https://www.drfernandorangel-traumatologotorreon.com/lca/estado-actual-de-la-reconstruccion-del-ligamento-cruzado-anterior-en-mexico-encuesta-nacional/

Estado actual de la reconstrucción del ligamento cruzado anterior en México.Encuesta Nacional 

octubre 14, 2023 por admin

La lesión de LCA representa más de la mitad de todas las lesiones de la rodilla, con frecuencia asociadas a la práctica deportiva, presenta una incidencia anual de 30-78/100,000.¹ En la península escandinava se registran los mismos rangos para deportistas.² La relación con lesiones asociadas se reporta con frecuencia, las más comunes son: edema óseo, lesiones de ligamento colateral interno y roturas meniscales, siendo meritorio la necesidad de un tratamiento quirúrgico. En el caso de una ruptura parcial, se encuentra asociado principalmente al fascículo anteromedial,³ depende de la valoración clínica y funcional de la rodilla, se clasifica como laxa, no laxa e inestable, en este último caso la necesidad de un tratamiento quirúrgico es indispensable.

En la literatura médica se describen diferentes técnicas quirúrgicas y variantes en la reconstrucción del LCA con la finalidad de brindar estabilidad funcional a la articulación. Debido a la falta de un consenso en la técnica adecuada, la mayoría de los cirujanos planean la reconstrucción de LCA con base en su experiencia personal, en la evidencia disponible y en las tendencias mundiales o locales. Los resultados obtenidos en numerosas series de casos, así como en ensayos clínicos, reportan un nivel de satisfacción de 90%, con un retorno a las actividades deportivas en 82 y 63%, que vuelven a un nivel de competencia igual previo a la lesión.³

Respecto al tiempo, desde que ocurre la lesión del LCA hasta que se realiza la cirugía, se define como temprano el procedimiento que se efectúa entre 48 horas y tres semanas,^4,5 y cirugía retrasada cuando se realiza después de seis y 10 semanas posterior a la lesión. La finalidad de la reconstrucción temprana es restaurar la estabilidad y función articular, además de evitar un daño condral o meniscal subsecuente.⁶ El riesgo de una reconstrucción temprana en las primeras horas tras la lesión es desarrollar artrofibrosis de la articulación. Los injertos que se utilizan con mayor frecuencia en el mundo son: hueso tendón hueso, considerados por muchos el estándar de oro, e isquiotibiales, que se utilizan con mayor frecuencia en el mundo, tendón del cuadricipital y el aloinjerto.⁷

Existen varios factores que influyen en los resultados clínicos ampliamente debatidos, entre los cuales se encuentra la técnica para la realización del túnel femoral y la elección del injerto. Debido a la amplia extensión de literatura y la variedad de técnicas para la reconstrucción del LCA, no hay un consenso para los métodos de fijación y selección del injerto,⁸ siendo de vital importancia estas características para la recuperación funcional y regreso a las actividades deportivas del paciente.⁹

El objetivo de este estudio es conocer la tendencia actual en relación con la técnica preferida por los cirujanos articulares de México, también se analizaron el tipo de injerto que más se utiliza y el manejo postquirúrgico.

Introducción: la lesión del ligamento cruzado anterior (LCA) representa más de la mitad de todas las lesiones de la rodilla, en la literatura médica se describen diferentes técnicas quirúrgicas y variantes en su reconstrucción. Objetivo: conocer la tendencia actual en la reconstrucción de ligamento cruzado anterior (LCA) en México. Material y métodos: se aplicó una encuesta a través de la Federación Mexicana de Colegios de Ortopedia y Traumatología con respuestas de opción múltiple, a cirujanos en traumatología y ortopedia que realizan reconstrucción de LCA en México. Resultados: 373 cirujanos respondieron la encuesta de 14 preguntas acerca del tratamiento de la rotura de LCA encontrando los siguientes datos: el tiempo promedio para realizar la reconstrucción de LCA es mayor de cuatro semanas en 45.6% de los casos; 39.9% de los cirujanos encuentra lesiones meniscales asociadas en más de 50% de los casos; 76% de los encuestados utilizan injerto isquoitibiales en reconstrucciones primarias de LCA y en cirugías de revisión 38.9% utilizan aloinjerto versus 38.1% injerto hueso tendón hueso. El método de fijación femoral que se utiliza con mayor frecuencia es el sistema de corticosuspensión por 72% de los cirujanos y para la fijación en tibia 81.2% usa tornillos bioabsorbibles. La tendencia actual en la perforación para el túnel femoral es por vía anteromedial en 47.7% y 37.5% de los cirujanos no dejan rodillera en el postoperatorio. Conclusión: en este estudio se reporta la tendencia actual en la reconstrucción de ligamento cruzado anterior en México en diferentes aspectos de la técnica quirúrgica.

