[Early clinical and radiological basic detection of congenital hip dysplasia at primary health care units]. / Detección temprana clínica y radiológica básica de la displasia congénita de cadera en unidades médicas del primer nivel de atención.

DISCUSSION: The number of cases of late congenital hip dysplasia has increased, together with its sequelae, disability and absence of early diagnosis. The problem is that there is a difference between the sensitivity and the clinical exam, and the physicians knowledge of this topic is poor. We evaluated the quality of the training provided to the primary health care staff on congenital hip dysplasia. A prospective cohort study was undertaken to study 228 physicians for 3 years. A workshop was delivered and the physicians took a pre-workshop and a post-workshop exam. Then pelvic X-rays of infants under 6 months of age were taken and the X-ray references and measurements were assessed. The statistical analysis assesses the change in the pre-workshop and post-workshop grades in both the group that participated in the workshop and the group that did not. The statistical variables used included means, standard deviation, minimum and maximum grades, and the score differences. Students t test was used to prove the statistical significance of the differences, with n-1 degrees of freedom. Thirty-one pathological hips were detected in infants under 6 months of age in the group that took the workshop. The group that received the training shows that the latter may have a positive impact since an improvement in the grades (p 0.0001) was seen after the theoretical and practical course and after the X-ray measurements. A low knowledge level was observed. The training raised the awareness of the health care staff and a progressive increase was seen in the number of infants under 6 months of age who received a timely detection.

Hay un aumento en el número de casos de displasia de cadera congénita tardía, secuelas, discapacidad y falta de diagnóstico temprano. La problemática observada es que difieren la sensibilidad y exploración clínica y los conocimientos del tema en médicos son deficientes. Se evaluó la calidad de la capacitación en displasia congénita de cadera al personal del primer nivel de la atención médica. Se realizó un estudio de cohorte prospectiva estudiando a 228 médicos por tres años; se les aplicó un examen pre- y postcurso, se dio un taller. Posteriormente, se inició la toma de radiografías de pelvis en menores de seis meses, se evaluó la referencia y la medición radiográfica. El análisis estadístico valoró el cambio de calificación obtenida en las mediciones antes y después del taller, tanto en el grupo que lo recibió como en el que no lo llevó. Se utilizaron promedios, desviación estándar, mínimo y máximo para describir las calificaciones, así como para las diferencias de puntajes. Para probar la significancia en las diferencias, se utilizó «t¼ de Student, con n-1 grados de libertad. Se detectaron 31 caderas patológicas en menores de seis meses de vida con el taller. El grupo capacitado reflejó que el curso podría tener impacto positivo al mejorar significativamente la calificación (p 0.0001) posterior al curso tanto teórico como práctico y la medición radiográfica. Se evidenció un bajo conocimiento. La capacitación con el taller sensibilizó al personal médico y se observó un número progresivo de pacientes menores de seis meses con una detección oportuna.

[Quality of life of patients after periprosthetic hip fracture surgery]. / Calidad de vida en los pacientes postoperados de fracturas periprotésicas de cadera.

INTRODUCTION: The quality of life of patients with periprosthetic fracture is complex; it interacts with the severity of the lesion, their independence level, and available resources, all of which could cause alterations secondary to their condition. OBJECTIVE: To know the quality of life and clinical course of patients after periprosthetic hip fracture surgery. MATERIAL AND METHODS: Patients with periprosthetic hip fracture were assessed. Physical exam was performed and the SF-36 questionnaire was applied. RESULTS: A total of 15 patients were included, 8 (53.3%) females and 7 (46.7%) males, with mean age 74 years (SD 12.51). Concerning underlying conditions, 5 patients had none (33.3%), one had hypertension (6.7%), one had a neoplasia (epidermoid), and 8 had more than one underlying condition. A predictive variable model was designed. In the overall score a 75.6% positive correlation was found, and a 57.2% determination coefficient. There was no statistical significance (p = 0.162). The same variables as in the previous model were included. Correlation was 0.678 and determination 45.9%, without statistical significance, p = 0.332. CONCLUSIONS: Patients reported feeling fair from the perspective of their overall health, physical function, physical role, emotional role, and social function; mental health wise, 50% reported feeling calm and full of life, and 50% reported anxiety and fear.