Modificación a la clasificación de Lloyd Milton Nyhus al añadir la variable reductibilidad / Modification to the Lloyd Milton Nyhus's Classification upon Adding the Variable Reducibility

Introducción: Las clasificaciones de las hernias de la pared abdominal nos permiten agruparlas homogéneamente y comparar así resultados de diferentes estudios. Numerosas han sido descritas con el uso de diversas variables, pero ninguna logra cubrir todas las expectativas para lo cual fueron creadas. Objetivo: Presentar nuestra modificación a la clasificación original de Lloyd Milton Nyhus al añadir la variable reductibilidad para la estratificación de las hernias inguinocrurales. Métodos: Se realizó un trabajo descriptivo y prospectivo de 449 pacientes con hernia de la región inguinocrural atendidos en el Hospital Universitario "Dr. Juan Bruno Zayas Alfonso", de Santiago de Cuba, en el periodo comprendido de enero de 2018 a diciembre de 2019. Los datos fueron extraídos del Registro Electrónico de Hernias creado en el procesador estadístico Epi info versión 3.5.4 y presentados en tablas y porcientos. Resultados: Se presentó la nueva nomenclatura para identificar los diferentes subgrupos de hernias y se obtuvo que el 85,3 por ciento presentaban hernias reductibles, el 1,5 por ciento incarceradas, el 9,3 por ciento atascadas y el 1,7 por ciento estranguladas. Con esta nueva clasificación, disponemos en nuestro Registro de Hernias, de todos los subgrupos clínicos de hernias de la región inguinocrural. Conclusiones: La nueva modificación, nos permite estratificar y comparar homogéneamente por subgrupos a los pacientes, es sencilla de usar y de gran valor asistencial, docente y científico(AU)

Introduction: Classifications of abdominal wall hernias allow us to group them homogeneously and thus compare the results of different studies. Many have been described with the use of several variables, but none can meet all the expectations for which they were created. Objective: To present our modification to the original Lloyd Milton Nyhus's classification by adding the variable reducibility for the stratification of inguinocrural hernias. Methods: A descriptive and prospective study was carried out, in the period from January 2018 to December 2019, in 449 patients with hernia of the inguinocrural region treated at Dr. Juan Bruno Zayas Alfonso University Hospital of Santiago de Cuba. The data were obtained from an Electronic Registry of Hernias created in the statistical processor Epi info (version 3.5.4), as well as presented then in tables and percentages. Results: The new nomenclature to identify the different subgroups of hernias was presented. It was obtained that 85.3 percent had reducible hernias, 1.5 percent had incarcerated hernias, 9.3 percent had stuck hernias and 1.7 percent had strangulated hernias. With this new classification, we have, in our Hernia Registry, all the clinical subgroups of hernias in the inguinocrural region. Conclusions: The new modification allows us to stratify and compare patients homogeneously by subgroups; it is easy to use and of great care-related, teaching and scientific value(AU)

Factors Correlated with the Reducibility of Varus Deformity in Knee Osteoarthritis: An Analysis Using Navigation Guided TKA

BACKGROUND: We hypothesized that a number of clinical and radiologic parameters could influence the reducibility of varus deformity in total knee arthroplasty. The aim of this study was to identify the factors correlated with reducibility of varus deformity and predict more accurately the amount of medial soft tissue release required in varus deformity total knee arthroplasty. METHODS: One hundred forty-three knees with preoperative varus alignment and medial osteoarthritis were included in this retrospective study. The total knee arthroplasties were performed using a navigation system (OrthoPilot) by single surgeon. To assess varus deformity, the authors measured preoperative mechanical axis angles and valgus stress angles. Mechanical tibial angles, mechanical femoral angles, femoral osteophyte sizes, and tibial osteophyte sizes were measured. The Ahlback grading scale was applied for radiologic parameters, and clinical parameters (age, body mass index, sex, duration of pain, and preoperative range of motion) were documented. Correlations between these factors and preoperative valgus stress angle were analyzed. RESULTS: A negative correlation was found between preoperative mechanical axis angle and preoperative valgus stress angle (p < 0.01, r = -0.38), and a positive correlation was found between the preoperative mechanical tibial angle and preoperative valgus stress angle (p = 0.01, r = 0.19). CONCLUSIONS: The present study shows that preoperative varus deformity and proximal tibial vara (measured by preoperative mechanical axis angle and mechanical tibial angle, respectively) are correlated with reducibility of varus deformity (measured by preoperative valgus stress angle), and clinical parameters (age, range of motion, duration of pain and body mass index) and other radiologic parameters (osteophyte size, severity of osteoarthritis and angulation of distal femoral joint surface) were not significantly correlated with reducibility of varus deformity.