Acta ortopédica mexicana
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The incidence rate of periprosthetic fractures has increased in the past decade. Osteolysis, age and preoperative function are factors that influence morbidity. Treatment options include conservative and surgical treatment. ⋯ At the ABC Medical Center, the outcomes of the treatment of periprosthetic hip fractures are considered as good according to the Oxford Hip Score.
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Patients undergoing joint replacement surgery may experience intense and sustained postoperative pain due to inappropriate analgesia that delays recovery and hospital discharge. Traditionally, postoperative analgesia following arthroplasty is achieved with scheduled analgesia, either patient-controlled or with epidural spinal blocks. ⋯ Numerous trials report that the use of multimodal analgesia based on peripheral nerve blocks may control pain and offer functional results similar to those obtained with continuous epidural blocks or systemic opioids, but without their unwanted systemic effects. This review discusses the indications, benefits and adverse effects associated with standard and new analgesic techniques.
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Acta ortopédica mexicana · Mar 2013
Clinical Trial[Lumbar herniated disks treated with a dynamic interspacer].
Lumbar herniated disks result in lumbar pain with neurologic involvement. Medical treatment and rehabilitation provide improvement for this type of lumbar pain at the early stages. When conservative treatment fails, the surgical option offers the possibility of improving patients' health status. Moojen considers that the application of interspinous spacers provides good results. The purpose of this research is to assess the clinical and imaging results in patients with contained lumbar herniated disk treated with the DYNAMIC INTERSPACER interspinous spacer, a Mexican product. ⋯ Multiple types and brands of foreign interspinous devices are applied in Mexico which results in patients' clinical improvement. We proved that the use of the Mexican interspinous device can clinically improve patients with lumbar pain due to herniated disk. A decrease in the compression of the sac or the nerve roots by the hernia was observed in the comparative preoperative and postoperative MRI images.
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Acta ortopédica mexicana · Jan 2013
[Anatomical variants of the medial calcaneal nerve and the Baxter nerve in the tarsal tunnel].
The tarsal tunnel is composed of the posterior border of the medial malleoulus, the posterior aspect of the talus and the medial aspect of the calcaneus. The medial calcaneal nerve emerges from the posterior aspect of the posterior tibial nerve in 75% of cases and from the lateral plantar nerve in the remaining 25%. Finally, the medial calcaneal nerve ends as a single terminal branch in 79% of cases and in numerous terminal branches in the remaining 21%. ⋯ Baxter nerve was found in 100% of cases. In 100% of cases in our series the nerve going to the abductor digiti minimi muscle of the foot was found; 87.5% of cases had two terminal branches. The dissections proved that a crucial step was the release of the distal tarsal tunnel.
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Acta ortopédica mexicana · Nov 2012
Observational Study[Total shoulder arthroplasty with interscalene block. Feasibility study].
General anesthesia is considered as the technique of choice for shoulder surgery, either alone or combined. We propose to show the feasibility of using guided interscalene block as the single anesthetic technique for total shoulder arthroplasty. ⋯ This type of surgery is feasible with interscalene block plus sedation; it is a safe and efficacious technique.