Dr. Juan Agustín Valcarce León

Dr. Juan Agustín Valcarce León

domingo, 30 de marzo de 2014

Oscar Noriega fue operado | lavinotinto.com

Oscar Noriega fue operado | lavinotinto.com

Publicada el 29 marzo 2014 a las 9:26 am
El mediocampista del Zamora FC Oscar Noriega pasó por el quirófano
este viernes para ser tratado en su rodilla derecha, y se estima que en
tres semanas podrá estar de regreso a las canchas.

En una nota de prensa el cuadro barinés informó que tras la lesión sufrida en febrero pasado no se observó una recuperación favorable, por lo que se decidió hacer una artroscopia para determinar el verdadero alcance de la molestia física.

“Se le realizó una artroscopia de rodilla derecha para saber qué
era lo que estaba causando el dolor que no permitía la recuperación
pertinente. Se le encontró una lesión condral de la rótula derecha y se
extrajeron múltiples fragmentos cartilaginosos”,
explicó el médico del equipo, Rafael Viloria.

El mismo día de la operación inició la rehabilitación del jugador y se espera que entre dos o tres semanas esté listo para jugar de nuevo.


Foto: Prensa Zamora FC

jueves, 27 de marzo de 2014

Congenital Pseudoarthrosis of Medial Malleolus in A Young Soccer Player - Diagnosis in Clinical setting of Ankle Sprain

Congenital Pseudoarthrosis of Medial Malleolus in A Young Soccer Player - Diagnosis in Clinical setting of Ankle Sprain

Congenital Pseudoarthrosis of Medial Malleolus in A Young Soccer Player – Diagnosis in Clinical setting of Ankle Sprain

Congenital Pseudoarthrosis of Medial Malleolus in A Young Soccer Player – Diagnosis in Clinical setting of Ankle Sprain

What to Learn from this Article?

Diagnosis of congenital pseudoarthrosis of medial malleolus specially in a confusing setting of ankle sprain

Case Report |  Volume 4 | Issue 1 | JOCR Jan-Mar 2014 | Page 11-14 | Giuliano C, Fabiano F, Gabriele P, Giacomo P, Enrico S

DOI: 10.13107/jocr.2250-0685.139

Authors: Giuliano C[1], Fabiano F[2], Gabriele P[1], Giacomo P[3], Enrico S[3]

[1]Nicola’s Foundation Onlus, Arezzo, Italy.

[2]Nuova Clinica San Francesco, Foggia, Italy.

[3]University of Perugia, Italy.

Address of Correspondence:

Giuliano Cerulli, Orthopaedic and Traumatology Residency Program,
University of Perugia, via GB Pontani 9, Perugia,
Italy. Email:clinreslpm@gmail.com

Introduction: We
report a case of a young female soccer player affected by congenital
medial bilateral malleolus pseudoarthrosis and os subfibulare.
Congenital pseudoarthrosis is the failure of the bones to fuse prior or
at birth.  The etiology is still unknown, although frequency is high in
subjects affected by neurofibromatosis or correlated syndromes, so it
has been suggested that these congenital disorders may be the cause of
congenital pseudoarthrosis.

Case Report: Our
patient, a 16-year-old female, high level soccer player, was referred
to us following a right ankle sprain during a match. She reported no
medical history of tibia-tarsus joint injuries or disease. Pain,
swelling and functional impairment were noted immediately after the
accident. Standard radiographs in the emergency department revealed a
displaced fracture of the medial malleolus and the presence of os
subfibularis. The patient was transferred to our Traumatology and
Orthopaedic Department to undergo malleolus ostheosynthesis. Before
surgery swelling, functional impairment and intense pain at the medial
malleolus level were confirmed. However, there was no radiological
opening of ankle, instability or pronation pain; furthermore the
flexion-extension was preserved with slight pain. Twenty-four hours
later a considerable remission of symptoms was evident with increased
range of motion and reduction in the swelling and post-traumatic edema. A
radiograph on the left ankle to compare with that of the right ankle
was necessary to overcome the discrepancy between the radiological
diagnosis and the clinical examination. The radiographic results of both
medial malleoli were comparable although on the left the os
subfibularis was absent. Since the diagnosis of fracture by the
association between the radiographs and the symptomatology was doubtful,
a bilateral CT was performed. The scan revealed a medial bilateral
malleolus pseudoarthrosis and an accessory right subfibularis nucleus.
The patient was discharged from hospital with the diagnosis of “second
degree right ankle sprain in patient affected by congenital medial
bilateral malleolus pseudoarthrosis”. A therapeutic-rehabilitative
program was prescribed for the ankle sprain and unnecessary surgery was
avoided. After 30 days there was an almost complete remission of pain.
At a follow-up of six months the patient was completely asymptomatic and
gradually began competitive activity.

Conclusion: An
accurate history and an objective examination should be performed and
correlated with the results of diagnostic procedures in order to avoid
the incorrect diagnosis of a fracture needing surgery. The rarity of
this ailment and the absence of consequences on long-term function, show
that this disease does not justify sports activity cessation. Traumatic
events at this site must be assessed properly in order to avoid being
confused with malleolus fractures leading to over treatment.

Keywords: Ankle sprain, medial malleolus, pseudoarthrosis Introduction.

martes, 25 de marzo de 2014

Surgery of the athlete´s knee

Our 2014 surgical skills course offers sports medicine specialists the chance to master athletic knee operations - and we still have spots available! Learn more about this educational opportunity:http://bit.ly/NPs4nw

sábado, 22 de marzo de 2014

Discusión entre pares / 4year boy 40day old ago

4year boy
40day old ago 

  • Alberto Padilla D tibial osteotomy and fix w/ plate or ex fix

  • Siddhartha V Paluvadi Conservative. Well remodel without doubt.

  • Ananda Regmi It is an angular malalignment needs osteotomy n plating as because angulation is towards upperpart of lower third.

  • John Rabadi No thing to do.. It will be remodeling nevermind

  • Alberto Padilla D NO, the deformity is to much to remodel is about 20°. Osteotomy and plate

  • Omar Kelany 4y ....High tendency for remodeling which already start....conservative

  • Sagar Chhetri Angular malalignment.....needs osteotomy n fixation probably plating will be good choice...........

  • Kanav Padha Should do osteotomy. Reasons-1. Ankle are not growing ends so chance or remodelling less.2.deformity not in plane of motion of joint.3. Varus less tolerated than valgus.
    Remember we do corrective osteotomy in cubitus varus ( non wt bearing joint) why not in wt bearing joint.

  • Alberto Padilla D the osteotomy must be made in CORA (center of rotation). or curve, wedge ???

  • Safooh Shoairieh Only 4 yesrs! Conservative and shoe insert to enhance remodeling.

  • Pedro Jorba I measure it to be about 15 degrees. It might indeed need an osteotomy, but personally, I would wait 4-6 months to see how much it remodels. It won't hurt to wait a little bit, and really, it's such a young child.

  • Deepak N Inamdar wait for an year-two at least see remodeling then plan further

  • Vishal Garg follow up X rays:: if deformity does not increase in next 2 years then it should correct itself in adolescence::::: but if it deteriorates: corrective osteotomy

  • Shyamlal Mukhi Ball Osteotomy both fibula and tibia and cast ( drill holes)

  • Anuj Agrawal The deformity, if correctly measured, is around 15-16°. I have checked the literature regarding acceptable limits of angulation in tibial fractures, and surprisingly could not find any for young children less than 5-6 years of age.
    For children less th
    ...Ver más

  • Deepak N Inamdar am surprised that so many are suggesting osteotomy at first shot ....for a 4yr old child ???