ABSTRACT
Históricamente, las médicas han sido asociadas a especialidades determinadas. En los últimos años, estos estereotipos han sido lentamente revertidos con mayor participación de la mujer en especialidades quirúrgicas. En el proceso de aprendizaje se sabe la importancia que tienen los modelos y mentores. Buscamos evaluar el grado de satisfacción y el éxito profesional de las mujeres en Traumatología, y qué factores cumplieron un rol positivo en la decisión de optar por ella.Se encuestó a 108 mujeres dedicadas a la Traumatología, y se evaluaron las influencias positivas y los mentores como modelo en la toma de decisión por la especialidad y los grados de satisfacción personal y profesional.Pese a una mayor percepción de dificultades en lograr el objetivo, destacan los altos grados de satisfacción profesional y personal de las mujeres en Traumatología: 95% refirió haber elegido la especialidad correcta, 100% afirmó que las dificultades se compensan con los resultados obtenidos, y 96% volvería a elegir la misma especialidad. En relación con la percepción de éxito, 73% se considera exitosa en su vida profesional, y en la vida personal, 85%.Muy relevante en la toma de decisión por la especialidad es el rol que cumplen docentes, mentores, y el gusto por la cirugía y los deportes. Un 84% recibió alguna influencia positiva, 61% tuvo como modelo en su formación una traumatóloga, y un 98% recomendaría a otras mujeres en período de formación que se dedicaran a la Traumatología.Las estrategias de incremento de la participación femenina en la especialidad pudiesen orientarse a fomentar modelos femeninos durante el aprendizaje.
Historically, female doctors have been associated with certain specialties. In recent years, these stereotypes have been slowly reversed with an increased participation of women in surgical specialties. The importance of models and mentors in the learning process is known. We seek to evaluate the level of professional satisfaction and success of women in Traumatology, as well as the factors that may have played a positive role in the decision to pursue this specialty. We surveyed 108 women working in Traumatology and evaluated the positive influences and mentors as models in the decision-making regarding the specialty and the degrees of personal and professional satisfaction. Despite a greater perception of difficulties in achieving the purpose, the high degrees of professional and personal satisfaction of women in Traumatology stands out: 95% reported having chosen the correct specialty, 100% stated that the difficulties are offset by the results obtained, and 96% would choose the same specialty again. Regarding the perception of success, 73% consider themselves successful in their occupation, and 85% consider themselves successful in their personal lives. The role played by teachers, mentors, as well as an interest in surgery and sports are very relevant in choosing the specialty. In total, 84% of the sample received some positive influence 61% had a female traumatologist as a model during their training, and 98% would recommend other women in training to dedicate themselves to Traumatology. The strategies to increase female participation in the specialty could be aimed at promoting female role models during learning.
Subject(s)
Humans , Female , Personal Satisfaction , Physicians, Women/psychology , Orthopedic Surgeons/psychology , Orthopedics , Perception , Traumatology , Mentors , Career Choice , Chile , Epidemiology, Descriptive , Surveys and Questionnaires , Job SatisfactionABSTRACT
The successful treatment of hip dysplasia consists of achieving a concentric reduction and avoiding residual dysplasia. One of the essential factors is early diagnosis and treatment. OBJECTIVE: Evaluate the relationship between the age at initiation of hip dysplasia treatment and the presence of residual dysplasia at one year of age. PATIENTS AND METHOD: Prognostic retrospective study. Patients with hip dysplasia treated with Pavlik harness in a tertiary healthcare center were selected. Residual dyspla sia was defined as an acetabular index greater than 28 degrees at one year of age. An association of residual dysplasia with the age at treatment initiation, bilaterality, and acetabular index more than 36 degrees was determined. The T-Student, Chi-Square, and Youden index tests were used. A p- value < 0.05 was considered significant. The STATA v.16 software was used. RESULTS: 153 patients (262 hips) were included, 84.3% (129) were females, and 71.2% (109) presented bilateral dysplasia. Fifty-nine hips (22.52%) presented residual dysplasia, finding a significant association with the age at treatment initiation (p = 0.03), bilateral dysplasia (p < 0.01), and acetabular index greater than 36 degrees (p = 0.01). Starting treatment after 4.5 months increases the risk of residual dysplasia by 2.5 times (95% CI 1.25-5.03). CONCLUSION: An increase in residual dysplasia was observed at the start of treatment after 4.5 months. It is relevant to consider this result in local clinical guidelines to achieve a successful diagnosis and treatment.
