Incidencia de las disfunciones rotatorias de la tibia en las condropatias rotulianas / Incidence of rotary disfunctions of the tibia in patellar chondropathy

Objetivos: Observar la relación entre degeneración del cartílago fémoro-rotuliano y la disfunción rotatoria tibial, en pacientes afectos de condropatía rotuliana unilateral. Material y Métodos: De una muestra de 133 sujetos se seleccionaron 50 sujetos, a los que se les aplicaron evaluaciones manuales y radiológicas (medición goniométrica en rotación tibial y radiología) para observación del posicionamiento rotuliano, mediante la medición del ángulo de congruencia y el desplazamiento transversal de la rotula. Resultados: Se observan diferencias significativas entre la rodilla afectada y la rodilla sana, tanto al comparar la rotación interna tibial, como la rotación externa tibial (p< 0,0001). En relación a la posición de la rótula, cuando se encuentra afectada la rotación interna, observamos una angulación de la rótula en sentido lateral (con respecto a la rodilla sana). Cuando está afectada la rotación externa o ambas rotaciones conjuntas, la rótula se angula hacia medial (con respecto a la rodilla sana) (p<0,02). En relación al desplazamiento lateral, no observamos resultados significativos. Conclusiones: Los procesos degenerativos del cartílago articular fémoro-rotuliano se asocian con una disfunción rotatoria tibial. Existe un sentido de angulación concreto asociado a cada tipo de afectación de rotación determinada, y tendencia a que la rótula se angule y se desplace de una manera distinta en la rodilla afecta, comparada con la rodilla sana (AU)

Objectives: To observe the relationship between degeneration of the femur-patellar cartilage and the rotating tibial dysfunction, in patients suffering from unilateral patellar chondropathy. Material and methods: From a sample of 133 subjects, 50 subjects were selected, to whom manual and radiological tests were applied (goniometric measurement in tibial and radiological rotation) for observation of patellar positioning by the measurement of the angle of congruence and lateral displacement of the patella. Results: Significant differences are observed between the affected knee and the healthy knee, both when comparing internal tibial rotation and external tibial rotation (p <0.0001). In connection with the patella position, when internal rotation is affected, we observe a lateral angulation of the patella (with regard to the healthy knee). When external rotation or both joint rotations are affected, the patella is angled inward (with respect to the healthy knee) (p <0.02). With regard to lateral displacement, we observed no significant results. Conclusions: The degenerative processes of the femur-patellar joint cartilage are associated with rotational or tibial dysfunction. There is a sense of concrete angulation associated with each type of affectation of determined rotation, and a tendency for the patella to angulate and move differently to the affected knee when compared to the healthy knee (AU)

Reproducibility of sonographic measurements of the median nerve.

OBJECTIVE: The purpose of this study was to evaluate the reproducibility of median nerve cross-sectional area (CSA) measurements using the indirect method (ellipsoid formula) and the direct or tracing method. METHODS: The median nerve CSA was measured in 22 wrists of patients with carpal tunnel syndrome by means of high-frequency sonography. Measurements were made at the level of the pisiform bone by a standardized sonographic examination protocol. Two observers with different levels of experience performed the measurements, independently and blinded. An analysis of reliability was carried out, and the concordance between the methods was determined with parametric statistical tests. RESULTS: The results point to good reproducibility of the median nerve CSA measurements obtained by both methods, whether performed by an experienced observer or by an inexperienced observer after a short learning period. CONCLUSIONS: The results suggest sonography for median nerve CSA measurements is reproducible by either the direct or indirect method when a standardized sonographic examination protocol is used.

Wrist arthrography: a simple method.

A technique of wrist arthrography is presented using an adhesive marker-plate with radiopaque coordinates to identify precisely sites for puncture arthrography of the wrist and to obviate the need for fluoroscopic guidance. Radiocarpal joint arthrography was performed successfully in all 24 cases, 14 in the cadaveric wrists and 10 in the live patients. The arthrographic procedure described in this study is simple, safe, and rapid, and has the advantage of precise localisation of the site for puncture without need for fluoroscopic guidance.