Biomedical subjects

J M Rapariz

Publications and source records attributed to J M Rapariz.

6 recordsLinked to original sources

PubMed1998

Anterior endoscopic approach to the thoracolumbar spine.

STUDY DESIGN: A technique for anterior endoscopic exposure of the thoracolumbar spine is described. OBJECTIVE: To develop an endoscopic approach to the thoracolumbar spine with fewer complications than are encountered in the conventional approach. SUMMARY OF BACKGROUND DATA: The efficacy of the anterior endoscopic approach to the thoracic spine has been shown. The thoracolumbar hinge is usually approached by open surgery. METHODS: The study was performed in three stages. The first phase was carried out on experimental animals (pigs). Once the bases were established, the approach was studied in fresh cadavers. Finally, it was performed on three patients with thoracolumbar scoliosis who required discectomy and anterior release. RESULTS: After a series of attempts on the animals, it was found that the most effective method for exposure of the thoracolumbar spine was the initial thoracoscopic approach followed by the retroperitoneal endoscopic approach. This was confirmed in cadavers. When applied to the clinical situation, there were no significant complications in any of the patients treated with this method, and postoperative pain and discomfort were minimal. CONCLUSIONS: The anterior endoscopic approach to the lumbar spine involves minor trauma, results in rapid recovery and less pain, and produces good results aesthetically.

Adolescent↗

PubMed1997

Traumatic proximal tibiofibular dislocation.

Proximal tibiofibular dislocation is an exceptional lesion. Rarer still is its presentation in childhood. We describe the clinical case of a 6-year-old boy, the victim of a road accident. He had a tibiofibular dislocation associated with a metaphyseal fracture of the tibia.

Child↗

PubMed1995

Secondary avascular necrosis after treatment for congenital dislocation of the hip.

We made a radiographic study of 104 unilateral congenital dislocations of the hip (CDH) that had an average age of 12 months (range 4-24), were treated with the same therapeutic protocol, and had an average six years follow-up (range 3-13). Radiographic changes were evident in the proximal femoral epiphysis in 57 hips (55%). In 7 (7%) the changes consisted of central osteoporosis with a cystic aspect, without metaphyseal or physeal changes, and had a normal end result without sequelae. This group was classified as type I. Fifty hips (48%) that were type II showed epiphyseal changes consisting of trabecular rarefaction with osteoporosis and irregular sclerosis, followed by a decrease of epiphyseal height and trabecular recovery. Forty-two hips (40%) were type IIA, with < 75% decrease in epiphyseal height with respect to the healthy side; five of these had a normal evolution, 35 had coxa magna and/or decrease of epiphyseal height, and only two cases had physeal lesion. In type IIB, hips, with > 75% decrease of epiphyseal height, 8 cases (8%) had a final physeal lesion.

Child↗

PubMed1995

Intramedullary nailing of the femur in children. Effects on its proximal end.

We have studied the medium- and long-term effects of femoral intramedullary nailing in 34 children. There was a high incidence of abnormality at the proximal end of the femur, including coxa valga, arrest of growth of the greater trochanter and thinning of the neck of the femur, because of damage to the trochanterocervical growth plate. These disorders affected 30% of the patients, mostly under the age of 13 years (p < 0.05), and were seen more frequently when the nail had been introduced through the piriform fossa. Other factors, such as the side, gender, aetiology, proximal or retrograde insertion, the size of nail and removal of the implant did not influence the result. We recommend that in patients under the age of 13 years other methods of management should be used to avoid damage to the growth plate.

Adolescent↗

PubMedDate not supplied

Distal tibial triplane fractures: long-term follow-up.

The cases of 35 patients in whom a triplane fracture had been treated at the Ramón y Cajal Hospital were reviewed. The diagnosis of biplane and triplane fracture can now be made by standard radiograph. However, plain radiographs alone did not accurately demonstrate the configuration of the fracture, and computed tomography must be performed. Closed reduction should be attempted first. Failure to obtain or maintain (or both) an adequate closed reduction is an indication for operative treatment. Prognosis is surprisingly good. Only when adequate reduction (< 2 mm displacement) has not been achieved can degenerative changes be seen at long-term follow-up (> 5 years).

Adolescent↗

PubMedDate not supplied

Displaced radial neck fractures in children treated by closed intramedullary pinning (Metaizeau technique).

We report the retrospective results of 17 displaced radial neck fractures (O'Brien type II-III) in children aged between 6 and 16 years treated with closed intramedullary pinning according to the Metaizeau technique, from 1988 to 1992 in our Pediatric Orthopaedic Service at the Ramón y Cajal Hospital. The average follow-up was 4.1 years. Excellent results were observed in all cases except one (94%). Overgrowth of the radial head was present in three cases without functional impairment. We recommend this closed method of treatment because it is simple, easy to perform, and obtains exciting results with few complications.

Adolescent↗