Antonio Jiménez-Martín

Arthroscopic arthrodesis of the shoulder: Fourteen-year follow-up

Shoulder arthrodesis is indicated in infections, brachial paralysis, irreparable rotator cuff tears, osteoarthritis without indication of prosthesis, rescue after arthroplasty, or after surgery for cancer. Arthroscopic arthrodesis is exceptional. Our aim is presenting our result after 14 years of follow-up of one patient. We present a case report of a 17-year-old male patient. He suffered fracture of left scapula (type V, Ideberg), fracture of left clavicle (type I, Craig), and fracture of left distal ulna. We realized osteosynthesis of clavicle (plate and screws) with the aim of treating this floating shoulder. Electromyography showed partial axonotmesis of axilar nerve. After 7 months of follow-up, axonotmesis was still present. We realized arthroscopic shoulder arthrodesis (three cannulated screws). Fourteen years later, shoulder movement was as follows: Flexion, 0-90°; maximum abduction, 40° with shoulder atrophy; Constant, 47 points; and UCLA, 17 points, without pain. Arthrodesis with screws reaches a subjective benefit in 82% of patients. Percentage of pseudarthrosis is less than in patients treated with plates, although the risks of infections, fractures, and material removal are greater than in patients treated with plates. Shoulder arthroscopic arthrodesis is exceptional, but it allows minimal surgical aggression.

Tratamiento artroscópico de la condromatosis sinovial, una inusual causa de omalgia

Synovial chondromatosis is a benign idiopathic metaplasia of the synovial membrane. It affects one in 100 000 persons. It is 3 times more common in males, arising between 30 and 50 years of age and mainly affects large joints such as the knees (70%), hips (20%) and shoulders (19%). Its etiology is unknown, although it has been associated with chromosomal mutations (p21.3 and 12q13) that affect proteins, Milgram1 described three stages: (1) active disease without intraarticular loose bodies, (2) transitional lesions with synovial proliferation and loose bodies, and (3) loose bodies without synovial disease. The objective of this paper is to review the pathology report of a patient who was treated arthroscopically.

Osteoporosis transitoria migratoria en miembros inferiores

Transient osteoporosis is rare and idiopathic.1 It is characterised by arthralgias, radiographic periarticular osteopenia and spontaneous recovery. It was first described in the hip and in women who were in the last three months of their pregnancy.2 Only 10%–40%3 of patients affected develop this process in several joints, either simultaneously or successively, in the same limb or even in the contralateral side, which is then called transient migratory osteoporosis.4 The aim of this study is to present a case where the disease migrated to the contralateral knee and to an ankle.

Evolución tórpida tras fractura humeral proximal

The patient was a 54-year-old male with liver disease, allergic to penicillin, presenting a proximal humeral fracture with a cervicodiaphysal angle of 80◦ and a trochiter ascent of 11 mm. Pl osteosynthesis was performed with a Philos plate (Synthes) (Fig. 1). The patient began rehabilitation, with a limited arc (60◦ of active abduction and 50◦ of anterior active flexion), fever and wound seroma (ultrasound size: 25 mm×12 mm), at 2 months and 22 days after the intervention, requiring 2 surgical debridements and the taking of cultures and antibiograms.Varón, 54 años, hepatópata, alérgico a penicilina, que sufre fractura humeral proximal, con angulación cervicodiafisaria de 80◦ y ascenso troquiteriano de 11 mm. Se realiza osteosíntesis con placa Philos (Synthes) (fig. 1). El paciente comienza la rehabilitación, con arco limitado (60◦ de abducción activa y 50◦ de flexión anterior activa), fiebre y seroma en la herida (tamaño ecográfico: 25 × 12 mm), a los 2 meses y 22 días desde la intervención, precisando 2 limpiezas quirúrgicas y toma de cultivos/antibiograma.

Omalgia en paciente con colitis ulcerosa

Proximal humeral osteonecrosis is an uncommon disease, associated with traumatisms (15%-30%), corticosteroids1 (5%), Caisson or Gaucher disease, sickle cell disease, alcoholism (6%-39%), lupus, or renal failure2 and is exceptional after taking sulfasalazine. Our objective is to present a case where this drug was the only demonstrable aetiological agent of the disease, as well as the final surgical treatment employed to resolve the omalgia.