XIV CURSO INTERNACIONAL DE CIRUGIA DE LA MANO Y II CONGRESO

Estimado amigo y colega:

 

Es muy grato para mi poder hacerte una cordial invitación para que nos acompañes en el XIV CURSO INTERNACIONAL DE CIRUGIA DE LA MANO Y II CONGRESO  que se realizara del 9 al 12 de octubre en el Instituto Nacional de Rehabilitación, contaremos con la presencia de reconocidos profesores nacionales e internacionales.

Profesores Internacionales

Dr. Jesse Jupiter                                                   ESTADOS UNIDOS DE AMERICA

Dr. Diego Fernández                                             BERNA SUIZA

Dr. Rames Mattar                                                  BRASIL

Dr. Alex Lluch                                                       BARCELONA ESPAÑA

Dr. Javier González                                               CHILE

Dr. Philippe Liverneaux                                        FRANCIA

En este curso veremos las patologías mas frecuentes de la mano desde padecimientos congénitos, traumáticos, lesiones de nervios periféricos, trauma complejo de mano, lesiones de plexo braquial, inestabilidades del carpo, fracturas de radio, etc etc,  lo mas nuevo en artroscopia y microcirugía.

Tendremos la oportunidad de discutir casos clínicos con los profesores y se realizara transmisión de cirugias en vivo. ademas de Talleres de osteosintesis de radio y metacarpianos y falanges.

Espero poder saludarte personalmente en este importante evento

Atentamente 

Dr Alejandro Espinosa

NJR study reveals dramatic fall in death rates after hip replacement surgery

http://www.njrcentre.org.uk/njrcentre/NewsandEvents/Dramaticfallindeathratesafterhipreplacement/tabid/331/Default.aspx

una publicación de British Orthopaedic Association.

Artroscopia. Alerta

Un paciente reclama 47.000 ? por las secuelas de una artroscopiaLa Voz de Galicia

Un paciente lucense reclama al Sergas alrededor de 47.000 euros por las secuelas que le produjo una artroscopia que le efectuaron. Su petición va camino de ...

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Manu Gómez, operado con éxito de su rodilla izquierdaLa Voz de Galicia

Manu Gómez fue sometido esta mañana a una artroscopia en su rodilla izquierda. En una intervención realizada en el FREMAP de Madrid, al pívot del Breogán ...

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FEB.es

Westbrook es operado de la rodillaTerra Perú

El gerente general, Sam Presti, dijo que Westbrook tenía la rodilla hinchada por un punto suelto, y la artroscopía fue para resolver el problema. El base fue ...

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El Nuevo Herald

Discusión entre pares.

Rakesh Agarwal
frykmann grade 8 fracture distal end radius treated in above elbow cast, serial xrays showed reduction maintained. reduction seems to be acceptable. kindly opine.



A Shrikant Sakore le gusta esto.


Vijayanand Addanki How many weeks old



Rakesh Agarwal it was a fresh fracture, immediate reduction was done



Sanjay Ganorkar dont be complacent .reduction will slip ..fracture will show subsidence in the weeks to come... better to recognise that explain to the patient and operate or put k wires



Vijayanand Addanki Post reduction how many weeks age of pt , , whether dominant hand....I feel should have been plated



Rakesh Agarwal followed upto 5 weeks reduction maintained, left hand age 25yrs



Drmahesh Dama or volar plate



Rakesh Agarwal yes that was always on my mind if reductuction slipped, will you still do if reduction is maintained till 4 or 5 weeks?
Hace 20 horas · Me gusta


Suresh Chandra Gaur Reduction will slip more. Volar plate after ext.fixater together will solve the problem
Hace 20 horas a través de móvil · Me gusta · 2


Anshuman Roy Needs to be fixed always...



Gaurav Vala Whenever cast will b removed, carpus will wedged thru' # site, only treatment is to buttress volar fragment, pls dont mislead by reduction xray!



Mavv Prasad Buttress plating is best



Diwakar Mishra volar subluxation of carpus, unacceptable position



Alok Jain Some how...
Could never accept the Cast treatment in displaced intra-articular fractures....
What do we want to prove with this...???
We all know, Union is almost never an issue...
Restoration of anatomy is the key...
If done because of economic reason, than I wl refer the patient to government hospital...
Gold standard is Volar plating...



Aung Kyi Win Can do.It is one option.Nice.



Alok Jain Aung Kyi Win
My Philosophy is simple...
I will treat, what I would want for myself...



Aung Kyi Win severe comm united # is difficult to maintain for small fragments. S/T I apply rubber band(isthmus)around the wrist& reduction done.Remove it& pop apply.Result is not bad.



