Artroplastia total de rodilla en el adolescente

http://www.ortopediaenpediatrica.com.mx/ortopedia-pediatrica/artroplastia-total-de-rodilla-en-el-adolescente/

Adolescent total knee arthroplasty

Fuente

Este artículo es originalmente publicado en:

https://www.ncbi.nlm.nih.gov/pubmed/28695182

http://www.arthroplastytoday.org/article/S2352-3441(16)30007-3/fulltext

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5484984/

De:

Martin JR1,Sutak AK1,Milbrandt TA1,Martin VA2,Trousdale RT1.

Arthroplast Today.

2017 Feb 13;3(2):105-109. doi: 10.1016/j.artd.2016.04.002. eCollection 2017 Jun.

Todos los derechos reservados para:

Copyright

© 2016 The AuthorsThis is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).© 2016 The Authors. Published by Elsevier Inc. on behalf of American Association of Hip and Knee Surgeons.AbstractBACKGROUND:

Management of adolescent patients with end-stage arthritis is challenging. Nonoperative treatments may be ineffective and total knee arthroplasty (TKA) is rarely performed. Currently, minimal long-term data are available on the outcomes in this patient population. Our goal was to describe TKA for patients with end-stage arthritis who were aged 20 years and younger.

CONCLUSIONS:

We identified a 95% 10-year implant survivorship utilizing standard TKA components in pediatric patients. Performing a TKA in adolescent patients has long-term potential risks including infection and bone loss but may provide pain relief and good long-term results and should be used with caution.

KEYWORDS:

Adolescent orthopedics; Arthritis; Total knee arthroplasty

Resumen

ANTECEDENTES:
El manejo de los pacientes adolescentes con artritis en etapa terminal es un desafío. Los tratamientos no operatorios pueden ser ineficaces y la artroplastia total de rodilla (TKA) rara vez se realiza. Actualmente, se dispone de datos mínimos a largo plazo sobre los resultados en esta población de pacientes. Nuestro objetivo era describir TKA para pacientes con artritis en etapa terminal que tenían 20 años o menos.

CONCLUSIONES:
Se identificó un 95% de supervivencia del implante de 10 años utilizando componentes TKA estándar en pacientes pediátricos. Realizar un TKA en pacientes adolescentes tiene riesgos potenciales a largo plazo incluyendo infección y pérdida ósea, pero puede proporcionar alivio del dolor y buenos resultados a largo plazo y debe utilizarse con precaución.

PALABRAS CLAVE:
Ortopedia adolescente; Artritis; Artroplastia total de rodilla

PMID:  28695182   PMCID:  

PMC5484984  

DOI:  

10.1016/j.artd.2016.04.002

Free PMC Article

#artroplastia total de rodilla#adolescente#artritis

Deslizamiento de la fisis de la cabeza femoral en niños menores de 10 años de edad: características clínicas y la eficacia de los procedimientos en la preservación de la placa de crecimiento.

http://www.ortopediaenpediatrica.com.mx/academia/deslizamiento-de-la-fisis-de-la-cabeza-femoral-en-ninos-menores-de-10-anos-de-edad-caracteristicas-clinicas-y-la-eficacia-de-los-procedimientos-en-la-preservacion-de-la-placa-de-crecimiento/

Slipped capital femoral epiphysis in children younger than 10 years old: clinical characteristics and efficacy of physeal-sparing procedures.

Fuente

Este artículo es originalmente publicado en:

https://www.ncbi.nlm.nih.gov/pubmed/28704299

https://insights.ovid.com/crossref?an=01202412-900000000-99053

De:

Song MH1,Jang WY,Park MS,Yoo WJ,Choi IH,Cho TJ.

J Pediatr Orthop B.

2017 Jul 12. doi: 10.1097/BPB.0000000000000485. [Epub ahead of print]

Todos los derechos reservados para:

Copyright © 2016 Ovid Technologies, Inc., and its partners and affiliates. All Rights Reserved.

