Revisiones_bibliográficas TyO

martes, 28 de marzo de 2017

La Necesidad Urgente de Evidencia en la Cirugía Meniscal Artroscópica

http://www.clinicadeartroscopia.com.mx/academia/la-necesidad-urgente-de-evidencia-en-la-cirugia-meniscal-artroscopica/

The Urgent Need for Evidence in Arthroscopic Meniscal Surgery

Fuente
Este artículo es originalmente publicado en:

https://www.ncbi.nlm.nih.gov/pubmed/27432053

http://journals.sagepub.com/doi/abs/10.1177/0363546516650180?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%3dpubmed

De:

Monk P1,Garfjeld Roberts P1,Palmer AJ1,Bayliss L1,Mafi R1,Beard D1,

Hopewell S1,Price A1.

Am J Sports Med.

2017 Mar;45(4):965-973. doi: 10.1177/0363546516650180. Epub 2016 Jul 21.

Abstract

BACKGROUND:

Arthroscopic surgery of the knee is one of the most frequently performed orthopaedic procedures. One-third of these procedures are performed for meniscal injuries. It is essential that this commonly performed surgery be supported by robust evidence.

PURPOSE:

To compare the effectiveness of arthroscopic surgery for meniscal injuries in all populations.

STUDY DESIGN:

Systematic review.

CONCLUSION:

Further evidence is required to determine which patient groups have good outcomes from each intervention. Given the current widespread use of arthroscopic meniscal surgeries, more research is urgently needed to support evidence-based practice in meniscal surgery in order to reduce the numbers of ineffective interventions and support potentially beneficial surgery.

KEYWORDS:

arthroscopy; knee; meniscal tear; meniscus; systematic review

Resumen
ANTECEDENTES:
La cirugía artroscópica de la rodilla es uno de los procedimientos ortopédicos más frecuentes. Un tercio de estos procedimientos se realizan para lesiones meniscales.Es esencial que esta cirugía comúnmente realizada sea apoyada por pruebas sólidas.
PROPÓSITO:
Comparar la efectividad de la cirugía artroscópica para lesiones meniscales en todas las poblaciones.

CONCLUSIÓN:
Se requiere más evidencia para determinar qué grupos de pacientes tienen buenos resultados de cada intervención. Dado el uso generalizado de las cirugías meniscales artroscópicas, se necesita más investigación para apoyar la práctica basada en la evidencia en la cirugía meniscal con el fin de reducir el número de intervenciones ineficaces y apoyar la cirugía potencialmente beneficiosa.
PALABRAS CLAVE:
Artroscopia; rodilla; desgarre meniscal; menisco; revisión sistemática

PMID: 27432053 DOI:

10.1177/0363546516650180

#artroscopia #rodilla #desgarre meniscal #menisco

Examen clínico del tobillo

http://www.mishuesosyarticulaciones.com.mx/academia/examen-clinico-del-tobillo/

Clinical Examination of Ankle

Fuente
Este artículo es originalmente publicado en:

https://youtu.be/yURalgCDQW8

Courtesy: Prof Nabil Ebraheim, University of Toledo, Ohio, USA

Dr. Ebraheim’s educational animated video describing fractures of the ankle, Clinical examination, Educational video describing fractures of the ankle X-rays.
It describes ankle fracture classification, ankle fracture dislocation.
It also describes ankle fracture treatment and ankle fracture surgery and ankle fracture recovery.
You look for the circulation, diabetes, peripheral neuropathy.
Make sure that the patient doesn’t have Charcot- fracture or Charcot- joint, as this is very important.
Look also for the soft tissue condition; you may want to delay the surgery until soft tissue condition improves.
You want to do elevation.
Try to identify if there is any open fracture.
Try to reduce the dislocation, try to improve the position of the fractures and splint the patient.
There are 2 points related to clinical exam that is worth mentioning:
1- Clinical exam is unreliable in predicting the medial injury; so if you have swelling, tenderness, or ecchymosis, it’s not reliable in predicting medial injury, you probably need to get stress views, to see if the deltoid ligament is injured or not.
2- If the patient has tenderness over the medial malleolus and unable to bear weight, and the patient is older, get an x-ray, this is not an ankle sprain, this may be a fracture.

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