Bahaa Maklad Volar Parton fracture
ORIF using T buttress plate



Gopal Goel how old is the injury-- If serial x-rays are good then continue conservative tt



Sunil Kumar Pd its not acceptable with this much volar subluxation of wrist,,,,, osteoclasis and re do it



Pavan Belehalli Dr.Rakesh - telling you by my experience these type of fractures are one of the most notorious ones which give rise to lot of problems if not reduced and fixed anatomically...I agree with Dr.alok ...a volar plate will be the best option...and don't forget the ulnar styloid since its a young patient...it in itself can give rise to a lot of problems. .all the best...and pl let us know what u did..



Sabyasachi Bardhan There seems to be volar subluxation if the carpas....I wud fix it with a volar locking plate



Dasanna Satyarup Agree with Alok Jain



Ashit Mehta There is volar subluxation. It will furgher displace. Waiting further would give rise to stiffness. Volar plating is the answer.
Hace 16 horas a través de móvil · Me gusta


DrManoj Agrawal MUST GO FOR ORIF



Anup Msf Volar buttress platin r synthes variable angle plating r best options
Wrist diatractor with k wires will also do



Anup Msf Immediate xrays after cclosed redn r vry fancy, but will not maintain all thru



Santosh Yadav distracter bd k wire can be a option



Kir Pat Only ORIF....



Abdelmoniem Hassan volar barton for ORIF

Dr Oscar Suárez Requena ha dejado en alto a Tabasco

http://www.tabascohoy.com/2/notas/index.php?ID=151407

Originario de Tenosique, Tabasco, el Dr. Óscar Suárez Requena, recibió en 2006 el Premio Nacional

de Ortopedia al ser pionero nacional en Microcirugía Láser Endoscópica para el tratamiento microquirúrgico de las hernia de disco lumbar y cervical.

Esta técnica la aprendió en los Estados Unidos con el Dr. Anthony T Yeung, director del Instituto del Desierto de Microcirugía Endoscópica de Columna en Phoenix Arizona, EU. 

En 2011 por sus aportaciones a la medicina recibió del entonces Presidente de la República, Felipe Calderón Hinojosa, un reconocimiento. 

Suárez Requena ha sido pionero en México de esta Técnica de Microcirúrgica de Disco Lumbar y Modulada con Rayos Láser, y ha impartido conferencias y entrenado a otros especialistas en México y otros países como Cuba, Venezuela, Colombia, Panamá, Costa Rica, Estados Unidos. Este octubre viajará a Guatemala para entrenar a ocho neurocirujanos.

¿Cuál ha sido la mayor satisfacción en su carrera? 

Además de poder ayudar a muchas personas, ofreciéndoles una mejor calidad de vida, a través de un método menos doloroso, es poder representar a mi país y a mi estado, fuera de la República, poder ofrecer conferencias y enseñarle a otros médicos este método.  

¿Qué le ha motivado a seguir adelante? 

Cambiarles a  cientos  de pacientes su  calidad  de  vida ya que se han recuperado  con este tratamiento.  

¿Qué siente al llevar sus conocimientos y compartirlos fuera de Tabasco y México? 

Todo lo contrario a lo que siento en el estado, la gente me invita a participar y reconoce mi trabajo. Es una tristeza que todo tenga que ver con la política y se dejen de un lado los conocimientos y las aportaciones que tienen que ver con el crecimiento y desarrollo de nuestro estado y nuestro país.  

¿Qué ha aportado? 

*Fue además fundador del Servicio de Traumatología y Ortopedia del Hospital Rovirosa. 

*Fundador de la Residencia de la especialidad de ortopedia y traumatología de Tabasco.  

*Fundador del Sistema Estatal de urgencias, que sirvió  de modelo nacional y de otros estados venían a aprender y  copiar  el modelo,  

*Profesor de posgrado de la Universidad Juárez Autónoma de Tabasco.  

--- AMC

Su pasión, la medicina

Es egresado de la UNAM realizó su especialidad en el Hospital de Traumatologia y Ortopedia del Centro Médico Nacional siglo XXI del IMSS
.

Six-week prehabilitation program improves knee function prior to ACL reconstruction

http://www.healio.com/orthopedics/sports-medicine/news/online/%7Bebf0d427-6b2a-4387-9590-1d198fba862f%7D/six-week-prehabilitation-program-improves-knee-function-prior-to-acl-reconstruction

Six-week prehabilitation program improves knee function prior to ACL reconstruction

Shaarani SR. Am J Sports Med. 2013;doi:10.1177/0363546513493594.

• October 1, 2013

Researchers in this study found a 6-week prehabilitation program for patients before undergoing ACL reconstruction improved knee function and self-reported outcomes after surgery.

“There were significant improvements in postexercise measurements of the single-legged hop, Modified Cincinnati total score, quadriceps peak torque, [cross-section area] CSA, and  [insulin-like growth factor 1] IGF-1 [messenger RNA] levels compared with baseline measurements,” Shahril R. Shaarani, MB, BCh, BaO, and colleagues wrote in their study. “This study supports prehabilitation for patients awaiting [ACL reconstruction]; however, further studies are required before such recommendation can be introduced into [ACL reconstruction] guidelines.”