Some content from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.Abstract

We aimed to investigate the clinical characteristics of slipped capital femoral epiphysis (SCFE) in patients aged less than 10 years and identify the efficacy of physeal-sparing procedures in this age group. Obesity may be associated more with early-onset SCFE (onset<10 years). Physeal-sparing procedures are safe and effective in preventing leg-length discrepancy and allowing the remodeling of the deformed proximal femur in this age group.

Resumen

El objetivo de este trabajo fue investigar las características clínicas  del deslizamiento de la epífisis femoral de capital SCFE) en pacientes menores de 10 años e identificar la eficacia de los procedimientos de preservación fisiológica de la placa de crecimiento en este grupo de edad.  La obesidad puede estar asociada más con SCFE de inicio precoz (inicio <10 años). Los procedimientos de la preservación de la placa de crecimiento son seguros y efectivos para prevenir la discrepancia entre las piernas y permitir la remodelación del fémur proximal deformado en este grupo de edad.

PMID:   28704299   DOI:  

10.1097/BPB.0000000000000485

#deslizamiento#cabeza femoral#placa de crecimiento#niños

Resultado funcional y cosmético de la amputación de un solo dígito en mano

http://www.manoytrauma.com.mx/academia/resultado-funcional-y-cosmetico-de-la-amputacion-de-un-solo-digito-en-mano/

Functional and cosmetic outcome of single-digit ray amputation in hand.

Fuente

Este artículo es originalmente publicado en:

https://www.ncbi.nlm.nih.gov/pubmed/28681161

https://link.springer.com/article/10.1007%2Fs12306-017-0484-x

De:

Bhat AK1,Acharya AM1,Narayanakurup JK2,Kumar B1,Nagpal PS1,Kamath A3.

Musculoskelet Surg.

2017 Jul 5. doi: 10.1007/s12306-017-0484-x. [Epub ahead of print]

Todos los derechos reservados para:

Copyright information

© Istituto Ortopedico Rizzoli 2017AbstractPURPOSE:

To assess patient satisfaction, functional and cosmetic outcomes of single-digit ray amputation in hand and identify factors that might affect the outcome.

CONCLUSION:

Following ray amputation, one can predict an approximate 43.3% loss of grip strength and 33.6% loss of pinch strength. The patients can be counselled regarding the expected time off from work, amount of disability and complications after a single-digit ray amputation. Majority of the patients can return to the same occupation after a period of dedicated hand therapy.

KEYWORDS:

Grip strength; Pinch strength; Ray amputation; Replantation; Transposition

Resumen

PROPÓSITO:
Evaluar la satisfacción del paciente, los resultados funcionales y cosméticos de una amputación de rayos de un solo dígito en la mano e identificar los factores que podrían afectar el resultado.

CONCLUSIÓN:
Después de la amputación de rayos, se puede predecir una pérdida aproximada del 43,3% de la fuerza de agarre y una pérdida del 33,6% de la fuerza de pellizco. Los pacientes pueden ser aconsejados con respecto al tiempo esperado fuera del trabajo, la cantidad de discapacidad y las complicaciones después de una amputación de rayos de un solo dígito. La mayoría de los pacientes pueden volver a la misma ocupación después de un período de terapia de mano dedicada.

PALABRAS CLAVE:
La fuerza de prensión; Fuerza de pellizco; Amputación de rayos; Replantación; Transposición

PMID:  28681161    DOI:  

