Glenoid track ''off-track'' as a risk factor for recurrence of anterior glenohumeral instability in postoperative patients.

INTRODUCTION: Glenoid track is used to assess the engagement of Hill-Sachs lesions. The objective of this study was to identify if off-track glenoid track was a risk factor for recurrence of anterior glenohumeral instability in postoperative patients with arthroscopic anterior labrum repair. MATERIAL AND METHODS: Sixty patients with glenohumeral instability who underwent arthroscopic repair of the anterior labrum were studied. Study group (patients with recurrence of postoperative dislocation) and control (no dislocation). Radiographic measurements were made on magnetic resonance imaging and computed tomography. Measurements of glenoid diameter, glenoid bone loss, as well as the presence and size of Hill-Sachs lesions were obtained. Later they were classified as "on-track" or "off-track". RESULTS: Seven (11.67%) patients suffered recurrence, of which six (10%) were carriers of an off-track injury and 1 (1.67%) on-Track. 53 (88.33%) patients did not experience recurrence, of which 11 (18.33%) were carriers of an off-track injury and 42 (70%) on track. A 23.47 increased risk of recurrence of instability was interpreted in patients with "off-track" lesions compared to patients with "On track" lesions. CONCLUSIONS: Off-track injuries were a risk factor for recurrence of instability in patients who underwent Bankart-type arthroscopic repair. This allows us to recommend that the presence of lesions be routinely studied and classified as "on-track" or "off-track" to provide a better therapeutic approach.

INTRODUCCIÓN: El encarrilamiento glenoideo se emplea para valorar el enganche de lesiones Hill-Sachs. El objetivo de este estudio fue identificar si el encarrilamiento glenoideo. MATERIAL Y MÉTODOS: off-track fue un factor de riesgo de recidiva de inestabilidad glenohumeral anterior en pacientes postoperados de reparación de labrum anterior por vía artroscópica. Se estudiaron 60 pacientes sometidos a reparación artroscópica del labrum anterior. Grupo de estudio (pacientes con recidiva de luxación postoperatoria) y control (sin luxación). Las mediciones radiográficas se realizaron en resonancia magnética y en tomografía axial computarizada. Se obtuvieron mediciones del diámetro glenoideo, pérdida ósea glenoidea así como la presencia y tamaño de lesiones de Hill-Sachs. Posteriormente se clasificaron como. RESULTADOS: on-track u off-track. Siete (11.67%) pacientes sufrieron recidiva, de los cuales seis (10%) eran portadores de lesión. CONCLUSIONES: off-track y uno (1.67%) on-track. 53 (88.33%) pacientes sin recidiva, de los cuales 11 (18.33%) eran portadores de lesión off-track y 42 (70%) on-track. Se interpretó un aumento de riesgo de recidiva de inestabilidad de 23.47 en los pacientes portadores de lesión de tipo off-track en comparación con los pacientes portadores de lesiones on-track. Las lesiones.

[Long-term usefulness and late complications of percutaneous endoscopic gastrostomy]. / Utilidad a largo plazo y complicaciones tardías de la gastrostomía endoscópica percutánea.

OBJECTIVE: To investigate the usefulness of endoscopic gastrostomy and long-term complications. BACKGROUND DATA: Endoscopic gastrostomy is well established as the procedure of choice for long-term feeding, given the low morbidity-mortality and ease of placement. METHOD: We evaluated retrospectively one hundred endoscopically placed gastrostomy feeding tubes and complications occurring more than 30 days after placement were recorded. RESULTS: Gastrostomy feeding tubes remained in place for a mean of 92 days (range 30-547 days). Fifteen percent developed evident gastroesophageal reflux, two patients developed aspiration pneumonia and one presented with infection at the site of gastrostomy. Our long-term complications rate thus was 3.0% and 0% mortality. CONCLUSIONS: Our experience suggests that endoscopic gastrostomy is a relatively simple procedure, associated with very low morbidity and mortality. It is the procedure of choice in patients requiring long-term enteral nutrition.