Revista Ecuatoriana de Ortopedia y Traumatologia

Spine Infections. Treatment: general principles.

2024-02-12T03:53:32+00:00

Postoperative surgical site infections are a major complication occurring in 1 to 12% of all spine surgeries.
This guide seeks to guide the general principles of management and treatment of these infections according to 
the consensus of specialists.

Successful surgical management of a spinal disc herniation in a patient with neurological disorders at the T12 level: Case report and review of the literature

2024-02-11T23:33:24+00:00

In this paper, a successful case of surgical treatment of an intradural hernia in a patient with neurological disorders at the T12 level is presented, and the available literature on the subject is reviewed. The purpose of this case report is to share clinical experience and the results obtained in this patient, in order to contribute to the knowledge and discussion about the management of intradural hernias in medical practice.

Reconstruction of the acetabular labrum with fibular longus allograft. Clinical case report and literature review.

2024-02-12T00:04:59+00:00

Femoroacetabular impingement is caused by morphological abnormalities at the level of the acetabulum, femur, or mixed. It is the cause of 38% of coxalgia, with an incidence of 54.4 cases per 100.000 inhabitants per year and a higher prevalence in males. They are also associated with chondrolabral lesions due to altered joint mechanics. The labrum fulfills important biomechanical functions, so its preservation is important. The treatment of choice is hip arthroscopy with the aim of performing meticulous correction of bone morphology, restoration of labral function and joint capsular preservation. In the case of complex lesions of the acetabular labrum, labral reconstruction is indicated, this can be circumferential or segmental, either with autograft or allograft. The world bibliography reports adequate clinical and functional results in the short, medium and long term. For this reason, a case of labral reconstruction with cadaveric allograft in a male patient with a complex right labral lesion is described below, with results consistent with those reported.

Luxación Subtalar

2024-02-12T01:15:48+00:00

The subtalar joint participates in the transmission of rearfoot loads and adapts to different ground surfeces, performing many types of movements. Subtalar dislocations are rare among the injuries described. They can be caused by rotational and shear forces, and usually occur in the context of high- energy injury like traffic accidents, falls or sports activities. The descriptive classification adopted by Malgaigne and Henke divided the injuries into: anterior, medial, lateral and posterior, being the medial ones the most frequent. In addition, those injuries can be associated with other types of bone injuries, such fractures of the tarsal bones. This article presents a clinical case of a female patient with left ankle trauma with a mechanism of injury in supination- external rotation, after a fall from a meter high. Her physical examination, as well as the complementary tests performed, showed a loss of total left subtalar joint congruence. We decided to start a conservative management with immobilization. It is important to take a detailed clinical history and rely on complementary imaging tests to establish an accurate diagnosis and determine the appropriate initial and long-term management for the type of subtalar dislocation presented in each patient. Likewise, it is important to know the characteristics of the dislocation in order to choose between conservative or surgical management depending on the case.

Ochronosis

2024-02-12T03:12:01+00:00

Alkaptonuria is a disorder characterized by a metabolic alteration of the amino acids phenylalanine and tyrosine, which causes the accumulation of benzoquinone homogentisic acid and acetic acid in various tissues, including articular cartilage. Its deposit leads to cartilage and joint injury, triggering peripheral arthropathy, known as ochronosis. This disease has a low prevalence worldwide. Among the clinical findings to consider for diagnosis is the presence of black spots in the diaper as a sign at an early age. With the development of the disease, patients present low back pain, arthralgia, as well as pigmentation of the sclera or the auricle as late signs. It is important to carry out a detailed medical history, a meticulous physical examination, and complementary tests such as skin biopsy and histological study to reach the diagnosis. Clinical management is controversial so far, however, favorable results have been reported with nitisinone as a therapeutic option. This article reports the clinical case of a patient with a picture of left knee pain of one year evolution, the tests and interventions performed, as well as the detail of the reported histopathological study. Being a disease with few detected cases, it is necessary to emphasize the importance of knowing it in order to diagnose it properly.