Trombosis venosa profunda en extremidad superior como complicación tras luxación de la articulación acromioclavicular / Upper limb deep vein thrombosis as complication of acromioclavicular joint dislocation

Un 5-10% de las trombosis venosas profundas ocurren en el miembro superior. Su causa más frecuente suele ser secundaria a cáncer, catéter venoso central, tratamiento con radio-quimioterapia u hormonal. Con menor frecuencia, los traumatismos en la región del hombro también pueden ser causantes de una trombosis venosa profunda. Su diagnóstico probablemente sea más complejo que en la extremidad inferior debido a su baja frecuencia, así como por la clínica que presenta, siendo un 50% de los casos asintomáticos o presentando tan solo una cervicalgia u omalgia leves. Debido a su infrecuencia, las recomendaciones terapéuticas se basan en la evidencia indirecta de estudios de la trombosis venosa profunda de la extremidad inferior, siendo la anticoagulación oral el mejor tratamiento. Presentamos un caso clínico de trombosis venosa profunda en miembro superior tras sufrir traumatismo directo en el hombro por una caída con bicicleta de montaña, causando una luxación acromioclavicular grado III de Rockwood

Around 5%-10% of deep vein thrombosis occurs in the upper limb. Its most frequent cause is usually cancer, central venous catheter, radio-chemotherapy or hormonal treatment. Less commonly, trauma around the shoulder region can also be a cause of deep vein thrombosis. Its diagnosis is probably more complex than in the lower limb due to its low frequency and clinical suspicion, as well as the clinical presentation, 50% of the cases being asymptomatic or presenting only with mild neck pain or omalgia. Because of their infrequency, therapeutic recommendations are based on indirect evidence from studies of deep vein thrombosis of the lower limb, considering oral anticoagulation the best treatment. We report a case of deep vein thrombosis in the upper limb after trauma to the shoulder causing grade III Rockwood acromioclavicular dislocation

Upper limb deep vein thrombosis as complication of acromioclavicular joint dislocation. / Trombosis venosa profunda en extremidad superior como complicación tras luxación de la articulación acromioclavicular.

Around 5%-10% of deep vein thrombosis occurs in the upper limb. Its most frequent cause is usually cancer, central venous catheter, radio-chemotherapy or hormonal treatment. Less commonly, trauma around the shoulder region can also be a cause of deep vein thrombosis. Its diagnosis is probably more complex than in the lower limb due to its low frequency and clinical suspicion, as well as the clinical presentation, 50% of the cases being asymptomatic or presenting only with mild neck pain or omalgia. Because of their infrequency, therapeutic recommendations are based on indirect evidence from studies of deep vein thrombosis of the lower limb, considering oral anticoagulation the best treatment. We report a case of deep vein thrombosis in the upper limb after trauma to the shoulder causing grade III Rockwood acromioclavicular dislocation.

Comparación de resultados funcionales en 2 sistemas de fijación mediante hilera simple en sutura de manguito rotador / Comparison of functional results of two fixation systems using single-row suturing of rotator cuff

Introducción: La reparación artroscópica de los trastornos del manguito rotador es un procedimiento técnicamente exigente pero exitoso. En la actualidad hay disponibles muchas alternativas de anclas y suturas. La elección del implante por parte del cirujano es menos importante que la configuración de la sutura usada para fijar el tendón, no obstante hay que conocer si existen diferencias en cuanto a los resultados, utilizando cada uno de ellos. El objetivo del estudio es valorar si existen diferencias entre el implante anudado y no anudado en cuanto a resultados funcionales y de satisfacción. Material y métodos: Se realiza un estudio retrospectivo en 83 pacientes intervenidos entre 2010 y 2014 en nuestro centro mediante 2sistemas de anclaje con y sin anudado (39 frente a 44 pacientes respectivamente), con hilera simple en rotura completa de manguito rotador. Resultados: Una vez finalizado el seguimiento, se consiguió una puntuación media en la escala de Constant de 74,6. Un 98% de los pacientes, consideraron el resultado de la cirugía como satisfactorio. A nivel estadístico no hubo diferencias significativas entre ambos grupos en parámetros de funcionalidad, satisfacción ni reincorporación a actividades. Discusión y conclusiones: Los resultados funcionales de la sutura de manguito mediante hilera simple son satisfactorios, aunque estudios biomecánicos muestran ventajas a favor de suturas que reproducen un sistema transóseo. En nuestra serie de pacientes la presencia de anudado no muestra per se una diferencia funcional significativa siendo ambas técnicas superponibles en valores absolutos de funcionalidad y satisfacción de los pacientes

Introduction: Arthroscopic repair of rotator cuff disorders is a technically demanding but successful procedure. Many anchor and suture alternatives are now available. The choice of the implant by the surgeon is less important than the configuration of the suture used to fix the tendon, however it is necessary to know if there are differences in the results, using each one of them. The aim of the study is to evaluate if there are differences between the knotted and non-knotted implant in terms of functional and satisfaction results. Material and methods: A retrospective study was carried out on 83 patients operated between 2010 and 2014 in our center using 2anchoring systems with and without knotting (39 versus 44 patients respectively), with single row in complete rupture of the rotator cuff. Results: At the end of the follow-up, an average score was obtained on the Constant scale of 74.6 points. 98% of the patients considered the result of the surgery satisfactory. Statistically, there were no significant differences between the 2groups in terms of functionality, satisfaction or reincorporation to activities. Discussion and conclusions: The functional results of the single-row cuff suture are satisfactory, although biomechanical studies show advantages in favor of sutures that reproduce a transoseo system. It our series of patients the presence of knotting does not show per se a significant functional difference being both superimposable techniques in absolute values of functionality and patient satisfaction

Comparison of functional results of two fixation systems using single-row suturing of rotator cuff. / Comparación de resultados funcionales en 2 sistemas de fijación mediante hilera simple en sutura de manguito rotador.

INTRODUCTION: Arthroscopic repair of rotator cuff disorders is a technically demanding but successful procedure. Many anchor and suture alternatives are now available. The choice of the implant by the surgeon is less important than the configuration of the suture used to fix the tendon, however it is necessary to know if there are differences in the results, using each one of them. The aim of the study is to evaluate if there are differences between the knotted and non-knotted implant in terms of functional and satisfaction results. MATERIAL AND METHODS: A retrospective study was carried out on 83 patients operated between 2010 and 2014 in our center using 2anchoring systems with and without knotting (39 versus 44 patients respectively), with single row in complete rupture of the rotator cuff. RESULTS: At the end of the follow-up, an average score was obtained on the Constant scale of 74.6 points. 98% of the patients considered the result of the surgery satisfactory. Statistically, there were no significant differences between the 2groups in terms of functionality, satisfaction or reincorporation to activities. DISCUSSION AND CONCLUSIONS: The functional results of the single-row cuff suture are satisfactory, although biomechanical studies show advantages in favor of sutures that reproduce a transoseo system. It our series of patients the presence of knotting does not show per se a significant functional difference being both superimposable techniques in absolute values of functionality and patient satisfaction.