Osteosíntesis mínimamente invasiva con placa en fracturas de radio distal tipo C

Introducción. La tendencia hacia el uso de técnicas mínimamente invasivas (MIPO) en el tratamiento de fracturas se justifica, por la reducción de la exposición de la fractura y la disección de los planos musculares, lo que facilita la recuperación precoz. Material y Método. Se realizó un estudio en dos fases, la primera descriptiva retrospectiva de una serie de 48 casos, y la segunda, del estudio longitudinal prospectivo de una serie de 23 casos, que se sometieron a MIPO tras una fractura intraarticular de radio distal tipo C de AO. Además de las variables: edad, sexo, lateralidad y mecanismo de lesión, se evaluaron los resultados funcionales, dolor, rango de movimiento y fuerza, a través de Mayo Wrist Score escala y el cuestionario DASH. Las fracturas se clasificaron utilizando las directrices AO, se evaluaron los resultados radiológicos y complicaciones. Resultados. Se realizó la descripción del abordaje quirúrgico de los71 pacientes: 43 mujeres y 28 hombres, con una media de edad de 57 años. El lado más afectado fue el izquierdo con 51 casos. El resultado funcional fue 68,33 en el primer estudio (retrospectivo) y 85,86 en el estudio prospectivo. Observamos una pérdida de fuerza en comparación con el lado contralateral, medida con un dinamómetro, de 5,19 Kg. (retrospectivo) y 2,98 Kg. (prospectivo). Radiográ- ficamente no hubo colapso intraarticular o pérdida de la reducción en el estudio prospectivo, y la consolidación se obtuvo en el 100% de los casos. Se observó, en el segundo estudio, un caso de síndrome de dolor regional complejo y sólo un caso requirió la retirada de material debido a la protrusión dorsal de un tornillo. Conclusiones. Se trata de una técnica segura que permite la reducción y estabilización de las fracturas de la extremidad distal del radio. No solo la estética, sino también, los resultados funcionales son mejores con la técnica MIPO.Introduction. The current trend towards the use of minimally invasive techniques (MIPO) in the treatment of fractures is justified by the reduced exposure of the fracture and dissection of the muscle planes, which facilitates early recovery. Materials and Methods. We performed a double study, a retrospective descriptive study of a series of 48 cases and a prospective longitudinal study of a series of 23 patients that underwent MIPO after intra-articular distal radius fracture. In addition to the variables: age, sex, side and injury mechanism, etc., functional outcomes, pain, range of motion and strength, through Mayo Wrist Score scale and DASH were assessed. Fractures were classified using the AO guidelines, radiological results and complications were assessed. Results. We conducted the description of surgical approach with surgical images. We analyzed a total of 71 patients, 43 women and 28 men with a mean age of 57 years. The most affected side was the left with 51 cases. According to the Mayo Wrist Score, functional outcome was 68,33 in the first study (retrospective) and 85.86 in the prospective study. A mean loss in strength, measured with a dynamometer of 5,19 Kg. (retrospective) and 2,98 Kg. (prospective), was observed when compared to the contralateral side. Radiographically no intraarticular collapse or loss reduction were observed in prospective study, and consolidation was obtained in 100% of the cases. One case of complex regional pain syndrome was observed and only one case required the removal of material because of dorsal protrusion of a screw in this study. Conclusions. It is a safe technique that allows the reduction and stabilization of fractures of the distal radius. Not only the aesthetic but also functional results are better with MIPO technique

Ácido tranexámico más bloqueo anestésico con adrenalina frente a recuperador de sangre en artroplastia total de rodilla primaria. : eficacia como protocolos en el ahorro de sangre

The aim of the present study was to compare two blood-saving protocols: the use of the postoperative blood recuperator for autotransfusion (RSPA), the use of intraoperative tranexamic intravenous (ATX) and intra-articular ATX, and anesthetic block with Adrenaline intrarticular. Material and method. Retrospective descriptive observational study of a series of 54 patients operated in our Center by Gonarthrosis, and who were implanted with a total primary knee prosthesis in 2015. They were divided into two groups: group A, patients treated with ATX and anesthetic block according to the protocol described below, and group B, patients in whom a blood recuperator was used during the immediate postoperative period for autotransfusion. Results. The ATX and RSPA groups were comparable in terms of demographic values (ATX 71.59 - recovery 68.63) and distribution by sex (ATX 66.7% women, 33.3% men / recuperator 59.3% women, 40.7% men) similar. The data analysis, the mean hemoglobin decrease was lower in the ATX group (2.23 g / dL), compared to 2.73 g / dL in the group of the recuperator, this difference being not statistically significant (p value of 0.15). Conclusion. The protocol for the use of ATX was more effective as a blood-saving program compared to the use of autologous blood recuperator in primary ATR, although it would be necessary to study a greater number of cases

