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1.
Angiol. (Barcelona) ; 75(4): 204-211, Juli-Agos. 2023. tab
Article in Spanish | IBECS | ID: ibc-223700

ABSTRACT

Introducción y objetivos: los objetivos de este trabajo han sido conocer qué factores influyen en la recupera ción funcional de los pacientes ancianos que sufren una amputación mayor de una extremidad inferior (AMeI) de etiología vascular y analizar la recuperación de la marcha y de la mortalidad al año de la amputación. Material y métodos: estudio longitudinal observacional de los pacientes mayores de 70 años valorados por el servicio de rehabilitación tras una AMeI desde el 1 enero de 2019 hasta el 1 enero de 2021. Se recogieron las siguientes variables: edad, sexo, etiología, índice de masa corporal, comorbilidad (escala de Charlson), independencia en las AVd básicas (índice de Barthel) y capacidad de marcha (FAC) previas. Al año se analizaron la capacidad de marcha y la mortalidad. Resultados: el estudio se realizó en 45 pacientes con una edad media de 80,3 años (el 64,3 % varones). Todos fueron de etiología vascular. el nivel de amputación fue supracondíleo en 31 pacientes e infracondíleo en 14. Se protetizaron 13. Al año solo caminaban 5 pacientes y habían fallecido 21. Las variables relacionadas con la posibilidad de rehabilitación-protetización fueron: presentar menos comorbilidad (p = 0,004) y tener una mayor independencia funcional y de marcha previa a la amputación (p = 0,000), al igual que las relacionadas con la no mortalidad, con p = 0,005 y p = 0,017 (p = 0,013), respectivamente. Conclusión: la mejor situación funcional y clínica previa a la amputación son los factores más importantes tanto para la posibilidad de rehabilitación protésica como para la supervivencia de nuestros ancianos amputados.(AU)


Introduction and objectives: the objectives of this work have been to know what factors influence in thefunctional recovery of elderly patients who suffer a major lower limb amputation (SMA) of vascular etiology andto analyze the recovery of gait and mortality one year after the amputation. Material and methods: longitudinal observational study of patients older than 70 years assessed by the Reha-bilitation Service after SMA from January 1, 2019 to January 1, 2021. The following variables were collected: Age, sex, etiology, body mass index, comorbidity (Charlson scale), independence in basic ADL (Barthel index) and previous walking capacity (FAC). One year later, walking ability and mortality. Results: the study was conducted in 45 patients with a mean age of 80.3 years, 64.3 % male. All were of vascularetiology. The level of amputation was: supracondylar 31 and infracondylar 14. After a year, only 5 patients werewalking and 21 had died. The variables related to the possibility of rehabilitation-fitting were: having less comorbidity (p = 0.004) as well as having greater functional and gait independence prior to amputation (p = 0.000), as well as those related to nomortality, with a (p = 0.005) and (p = 0.017) (p = 0.013) respectively. Conclusion: the best functional and clinical situation prior to amputation are the most important factors both forthe possibility of prosthetic rehabilitation and for the survival of our elderly amputees.(AU)


Subject(s)
Humans , Male , Female , Aged , Amputation, Surgical/rehabilitation , Amputation, Surgical/mortality , Lower Extremity/injuries , Lower Extremity/surgery , Walking Speed , Peripheral Arterial Disease , Longitudinal Studies , Cardiovascular System , Cardiovascular Surgical Procedures
2.
Rev. colomb. ortop. traumatol ; 32(3): 197-201, 2018. ilus.
Article in Spanish | LILACS, COLNAL | ID: biblio-1373485

