[Reconstruction of medial collateral ligament: Description of a new augmentation technique with allograft and interference biocomposite screws]

INTRODUCTION

Medial Collateral Ligament (LCM) instability is associated with multi-ligamentary lesions. There are several procedures for the reconstruction of MCL, we present a percutaneous technique of augmentation. Our goal is to describe a new technique of reconstruction of the LCM by grafting and fixing with biocomposite screws.

MATERIAL AND METHODS

We present the technique in a total of 21 consecutive patients with MCL injury operated in the period of December 2011 to October 2014. Reconstruction of MCL was performed with long, tibial or long hallux tendon allografts in 18 patients and only one patient was used autograft. Eighteen of the 20 patients had associated lesions: 5 with medial meniscus injury, 8 with anterior cruciate ligament injury, (ACL), 8 with condral injury and 1 with lateral meniscus injury.

CONCLUSION

The surgical technique presented is simple to perform, without damage to other structures and with a strong fixation.

A comparative study in patients with fractures of the lower limbs between rivaroxaban versus enoxaparin and its impact on bone healing time

BACKGROUND

Each year it is estimated in the United States an approximate of 8 million fractures; 5 to 10% develop delayed union or absence of periosteal new bone. There are several factors that can cause delay in fracture healing, among the well known, is the use of prophylactic antithrombotic therapy for deep vein thrombosis (DVT). DVT appears in 40 to 60% of the patients undergoing orthopedic surgery without prophylactic antithrombotic therapy. The goal of this study was to assess whether there is a difference in time of bone healing in lower limb fractures (femur and tibia) comparing rivaroxaban to enoxaparin as the prophylactic antithrombotic management.

MATERIAL AND METHODS

We present a retrospective observational and analytic study in a sample of cases. It is a cross-sectional study with patient data from the database of the American British Cowdray (ABC) Medical Center. We included patients with femur and tibia fractures under antithrombotic prophylactic management with rivaroxaban or enoxaparin during the period of January 2011 to December 2012. Our sample included 32 patients separated into two groups. Students t-test was used for comparing parametric variables and the Mann-Whitney U test for nonparametric variables. Linear regression model was preformed considering the variables related to the time it took the fracture to heal.

RESULTS

All fractures consolidated in a time of 13 and 14 weeks for rivaroxaban and enoxaparin respectively (p = 0.67).

DISCUSSION

We found no difference in bone healing time for lower limb fractures in patients receiving antithrombotic prophylaxis treatment comparing rivaroxaban with enoxaparin.

[Toddler's fracture, case report and review of literature]

INTRODUCTION

The suspected diagnosis of a Toddler's fracture can often be complicated by an unclear history, the lack of specific clinical findings and the absence of obvious changes in the initial radiographs. We present the case of an infant of 3 years and 7 months old with a history of falling from her own height with a rotation mechanism of the left pelvic limb. The purpose of this paper is to describe the etiopathology, diagnosis and therapeutic management of these fractures.

DISCUSSION

The clinical history, physical examination and the use of imaging studies help identify Toddler's fractures, pathology that must be known to medical specialists for an ideal treatment.