Optimization of a decellularized protocol of porcine tracheas. Long-term effects of cryopreservation. A histological study

[EN] Objective: The aim of this study was to optimize a decellularization protocol in the trachea of Sus scrofa domestica (pig) as well as to study the effects of long-term cryopreservation on the extracellular matrix of decellularized tracheas. Methods: Porcine tracheas were decellularized using Triton X-100, SDC, and SDS alone or in combination. The effect of these detergents on the extracellular matrix characteristics of decellularized porcine tracheas was evaluated at the histological, biomechanical, and biocompatibility level. Morphometric approaches were used to estimate the effect of detergents on the collagen and elastic fibers content as well as on the removal of chondrocytes from decellularized organs. Moreover, the long-term structural, ultrastructural, and biomechanical effect of cryopreservation of decellularized tracheas were also estimated. Results: Two percent SDS was the most effective detergent tested concerning cell removal and preservation of the histological and biomechanical properties of the tracheal wall. However, long-term cryopreservation had no an appreciable effect on the structure, ultrastructure, and biomechanics of decellularized tracheal rings. Conclusion: The results presented here reinforce the use of SDS as a valuable decellularizing agent for porcine tracheas. Furthermore, a cryogenic preservation protocol is described, which has minimal impact on the histological and biomechanical properties of decellularized porcine tracheas.The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported by grants MAT2016-76039-C4-2-R (MST) and PID2019-106099RB-C42 (MM) from the Ministry of Economy and Competitiveness of the Spanish Government, by grant PI16-01315 from the ISCIII (Ministerio de Ciencia, Innovacion y Universidades, Spain), and by grant PROMETEO/2020/069 (CC) from the local government of the Comunitat Valenciana (Spain), CIBER-BBN and CIBERER are funded by the VI National R&D&I Plan 2008-2011, Iniciativa Ingenio 2010, Consolider Program, CIBER Actions, and the Instituto de Salud Carlos III, with assistance from the European Regional Development Fund.Milián, L.; Sancho-Tello, M.; Roig-Soriano, J.; Foschini, G.; Martínez-Hernández, NJ.; Más Estellés, J.; Ruiz-Sauri, A.... (2021). Optimization of a decellularized protocol of porcine tracheas. Long-term effects of cryopreservation. A histological study. The International Journal of Artificial Organs. 44(12):998-1012. https://doi.org/10.1177/03913988211008912S9981012441

Micropartículas de PLLA y CHT como andamiaje para la regeneración del cartílago articular : modelo animal.

The avascular nature of cartilaginous tissue has historically lead to bad prognosis in osteochondral injuries. One of the possible treatment options of these injuries is the use of scaffolds, being superior to other options that obtain a fibrous cartilage as a result. We have elaborated PLLA and CHT microspheres as a scaffold for the treatment of osteochondral injuries carried out in albine New Zealand rabbits. They were distributed into groups with different proportions of microspheres, having also a control group with untreated injuries. Native cartilage of the contralateral knees was also analysed. Samples were evaluated in order to establish the quality of the cartilage obtained (using de macroscopic ICRS, microscopic ICRS II scales and a histomorphometric study).The groups with microspheres obtained a regeneration cartilage with hyaline characteristics, a good cell distribution and regular surface. The control group resulted in a cartilage with worse organization and an irregular surface

Osificación Heterotópica de Cadera : revisión bibliográfica y presentación de un caso.

Heterotopic ossification is a bone-developing disease whose etiology remains unknown, and whose risk factors include both fractures and luxations, traumatic brain injuries and long periods of immobilisation. Its treatment mainly consists of preventive measures, and may be done by either NSAIDs or radiotherapy. Once established, the elective treatment is surgical. We present a case of bilateral severe heterotopic ossification, as well as a review of the existing literature and therapeutic guidelines