ABSTRACT

Introducción El objetivo del estudio es conocer la incidencia, los resultados tras la cirugía y la necesidad de rehabilitación de las fracturas por avulsión de tipo II de la tuberosidad posterior del calcáneo. Materiales y métodos Se realizó un estudio observacional de tipo serie de casos. Se revisaron retrospectivamente todas las fracturas de calcáneo diagnosticadas en nuestro hospital en los últimos 12 años y se seleccionaron aquellas que fueron clasificadas como fracturas por avulsión de la tuberosidad del calcáneo (pico de pato). Resultados Encontramos 10 fracturas con un patrón de fractura por avulsión de la tuberosidad del calcáneo (pico de pato), que corresponden al 4% de todas las fracturas de calcáneo revisadas. Todas fueron tratadas mediante reducción abierta y fijación interna. Un caso fue tratado de forma urgente debido a signos de sufrimiento de partes blandas. Cuatro casos presentaron complicaciones posquirúrgicas. Tres casos requirieron tratamiento específico de rehabilitación. Ningún paciente necesitaba ayuda técnica un año después de la cirugía. Discusión Es razonable esperar un aumento de la incidencia en los próximos años debido al envejecimiento de la población y la prevalencia en aumento de diabetes y osteoporosis. El fragmento desplazado producido por el tendón aquíleo puede poner en peligro la viabilidad cutánea y afectar a la cicatrización posterior. A menudo, no se necesita un protocolo rehabilitador específico. Nivel de evidencia clínica. Nivel IV.


Background The objective of the study is to know the incidence, the results of the surgery and the need for rehabilitation of type II avulsion fractures of the posterior tuberosity of the calcaneus. Materials and methods An observational study of a series of cases was carried out. We retrospectively reviewed all the calcaneal fractures diagnosed in our hospital in the last 12 years and selected the ones classified as avulsion fractures of the tuberosity of the calcaneus (duck beak). Results We found 10 fractures with an avulsion fracture pattern of the calcaneal tuberosity (duck beak), which correspond to 4% of all the calcaneal fractures reviewed. All were treated by an open reduction and internal fixation. One case was treated urgently due to signs of suffering of soft tissue. Four cases presented post-surgical complications. Three cases required specific rehabilitation treatment. Usually, there is no a unique formula to establish a rehabilitation program after surgery. Discussion It is likely to expect an increase rate of this particular fracture according to that elderly population increase with associated osteoporosis and diabetes. The displaced fragment produced by the Achilles' tendon may compromise scaring after surgery. Often a specific rehabilitative protocol is not needed. Evidence level. IV.


Subject(s)
Humans , Calcaneus , Therapeutics , Fractures, Avulsion
3.
Rev. esp. geriatr. gerontol. (Ed. impr.) ; 48(1): 22-25, ene.-feb. 2013.
Article in Spanish | IBECS | ID: ibc-109116

ABSTRACT

El objetivo de este trabajo es describir los resultados funcionales, a partir del año de la intervención, de un grupo de pacientes mayores de 65 años intervenidos con artroplastia parcial de hombro (APH). Material y método. Estudio descriptivo de 40 pacientes que tras fractura de la extremidad proximal del húmero (FEPH), fueron intervenidos mediante APH entre los años 2006-10. Utilizamos el cuestionario Quick Dash para conocer el resultado funcional, la escala visual analógica (EVA) para el dolor y el goniómetro manual para el recorrido articular del hombro. Para el análisis estadístico se utilizó el programa SPSS versión 15. Resultados. La edad media fue de 75,6 años (rango 65-88). El número de sesiones de rehabilitación fue de 38,8 de media. El tiempo transcurrido desde la cirugía a la valoración funcional final fue de 17,2 meses como media, el valor de la escala Quick Dash en esta valoración fue de 2,44 lo que pasado a porcentajes equivale a 36/100 (entre poca y moderada dificultad para las actividades); al analizar el dolor encontramos un valor medio de la EVA de 3,1. El valor medio de la antepulsión activa al finalizar la rehabilitación fue de 83,6°, la rotación externa: 33,1°, la rotación interna 30,6° y la abducción 74,6°. Conclusiones. Los pacientes mayores obtienen unos resultados funcionales aceptables y con escaso dolor tras APH, a pesar de no conseguir el recorrido articular activo completo del hombro(AU)