Estado actual de la reconstrucción del ligamento cruzado anterior en México.Encuesta Nacional (medigraphic.com)

Estado actual de la reconstrucción del ligamento cruzado anterior en México. Encuesta Nacional (medigraphic.com)

Rangel GF, Hernández AG, Macías GEDJ, et al. Estado actual de la reconstrucción del ligamento cruzado anterior en México.Encuesta Nacional. Ortho-tips. 2023;19(1):5-10. doi:10.35366/109760.

El libro azul de las fracturas en México

http://libros.facmed.unam.mx/index.php/2021/07/24/libro-azul-de-fracturas-mexico/#:~:text=Este%20libro%20representa%20el%20esfuerzo,y%20la%20manera%20de%20prevenirla.

Libro Azul de Fracturas México

Diagnóstico y Tratamiento, Libros, Libros electrónicos, Novedades

Autor (es): Patricia Clark, Alheli Bremer

Descarga gratuita y Legal:

http://libros.facmed.unam.mx/wp-content/uploads/2021/08/LIBRO-AZUL-DE-FRACTURAS-MEXICO-FINAL-SIN-MARCAS.pdf

Asistiendo al taller exclusivo del modelo plástico de la prótesis reversa de hombro “Shoulder Comprehensive” de Zimmer Biomet

http://www.lesionesdeportivas.com.mx/academia/asistiendo-al-taller-exclusivo-del-modelo-plastico-de-la-protesis-reversa-de-hombro-shoulder-comprehensive-de-zimmer-biomet/



Dr. Michell Ruiz – Traumatólogo Alta especialidad en Hombro, Codo y Rodilla ha añadido 3 fotos nuevas.
Publicidad ·
Asistiendo al taller exclusivo del modelo plástico de la prótesis reversa de hombro “Shoulder Comprehensive” de Zimmer Biomet, la segunda compañía más grande del mundo en soluciones de Ortopedia.
En preparación continua para ofrecer siempre la solución más avanzada como tratamiento acertado.
#MiPrioridadTuMovilidad #TraumatologíaDeportiva #Traumatología #México #CDMX