Subject(s)
Hip Dislocation, Congenital , Hip Dislocation , Female , Humans , Male , Retrospective Studies , Orthotic Devices , Treatment Outcome , Time Factors , Hip Dislocation, Congenital/diagnostic imaging , Hip Dislocation, Congenital/therapyABSTRACT
La osteogenesis imperfecta (OI) es un grupo de trastornos del tejido conectivo que genera anomalías esqueléticas caracterizadas por fragilidad y deformidades óseas. Las características genéticas son variables y se han descrito nuevos subgrupos los últimos años agregando información a las clasificaciones tradicionales. Su incidencia es de 1/10.000 a 20.000 RN vivos. Existe un amplio espectro de manifestaciones clínicas, que van desde una leve fragilidad ósea, en niños asintomáticos, hasta versiones que son letales al momento de nacer. El diagnóstico es principalmente clínico y debe diferenciarse de otras anomalías del esqueleto que producen fragilidad y de lesiones por maltrato infantil. El tratamiento es multidisciplinario y está orientado a mejorar la calidad de vida de los pacientes. Para lo que se debe mejorar la densidad ósea, a través de medicamentos, buena musculatura y cargas fisiológicas. Las fracturas se tratan con períodos cortos de inmovilización y carga precoz, o con cirugías que limiten el tiempo de inmovilización. Por otro lado, las deformidades esqueléticas deben tratarse en forma quirúrgica utilizando osteosíntesis que sean extensibles y mantengan la corrección a medida que el niño crece. El manejo coordinado de los distintos profesionales involucrados es de gran importancia para lograr los mejores resultados en esta enfermedad crónica que involucra al niño y todo su entorno
Osteogenesis Imperfecta (OI) is a group of connective tissue disorders involved in skeletal abnormalities characterized by bone fragility and deformities. Genetic abnormalities are variable and new subgroups have been described recently, adding information to traditional classifications. There is a wide spectrum of clinical manifestations, ranging from mild bone fragility, in otherwise asymptomatic children, to versions that are lethal at birth. Its incidence is 1/10.000-20.000 newborns. The diagnosis is mainly clinical and must be distinguished from other skeletal abnormalities and child abuse. The treatment is multidisciplinary, and it is aimed to improve the quality of life of patients. For which the bone density must be improved, through medications, strong musculature, and physiological loads. Fractures are treated by immobilizing for short periods, trying to load at soon as possible, or by surgeries that limit immobilization time. On the other hand, skeletal deformities should be treated surgically using dynamic rods that are extensible and maintain correction as the child grows. The coordinated management of the different professionals involved is of the utmost importance to achieve the best results in this chronic disease that involves the child and his entire environment
Subject(s)
Humans , Osteogenesis Imperfecta/diagnosis , Osteogenesis Imperfecta/etiology , Osteogenesis Imperfecta/therapy , Osteogenesis Imperfecta/classification , Diagnosis, DifferentialABSTRACT
En adolescentes que consultan por dolor de cadera o pelvis, es crucial una adecuada historia clínica para orientarnos sobre la etiología del dolor y comprender los mecanismos que lo generan. Es importante conocer y realizar un exhaustivo examen físico, con especial énfasis en la cadera, incluyendo pruebas específicas para diferentes patologías, además de comprender las indicaciones de los diferentes estudios de imágenes, para así lograr un correcto diagnóstico.Entre las causas más frecuentes de coxalgia en adolescentes debemos considerar la epifisiolisis, el pinzamiento femoroacetabular con o sin roturas del labrum, las lesiones avulsivas de la pelvis, la coxa saltans, entre otras. Aunque son poco frecuentes, patologías sistémicas como reumatológicas y oncológicas también deben ser descartadas en adolescentes. Un diagnóstico de certeza nos permitirá realizar una adecuada estrategia de tratamiento, a fin de lograr una rehabilitación precoz y evitar futuras complicaciones.
In adolescents presenting with hip or pelvis pain, an adequate medical history is crucial to guide the etiology and understand the mechanisms that generate it. It is important to know and carry out an exhaustive physical examination, with special attention to the hip, including specific tests for different pathologies, in addition to understand the indications of the different imaging studies, in order to achieve a correct diagnosis. Among the most frequent causes of hip pain in adolescents, we must rule out slipped capital femoral epiphysis, femoroacetabular impingement with or without labral tears, avulsion lesions of the pelvis, snapping hip, among others. Although rare, systemic pathologies such as rheumatologic and oncologic diseases must also be ruled out in adolescents. An accurate diagnosis will allow us to carry out an adequate treatment strategy, in order to achieve early rehabilitation and avoid future complications.
Subject(s)
Humans , Adolescent , Pain/etiology , Epiphyses, Slipped/diagnosis , Femoracetabular Impingement/diagnosis , Hip Joint , Pelvic Pain/etiology , Epiphyses, Slipped/therapy , Femoracetabular Impingement/therapy , GroinABSTRACT
BACKGROUND: Different techniques for gradual correction of angular deformities of lower limbs exist. Long-term behavior of the growth plate after hemiepiphysiodesis is not yet well understood. We assessed the restoration of normal physeal activity in New Zealand rabbits, after transitory hemiepiphysiodesis, using screws and nonabsorbable filament. METHODS: We performed a lateral distal femoral epiphysiodesis using nonabsorbable filament and screws, in the right knees of 14 New Zealand male rabbits, aged 11 weeks. Two groups were created: in group 1, the suture was cut after 1 month, and in group 2 it was left uncut. Simple plain radiographs were taken at the beginning and at 4, 8, and 12 weeks of follow-up to evaluate lower limb deformity rate and femoral length. The left knee of each rabbit served as controls. Angular deformity and femoral length were compared between the groups. RESULTS: Eleven rabbits completed the protocol. The control group had no modification in lower limb mechanical axis. On the fourth week, all operated limbs had a significant valgus tibiofemoral angle variation (mean 24 degrees, P<0.05). When the filament was cut, there was complete restoration of the mechanical axis. When the filament was kept, tibiofemoral angle increased its valgus deformity until the eighth week (mean 32 degrees) without changes thereafter. The final femoral length was shorter in group 2 compared with the other 2 groups (P<0.05), whereas group 1 was slightly longer than the control group (P>0.05). CONCLUSIONS: Lateral distal femoral hemiepiphysiodesis with nonabsorbable filament resulted in a valgus deformity on the femur. Once the filament is cut, the femur can restore its normal alignment, while maintaining longitudinal growth. Keeping the physeal tether increases the valgus achieved during the first 8 weeks, and remained stable throughout the study, shortening the bone. CLINICAL RELEVANCE: This is an effective alternative for the correction of angular limb deformities that maintains physeal function and may be useful for orthopedic surgeons. It could also represent an adequate model for the study of rebound effect.
