Acta ortopédica mexicana
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Acta ortopédica mexicana · Jan 2016
Review Case Reports[Post-traumatic pseudoaneurysm of the anterior tibial artery secondary to tibial shaft fracture. Case report].
Arterial pseudoaneurysm of the lower limb is an infrequent entity, particularly in the infrapopliteal segment. It is commonly associated to vascular repairs or follows a localized arterial lesion, a fracture or a surgical procedure. There is little information in Mexico about this entity in cases involving the anterior tibial artery, and secondary to trauma and osteosynthesis. ⋯ Current reports show that the best treatment option is an autologous saphenous vein graft, which maintains blood flow and minimizes the risk of peripheral ischemia. The purpose of this paper is to report the case of a patient who sustained the above mentioned complication and provide a literature review. This topic should be further investigated, as this condition may go unnoticed in a large number of cases, given that its symptoms are silent.
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Acta ortopédica mexicana · Jul 2015
Case Reports[Spinal cord stimulation in teenager with complex regional pain syndrome for Lymes disease. Case report and review of the literature].
Lyme disease is an emerging pathology in Mexico, producer of painful muscle skeletal either neurotic pain difficult to control. We present the case of a teenager girl who has complex regional pain type II of pelvic limb secondary to it, where it established a multidisciplinary management that finally was controlled with the placement of a spinal cord stimulator. We consider this as an unusual situation in an adolescent, as well as its evolution by 60 months where the literature only was reported in a few cases.
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Acta ortopédica mexicana · Jan 2015
[Prevalence of hip, femur and knee fractures at the High Specialty Medical Unit, Hospital de Traumatología y Ortopedia "Lomas Verdes", Instituto Mexicano del Seguro Social].
Lower limb fractures are more frequent among older patients with osteopenia after a low energy fall and/or among young patients who sustain a high energy trauma. The prevalence of hip, femur and knee fractures at the High Specialty Medical Unit, Hospital de Traumatología y Ortopedia "Lomas Verdes" is unknown. ⋯ The prevalence of lower limb fractures at our hospital corresponds to what has been reported internationally.
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Acta ortopédica mexicana · Nov 2014
Comparative Study Observational Study[Hip fracture as risk factor for mortality in patients over 65 years of age. Case-control study].
Hip fracture among older patients is a devastating injury in most cases. It profoundly affects the physical, mental, functional and social balance that patients used to have and, beyond the orthopedic injury, it reflects the aging process and its dire consequences. Some reports show that up to 50% of patients with hip fracture die within six months and many of those who survive do not recover their baseline independence and function. In recent decades the increase in life expectancy after 60 years of age has led to an exponential growth in hip fractures. This is why it is essential to determine the patient-related and environmental factors leading to the increased mortality rates seen in patients with hip fracture, to improve the survival and quality of life of older adults. The objective was to determine the association between hip fracture and mortality in patients over 65 years of age. ⋯ Hip fracture is in fact a risk factor associated with mortality among patients over 65 years of age. Females are the group most prone to sustaining a hip fracture and, therefore, to increased mortality rates. The major cause of death among our patient population was sepsis, apparently caused by mismanagement of soft tissues, a poor aseptic technique during the surgical procedure, a long hospital stay or a poor family support network, and dementia, which is related to poor surgical wound care. The highest mortality rates were found in ages over 90 years, and they were associated with preexisting chronic-degenerative conditions. The age group at highest risk of hip fracture was 80-89 years. Patients with hip fracture should always be managed together with the internist and the geriatrician and they should be considered as orthopedic emergencies, as a long hospital stay and delayed surgical treatment are associated with major complications and increased mortality rates.
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Acta ortopédica mexicana · Jul 2014
Case Reports[Spondylodiscitis due to Fusobacterium nucleatum: new diagnostic method].
Fusobacterium spp. are Gram negative anaerobe bacteria. Vertebral osteomyelitis caused by these bacteria is very unusual; in fact, we could only find 11 cases in the literature. We report the case of a male, 46 year-old patient who had had lumbar pain for several weeks that irradiated to the right leg, and did not respond to NSAID treatment. ⋯ Final treatment consisted of clindamycin. In conclusion, spondylodiscitis due to Fusobacterium spp. is a rare and difficult to diagnose entity, due both to its clinical characteristics and to the difficulty in making the right microbiologic diagnosis. Vertebral biopsy and molecular microbiologic techniques such as Universal PCR rDNa, are essential to identifying the organism, making the diagnosis and prescribing appropriate antibiotic therapy.