MÉXICO ESTÁ DE PIE

Septiembre 21, 2017. No. 2818

Los huracanes y los terremotos han golpeado a México de una manera cruel. La devastación, la muerte y mil desgracias son el tema actual, y nosotros los Mexicanos nos hemos unido en gran apoyo a aquellos que han sido afectados por la Madre Naturaleza. Hurricanes and earthquakes have hit México in a crude way. Devastation, death and a thousand misfortunes are the current theme, and we Mexicans have united in great support for those who have been affected by Mother Nature.  Furacões e terremotos atingiram o México de uma maneira grosseira. A devastação, a morte e mil desgraças são o tema atual, e nós, os mexicanos, nos unimos em grande apoio para aqueles que foram afetados pela Mãe Natureza. Enlaces para donar / Links to donate International Community Foundation(ICF) https://donate.icfdn.org/npo/international-disaster-relief-fund Global Giving https://www.globalgiving.org/projects/mexico-earthquake-and-hurricane-relief-fund/   Red Cross Méxicohttps://www.cruzrojamexicana.org.mx Unicef México https://www.unicef.org/mexico/spanish/ Provisión de anestesia en desastres y conflictos armados. Anesthesia Provision in Disasters and Armed Conflicts. Trelles Centurion M1, Van Den Bergh R2, Gray H3. Author information Abstract Curr Anesthesiol Rep. 2017;7(1):1-7. doi: 10.1007/s40140-017-0190-0. Epub 2017 Feb 16. Local, spinal and general intravenous (mainly with Ketamine) anesthetics seem to be the most widely accepted. Inhalation anesthesia has constraints; regional is underused and epidural is not recommended. Standard operative procedures should be in place, and an informed consent from the patient must be granted. PDF Anestesia regional para lesiones dolorosas después de desastres (RAPID): protocolo de estudio para un ensayo controlado aleatorio. Regional Anesthesia for Painful Injuries after Disasters (RAPID): study protocol for a randomized controlled trial. Levine AC1, Teicher C2, Aluisio AR3, Wiskel T3, Valles P4, Trelles M4, Glavis-Bloom J3, Grais RF2. Author information Trials. 2016 Nov 14;17(1):542. Abstract BACKGROUND: Lower extremity trauma during earthquakes accounts for the largest burden of disaster-related injuries. Insufficient pain management is common in resource-limited disaster settings, and regional anesthesia (RA) may reduce pain in injured patients beyond current standards of care. To date, no controlled trials have been conducted to evaluate the use of RA for pain management in a disaster setting. METHODS/DESIGN: The Regional Anesthesia for Painful Injuries after Disasters (RAPID) study aims to evaluate whether regional anesthesia (RA), either with or without ultrasound (US) guidance, can reduce pain from earthquake-related lower limb injuries in a disaster setting. The proposed study is a blinded, randomized controlled equivalence trial among earthquake victims with serious lower extremity injuries in a resource-limited setting. After obtaining informed consent, study participants will be randomized in a 1:1:1 allocation to either: standard care (parenteral morphine at 0.1 mg/kg); standard care plus a landmark-guided fascia iliaca compartment block (FICB); or standard care plus an US-guided femoral nerve block. General practice humanitarian response providers who have undergone a focused training in RA will perform nerve blocks with 20 ml 0.5 % levobupivacaine. US sham activities will be used in the standard care and FICB arms and a normal saline injection will be given to the control group to blind both participants and nonresearch team providers. The primary outcome measure will be the summed pain intensity difference calculated using a standard 11-point Numerical Rating Scale reported by patients over 24 h of follow-up. Secondary outcome measures will include overall analgesic requirements, adverse events, and participant satisfaction. DISCUSSION: Given the high burden of lower extremity injuries in the aftermath of earthquakes and the currently limited treatment options, research into adjuvant interventions for pain management of these injuries is necessary. While anecdotal reports on the use of RA for patients injured during earthquakes exist, no controlled studies have been undertaken. If demonstrated to be effective in a disaster setting, RA has the potential to significantly assist in reducing both acute suffering and long-term complications for survivors of earthquake trauma. TRIAL REGISTRATION: ClinicalTrials.gov ( NCT02698228 ), registered on 16 February 2016. KEYWORDS: Earthquake; Humanitarian response; Natural disaster; Pain management; Randomized controlled trial; Regional anesthesia PDF ¿Una cuestión de vida o de miembro? Una revisión de los patrones de lesiones traumáticas y técnicas de anestesia para el alivio de desastres después de terremotos de gran magnitud. A matter of life or limb? A review of traumatic injury patterns and anesthesia techniques for disaster relief after major earthquakes. Missair A1, Pretto EA, Visan A, Lobo L, Paula F, Castillo-Pedraza C, Cooper L, Gebhard RE. Author information Anesth Analg. 2013 Oct;117(4):934-41. doi: 10.1213/ANE.0b013e3182a0d7a7. Epub 2013 Aug 19. Abstract BACKGROUND: All modalities of anesthetic care, including conscious sedation, general, and regional anesthesia, have been used to manage earthquake survivors who require urgent surgical intervention during the acute phase of medical relief. Consequently, we felt that a review of epidemiologic data from major earthquakes in the context of urgent intraoperative management was warranted to optimize anesthesia disaster preparedness for future medical relief operations. The primary outcome measure of this study was to identify the predominant preoperative injury pattern (anatomic location and pathology) of survivors presenting for surgical care immediately after major earthquakes during the acute phase of medical relief (0-15 days after disaster). The injury pattern is of significant relevance because it closely relates to the anesthetic techniques available for patient management. We discuss our findings in the context of evidence-based strategies for anesthetic management during the acute phase of medical relief after major earthquakes and the associated obstacles of devastated medical infrastructure. METHODS: To identify reports on acute medical care in the aftermath of natural disasters, a query was conducted using MEDLINE/PubMed, Embase, CINAHL, as well as an online search engine (Google Scholar). The search terms were "disaster" and "earthquake" in combination with "injury," "trauma," "surgery," "anesthesia," and "wounds." Our investigation focused only on studies of acute traumatic injury that specified surgical intervention among survivors in the acute phase of medical relief. RESULTS: A total of 31 articles reporting on 15 major earthquakes (between 1980 and 2010) and the treatment of more than 33,410 patients met our specific inclusion criteria. The mean incidence of traumatic limb injury per major earthquake was 68.0%. The global incidence of traumatic limb injury was 54.3% (18,144/33,410 patients). The pooled estimate of the proportion of limb injuries was calculated to be 67.95%, with a 95% confidence interval of 62.32% to 73.58%. CONCLUSIONS: Based on this analysis, early disaster surgical intervention will focus on surviving patients with limb injury. All anesthetic techniques have been safely used for medical relief. While regional anesthesia may be an intuitive choice based on these findings, in the context of collapsed medical infrastructure, provider experience may dictate the available anesthetic techniques for earthquake survivors requiring urgent surgery. PDF Los Siete Pasos a la Seguridad contra Terremotos html

