to the specific structural properties of a regulatory network is an important yet unsolved problem in systems biology. It is widely believed that the topological characteristics of a biological control network largely determine its dynamic behavior, yet the actual mechanism is still poorly understood. Here, we define a novel structural feature of biological networks, termed ‘regulation entropy’, to quantitatively assess the influence of network topology on the robustness of the systems. Using the cell-cycle control networks of the budding yeast (Saccharomyces cerevisiae) and the fission yeast (Schizosaccharomyces pombe) as examples, we first demonstrate the correlation of this quantity with the dynamic stability of biological control networks, and then we establish a significant association between this quantity and the structural stability of the networks. And we further substantiate the generality of this approach with a broad spectrum of biological and random networks. We conclude that the regulation entropy is an effective order parameter in evaluating the robustness of biological control networks. Our work suggests a novel connection between the topological feature and the dynamic property of biological regulatory networks

Prevalence of hallux valgus in the general population: a systematic review and meta-analysis

BACKGROUND: Hallux valgus (HV) is a foot deformity commonly seen in medical practice, often accompanied by significant functional disability and foot pain. Despite frequent mention in a diverse body of literature, a precise estimate of the prevalence of HV is difficult to ascertain. The purpose of this systematic review was to investigate prevalence of HV in the overall population and evaluate the influence of age and gender. METHODS: Electronic databases (Medline, Embase, and CINAHL) and reference lists of included papers were searched to June 2009 for papers on HV prevalence without language restriction. MeSH terms and keywords were used relating to HV or bunions, prevalence and various synonyms. Included studies were surveys reporting original data for prevalence of HV or bunions in healthy populations of any age group. Surveys reporting prevalence data grouped with other foot deformities and in specific disease groups (e.g. rheumatoid arthritis, diabetes) were excluded. Two independent investigators quality rated all included papers on the Epidemiological Appraisal Instrument. Data on raw prevalence, population studied and methodology were extracted. Prevalence proportions and the standard error were calculated, and meta-analysis was performed using a random effects model. RESULTS: A total of 78 papers reporting results of 76 surveys (total 496,957 participants) were included and grouped by study population for meta-analysis. Pooled prevalence estimates for HV were 23% in adults aged 18-65 years (CI: 16.3 to 29.6) and 35.7% in elderly people aged over 65 years (CI: 29.5 to 42.0). Prevalence increased with age and was higher in females [30% (CI: 22 to 38)] compared to males [13% (CI: 9 to 17)]. Potential sources of bias were sampling method, study quality and method of HV diagnosis. CONCLUSIONS: Notwithstanding the wide variation in estimates, it is evident that HV is prevalent; more so in females and with increasing age. Methodological quality issues need to be addressed in interpreting reports in the literature and in future research