Complicaciones en las fracturas supracondíleas de húmero en la infancia.

La fracturas supracondíleas de húmero tienen gran incidencia en la infancia, y además pueden presentar una gran cantidad de complicaciones previas y posteriores al tratamiento. Se realiza una revisión de las complicaciones más frecuentes en las fracturas supracondíleas de húmero en los niños.Supracondylar fractures of the humerus present high incidence in children, moreover, a high per - centage of complications may be present, both previously as posteriorly to treatment. A review of the most com - mon complications in supracondylar humerus fractures in children is performed

Revisión y actualización del tratamiento de las fracturas supracondíleas de húmero en la infancia

La fractura supracondílea de húmero en la infancia es una patología con gran incidencia en los niños. Su tratamiento está rodeado de muchos puntos controvertidos. Se realiza una revisión histórica del tratamiento de esta patología y una actualización de las nuevas técnicas que han surgido a lo largo de los años.Supracondylar fracture of the humerus in childhood presents high incidence in children. The treat - ment of this fracture is surrounded by many controversial points. A historical review of the treatment of this injury and an update about emerging techniques during last years were done

Fractura de estrés en la infancia: consideraciones diagnósticas sobre 9 casos

Las fracturas de estrés son lesiones que suelen estar en relación con ciclos repetidos de carga sobre un hueso normal sometido a un exceso de solicitaciones mecánicas o bien sobre un hueso con menor resistencia. Se presenta una revisión de 9 casos de fractura de estrés tratadas en el Hospital Infantil Miguel Servet de Zaragoza, en los últimos 10 años, con resultado de 5 niños y 4 niñas, con una edad media de 10,11 años (rango: 5-14). El tiempo de diagnóstico medio fue 17,6 días (rango: 1-92), y las localizaciones más frecuentes fueron los metatarsianos, la tibia y el cuello femoral. Solo dos de los casos estaban relacionados con la práctica deportiva. Todos presentaron clínica de dolor y alteración de la marcha. En uno de ellos se realizó un diagnóstico inicial de sospecha de sarcoma de Ewing. Todos fueron tratados de forma conservadora. El tiempo de seguimiento medio fue 23,92 meses (rango: 2-96).Stress fractures are injuries that are often related to repeated cycles of loading on a normal bone subjected to excessive mechanical stress, as well on a bone of less resistance. We present a review of 9 cases of stress fracture treated at Children's Hospital Miguel Servet in Zaragoza, in the last 10 years, resulting in 5 boys and 4 girls, mean age 10,11 years (3-14). Mean time for diagnosis was 17,6 days (1-92), and the most frequent location was metatarsals, tibia and femoral neck. Only two of the cases were related to sports. All of them presented clinical pain and abnormal gait. One patient received a suspect initial diagnosis of Ewing sarcoma. All were treated conservatively. The mean follow up was 23.92 months (2-96)

Surgical treatment of congenital pseudoarthrosis of the clavicle: Our 22-year, single-center experience

Objectives: This study reports the surgical outcomes in a patient cohort with congenital pseudarthrosis of the clavicle (CPC). Patients and methods: A total of nine pediatric patients (5 males, 4 females; mean age: 4.43 years; range, 2 to 12 years) who were diagnosed with CPC and treated surgically with a minimum one-year follow-up between January 1996 and December 2018 were retrospectively analyzed. The patients were divided into two groups according to the fixation method as the Kirschner wire (K-wire; Group A, n=2) or stabilization with a plate (Group B, n=7). The physical function and symptoms were evaluated using the Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) scale. Results: The mean age at the time of diagnosis was 2.95 (range, 0 to 12) years. Six cases were atrophic pseudarthrosis and three cases were hypertrophic. Radiographic consolidation occurred in all cases with a mean duration of 103.8±39.1 days, indicating no significant difference between the groups (p>0.05). Complications registered were a K-wire breakage in a patient in Group A and an internal fixation plate loosening in a patient in Group B. The mean postoperative follow-up was 2.98±1.82 years. The QuickDASH score was 0 points in all patients. Conclusion: The early surgical indication based on refreshment of the pseudarthrosis focus, with bone autograft interposition when a failure exists to restore adequate clavicular length, and fixation are reliable alternatives with favorable clinical and radiological results in the mid- and long-term with fewer complications

ZnO-mesoporous glass scaffolds loaded with osteostatin and mesenchymal cells improve bone healing in a rabbit bone defect

The use of 3D scaffolds based on mesoporous bioactive glasses (MBG) enhanced with therapeutic ions, biomolecules and cells is emerging as a strategy to improve bone healing. In this paper, the osteogenic capability of ZnO-enriched MBG scaffolds loaded or not with osteostatin (OST) and human mesenchymal stem cells (MSC) was evaluated after implantation in New Zealand rabbits. Cylindrical meso-macroporous scaffolds with composition (mol %) 82.2SiO2–10.3CaO–3.3P2O5–4.2ZnO (4ZN) were obtained by rapid prototyping and then, coated with gelatin for easy handling and potentiating the release of inorganic ions and OST. Bone defects (7.5 mm diameter, 12 mm depth) were drilled in the distal femoral epiphysis and filled with 4ZN, 4ZN + MSC, 4ZN + OST or 4ZN + MSC + OST materials to evaluate and compare their osteogenic features. Rabbits were sacrificed at 3 months extracting the distal third of bone specimens for necropsy, histological, and microtomography (µCT) evaluations. Systems investigated exhibited bone regeneration capability. Thus, trabecular bone volume density (BV/TV) values obtained from µCT showed that the good bone healing capability of 4ZN was significantly improved by the scaffolds coated with OST and MSC. Our findings in vivo suggest the interest of these MBG complete systems to improve bone repair in the clinical practice