Sistema Regional de Información
en línea para Revistas Científicas de América Latina,
el Caribe, España y Portugal

Introduction: The prevalence of shoulder pain varies between 6.7% and 66.7%; whereas rotator cuff disorders–especially rupture–can reach a prevalence of 22.1%. Due to the important advances and studies in the repair of this injury, arthroscopic surgery has allowed a better identification, visualization and classification, as well as a better handling of the patients. In addition, rotator cuff ruptures or greater tuberosity fractures increase the risk of nerve injury (relative risk -1.9), which is more significant in patients >60 years old. We discuss the case of a patient with post-traumatic rotator cuff rupture who required minimally invasive arthroscopic repair. No weight-bearing was allowed during the postoperative period. Patient presented a non-self-limited axillary nerve injury secondary to anterior dislocation and resulting instability after the original trauma.Conclusions: Axillary nerve injuries are more common than expected and, in many cases, early identification is not possible due to its high rate of association with other injuries. Therefore, treating physicians must be very careful in order to achieve a timely diagnosis and management of the patient.

In 1888, Lejars described the vein sole that bears his name. It is a venous network arranged on the sole of the foot, which involves the medial and lateral borders. Said author described it indirectly, by transparency, through an injection of resin and black smoke. In this update, a direct and detailed description of the Lejars venous sole is offered by injection with latex (Butachlor), which clearly identified two planes. The dissections were performed on adult feet and full-term fetuses. This work of anatomical research aims to demonstrate objectively the existence of a single venous mesh that is essential for hydraulic function, especially the posterior heel of the foot as a support and walking center. Likewise, the most appropriate surgical incisions are described for the treatment of conditions that compromise this network.

Introduction: Fractures of the thoracolumbar spine can trigger thecal sac injuries due to the impingement of the cauda equina between bone fragments.Objective: To carry out a retrospective analysis of clinical and radiological variables, the AOSpine Classification System and the possibility of secondary thecal sac injury in a series of thoracolumbar burst fractures treated at our center.Materials and Methods: A retrospective, observational study of a series of patients with thoracolumbar fractures with compromise of the posterior vertebral body wall, who underwent surgery at our center between January 2012 and December 2017.Results:Forty-six patients were included, 16 of which had secondary thecal sac injury. The differences in the variables—percentage of spinal canal involvement, interpedicular distance, angle of the retropulsed fragment, neurological deficit and type C fractures—were statistically significant according to the comparison made with the presence or absence of thecal sac injury (p=0.046, p=0.007, p=0.046, p=0.004, p=0,001 respectively).Conclusions: This study suggests that traumatic thecal sac injury could be suspected when managing burst fractures with prominent fragments in the posterior vertebral body wall, acute angle of the retropulsed fragment, severe compression of the spinal canal, wide interpedicular distance, neurological deficit and fracture displacement (fracture type C according to the AOSpine Classification System).

Introduction: Around 80% of pediatric patients who undergo spine surgery report moderate to severe pain in the immediate postoperative (POP) period, and only half of them are treated according to an adequate and standardized pain management scheme.Objectives: To describe the type and intensity of POP pain in children who underwent spinal surgery and evaluate the effectiveness of the current pain management protocol.Materials and Methods: We assessed children between 10 and 18 years of age who were able to understand the purpose of the study. We recorded presence of pain, time of POP pain onset, location, and referred intensity of the pain using a numeric rating scale (NRS), among other variables.Results: Overall, 84 pediatric patients were evaluated. Mean age at surgery: 12 years and 9 months. Etiology: idiopathic (41 patients), neuropathic (14 patients), syndromic (10 patients), muscular (7 patients), and miscellaneous (12 patients). Mean preoperative NRS was 2.1 and 7.3 on POP day 1, 6.6 on POP day 2, 6.2 on POP day 3, 5.1 on POP day 4, 3.7 on POP day 5, and 3.3 on POP day 6/at discharge. Mean hospital stay was 6.3 days. The mean cost of hospital stay was USD 1090 per patient.Conclusions: A high percentage of pediatric patients who underwent spinal surgery reported moderate to severe pain in the POP period, and just half of them received a standardized pain management protocol. A pain management protocol with a multimodal focus should be considered in a near future.

Introduction: The bent spine syndrome (BSS) or camptocornia is a cause of unstructured sagittal imbalance of difficult medical and surgical management.Objective: To describe the causes of BSS and how to approach its treatment.Materials and Methods: Retrospective analysis of 4 cases of BSS treated at our center and review of the literature.Results: The 4 cases were women between 60 and 82 years of age, 3 due to an isolated atrophy of the paravertebral spinal erectorae musculature and 1 case due to an inflammatory myopathy.Conclusions: The prognosis of any BSS is poor, so the symptoms usually progress to irreversible difficulty to maintain upright posture.