Anestesiología y Medicina del Dolor 52 664 6848905 vwhizar@anestesia-dolor.org anestesia-dolor.org

México está de pie

Septiembre 22, 2017. No. 2819

No obstante la destrucción en muchos sitios de México por los huracanes y los sismos recientes, nuestro país sigue recuperándose gracias a millares de muestras solidarias de apoyo entre cada mexicano y personas allende de nuestras fronteras que, trabajando codo con codo, han ido rescatando a cientos de personas donde la muerte se hacía inminente. Tenemos una sola meta y el camino para alcanzarla está lleno de sonrisas, apoyos y obstáculos. México está de pie, y en esta ocasión más unido que nunca. Mil gracias por darnos su apoyo. Despite the destruction in many places of Mexico due to recent hurricanes and earthquakes, our country continues to recover thanks to thousands of solidarity samples of support between each Mexican and people beyond our borders who, working side by side, have been rescuing hundreds of people where death was imminent. We have only one goal and the way to reach it is full of smiles, supports and obstacles. Mexico is standing, and this time more united than ever. Thank you for giving us your help. Apesar da destruição em muitos lugares do México devido a furacões e terremotos recentes, nosso país continua a recuperar graças a milhares de amostras solidárias de apoio entre cada mexicano e pessoas além de nossas fronteiras que, trabalhando lado a lado, estão resgatando centenas de pessoas onde a morte era iminente. Temos apenas um objetivo e a maneira de alcançá-lo é cheia de sorrisos, apoios e obstáculos. O México está de pé, e desta vez mais unido do que nunca. Obrigado por nos dar sua ajuda. En dépit de la destruction dans de nombreux endroits du Mexique en raison des récents ouragans et tremblements de terre, notre pays continue de se remettre grâce à des milliers d'échantillons de solidarité entre chaque Mexicain et des personnes au-delà de nos frontières qui, travaillant côte à côte, ont sauvé des centaines des personnes où la mort était imminente. Nous n'avons qu'un seul objectif et la façon de l'atteindre est pleine de sourires, de soutiens et d'obstacles. Le Mexique est debout, et cette fois plus unis que jamais. Merci de nous avoir donné votre aide. Enlaces para donar / Links to donate International Community Foundation(ICF) https://donate.icfdn.org/npo/international-disaster-relief-fund Global Giving https://www.globalgiving.org/projects/mexico-earthquake-and-hurricane-relief-fund/   Red Cross Méxicohttps://www.cruzrojamexicana.org.mx Unicef México https://www.unicef.org/mexico/spanish/ Utilización de los servicios médicos de emergencia de helicópteros en la respuesta médica temprana a incidentes graves: una revisión sistemática de la literatura. Utilisation of helicopter emergency medical services in the early medical response to major incidents: a systematic literature review. Johnsen AS1, Fattah S2, Sollid SJ3, Rehn M4. Author information BMJ Open. 2016 Feb 9;6(2):e010307. doi: 10.1136/bmjopen-2015-010307. Abstract OBJECTIVE:This systematic review identifies, describes and appraises the literature describing the utilisation of helicopter emergency medical services (HEMS) in the early medical response to major incidents. SETTING: Early prehospital phase of a major incident. DESIGN: Systematic literature review performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials, the Web of Science, PsycINFO, Scopus, Cinahl, Bibsys Ask, Norart, Svemed and UpToDate were searched using phrases that combined HEMS and 'major incidents' to identify when and how HEMS was utilised. The identified studies were subjected to data extraction and appraisal. RESULTS: The database search identified 4948 articles. Based on the title and abstract, the full text of 96 articles was obtained; of these, 37 articles were included in the review, and an additional five were identified by searching the reference lists of the 37 articles. HEMS was used to transport medical and rescue personnel to the incident and to transport patients to the hospital, especially when the infrastructure was damaged. Insufficient air traffic control, weather conditions, inadequate landing sites and failing communication were described as challenging in some incidents. CONCLUSIONS: HEMS was used mainly for patient treatment and to transport patients, personnel and equipment in the early medical management of major incidents, but the optimal utilisation of this specialised resource remains unclear. This review identified operational areas with improvement potential. A lack of systematic indexing, heterogeneous data reporting and weak methodological design, complicated the identification and comparison of incidents, and more systematic reporting is needed. PDF La reforma sanitaria en México: antes y después de los terremotos de 1985. The health care reform in Mexico: before and after the 1985 earthquakes. Soberón G, Frenk J, Sepúlveda J. Am J Public Health. 