La manipulacion diferida en las fracturas supracondileas humerales en el nino. / Defferred manipulation of humeral supracondylar fracture in children

Se analizan los resultados de la manipulacion diferida de las fracturas supracondileas en los ninos, en una serie de 32 casos estudiados en el Servicio de Ortopedia del Hospital Infantil de Mexico "Federico Gomez". Esta modalidad consiste en esperar a que el edema ceda casi totalmente para realizar la manipulacion, ya que se establecio como hipotesis de trabajo que el edema, moderado o severo, actua como fuelle que se retrae en el momento de la manipulacion. De los 32 casos, una primera parte de 22 se analizaron desde el punto de vista clinorradiologico y una segunda parte, 10 casos, solo desde el punto de vista radiologico, con tiempo de evolucion suficiente para ver los resultados de la consolidacion de la fractura, mostrando resultados muy satisfactorios, con un minimo de complicaciones (cubito varo), aun comparados con aquellos de series tratadas con procedimientos de reduccion abierta y osteosintesis. Lo sencillo, economico y seguro del procedimiento y sus magnificos resultados nos permite recomendarlo, tanto en la poblacion de enfermos hospitalarios con evidentes carencias economicas, como en todos los pacientes

[Progressive reduction and aseptic necrosis in congenital hip luxation]. / Reducción progresiva y necrosis aséptica en la luxación congénita de la cadera.

A septic necrosis subsequent to reduction is a problem which, for many years, has molested those who are devoted to the study of congenital dislocation of the hip, since it is a frequent and apparently irresoluble complication. However, through recent years, the application of modified treatment methods consisting in what has been called progressive reduction (traction, progressive manipulation in bed, with the patient fully awake and plaster in human position) have allowed a considerable drop of necrosis figures. The present study conducted with a group of patients treated with this method and compared with another group treated with methods previously followed in this institution, shows important drop in necrosis phenomena, specially in severe cases.

Reduccion progresiva y necrosis aseptica en la luxacion congenita de la cadera. / Progressive reduction and aseptic necrosis in congenital hip dislocation

La necrosis aseptica postreductiva es un problema que por muchos anos ha preocupado a quienes se dedican al estudio de la luxacion congenita de la cadera por ser una complicacion frecuente y al parecer irresoluble.Sin embargo, en los ultimos anos, el uso de metodos de tratamiento modificados, consistentes en lo que se ha llamado la reduccion progresiva (traccion, manipulacion progresiva en cama, con el paciente despierto y yeso en posicion humana) han permitido un abatimiento de la necrosis en cifras muy importantes. El presente estudio con un grupo de pacientes tratados por este metodo y relacionado con otro grupo tratado por procedimientos anteriores usados en esta institucion, obtiene resultados de abatimiento importante de los fenomenos de necrosis, sobre todo en lo referente a los casos graves

[Congenital pain insensitivity]. / Insensibilidad congénita al dolor.

A case showing multiple lesions that make it very illustrative is reported. Differential diagnosis is made with some other diseases that are similar in some isolated facts. Mention is also made on the pathophysiology of the disease as well as on the necessity of the intercourse of several medicosurgical specialties in the management of these patients. A brief review of the literature is made.

[Concentric centering of the normal hip and concentric reduction of the dislocated hip. Radiological study on their determination and clinical application]. / El "centraje concéntrico" de la cadera normal y la "reducción concéntrica" en la cadera luxada. Estudio radiológico para su determinación y aplicación clínica.

A radiological method to determine the ideal, geometrical, center of the acetabulum and femoral head is described by the author; the proceedings for these localizations and the interrelationship between them, are also described. These factors were taken from a series of simple radiography and arthograms, which is called; "Concentrical Centring" in normal hips, as well as other seires of dislocated hips, which were radiographed in anteroopsterior view, and in frog position, as well as in histological sections. The necessity to look for the concentrical reduction of the dislocated hips is also emphasized, as a basic point for the good development of the acetabulum, which is achieved, at the time of treatment, if the location is made of the point of the femoral head with that of the acetabulum (Concentrical Reduction). This method will permit to evaluate this interrelationship easily in a numerical scale figure and with a minimum of error. This is a useful resource previous to the arthrography in those hips which have been just recently reduced; and latter, in their follow-up.