We report two cases of low lumbar burst fractures that involve the fourth lumbar vertebra (L4), in patients who develop the activity known as “jineteada gaucha”, in which the horse falls on its back and imprisons the rider against the ground.

La presentación de trabajos científicos a través de un informe requiere de un armado que podemos llamar “anatomía de un informe” y una dinámica en su interior a la que consideramos “la fisiología del informe” para que tenga validez y credibilidad, pero ¿cómo se evalúan los trabajos científicos presentados en nuestros congresos? ¿Cuáles son los criterios para determinar que un trabajo sea aceptado o no? El Comité de Investigaciones de la AAOT elaboró las grillas de evaluación. El objetivo de publicar las grillas es poder contar con una herramienta objetiva de valoración cualitativa y cuantitativa de todos los trabajos presentados en sus diferentes géneros, que podrá ser utilizada por los evaluadores de trabajos como elemento de feedback y como elemento de evaluación objetiva, y por los escribientes como guía para el armado del informe de su trabajo de investigación. ABSTRACTFor validity and credibility purposes, the presentation of scientific publications in a report form requires a certain layout that we could call the "anatomy of the report", as well as the dynamics of it, considered the "physiology of the report". But how are conference scientific publications evaluated? What are the criteria used to determine whether a report is accepted or not? The Research Committee at the Argentine Association of Orthopedics and Traumatology (AAOT) developed evaluation grids with the aim of publishing them to have an objective tool for the qualitative and quantitative evaluation of all types of publications submitted. These grids could be used by evaluators to present their feedback, as well as an objective evaluation tool. Authors could use them as a guide to prepare the report of their research work.

Background: The objective of this study is to analyze and compare the characteristics of the membranes that form around cement spacers; as well as the one that develops around titanium and steel implants.Materials and Methods: 20 rabbits were divided into 2 groups of 10. In Group 1, an antibiotic-coated cement spacer was placed on the right femur, and a titanium elastic nail (TEN) on the left one. In Group 2, an antibiotic/steroid-coated cement spacer was placed on the right femur, and a steel peg on the left one. At 6 weeks, the membranes were removed and its macroscopic, imaging, biochemical and histological characteristics were evaluated.Results: Macroscopy: The membrane induced by the ATB-coated cement spacer was significantly wider, whereas the one induced by the steroid-coated cement spacer and the TEN was very thin and adherent. Microscopy: The membrane induced by the steroid-coated cement spacer showed less inflammation (p = 0.0502) and was similar to the one induced by the steel peg (p = 0.322). Steel pegs showed greater epithelial proliferation (p = 0.026), which was scarce on the membrane induced by the steroid-coated cement spacer (p = 0.071). There was a mild tendency towards less active vascular proliferation (p = 0.107) in the group of the steroid-coated cement spacer vs. the one without steroids. There were no differences between the steel peg and the TEN (p = 0.737). X-rays and CT showed no significant differences (p = 0.988). In MRIs, most of the responses indicated lack of osseointegration in the steel peg group due to metallic artifacts.Conclusions: Different materials (titanium, steel and cement) with different agents added to them (antibiotics and steroids), alter the membranes both macroscopically and histologically. The steroidcoated cement spacer showed less inflammation and fibrosis, less vascular proliferation, and thinner and adherent membranes.

Objective: Comparison of two series of patients operated on ligamentoplasty with autologous hamstring tendons by the two preferred surgical techniques: transtibial monotunnel and anatomic bitunnel, using identical bone fixations; and establishment of functional conclusions.Material and method: Retrospective study of two series of 30 patients followed up more than one year, undergoing anterior cruciate ligamentoplasty with hamstring tendons performing transtibial montunnel and bitunnel techniques with retrograde tunneling, using the cortical elastic fixation in femur and a tibial fixation by retrograde screw, evaluating the patients by IKDC scale, Lachman, pivot and monopodal jump tests, valuating the reincorporation to the previous habitual and sports activity, and performing radiological examination of the evolution of the bone tunnels.Results: the anatomical bitunnel technique presents significantly (p <0.05) better results in the evaluation of the IKDC scale, in the pivot and in the jump test and in the recovery of sports activity prior to injury, with no differences in the Lachman test. There were no cases of osteolysis in the bone tunnels in none of the two series.Conclusions: The anatomical bitunnel ligamentoplasty technique is better valued by the patient and more efficient than the transtibial monotunnel technique, fundamentally in patients with demanding sports activity, since in patients without impact activities, the results are satisfactory in the same way. With tibial retrograde screwing, there was no significant osteolysis in the tibial tunnel.