La integración en la transversalidad del compartimento posterior del suelo pélvico en el Hospital Universitario Comandante Manuel Fajardo (2013- 2015) / Posterior compartment of the pelvic floor and its integration in cross-sectional approach in Comandante Manuel Fajardo Hospital (2013-2015)

Introducción: las afecciones del suelo pélvico tienen alta prevalencia y su estudio debe ser realizado con enfoque transversal para proveer al paciente el tratamiento adecuado. Objetivo: describir las características clínicas de enfermedades del compartimento posterior con diagnóstico basado en enfoque transversal. Método: estudio descriptivo, transversal en pacientes atendidos en la consulta de Coloproctología en el Hospital Universitario Comandante Manuel Fajardo, desde septiembre 2013 hasta mayo 2015. El universo estuvo constituido por 67 pacientes. Fueron calculadas frecuencias y porcentajes para las variables cualitativas e intervalos de edad, y estadísticos descriptivos de la edad. Resultados: la mayoría de los pacientes fueron ≤ 45 años, con predominio de la tercera edad (43,3 por ciento). Las mujeres constituyeron la mayoría del grupo (80,6 por ciento). Los antecedentes de riesgo más frecuentes fueron los relacionados con la historia obstétrica, fundamentalmente la multiparidad (83,3 por ciento). La forma de presentación más frecuente fue la incontinencia anal. Predominó la afectación exclusiva del compartimento posterior (59,7 por ciento). La afectación bicompartimental predominante fue la anterior y posterior, determinada en su mayoría por incompetencia dual (única afección en 17,9 por ciento). No se detectó afectación tricompartimental. Conclusiones: las afecciones del compartimento posterior se asociaron en alta proporción a enfermedades de otros compartimentos del suelo pélvico, lo que ratifica la importancia del enfoque transversal(AU)

Introduction: pelvic floor illnesses have high prevalence and their study must be conducted with a cross-sectional approach to provide the patient with adequate treatment. Objectives: to describe the clinical characteristics of the posterior compartment illnesses by using cross-sectional approach-based diagnoses in patients seen at the coloproctology service of Manuel Fajardo university hospital from September 2013 to May 2015. Method: descriptive and cross-sectional study. The universe of study was 67 patients. Frequencies and percentages for qualitative variables and age intervals as well as summary statistics for age were all calculated. Results: many patients were 45 years and over, being the older age predominant (43.3 percent). Women were the majority in the group (80.6 percent). The most frequent risk antecedents were those related to obstetric history, mainly multiparity (83.3 percent). The most common form of presentation was anal incontinence. Single affection of the posterior compartment (59.7 percent) prevailed. The predominant bi-compartmental affection was the anterior and posterior one, mainly determined by dual incontinence (single affection in 17.9 percent of cases). Tricompartmental affection was not detected. Conclusions: the posterior compartment affections were greatly associated to diseases in other pelvic floor compartments, which supports the importance of using the cross-sectional approach(AU)

Combined entrances for the arthroscopic surgery of posterior compartment of the knee joint / 中国矫形外科杂志

[Objective]To study the feasibility and significance of a safe arthroscopic entrance technique to posterior compartment of the knee joint.[Method]Exploratory surgery of posterior compartment of 239 knee joints was performed by arthroscope or its working instruments through the combined entrances of anteromedial,anterolateral,intercondylar notch,posteromedial,posterolateral and trans-septal.Their results were evaluated.[Result]With this technique,complete arthroscopic visualization of the posterior compartment of knee joint and arthroscopic procedures for this compartment could be easily performed in 216 cases(239 knees),except 5 cases with arthro-stiffness.There occurred 1 case of saphenous nerve injury but no complications such as injuries of popliteal neurovascular structures.[Conclusion]Combined entrances of posterior compartment of knee joint is a satisfactory approach for arthroscopic surgery of posterior compartment of knee joint and can give a high efficiency and quality of arthroscopic surgery for posterior compartment of knee joint.

Arthroscopic Removal of Loose Bodies from the posterior Knee Compartment using Direct Posterior - Posterior Triangulation

PURPOSE: To report the advantages and the results of arthroscopic removal of loose bodies by posteri-or-posterior triangulation, using the posteromedial and posteroleteral portal. MATERIALS AND METHODS: Sixteen cases in this study had loose bodies in the posterior compartment of the knee joint; nine cases in the posteromediaI, three cases in the posterolateral and four cases in the both compartments. Under the supine position, the knee is flexed to a 90 angle, and an obturator was inserted in the posterolateral compartment through the fat areolar tissue eliminating the loose bodies in the posterior compartment. RESULT: In sixteen cases we eliminated all loose bodies under arthroscopy which were in the posterior compartment of the knee joint and there was no complication such as saphenous nerve palsy, common peroneal nerve palsy, or the rupture of popliteal artery. CONCLUSION: Arthroscopic removal of loose body in the posterior compartment of the knee joint using posterior-posterior triangulation was considered as one of the useful methods in terms of safety and good visualization.

Localized Pigmented Villonodular Synovitis of the Posterior Compartment of the Knee: A Case Report / 대한정형외과학회잡지

Localized pigmented villonodular synovitis is a monoarticular proliferative condition that may affect any joint but is frequently found in the knee. The locaiized form was less frequent than the diffuse one. The estimated frequency of localized pigmented villonodular synovitis among patients performed an arthroscopic procedure was known one case lor each 2,500 cases. Previous reports pointed that the lower recurrence rate after the arthroscopic excision for localized form. We also experienced a case of localized pigmented viilonodular synovitis located at the posterior compartment of the knee, so we report this case with review of literatures.

Posterior Cervical Plate Fixation in Cervical Injuries

Posterior stabilization of unstable cervical spine injury using metal plate and screw has been commonly used in Europe but very rarely in Korea where it has been usually achieved with wires supplemented by bone graft. We have experienced 11 patients of unstable lower cervical spine injuries which were stabilized with posterior cervical plate without bone graft. One patient was total quadriplegia and two patients showed minor motor and sensory changes and the others were neurologically intact. Operations were performed within 10 days after trauma(average 4.9 days) except 2 cases of late instability. Most of the patients could ambulate the day after operation with a Philadelphia collar which was kept for 3 months. We achieved good postoperative alignment of injured cervical spine and tolerable neck motion limitation and we experienced no surgical complication. So we suggest that posterior cervical plate fixation technique is a good method of cervical stabilization for lower cervical spine injury, especially when posterior compartment injury is predominant.