ABSTRACT
Objetivo: Establecer un modelo experimental sencillo, reproducible y seguro para conocer el desarrollo de la necrosis vascular isquémica de la cadera en el cordero. Material y metodología: Utilizamos 15 corderos (10 machos y 5 hembras) de 4 semanas de edad, divididos en un grupo control (7 animales) y otro grupo experimental (8 animales), a los que se provocó la isquemia de la extremidad proximal del fémur. Se efectuaron radiografía convencional y resonancia nuclear magnética. Tras el sacrificio de los animales, a la 4.a, 8.a y 12.a semanas poscirugía, extrajimos y medimos la cabeza femoral. Una vez fijada la pieza obtuvimos cortes histológicos de diferentes zonas que se tiñeron con hematoxilina-eosina. Resultados: Radiográficamente disminuyó la altura y aumentó la anchura de la cabeza femoral, más evidente a partir de la 4.a semana. No objetivamos cambios en la altura del pilar lateral ni en la distancia artículo-trocantérea. El grupo experimental macroscópicamente demostró hipertrofia y aplanamiento progresivo de la cabeza. A las 4 semanas de la cirugía aparecieron zonas de necrosis en el cartílago articular, una médula ósea más densa y menor altura de la fisis. Los vasos estaban engrosados por proliferación de la capa media y de la adventicia. A las 8 semanas encontramos una fibrosis subcondral, con un cartílago articular irregular, adelgazado y desvitalizado, y áreas de angiogénesis con grasa en el hueso subcondral. A las 12 semanas apreciamos el cierre de la fisis, áreas condrales en las trabéculas óseas y células adiposas en la médula diafisaria. Conclusión: Aunque los cambios histológicos son compatibles con necrosis de la cabeza femoral, las pruebas de imagen obtenidas no se asemejan a la enfermedad de Perthes, por lo que desaconsejamos este modelo experimental para el estudio de esta entidad (AU)
Objective: To establish a simple, reproducible and safe experimental model, for the development of ischemic vascular necrosis of the hip in the lamb. Material and methods: We used 15 lambs (10 males and 5 females) aged four weeks, divided into a control group (7 animals) and an experimental group (8 animals) producing ischemia in the proximal femur. Standard radiography and MRI were performed. The animals were euthanised at the 4th, 8th and 12th weeks after surgery. The femoral heads were extracted and measured and a histological analysis was performed with hematoxylin-eosin staining. Results: Decreased height and increased width of the femoral head was observed in the X -rays, particularly after the 4th week. We did not observe any changes in the height of the lateral pillar or trochanteric distance. The experimental group showed macroscopical hypertrophy and progressive flattening of the head. At 4 weeks necrotic areas in articular cartilage were observed, bone marrow was dense and the growth cartilage height was lower. The vessels were thickened by proliferation of the medial and adventitia layers. At 8 weeks, we found fibrosis in the subchondral bone with thinned and devitalized angiogenesis fat areas. The articular cartilage showed irregularities. At 12 weeks the closure of the physis was noted, as well as chondral areas in the trabecular bone and fat cells in the methaphysis. Conclusion: Although the histological changes are consistent with necrosis of the femoral head, the images obtained did not resemble Perthes disease, so we do not advise this experimental model for the study of this disease (AU)
Subject(s)
Animals , Legg-Calve-Perthes Disease/physiopathology , Femur Head Necrosis/physiopathology , Disease Models, Animal , SheepABSTRACT
OBJECTIVE: To establish a simple, reproducible and safe experimental model, for the development of ischemic vascular necrosis of the hip in the lamb. MATERIAL AND METHODS: We used 15 lambs (10 males and 5 females) aged four weeks, divided into a control group (7 animals) and an experimental group (8 animals) producing ischemia in the proximal femur. Standard radiography and MRI were performed. The animals were euthanised at the 4th, 8th and 12th weeks after surgery. The femoral heads were extracted and measured and a histological analysis was performed with hematoxylin-eosin staining. RESULTS: Decreased height and increased width of the femoral head was observed in the X-Rays, particularly after the 4th week. We did not observe any changes in the height of the lateral pillar or trochanteric distance. The experimental group showed macroscopical hypertrophy and progressive flattening of the head. At 4 weeks necrotic areas in articular cartilage were observed, bone marrow was dense and the growth cartilage height was lower. The vessels were thickened by proliferation of the medial and adventitia layers. At 8 weeks, we found fibrosis in the subchondral bone with thinned and devitalized angiogenesis fat areas. The articular cartilage showed irregularities. At 12 weeks the closure of the physis was noted, as well as chondral areas in the trabecular bone and fat cells in the methaphysis. CONCLUSION: Although the histological changes are consistent with necrosis of the femoral head, the images obtained did not resemble Perthes disease, so we do not advise this experimental model for the study of this disease.