Shaarani and colleagues assigned a 6-week home exercise and gym program or no exercise program to 20 patients who were awaiting ACL reconstruction, according to the abstract. After the program, patients in the exercise group improved significantly in the single-legged hop test. Modified Cincinnati Knee Rating System scores  also improved in the exercise group over the control group. The researchers found these results persisted at 12 weeks postoperatively.

http://ajs.sagepub.com/content/41/9/2117.abstract

Effect of Prehabilitation on the Outcome of Anterior Cruciate Ligament Reconstruction

1. Shahril R. Shaarani, MB, BCh, BaO*,†‡, 
2. Christopher O’Hare§,
3. Alison Quinn, BSc, MSc‖, 
4. Niall Moyna, PhD§, 
5. Raymond Moran, FRCS‡and 
6. John M. O’Byrne, FRCS†

+Author Affiliations

1. ^†Department of Orthopaedic Surgery Cappagh National Orthopaedic Hospital (CNOH) & Royal College of Surgeons in Ireland (RCSI), Dublin, Republic of Ireland
2. ^‡Department of Orthopaedic Surgery, Sports Surgery Clinic (SSC), Santry Demesne, Dublin, Republic of Ireland
3. ^§Department of Human Health and Performance, Dublin City University, Republic of Ireland
4. ^‖Department of Physiotherapy, Sports Surgery Clinic (SSC), Santry Demesne, Dublin, Republic of Ireland
5. Investigation performed at Cappagh National Orthopaedic Hospital and Sports Surgery Clinic, Dublin, Republic of Ireland

1. ↵* Shahril R. Shaarani, MB, BCh, BaO, Cappagh National Orthopaedic Hospital, Finglas, Dublin 11, Republic of Ireland (e-mail: delphaex@gmail.com).

Abstract

Background: Prehabilitation is defined as preparing an individual to withstand a stressful event through enhancement of functional capacity.

Hypothesis: We hypothesized that a preoperative exercise program would enhance postoperative outcomes after anterior cruciate ligament reconstruction (ACLR).

Study Design: Randomized controlled clinical trial; Level of evidence, 1.

Methods: Twenty volunteers awaiting ACLR were randomly assigned to a control or exercise intervention group. The exercise group completed a 6-week gym- and home-based exercise program. Assessments include single-legged hop test; quadriceps and hamstring peak torque and magnetic resonance imaging cross-sectional area (CSA); Modified Cincinnati Knee Rating System score; and muscle biopsy of the vastus lateralis muscle completed at baseline, preoperatively, and 12 weeks postoperatively. Myosin heavy chain (MHC) isoforms protein and messenger RNA (mRNA) expression were determined with SDS-PAGE (sodium dodecyl sulfate polyacrylamide gel electrophoresis) and RT-PCR (real-time polymerase chain reaction), respectively; IGF-1 (insulin-like growth factor 1),MuRF-1 (muscle RING-finger protein-1), and MAFbx (muscle atrophy f-box) mRNA expression were determined with quantitative RT-PCR.

Results: Following 6 weeks of exercise intervention, the single-legged hop test results improved significantly in the exercise-injured limb compared with baseline (P = .001). Quadriceps peak torque in the injured limb improved with similar gains in CSA compared with baseline (P = .001). However, this was not significantly increased compared with the control group. Quadriceps and vastus medialis CSA were also larger in the exercise group than in controls (P = .0024 and P = .015, respectively). The modified Cincinnati score was better in the exercise-injured limb compared with baseline. At 12 weeks postoperatively, the rate of decline in the single-legged hop test was reduced in the exercise group compared with controls (P = .001). Similar trends were not seen for quadriceps peak torque and CSA. The vastus medialis CSA had regressed to similar levels as the control group (P = .008). The modified Cincinnati score continued to increase in the exercise group compared with controls (P = .004). The expression of the hypertrophic IGF-1 gene was significantly increased after the exercise intervention (P = .028), with a decrease back to baseline 12 weeks postoperatively (P = .012). Atrophic MuRF-1 gene expression was decreased after intervention compared with baseline (P = .05) but increased again at 12 weeks postoperatively (P = .03). The MAFbx levels did not change significantly in either group and within each time point. On the mRNA level, there was a shift from MHC-IIx isoform to MHC-IIa after exercise, with significant changes compared with control preoperatively (P = .028). Protein testing was able to reproduce this increase for MHC-IIa isoform expression only.

Conclusion: The 6-week progressive prehabilitation program for subjects undergoing ACLR led to improved knee function based on the single-legged hop test and self-reported assessment using the modified Cincinnati score. These effects were sustained at 12 weeks postoperatively. This study supports prehabilitation as a consideration for patients awaiting ACLR; however, further studies are warranted.

Keywords:

• prehabilitation
 
• preoperative rehabilitation
 
• anterior cruciate ligament

INR. Congreso Internacional de cirugía de mano