The aim of this study is to describe functional results one year after intervention in a group of patients over 65 years with partial shoulder replacement (PSR). Material and methods. A descriptive study, conducted between 2006 and 2010, that included 40 patients with PSR after fracture proximal humerus (FPH). We used Quick Dash questionnaire to evaluate functional results, visual analogue scale (VAS) for pain and manual goniometer for the shoulder joint range. Statistical analysis was performed using SPSS program version 15. Results. The mean of age was 75.6 years (range 65-88). The mean number of rehabilitation sessions was 38.8. The mean time from surgery up to final functional evaluation was 17.2 months. The score on Quick Dash questionnaire in this evaluation was 2.44 which is equal to 36% (between low and moderate difficulty in activities). The VAS score in the analysis of pain gave a mean of 3.1. The mean of the active joint ranges after rehabilitation were, 83.6° in antepulsion, 33.1° in external rotation, 30.6° in internal rotation, and 74.6° in abduction. Conclusions. Elderly patients obtained acceptable functional results and low pain after PSR, although they did not obtain the full active range of movement of the shoulder(AU)


Subject(s)
Humans , Male , Female , Middle Aged , Aged , Aged, 80 and over , Arthroplasty/methods , Arthroplasty/statistics & numerical data , Arthroplasty/trends , Shoulder Dislocation , Shoulder Fractures/surgery , Shoulder Fractures/complications , Shoulder Fractures/diagnosis , Arthroplasty/standards , Arthroplasty , Humerus/injuries , Humerus/surgery , Humerus , Surveys and Questionnaires , Shoulder/pathology , Shoulder , Shoulder Dislocation/diagnosis , Shoulder Dislocation/surgery
4.
Rev Esp Geriatr Gerontol ; 48(1): 22-5, 2013.
Article in Spanish | MEDLINE | ID: mdl-23200630

ABSTRACT

UNLABELLED: The aim of this study is to describe functional results one year after intervention in a group of patients over 65 years with partial shoulder replacement (PSR). MATERIAL AND METHODS: A descriptive study, conducted between 2006 and 2010, that included 40 patients with PSR after fracture proximal humerus (FPH). We used Quick Dash questionnaire to evaluate functional results, visual analogue scale (VAS) for pain and manual goniometer for the shoulder joint range. Statistical analysis was performed using SPSS program version 15. RESULTS: The mean of age was 75.6 years (range 65-88). The mean number of rehabilitation sessions was 38.8. The mean time from surgery up to final functional evaluation was 17.2 months. The score on Quick Dash questionnaire in this evaluation was 2.44 which is equal to 36% (between low and moderate difficulty in activities). The VAS score in the analysis of pain gave a mean of 3.1. The mean of the active joint ranges after rehabilitation were, 83.6° in antepulsion, 33.1° in external rotation, 30.6° in internal rotation, and 74.6° in abduction. CONCLUSIONS: Elderly patients obtained acceptable functional results and low pain after PSR, although they did not obtain the full active range of movement of the shoulder.


Subject(s)
Hemiarthroplasty , Shoulder Joint/surgery , Aged , Aged, 80 and over , Female , Humans , Male , Recovery of Function , Shoulder Joint/physiology
5.
Rev Esp Geriatr Gerontol ; 44(3): 120-3, 2009.
Article in Spanish | MEDLINE | ID: mdl-19443085

ABSTRACT

OBJECTIVE: Surgical treatment of osteoarthritis with total knee arthroplasty (TKA) has become a routine technique in patients of "almost" any age. The aim of the present study was to compare the results of TKA according to patient age. MATERIAL AND METHODS: A prospective study was performed in 112 patients with osteoarthritis who underwent TKA from March 1st, 2007 through May 31st, 2007. There were two groups; the first comprised 61 patients aged 65- to 75-years-old and the second included 51 patients aged 76- to 85-years-old. Sociodemographic data and health system use were evaluated. The results were evaluated by using the Hospital Special Surgery (HSS) scale, the SF-36 health survey questionnaire, the visual analogue scale (VAS) for pain, and joint measurement with manual goniometrics. The patients were evaluated before surgery and at 6 months after surgery. RESULTS: No significant differences were observed between the two groups. Complications and length of hospital stay were similar in both groups. A greater proportion of older patients were referred to a rehabilitation hospital but this difference was not statistically significant. CONCLUSIONS: The results of the present study were similar to those of other studies that found that greater age does not lead to worse functional results.