10.1007/s12306-017-0484-x

#fuerza de prensión#Fuerza de pellizco#amputación

Mas de feocromocitoma / More on pheochromocytoma

Julio 6, 2017. No. 2741

Alfa bloqueo selectivo versus no selectivo antes de adrenalectomía laparoscópica Selective Versus Non-selective α-Blockade Prior to Laparoscopic Adrenalectomy for Pheochromocytoma. Randle RW1, Balentine CJ2, Pitt SC2, Schneider DF2, Sippel RS2. Ann Surg Oncol. 2017 Jan;24(1):244-250. doi: 10.1245/s10434-016-5514-7. Epub 2016 Aug 25. Abstract BACKGROUND: The optimal preoperative α-blockade strategy is debated for patients undergoing laparoscopic adrenalectomy for pheochromocytomas. We evaluated the impact of selective versus non-selective α-blockade on intraoperative hemodynamics and postoperative outcomes. METHODS: We identified patients having laparoscopic adrenalectomy for pheochromocytomas from 2001 to 2015. As a marker of overall intraoperative hemodynamics, we combined systolic blood pressure (SBP) > 200, SBP < 80, SBP < 80 and >200, pulse > 120, vasopressor infusion, and vasodilator infusion into a single variable. Similarly, the combination of vasopressor infusion in the post-anesthesia care unit (PACU) and the need for intensive care unit (ICU) admission provided an overview of postoperative support. RESULTS: We identified 52 patients undergoing unilateral laparoscopic adrenalectomy for pheochromocytoma. Selective α-blockade (i.e. doxazosin) was performed in 35 % (n = 18) of patients, and non-selective blockade with phenoxybenzamine was performed in 65 % (n = 34) of patients. Demographics and tumor characteristics were similar between groups. Patients blocked selectively were more likely to have an SBP < 80 (67 %) than those blocked with phenoxybenzamine (35 %) (p = 0.03), but we found no significant difference in overall intraoperative hemodynamics between patients blocked selectively and non-selectively (p = 0.09). However, postoperatively, patients blocked selectively were more likely to require additional support with vasopressor infusions in the PACU or ICU admission (p = 0.02). Hospital stay and complication rates were similar. CONCLUSION: Laparoscopic adrenalectomy for pheochromocytoma is safe regardless of the preoperative α-blockade strategy employed, but patients blocked selectively may have a higher incidence of transient hypotension during surgery and a greater need for postoperative support. These differences did not result in longer hospital stay or increased complications. PDF Manejo perioperatorio actual de los feocromocitomas Current perioperative management of pheochromocytomas. Ramachandran R1, Rewari V1. Indian J Urol. 2017 Jan-Mar;33(1):19-25. doi: 10.4103/0970-1591.194781. Abstract Neuroendocrine tumors which have the potential to secrete catecholamines are either associated with sympathetic adrenal (pheochromocytoma) or nonadrenal (paraganglioma) tissue. Surgical removal of these tumors is always indicated to cure and prevent cardiovascular and other organ system complications associated with catecholamine excess. Some of these tumors have malignant potential as well. The diagnosis, localization and anatomical delineation of these tumors involve measurement of catecholamines and their metabolic end products in plasma and urine, 123I-metaiodobenzylguanidine scintigraphy, computed tomography, and/or magnetic resonance imaging. Before surgical removal of the tumors, the optimization of blood pressure, as well as intravascular volume, is an important measure to avoid and suppress perioperative adverse hemodynamic events. Preoperative preparation includes the use of alpha-adrenergic antagonists, beta-adrenergic antagonists with or without other antihypertensive agents, fluid therapy as well as insulin therapy for hyperglycemia if required. Due attention should be given to type and dose of alpha-receptor antagonists to be used and the duration of this therapy to achieve an optimal level of preoperative "alpha-blockade." Despite this preoperative preparation, many patients will have hypertensive crises intraoperatively which need to be promptly and carefully managed by the anesthesia team which requires intensive and advanced monitoring techniques. The most common complication after tumor removal is hypotension which may require fluid therapy and vasopressor support for a few hours. With advancement in surgical and anesthetic techniques, the incidence of severe morbidity and mortality associated with the surgery is low in high volume centers. HTLM XIV Congreso Virtual Mexicano de Anestesiología 2017 Octubre 1-Diciembre 31, 2017 Información / Information

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