Revista Española de Cirugía Osteoarticular. Nº 281 Vol. 55. ENERO-MARZO 2020 /22Utilidad del drenaje quirúrgico en la cirugía de Artroplastia Total de Rodilla.

Introduction. The aim of this work is to study the effect of the use of surgical drains in Total Knee Arthroplasty surgery, regarding the appearance of associated complications, the need for reoperation, blood loss and the need for transfusion, as well as postoperative mobility. Material and methods. This is a retrospective, observational, descriptive study in which 112 patients operated on for Total Knee Arthroplasty are divided into 2 groups based on the use or not of drainage. In addition to demographic variables, the following were studied: Days of post-surgery stay, loss of Hemoglobin and Hematocrit, need for transfusion, complications, and reoperations. Results. Demographic characteristics were similar in the two study groups. In the variables hemoglobin loss and hematocrit loss, statistically significant differences (p <0.05) were highlighted, with a greater decrease in the group of patients who used drainage. The demographic variables, radiological Ahlbäck classification and type of prosthesis, showed potential to be modifying factors for blood loss, showing a greater decrease in PS models and in high degrees of osteoarthritis. In the other variables, no relevant differences were found between two groups. Conclusions. This study shows the absence of benefit in the use of surgical drains in total knee arthroplasty surgery. The use of this surgical technique does not entail any postoperative improvement compared to patients who did not use it in terms of reoperation needs, the appearance of complications or limitations in mobility. In fact, the drains produce a greater blood loss characterized by a greater decrease in hemoglobin and hematocrit after surgery, despite the fact that said loss does not lead to an increased need for blood transfusion

Tumor de Células Gigantes del Primer Metacarpiano

Se presenta un caso de tumor de células gigantes que afecta al primer metacarpiano. El tratamiento consistió en la resección en bloque del metacarpiano y su sustitución por injerto cortico-esponjoso de cresta ilíaca.A case of giant cell tumor affecting the first metacarpal bone was presented. Treatment consisted of block resection of the metacarpal and its substitution by porous cortical bone graft from the iliac crest

Tratamiento de las fracturas complejas del fémur: nuestra experiencia con el clavo de Brooker-Wills

Se estudian 26 casos de fracturas de fémur tratadas con clavo de Brooker-Wills. De ellas, 22 fueron cerradas y 4 abiertas. El trazo de fractura fue simple en 8 casos y con cominución en 18. El tipo de montaje realizado fue dinámico, con encerrojado distal, en 13 casos (50%) y estático en 12 (46%). En un caso no se practicó ninguna clase de bloqueo. En 5 pacientes (19%) ocurrió alguna complicación peroperatoria relacionada con la técnica. Eos resultados obtenidos valorados según los criterios de Thoresen han sido: 17 excelentes (65%), 6 buenos (23%), 2 regulares (8%) y 1 malo (4%). Hubo una rotura del clavo relacionada con una pseudoartosis. En nuestra experiencia el clavo de Brooker-Wills se ha mostrado como un dispositivo eficaz en el tratamiento de las fracturas complejas de la diálisis femoral capaz de prevenir el acortamiento, las angulaciones y la rotación de los fragmentos.We studied 26 femoral fractures treated with Brooker-Wills nail. There were 22 closed and 4 open fractures. Eight were simple fractures and 18 conminuted. We performed distal (dynamic) locking in 13 cases (50%) and static locking in 12 (46%). One case had no locking. In 5 cases (19%) we had some complications, all of them related with the technique. Following the Thoresen's criteria, the results obtained were excelent in 17 cases (65%), good in 6 (23%), fair in 2 (8%) and poor in one (4%). We found a broken nail in a case who developed a pseudarthrosis. In our experience Brooker-Wills nail was found to be an effective device for the treatment of complex femoral shaft fractures, being able to avoid shortening, angulation and rotation of the fragments

Operacion de maquet : resultados e indicaciones

We have reviewed thirty-four patients in what we have realized forty-three operations with Maquet effect (Maquet alone or Maquet plus upper tibial osteotomy), twenty operations made for patellofemoral osteoarthritis, fifteen for patellofemoral osteoarthritis associated to genu varum and, finally, eight operations for chondromalacia patellae or first stage of patellofemoral osteoarthritis. We have found satisfactory results on the patients with chondromalacia patellae and patellofemoral osteoarthritis associated to genu varum and unsatisfactory results on the patients with patellofemoral osteoarthritis alone, So we think the Maquet procedure would be indicated on the patients with chondromalacia patellar or when it is associated to the osteotomy for valgus deformity