Miguel del Valle Soto

Sonographically Guided Intrasheath Percutaneous Release of the First Annular Pulley for Trigger Digits, Part 1 Clinical Efficacy and Safety

For trigger digits, intrasheath sonographically guided first annular (A1) pulley release has shown safety and effectiveness in cadavers. This clinical study describes sonographically guided A1 pulley release results in terms of resolution of symptoms, safety, and functional recovery.

Percutaneous intrasheath ultrasonographically guided first annular pulley release: anatomic study of a new technique.

Objective. The purpose of this study was to define in volunteers a safe area for performing a percutaneous intrasheath first annular (A1) pulley release under ultrasonographic guidance in cadavers for the treatment of trigger fingers. Methods. First, in 100 fingers of 10 volunteers, we used Doppler ultrasonography to determine the limits of the sectors enclosing structures at risk (arteries and tendons). From the synovial sheaths most volar point, we determined the relative position of the arterial walls and the distance to the flexor tendons. A scatterplot overlay of the arterial positions was digitally analyzed for determining the limits of the safe area. Second, we released the A1 pulley in 46 fingers from 5 cadavers, directing the edge of the cutting device toward our safe area from an intrasheath instrument position. The precision, safety, and efficacy of the release were evaluated by surgical exposure of the A1 and A2 pulleys and the neurovascular bundles. Results. In our volunteers, we observed a volar safe area from +6.1° to +180°. Surgical precision was good in the cadavers, with no injuries to adjacent structures, a complete release in 44 fingers (95.7%), and an incomplete release of less than 1.6 mm in 2 fingers. Conclusions. This study determined a safe volar area for aiming surgical instruments from an intrasheath position for percutaneous ultrasonographically guided A1 pulley release. The technique can be performed safely in all fingers, but we suggest being cautious in the thumb and converting the surgery to an open procedure if ultrasonographic visualization is not optimal.

Physiological response of beach lifeguards in a rescue simulation with surf

The objective of this study was to examine the physiological response of 14 lifeguards in a swimming pool simulation with 1.7 m waves and to study the efficiency of the torpedo buoy. The rescue time was determined with and without material, as were lactate levels, heart rate and VO2max. The results obtained showed a VO2 max rate of 3.4 ± 0.8 l/min without equipment and 3.3 ± 0.8 l/min with equipment. Moreover, the time taken to swim towards the victim without equipment decreased by 7.7 s, while towing time was reduced by 10.8 s if said equipment was used. These results show that aquatic rescue makes considerable physiological demands on the swimmer and they also provide important data on the type of training and aptitude levels required by individuals wishing to join these rescue groups. The equipment currently used has a negative affect on the swim. Statement of Relevance: The study shows that beach rescues make very high physiological demands on rescuers, thus underlining the need to perform entry tests for these highly demanding rescue teams. The auxiliary equipment is a help in the return time of rescue. However, it causes delays in the approach to the victim.The objective of this study was to examine the physiological response of 14 lifeguards in a swimming pool simulation with 1.7 m waves and to study the efficiency of the torpedo buoy. The rescue time was determined with and without material, as were lactate levels, heart rate and VO(2max). The results obtained showed a VO(2 max) rate of 3.4 +/- 0.8 l/min without equipment and 3.3 +/- 0.8 l/min with equipment. Moreover, the time taken to swim towards the victim without equipment decreased by 7.7 s, while towing time was reduced by 10.8 s if said equipment was used. These results show that aquatic rescue makes considerable physiological demands on the swimmer and they also provide important data on the type of training and aptitude levels required by individuals wishing to join these rescue groups. The equipment currently used has a negative affect on the swim. STATEMENT OF RELEVANCE: The study shows that beach rescues make very high physiological demands on rescuers, thus underlining the need to perform entry tests for these highly demanding rescue teams. The auxiliary equipment is a help in the return time of rescue. However, it causes delays in the approach to the victim.

Spanish Consensus Statement: Clinical Management and Treatment of Tendinopathies in Sport:

On October 15, 2016, experts met at Clínica CEMTRO in Madrid, Spain, under the patronage of the Spanish Society for Sports Traumatology (SETRADE), the Spanish Society of Sports Medicine (SEMED), the Spanish Association of Medical Services for Football Clubs (AEMEF), the Spanish Association of Medical Services for Basketball Clubs (AEMB), F.C. Barcelona, and Clínica CEMTRO. The purpose was to consider the most appropriate clinical management and treatment of tendinopathies in sports, based on proven scientific data described in the medical literature as well as on each expert’s experience. Prior to the meeting, each expert received a questionnaire regarding clinical management and treatment of tendinopathies in sports. The present consensus document summarizes the answers to the questionnaire and the resulting discussion and consensus regarding current concepts on tendinopathies in sports.

Spanish Consensus Statement The Treatment of Muscle Tears in Sport

On the 21st of March, 2015, experts met at Clínica CEMTRO in Madrid, Spain, under the patronage of The Spanish Society for Sports Traumatology (SETRADE), The Spanish Federation of Sports Medicine (FEMEDE), The Spanish Association of Medical Services for Football Clubs (AEMEF), and The Spanish Association of Medical Services for Basketball Clubs (AEMB) with the aim of establishing a round table that would allow specialists to consider the most appropriate current general actions to be taken when treating muscle tears in sport, based on proven scientific data described in the medical literature. Each expert received a questionnaire prior to the aforementioned meeting comprising a set of questions concerning therapeutic indications generally applied in the different stages present during muscle repair. The present Consensus Document is the result of the answers to the questionnaire and resulting discussion and consensus over which are the best current indications in the treatment of muscle tears in sport. Avoiding immobilization, not taking nonsteroidal anti-inflammatory drugs (NSAIDs) randomly, fostering early mobilization, increasing vascularization of injured, site and regulating inflammatory mechanisms—without inhibiting these from the early stages of the recovery period—all stood out as main points of the Consensus Document. Additionally, there is controversy concerning cell stimulation techniques and the use of growth factors or cell inhibitors. The decision concerning discharge was unanimous, as was the criteria considered when it came to performing sport techniques without pain.