Tratamiento del choque femoroacetabular mediante miniabordaje anterior. Resultados a corto plazo

El tratamiento quirúrgico del choque femoroacetabular (CFA) es un práctica clínica cada vez más frecuente en nuestra especialidad. Objetivo. Analizar los resultados clínicos y radiológicos de una primera serie de pacientes diagnosticados de CFA intervenidos mediante miniabordaje anterior. Material y métodos. Estudio prospectivo de 30 pacientes con una edad media de 36,2 años y un seguimiento mínimo de 12 meses. La valoración clínica se ha realizado mediante las escalas SF-36, WOMAC y NAHS. Evaluamos la corrección radiológica de la deformidad y la progresión o no del grado de coxartrosis. Resultados. Se obtuvo una corrección adecuada de la deformidad en el 93% de los casos, 27 de los 30 pacientes presentaron una mejoría clínica significativa en los test realizados. La complicación más frecuente fue la meralgia parestésica del femorocutáneo (5 casos), 1 paciente precisó de sustitución protésica por evolución del grado de coxartrosis. Conclusiones. El tratamiento del CFA mediante mini abordaje anterior es un procedimiento seguro y reproducible. Permite la corrección de las anormalidades anatómicas y la obtención de resultados clínicos satisfactorios en una cohorte de pacientes jóvenes.Surgical treatment of femoroacetabular impingement (FAI) is an increasingly common clinical practice in our speciality. Aim. To analyze the clinical and radiological results of a first series of patients diagnosed with a FAI treated with anterior mini-open approach. Material and methods. Prospective study of 30 patients with a mean age of 36.2 years with a minimum follow-up of 12 months was made. Clinical assessment was performed using the SF-36, WOMAC and NAHS scales. We evaluate the correction of the radiologic deformity and progression of the osteoarthritis grade. Results. An adequate correction of the deformity in 93% of cases was obtained, 27 of the 30 patients showed significant clinical improvement in all tests performed. The most common complication was meralgia paresthesia of the femoro-cutaneous nerve (5 cases), 1 patient required prosthetic replacement for progression of the osteoarthritis grade. Conclusions. FAI treatment by mini-open approach is a safe and reproducible procedure. This technique allows correction of anatomical abnormalities and obtains satisfactory clinical outcomes in a cohort of young patients

Case Report Skin Abscess due to Serratia marcescens in an Immunocompetent Patient after Receiving a Tattoo

The incidence of skin infections caused by Serratia marcescens is extremely low and such infections are typically observed in immunocompromised patients. The clinical manifestations of these infections include cellulitis, abscesses, fluctuant nodules, or granulomatous lesions. Infections caused by S. marcescens are very difficult to treat due to their resistance to many antibiotics, which often leads to specific and prolonged treatment. Infections after receiving a tattoo are very rare and are caused by unhygienic conditions or the inexperience of the tattooist. In this paper we present the case of a 32-year-old male with no comorbidity, who presented an abscess caused by S. marcescens in a area that was tattooed one month earlier. The case was resolved with surgery and antimicrobial therapy that was based on the antibiogram. To our knowledge, this is the first reported case of a S. marcescens skin infection following a tattoo, in the absence of immunosuppression

Vástagos monobloque de recubrimiento completo en cirugía de revisión femoral. Resultados a largo plazo de 80 casos.

Bone stock lost and anatomical changes in the proximal femur make femoral revision surgery a complex procedure where the implant chooses will be essential. With the aim of evaluating the clinical and radiological results of the fully coated monoblock stems, we retrospectively studied 80 consecutive cases of femoral revision surgery operated by our hip team. The mean follow-up was 8.6 years. The average score on the Harris Hip Score was 81,2 points. We achieved better results in patients with less bone defects (Paprosky I, II and IIIA) in contrast to those with Paprosky type IIIB defects (p=0.005), in patients with a single previous surgery (p=0.031), in patients under 65 years (p=0.009) and in those who did not suffer complications (p=0.024). The survival rate was 96.1% at 10 years if we consider as failure the removal of the stem due to aseptic loosening and 89.9% if we consider revision of the stem as a failure due to any cause. After the results obtained, we think that fully coated stems provide a solid and stable fixation in femoral revision surgery. However, worst results obtained in patients with bigger bone defects make other options to be considered

Tratamiento de oligometástasis mediante cirugía oncológica con intención curativa

Oligometastasis is a clinical condition characterized by the presence of one to five metastases in a controlled or potentially controllable neoplasm, which can be treated at a local level through ablative therapy. Material and methods. We report the case of a 49 years old male who is diagnosed of a renal cell carcinoma, and presents metastases in the left humerus and the right radius. Two-stage surgery is carried out with the placement of tumor prosthesis in the humerus and reconstruction by using the fibula and osteosynthesis with a plate in the radius. Results. In the course of two years of monitoring, the patient is now disease free at both a local and systemic levels with a good clinical, functional and radiological condition. Conclusions. The management of patients with metastatic cancer has changed. Patients affected by oligometastasis can be treated with oncology surgery with a curative intention, increasing the chances of survival and even achieving the recovery of the patient