Long-term results of the retrocapital metatarsal percutaneous osteotomy for hallux valgus

Producción CientíficaThe current trend in hallux valgus surgery is directed toward percutaneous procedures. However, no evidence that any of these methods of treatment are superior to the others has been described, excepting studies in the long term. The aim of this study was to analyse a series of patients who had undergone a percutaneous distal retrocapital osteotomy of the first metatarsal, and had been followed up for ten years. METHODS: We carried out a clinical and radiological evaluation of 115 feet ten years after surgery. RESULTS: The AOFAS scale results in the tenth postoperative year remained significantly favourable compared to their corresponding values in the preoperative period, yielding an improvement of 42.2 points overall on average. In relation to radiological findings, the mean hallux angle was maintained below 20 °, with a mean intermetatarsal angle of 8.1 °. CONCLUSION: Percutaneous retrocapital metatarsal osteotomy for treatment of mild to moderate hallux valgus is effective in the long term, with the advantages of a minimally invasive procedure

Oxford phase 3 unicondylar knee arthroplasty through a minimally invasive approach: long-term results

Producción CientíficaSurgical treatment options for medial compartment osteoarthritis of the knee include high tibial osteotomy, total knee arthroplasty or unicompartmental knee arthroplasty (UKA), depending on the patient's age, level of physical activity and the degree of deformity. METHODS:In this study, we evaluated the long-term results of patients who underwent the Oxford cemented meniscal-bearing unicondylar knee prosthesis through a minimally invasive approach including a clinical, functional and radiographic assessment. RESULTS:Favourable clinical and radiological outcomes were registered overall at ten years after surgery. Overall results of UKA according to the American Knee Society (AKS) using Insall's criteria showed an excellent or good outcome for 492 knees (96.28 %), fair for 11 (2.15 %) and poor for eight (1.57 %) in the post-operative long term. CONCLUSIONS:We believe that with appropriate surgical technique, patient selection, prosthetic design and specific training, surgeons should achieve good outcomes with the added advantages of a minimally invasive approach. High volume for this technique is important in our opinio

Fracturas supracondíleas infantiles: resultados clínico – radiológicos. Relación con factores ambientales: vitamina D y obesidad

Las fracturas supracondíleas en niños son frecuentes. Es objeto de debate la técnica quirúrgica que permita mantener una adecuada reducción evitando lesiones neurovasculares, pero pueden existir otros factores que contribuyan al desarrollo de estas fracturas o sus complicaciones. Este estudio analiza los resultados de las técnicas de osteosíntesis empleadas y de la influencia de la vitamina D y la obesidad en estas fracturas mediante dos metodologías: un estudio retrospectivo y uno prospectivo. En cuanto al tipo de cirugía no se encuentran diferencias estadísticamente significativas pero se objetiva como los niños obesos padecen menos fracturas pero la gravedad de estas es mayor. Así mismo sin llegar a poseer significación estadística se objetiva como incrementar 5ng/ml los niveles séricos de vitamina D disminuiría en 5,7 veces el riesgo de fractura. Nos planteamos la necesidad de suplementar con Vitamina D a niños obesos y/o en latitudes con exposición solar insuficiente para suplir sus necesidades

Rhizarthrosis fourth grade of eaton with hyperextension of themetacarpophalangeal joint

Producción CientíficaRestoration of thumb function with a painfree, stable, and mobile joint with preserved strength are the main goals of treatment of painful arthritis of the thumb. We present our clinical experience in surgical treatment of this disease, in its highest degree of affectation. PRESENTATION OF CASE:A 57-year-old woman presents with a 2-year history of worsening pain at the base of her right, dominant, trapezial-metacarpal (TM) joint. Her thumb metacarpophalangeal (MCP) joint hyperextends 30° with lateral pinch. Radiographs demonstrate Eaton stage IV degenerative changes of her TM joint and no arthritis of her thumb MCP joint. She was successfully treated with a modified Burton-Pellegrini arthroplasty and sesamoidesis to the metacarpal head. DISCUSSION:In cases of advanced rhizarthrosis conventional surgery does not serve to correct deformities of the metacarpophalangeal joint that may affect to the postsurgical outcomes. CONCLUSION:rhizarthrosis management must be carried out in a global way. When a surgical treatment is planned, all deformities must be taken into account