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

Introduction: Coverage defects in the leg are a challenge due to the particulars of the anatomy in said area, different reconstruction strategies have been developed, being the fasciocutaneous perforator flaps the most frequently used. The aim of this paper is to discuss the therapeutic alternative and to describe the surgical technique, the results and the complications of the posterior tibial artery perforator flap (PTAPF) to treat coverage defects.Materials and Methods: We performed a retrospective review of patients treated with a fasciocutaneous flap. We analyzed preoperative demographic variables. The surgical technique and the indications in each patient are described. Finally, the postoperative variables, such as complications and flap survival, were analyzed.Results: Twelve patients (all male) treated with PTAPF were included. The average age at the time of surgery was 52 years (range: 29-77 years). The maximum follow-up was 55 months, with a minimum of 5 months (average: 18 months). There were two flaps with transient congestion that reverted spontaneously: one partial failure and one total failure.Conclusions: PTAPF should be considered a viable option for the treatment of small- and medium-sized leg wounds, since they provide similar tissue thickness, texture and color on the recipient site, achieving good clinical and cosmetic results.

The mechanical compression of a peripheral nerve at two different sites is defined as double compression syndrome. This concept is based on the theory of the higher susceptibility that a nerve would present at a distal level when it is also compressed asymptomatically at a more proximal site. While carpal tunnel release is a surgery with predictable results, there are patients undergoing carpal tunnel decompression who do not have the expected improvement after surgery. Excluding from this analysis comorbidities such as diabetes, advanced cases with thenar atrophy, or incomplete decompressions, many of these therapeutic failures could be explained on the sub diagnosis of a second concomitant compression site. Despite this, there exists a big controversy around the double compression syndrome involving not only its existence but also its incidence and pathophysiology. Our objective is to perform a critical literature review of the double compression syndrome focused on the entrapment of the median nerve in the wrist and elbow.

Introduction: Plantar fasciitis, described for the first time by Plettner, is the most common cause of heel pain. In the etiology of this pathology under study, involved anatomical factors such as shortening of plantar flexion and related to weight gain. Although the current treatment does not exist in the current literature, the early start of conservative treatment has been recommended. The objective of the present study is to compare 3 treatment methods of plantar fasciitis. Material and Methods: Between March 2016 and March 2017, 90 patients with plantar fasciitis were treated. They were divided into 3 groups based on the treatment performed. Group A: plantar fascia elongation exercises, Group B: anesthetic cortical infiltration and elongation exercises of plantar fascia and Group C: infiltration with saline solution and elongation exercises of plantar fascia.Results: Comparative results are mentioned based on age, affected side, previous pathologies, foot shape, previous foot surgeries, post infiltration pain, analogous visual scale Group A: 0.73 Group B: 1.03 Group C: 2.7 and return time a previous activity Group A: 19.1 days Group B: 12.63 days Group C: 15.12 days.Conclusions: Our study shows that the three treatments for PF are effective, seeing a recovery in less time to patients treated with anesthetic cortical infiltration with a low number of complications but no long-term differences.

La vocación en Ortopedia y Traumatología.

Introducción: El uso de los sistemas placa/tornillo deslizante para fracturas intertrocantéricas ha demostrado ser un método de fijación eficaz, pero no está exento de fallas. El propósito de este estudio fue evaluar las causas de falla en los pacientes con fracturas laterales de cadera, tratados con placa/tornillo deslizante, puntualizando los defectos técnicos en la colocación. Materiales y Métodos: En nuestro centro, se trató a 177 pacientes por fractura lateral de cadera, a 151 de ellos se les practicó osteosíntesis con placa/tornillo deslizante. Se analizaron la adecuada reducción posoperatoria, la medición de la distancia punta a vértice, la posición del tornillo cefálico en la cabeza femoral y las posibles complicaciones. Resultados: La serie quedó conformada por 143 pacientes. El seguimiento promedio fue de 18 meses (rango 12-48). La tasa de fallas fue del 8,4% (n = 12): 7 (4,8%) por migración cefálica (cut-out) del tornillo proximal, 2 (1,4%) por migración medial (cut-through), 2 (1,4%) presentaron seudoartrosis y un caso (0,70%) de reducción inadecuada en varo. El porcentaje de una segunda operación fue del 7,7% (n = 11). La peor posición fue la superior/posterior con un 100% de migración (n = 4) (p <0,001, diferencia estadísticamente significativa). Conclusión: El posicionamiento superior/posterior del tornillo cefálico podría incrementar la posibilidad de migración y, en consecuencia, la tasa de falla del sistema.   Abstract Introduction: The use of Dynamic Hip/Sliding Screw (DHS) for intertrochanteric fractures has proven to be an effective fixation method, but it also has its failures. The purpose of this study was to evaluate the reason of failures in patients with lateral hip fractures that were treated with a DHS. Method:177 patients were treated in our center for lateral hip fracture. In 151 of them we used a DHS. The adequate postoperative reduction, the measurement of the tip-to-apex distance, the position of the cephalic screw in the femoral head and the possible complications were analyzed. Results: The series was made up of 143 patients. The average follow-up was 18 months (range 12-48). The failure rate was 8.4% (n = 12): 7 (4.8%) due to cephalic migration (cut-out) of the proximal screw, 2 (1.4%) due to medial migration (cut-through) , 2 (1.4%) presented pseudoarthrosis and one case (0.70%) of inadequate reduction in varus. The percentage of a second operation was 7.7% (n = 11). The worst position was the superior / posterior with 100% migration (n = 4) (p <0.001, statistically significant difference). Conclusion: The superior / posterior positioning of the head screw could increase the possibility of migration and, consequently, the failure rate of the system.

Objective: To describe the sports injuries in young athletes that participated in the Olympic Youth Games. Buenos Aires 2018.Materials and methodology: A descriptive study with 39 sportsmen, that realized imaging studies, that participated in Youth Olympic Games Buenos Aires 2018. Athlete’s distribution by sex, age, sports discipline, and pathologic findings was analyzed.Results: 4012 athletes participated in Youth Olympic Games Buenos Aires 2018, with the particularity that the number of woman and male are equal. The most frequent lesions were in female athletes (61, 53 %), the high proportion were in South America (33, 33 %). Athletics was the discipline that more patients reported (7 studies). Soft tissues injuries were predominant in sportswomen, especially in the lower limb (79, 41 %).Conclusion: Young woman were made more imaging studies, most frequent lesions were in the soft tissues of the lower limbs.

A significant number of young active adults are affected by focal chondral lesions. These lesions, if left untreated, will progress to osteoarthritis (OA). OA is one of the main debilitating musculoskeletal diseases and leads to a high economic and social burden.Despite surgical cartilage repair for focal chondral lesions, which improve patient-reported outcomes at short- and mid-term, there is a risk of early OA progression. Biological treatments (i.e., stem-cell therapy, bioengineering) have made great progress in the last years. Tissue engineering is an evolving field for articular cartilage repair which could potentially be used for the treatment of focal chondral lesions, promoting regeneration and preventing joint surface degeneration. Stem cells and hydrogels may provide a functional, dynamic and biologically equivalent tissue that promotes tissue regeneration while being gradually degraded and replaced. The standard approach to tissue engineering consists in delivering cells within a hydrogel or a three-dimensional printed biomaterial scaffold into the chondral lesion to induce regeneration. This review focuses on the current and future use ofhydrogels and tissue scaffold bioprinting for the treatment of focal chondral lesions, and provides preliminary data from two pilot animal studies.

Mujer de 46 de años, que presenta una tumoración ubicada en la falange distal del tercer dedo de la mano derecha, de 20 años de evolución.