Subject(s)
Disease Models, Animal , Legg-Calve-Perthes Disease , Animals , Female , Legg-Calve-Perthes Disease/pathology , Male , SheepABSTRACT
Objetivo. Comparar la técnica quirúrgica abierta con la percutánea para el tratamiento de la tenosinovitis estenosante del pulgar en la infancia. Material y método. Se realizó un estudio retrospectivo donde se revisaron 108 pacientes (135 pulgares) con un período de seguimiento medio de 24 meses, comparando ambas técnicas quirúrgicas. Resultados. Seis pacientes de 92 (6,52%) presentaban incapacidad para la extensión completa de la articulación interfalángica del primer dedo tras cirugía abierta. Mediante cirugía percutánea la recidiva ocurrió en 15 pulgares de 43 intervenidos (34,8%). No aparecieron complicaciones relacionadas con déficit de sensibilidad, dolor residual, ni alteraciones de la movilidad del primer dedo en ninguna de las dos series comparadas. Conclusiones. El porcentaje de recidiva acontecido tras el tratamiento percutáneo del pulgar en resorte justifica no recomendar su utilización en la población infantil (AU)
Purpose. To compare open versus percutaneous surgery in the treatment of stenosing tenosynovitis in a pediatric population. Materials and methods. A retrospective study was performed comparing both surgical techniques by reviewing 108 patients (135 thumbs) with a follow-up period of 24 months. Results. Six patients out of 92 (6.52%) were incapable of complete extension of the interphalangeal joint of the thumb after open surgery. When percutaneous surgery was performed there was recurrence in 15 thumbs of the 43 that underwent surgery (34.8%). No complications were seen related to lack of sensitivity, residual pain, nor alterations of thumb mobility in any of the patients in the two compared series. Conclusions. Due to the percentage of recurrences seen, percutaneous surgery for trigger thumb is not recommended in a pediatric population (AU)
Subject(s)
Humans , Male , Female , Child , Tenosynovitis/surgery , Thumb/surgery , Retrospective Studies , Recurrence , Recovery of FunctionABSTRACT
Objetivo. Comparar los resultados del tratamiento del quiste óseo simple mediante aspiración e infiltración con corticoides frente al curetaje y relleno con injerto. Analizar la existencia de factores pronósticos que se relacionen con la respuesta al tratamiento. Material y método. Estudio retrospectivo de 29 niños con diagnóstico clínico-radiológico y/o anatomopatológico de quiste óseo simple que hayan sido tratados mediante alguno de los dos métodos. Se han comparado los resultados en función de la clasificación de Neer modificada. Resultados. La frecuencia de curaciones (completas o incompletas) fue del 85 por ciento para los tratados mediante curetaje e injerto y del 88 por ciento para los tratados mediante infiltración con corticoides. No se han encontrado diferencias significativas entre los dos grupos de tratamiento. La respuesta al tratamiento no se relacionó en nuestra serie con ninguno de los posibles factores pronósticos estudiados: edad, localización, actividad, tamaño y aspecto radiológico. No se observaron complicaciones entre los niños tratados con infiltraciones. Conclusiones. El tratamiento con infiltración con corticoides debe ser considerado de elección en el quiste óseo simple, por su menor morbilidad y coste (AU)
Subject(s)
Female , Male , Child , Humans , Bone Cysts/drug therapy , Adrenal Cortex Hormones/pharmacology , Adrenal Cortex Hormones/administration & dosage , Bone Transplantation , Retrospective Studies , InhalationABSTRACT
We have analysed the development of the cartilage canals in the tarsal navicular in 26 human foetuses and infants, aged between 12 weeks after gestation and 10 months, using a technique of transparentation and serial histological sections of the bone. The formation of cartilage canals starts in the first 12 to 13 weeks of gestation and can be seen by transparentation at 17 weeks after gestation. They increase in number with the age of the foetus or infant and develop a branching pattern almost to the centre of the tarsal navicular. They begin and are more numerous on the dorsal surface of the cartilage structure.