Subject(s)
Arthroplasty, Replacement, Knee , Age Factors , Aged , Aged, 80 and over , Female , Humans , Male , Prospective Studies , Treatment Outcome
6.
Rev. esp. geriatr. gerontol. (Ed. impr.) ; 44(3): 120-123, mayo 2009. tab
Article in Spanish | IBECS | ID: ibc-134853

ABSTRACT

Objetivo: El tratamiento quirúrgico de la gonartrosis mediante artroplastia total de rodilla (ATR) se ha convertido en una técnica habitual en pacientes de «casi» cualquier edad. El objetivo de este trabajo es comparar los resultados de un grupo de pacientes intervenidos mediante ATR en función de la edad. Material y métodos: Se realizó un estudio pospectivo en 112 pacientes intervenidos de gonartrosis mediante ATR entre el 1 de marzo de 2007 y el 31 de mayo de 2007. Se hicieron 2 grupos, el primero con 61 pacientes de 65 a 75 años de edad y el segundo de 51 pacientes con edades comprendidas entre los 76 y los 85 años. Evaluamos los datos sociodemográficos y de utilización del sistema de salud. Se valoraron los resultados mediante la escala Hospital Special Surgery (HSS), el cuestionario de salud SF-36, la escala visual analógica (EVA) para el dolor y el balance articular con goniómetro manual. Se hicieron 2 valoraciones, una antes de la cirugía y otra al sexto mes. Resultados: No encontramos diferencias estadísticamente significativas entre ambos grupos. Las complicaciones fueron similares, al igual que la estancia media hospitalaria. Sólo se trasladó a los pacientes mayores a un hospital de rehabilitación en una mayor proporción, que no fue significativa. Conclusiones: Los resultados que hemos encontrado son similares a los de otros trabajos en los que la edad no es un factor que determine peores resultados funcionales (AU)


Objective: Surgical treatment of osteoarthritis with total knee arthroplasty (TKA) has become a routine technique in patients of «almost» any age. The aim of the present study was to compare the results of TKA according to patient age. Material and methods: A prospective study was performed in 112 patients with osteoarthritis who underwent TKA from March 1st, 2007 through May 31st, 2007. There were two groups; the first comprised 61 patients aged 65 to 75 years old and the second included 51 patients aged 76 to 85 years old. Sociodemographic data and health system use were evaluated. The results were evaluated by using the Hospital Special Surgery (HSS) scale, the SF-36 health survey questionnaire, the visual analogue scale (VAS) for pain, and joint measurement with manual goniometrics. The patients were evaluated before surgery and at 6 months after surgery. Results: No significant differences were observed between the two groups. Complications and length of hospital stay were similar in both groups. A greater proportion of older patients were referred to a rehabilitation hospital but this difference was not statistically significant. Conclusions: The results of the present study were similar to those of other studies that found that greater age does not lead to worse functional results (AU)


Subject(s)
Humans , Male , Female , Aged , Aged, 80 and over , Arthroplasty, Replacement, Knee , Age Factors , Prospective Studies , Treatment Outcome
7.
Rev Esp Geriatr Gerontol ; 43(1): 13-8, 2008.
Article in Spanish | MEDLINE | ID: mdl-18684383

ABSTRACT

INTRODUCTION: the complications of hip arthroplasty in elderly patients can lead to resection of the prosthesis and cement, also known as the Girdlestone technique. This kind of surgery causes serious dysmetria and alters gait dynamics, thus affecting the patient's functional ability. The aim of this study was to describe the functional outcome, 1 year after surgery, in a group of patients that underwent surgery with this technique. MATERIAL AND METHODS: we performed a descriptive study of 48 patients aged more than 65 years old who underwent surgery with the Girdlestone technique from 1999 to 2005. Twenty-one patients completed the study. Functional outcome and pain were measured with the Harris scale, and gait with the Functional Ambulatory Classification (FAC) scale 1 year after surgery. RESULTS: the mean age was 79.71 years. The most frequent causes of exeresis were periprosthetic infection in 42% and recurrent hip dislocation in 36%. Of the 21 patients assessed 1 year after the intervention, 42.8% were unable to walk and needed a wheelchair and only 28.5% were able to walk with the aid of one or two crutches. Pain was moderate in 23.8% of the patients and was mild in the remainder. The mean score on the Harris scale was 51 out of 100 points. CONCLUSIONS: failure of hip arthroplasty requiring Girdlestone resection is very damaging to functional outcome in elderly patients.


