Elastofibroma Dorsi

Se realiza un estudio clínico-patológico de dos casos, mujeres de 57 y 45 años, de "elastofibroma dorsi" intervenidos quirúrgicamente. En una enferma apareció como una tumoracion asintomática y en otra asociada a dolor en el hombro irradiado a miembro superior derecho. Se describen las particularizadas clínicas, las exploraciones complementarias, los hallazgos quirúrgicos y las características histológicas de estos tumores de partes blandas cuyo origen debe referirse a una alteración del tejido fibroelástico. Se confronta nuestra experiencia con los casos anteriormente publicados confirmándose su aparición en mujeres adultas o añosas dedicadas a trabajos manuales rutinarios, que parecen estar implicados en la patogenia del elastofibroma dorsi. En uno de los casos, aunque localizado en el espacio anatómico escápulo-torácico, su situación era supraescapular frente a la típicamente infraescapular del elastofibroma dorsi, y la consideramos la primera observación de la literatura.A clinical-pathological study of two cases of elastofibroma dorsi was carried out. Both patients were female, 57 and 45 years old, and underwent surgical operation. One patients was sympton-free, while the other complained of pain in the shoulder which spread to the upper right arm. The autors describe the clinical details, the diagnostic methods employed, the results of surgery and the histopathological features of these tumours which must have originated in a modification of conective tissue, especially in elastic fibres. We compare our findings with those of previously published cases and can confirm the appearence of these tumours in adults or middle-aged women who carry out rutinary manual work, which seems to be connected with the pathogeny of the elastofibroma dorsi. These are normally found adjacent to the vertebral border of the escapula at its inferior angle, but in one case ot was located in the supra-escapular region and we believe this is the first evidence of this kind in the literature

Comparison of the application of low concentration and 80% phenol solution in pilonidal sinus disease

Objectives Many conservative methods have been applied in the treatment of pilonidal sinus disease (PSD). The most commonly used conservative treatment is 80% phenol solution. Our observations demonstrated that 80% phenol solution caused much destruction in the sacrococcygeal region. Design In this study low concentrations of phenol were used with the aim of reducing the unwanted side-effects of high-concentration phenol without reducing the therapeutic effects. Participants We treated 112 patients (18 women, 94 men) with PSD using phenol solution. Patients were divided into two groups: Group A was treated with a 40% solution of phenol solution, and Group B was treated with an 80% solution of phenol solution. Setting All patients were treated on an outpatient basis. One mL of low (40%) or high (80%) concentration phenol solution was injected into the main sinus orifice. During the check it was observed and noted whether there was skin necrosis, fatty tissue necrosis or abscesses. Main outcome measures The mean age was 27.4 years (6–44). The median length of symptoms was seven months (0.5–132). In the 2.8 years (1–6) of mean follow-up period, the disease recurred in 13 (11.6%) patients. Results This treatment procedure was well-tolerated by all the patients except for those who had unwanted results. No patients in group A had skin necrosis, and only one had abscesses. In group B two patients had abscesses, and three had skin necrosis. Fatty tissue necrosis was seen in one patient in Group A and in five patients in Group B. Recurrence rates were four (7.4%) cases in Group A and nine (15.5%) cases in Group B. Conclusions It is possible to treat patients in a shorter time with a considerably smaller loss of working time, since the destruction of peripilonidal adipose tissue and skin is less. Therefore, the use of low-concentration phenol solution is an option to be considered in the treatment of PSD.PubMe

Fracturas diafisarias de tibia : nuestra experiencia en su tratamiento

En esta serie retrospectiva de 814 fracturas diafisarias de tibia en 803 pacientes, llevan a cabo una clasificación de aquéllas, con especial énfasis en el tipo morfológico y mecanismo de producción; así como una revisión crítica de los tratamientos incruento y cruento puestos en práctica, y análisis de las complicaciones y resultados obtenidos. Destacan las complicaciones apreciadas tras la osteosíntesis con placas de compresión y neutralización. Los autores consideran que no hay un método ideal de tratamiento, y los diversos procederes deben ser sometidos a un examen crítico basado en la experiencia sobre grandes series de pacientes. Sin embargo, los mejores resultados en su serie se obtuvieron mediante enclavamientos intramedulares, especialmente cuando se utiliza la técnica «en cerrojo», que bloquea la rotación y amplía las indicaciones