1986 Jun;76(6):673-80. Abstract The earthquakes that hit Mexico City in September 1985 caused considerable damage both to the population and to important medical facilities. The disaster took place while the country was undertaking a profound reform of its health care system. This reform had introduced a new principle for allocating and distributing the benefits of health care, namely, the principle of citizenship. Operationally, the reform includes an effort to decentralize the decision-making authority, to modernize the administration, to achieve greater coordination within the health sector and among sectors, and to extend coverage to the entire population through an ambitious primary care program. This paper examines the health context in which the reform was taking place when the September earthquakes hit. After presenting the damages caused by the quakes, the paper analyzes the characteristics of the immediate response by the health system. Since many facilities within the system were severely damaged, a series of options for reconstruction are posited. The main lesson to be learned from the Mexican case is that cuts in health care programs are not the inevitable response to economic or natural crises. On the contrary, it is precisely when the majority of the population is undergoing difficulties that a universal and equitable health system becomes most necessary. PDF Los ciclones tropicales en un año de aumento de las temperaturas mundiales y un fortalecimiento de El Niño. Tropical cyclones in a year of rising global temperatures and a strengthening El Niño. Shultz JM1, Shepherd JM2, Bagrodia R3, Espinel Z4. Author information Disaster Health. 2015 Nov 16;2(3-4):151-162. doi: 10.1080/21665044.2014.1111722. eCollection 2014 Jul-Dec. Abstract The year 2015 is notable for the coincidence of several strong climate indicators that having bearing on the occurrence and intensity of tropical cyclones worldwide. This year, 2015, is clearly on track to become the warmest on record in terms of global temperatures. During the latter half of 2015, a very strong El Niño has formed and is predicted to build impressively, perhaps rivaling the memorable El Niño of 1997/1998. Warm Pacific Ocean temperatures, coupled with a strengthening El Niño, have supported the proliferation of Western North Pacific basin typhoons and Eastern/Central North Pacific Hurricanes. Most notable among these, Hurricane Patricia formed on October 20, 2015 and experienced extremely rapid intensification to become the strongest hurricane in the history of the Western Hemisphere and then weakened just as abruptly before dissipating on October 24, 2015. Rather than an aberration, these climate patterns of 2015 represent an ongoing trend with implications for the disaster health of coastal populations worldwide. KEYWORDS: ENSO; El Niño; accumulated cyclone energy (ACE); climate change; hurricanes; temperature anomalies; tropical cyclones; typhoons PDF Variabilidad Intrabasin de los Ciclones Tropicales del Pacífico Este durante el ENSO Regulado por los Vientos de Intervalo Centroamericanos Intrabasin Variability of East Pacific Tropical Cyclones During ENSO Regulated by Central American Gap Winds. Fu D1,2, Chang P3,4,5, Patricola CM6,7. Author information Sci Rep. 2017 May 10;7(1):1658. doi: 10.1038/s41598-017-01962-3.Abstract Hurricane Patricia in 2015 was the strongest Pacific hurricane to make landfall in Mexico. Although Patricia fortuitously spared major cities, it reminded us of the threat tropical cyclones (TCs) pose in the eastern North Pacific (ENP) and the importance of improving our understanding and prediction of ENP TCs. Patricia's intensity and the active 2015 ENP hurricane season have been partially attributed to the strong El Niño in 2015, however there is still a lack of fundamental understanding of the relationship between El Niño-Southern Oscillation (ENSO) and ENP TCs. Here, we demonstrate that ENSO drives intrabasin variability of ENP TCs, with enhanced (reduced) TC frequency in the western portion of the ENP during El Niño (La Niña), but reduced (enhanced) TC frequency in the eastern nearshore area, where landfalling TCs preferentially form. This intrabasin difference is primarily driven by the Central American Gap Winds (CAGW), which intensify (weaken) during El Niño (La Niña), producing low-level anticyclonic (cyclonic) relative vorticity anomalies and thus an unfavorable (favorable) environment for TC genesis. These findings shed new light on the dynamics linking ENP TC activity to ENSO, and highlight the importance of improving CAGW representation in models to make skillful seasonal forecasts of ENP TCs. PDF

Anestesiología y Medicina del Dolor 52 664 6848905 vwhizar@anestesia-dolor.org anestesia-dolor.org