Subject(s)
Arthroplasty, Replacement, Hip/methods , Arthroplasty, Replacement, Hip/rehabilitation , Aged , Aged, 80 and over , Female , Health Status Indicators , Humans , Male
8.
Rev. esp. geriatr. gerontol. (Ed. impr.) ; 43(1): 13-18, ene. 2008. ilus, tab
Article in Es | IBECS | ID: ibc-63675

ABSTRACT

Introducción: las complicaciones de las artroplastias de cadera en pacientes ancianos pueden obligar a la resección de la prótesis y del cemento, o técnica de Girdlestone. Esa intervención produce una grave dismetría y una alteración de la dinámica de la marcha que repercute en la capacidad funcional de los pacientes. En este trabajo queremos describir la situación funcional, a partir del año de la intervención, de un grupo de pacientes intervenidos mediante esta técnica. Material y métodos: estudio descriptivo de 48 pacientes mayores de 65 años, intervenidos de artroplastia de resección de Girdlestone, durante los años 1999-2005. Se completó el estudio en 21 pacientes. La situación funcional y el dolor se midieron mediante la escala de valoración de Harris y la capacidad de marcha mediante el Functional Ambulatory Classification (FAC), a partir del año de la intervención. Resultados: la edad media fue de 79,71 años. Las causas más frecuentes de la exéresis fueron: el 42% infección periprotésica y el 36% la luxación recidivante. De los 21 pacientes valorados un año después de la intervención, el 42,8% no podía caminar y precisaba una silla de ruedas, y tan sólo el 28,5% eran independientes para la marcha, con ayuda de uno o dos bastones. El 23,8% de los pacientes tenía dolor moderado; en el resto el dolor era leve. El valor medio de la escala de Harris fue de 51/100 puntos. Conclusiones: el fracaso de las artroplastias de cadera que precisan de una resección de Girdlestone supone un grave deterioro de la capacidad funcional de los pacientes ancianos


Introduction: the complications of hip arthroplasty in elderly patients can lead to resection of the prothesis and cement, also known as the Girdlestone technique. This kind of surgery causes serious dysmetria and alters gait dynamics, thus affecting the patient’s functional ability. The aim of this study was to describe the functional outcome, 1 year after surgery, in a group of patients that underwent surgery with this technique. Material and methods: we performed a descriptive study of 48 patients aged more than 65 years old who underwent surgery with the Girdlestone technique from 1999 to 2005. Twenty-one patients completed the study. Functional outcome and pain were measured with the Harris scale, and gait with the Functional Ambulatory Classification (FAC) scale 1 year after surgery. Results: the mean age was 79.71 years. The most frequent causes of exeresis were periprosthetic infection in 42% and recurrent hip dislocation in 36%. Of the 21 patients assessed 1 year after the intervention, 42.8% were unable to walk and needed a wheelchair and only 28.5% were able to walk with the aid of one or two crutches. Pain was moderate in 23.8% of the patients and was mild in the remainder. The mean score on the Harris scale was 51 out of 100 points. Conclusions: failure of hip arthroplasty requiring Girdlestone resection is very damaging to functional outcome in elderly patients (AU)


Subject(s)
Humans , Male , Female , Aged , Arthroplasty, Replacement, Hip/adverse effects , Prosthesis-Related Infections/surgery , Prosthesis Failure , Quality of Life , Movement Disorders/etiology , Arthroplasty, Replacement, Hip/rehabilitation
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