Search PubMed⌕ Search

Biomedical subjects

A Sarmiento

Publications and source records attributed to A Sarmiento.

At least 145 records · Page 8Linked to original sources
PubMedDate not supplied

On the behavior of closed tibial fractures: clinical/radiological correlations.

OBJECTIVE: To review the treatment of closed diaphyseal tibial fractures with functional braces and to identify patient and fracture characteristics, as well as possible correlations, that could be used to determine final outcomes. DESIGN: A comprehensive review of data obtained from 1,000 diaphyseal tibial fractures. SETTING: Major university teaching hospital. INTERVENTION: Identification of patient and fracture characteristics, including type and level of fracture, initial shortening and angulation, and severity of injury, to be correlated with final shortening and angulation and speed of healing. MAIN OUTCOME MEASUREMENTS: Degree of shortening and angulation; speed of healing. RESULTS: Neither the level nor the type of tibial fracture significantly influenced healing time, although there was a considerably higher probability of delayed union in fractures produced from vehicular accidents, as well as in comminuted and segmental fractures. Any delay in application of the functional brace resulted in slower healing. Maximum shortening of the fractures occurred at the time of the initial injury, with no additional shortening experienced after the introduction of graduated weight-bearing ambulation. Compared with a mean initial shortening of 4.25 millimeters, the overall final shortening of fractures was 4.28 millimeters. CONCLUSIONS: Correlations exist between patient and fracture characteristics that influence the final outcome for closed diaphyseal fractures treated with functional braces.

Adolescent↗
PubMedDate not supplied

The effect of simulated tibial deformities on the ankle joint during the gait cycle.

The effect of angular deformities of the tibial shaft on the area, location, and shape of the ankle joint contact during the normal extremes in the gait cycle was studied with the use of a cadaveric model. Six lower limbs were first examined radiographically and found to be free of pathology. These specimens were then stripped of soft tissues proximal to the ankle joint and had a custom-designed universal joint-plate inserted into the tibia at the proximal, middle, or distal third level. An anterior ankle arthrotomy was performed, and pressure sensitive film was inserted into the tibiotalar joint. Load was then applied with the ankle set in dorsiflexion or plantarflexion via metal wedges, and tibial deformities of 5, 10, and 15 degrees were simulated in varus, valgus, anterior bow, and posterior bow. Contact area and location changes were noted to be of greater magnitude with proximal and distal third tibial deformities than with middle third deformities. Varus and valgus deformities showed smaller contact area changes than anterior or posterior bow deformities. Contact area changes tended to be larger in dorsiflexion compared to plantarflexion for each level and degree of tibial angulation. Posterior bow deformities at all levels resulted in greater changes in contact area and shape than other deformities. The role of subtalar compensation, stiffness of the foot-ankle complex, and geometric factors are all thought to influence the changes noted. On the basis of this experimental study it would appear that angular deformity of the tibia less than 10 degrees would not significantly alter ankle joint contact.

Ankle Joint↗
PubMedDate not supplied

[Guidelines for the clinical management of neuropathic pain (I). Protocol].

AIMS: The aim of this study is to develop a set of guidelines for the clinical management of neuropathic pain (NP), a disorder suffered by up to 5% of the population, specifically for use by the Spanish-speaking community, in order to improve the quality of medical care and to standardise the treatments offered in medical centres. DEVELOPMENT: The paper describes the methodology used to search for guidelines concerning the clinical management of NP in databases, written communications and other resources, and the results of this search are presented. The research group is split into three groups: anatomical-physiological, diagnosis and therapeutic approach, each of which defines the nature of the papers that used to design the protocol.

Adult↗
PubMedDate not supplied

[Guidelines for the clinical management of neuropathic pain (II)].

INTRODUCTION: Up to 5% of the population suffers from neuropathic pain (NP). A bibliographical search in several databases revealed that, to date, there are no protocols to guide physicians who are not specialists in pain that enable them to treat NP and thus improve patients' quality of life. AIMS: The aim of this study is to provide Spanish-speaking physicians who are not specialists in pain with a set of guidelines for the treatment of NP. A bibliographical search was performed in order to base the results and conclusions on the evidence-based medicine methodology. DEVELOPMENT: First, we review the most effective clinical and paraclinical methods for diagnosing NP, and the LANSS pain scale is reported as the most appropriate method of clinically evaluating NP. The anatomical paths and the physiology of pain are then described and we review the molecular variables involved. Finally, we point out the current therapeutic options and propose an algorithm for the treatment of NP. CONCLUSIONS: There is no specific set of guidelines for the treatment of NP. At the present time, the keystone of NP treatment consists in the use of antidepressant and anticonvulsive drugs. There is a need for further clinical trials to prove the effectiveness of using combined medication.

Decision Trees↗
PubMedDate not supplied

Fracutres of the proximal tibia and tibial condyles: a clinical and laboratory comparative study.

Angulatory deformities frequently develop following condylar and proximal diaphyseal tibial fractures. Laboratory studies conducted in cadaver specimens with artificially created fractures closely resembled the behavior of fractures treated with functional braces. Providing that the fibula factor is properly assessed, selected condylar and proximal tibial shaft fractures can be successfully treated by nonsurgical means including early knee motion in a brace followed by graduated weight-bearing ambulation.

Adolescent↗
PubMedDate not supplied

Factors contributing to lysis of the femoral neck in total hip arthroplasty.

A radiographic analysis of 483 Charnley total hip arthroplasties performed from July 1970 to November 1975 demonstrated that 13% of the hips had lysis of the medial femoral neck. The findings suggest that the lysis of the medial femoral neck is significantly reduced if the femoral stem is oriented in a valgus or neutral position and with at least 5 mm of cement separating the stem of the prosthesis and the medial cortex of the femoral neck.

Bone Cements↗
PubMedDate not supplied

Functional bracing of Colles' fractures: a prospective study of immobilization in supination vs. pronation.

In a prospective study, 156 Colles' fractures were treated with a functional Orthoplast brace. Approximately one-half were braced in pronation and one-half in supination. One hundred and four were available for follow-up. Results were analyzed by type of fracture and position of immobilization (pronation versus supination). In evaluating the results, we found that: (1) displaced Colles' fractures without articular involvement (Type II) braced in supination yielded superior anatomic results when compared with those treated in pronation; (2) Type IV (displaced intra-articular) fractures braced in supination obtained a significantly higher percentage of excellent functional and anatomic results than those braced in pronation. In general, treatment with functional bracing yielded 90% excellent or good functional results.

Adolescent↗