Biomedical subjects

P Gonzalez-Herranz

Publications and source records attributed to P Gonzalez-Herranz.

6 recordsLinked to original sources

PubMed1998

Anterior endoscopic approach to the thoracolumbar spine.

STUDY DESIGN: A technique for anterior endoscopic exposure of the thoracolumbar spine is described. OBJECTIVE: To develop an endoscopic approach to the thoracolumbar spine with fewer complications than are encountered in the conventional approach. SUMMARY OF BACKGROUND DATA: The efficacy of the anterior endoscopic approach to the thoracic spine has been shown. The thoracolumbar hinge is usually approached by open surgery. METHODS: The study was performed in three stages. The first phase was carried out on experimental animals (pigs). Once the bases were established, the approach was studied in fresh cadavers. Finally, it was performed on three patients with thoracolumbar scoliosis who required discectomy and anterior release. RESULTS: After a series of attempts on the animals, it was found that the most effective method for exposure of the thoracolumbar spine was the initial thoracoscopic approach followed by the retroperitoneal endoscopic approach. This was confirmed in cadavers. When applied to the clinical situation, there were no significant complications in any of the patients treated with this method, and postoperative pain and discomfort were minimal. CONCLUSIONS: The anterior endoscopic approach to the lumbar spine involves minor trauma, results in rapid recovery and less pain, and produces good results aesthetically.

Adolescent↗

PubMed1997

Traumatic proximal tibiofibular dislocation.

Proximal tibiofibular dislocation is an exceptional lesion. Rarer still is its presentation in childhood. We describe the clinical case of a 6-year-old boy, the victim of a road accident. He had a tibiofibular dislocation associated with a metaphyseal fracture of the tibia.

Child↗

PubMed1995

Secondary avascular necrosis after treatment for congenital dislocation of the hip.

We made a radiographic study of 104 unilateral congenital dislocations of the hip (CDH) that had an average age of 12 months (range 4-24), were treated with the same therapeutic protocol, and had an average six years follow-up (range 3-13). Radiographic changes were evident in the proximal femoral epiphysis in 57 hips (55%). In 7 (7%) the changes consisted of central osteoporosis with a cystic aspect, without metaphyseal or physeal changes, and had a normal end result without sequelae. This group was classified as type I. Fifty hips (48%) that were type II showed epiphyseal changes consisting of trabecular rarefaction with osteoporosis and irregular sclerosis, followed by a decrease of epiphyseal height and trabecular recovery. Forty-two hips (40%) were type IIA, with < 75% decrease in epiphyseal height with respect to the healthy side; five of these had a normal evolution, 35 had coxa magna and/or decrease of epiphyseal height, and only two cases had physeal lesion. In type IIB, hips, with > 75% decrease of epiphyseal height, 8 cases (8%) had a final physeal lesion.

Child↗

PubMed1995

Traumatic hip dislocation with incomplete reduction due to soft-tissue interposition in a 4-year-old boy.

The case of a traumatic dislocation of the left hip in a 4-year-old boy is presented. After an initial attempt at reduction under general anesthesia, a permanent deformity in the flexion of the hip remained, and there was radiographic evidence of a nonconcentric reduction. Computed tomography (CT) showed interposition in the posterior part of the joint. Under general anesthesia, the mobilization of the hip reduced the dislocation correctly, removing the necessity of open treatment. This case stresses the need for early diagnosis of this serious complication and closed reduction of the joint, avoiding the poor results of open and deferred treatments.

Accidental Falls↗

PubMed1993

Factors responsible for the development of avascular necrosis secondary to the treatment of congenital dislocation of the hip.

We present 104 cases of unilateral congenital dislocation of the hip treated with the same regime between 1977 and 1988. The patients had an average age of 12 months (range 4-24). The average age at follow-up was 6 years (range 3-13). The incidence of avascular necrosis was 37%. Avascular necrosis presented most frequently in babies of 7 months at the start of treatment, in Tonnis type IV when an adductor tenotomy was not performed, and after open reductions. The most influential factor was the absence of the femoral head descent at the end of the period of traction. The "effective" prereduction traction and the performance of an adductor tenotomy when necessary were the principle factors in avoiding avascular necrosis.

Child↗

PubMed1993

Fractures of the proximal humeral epiphysis.

Twenty-two patients with marked displacement of a fracture of the proximal humeral epiphysis have been treated with closed or open reduction and fixation by Kirschner wires. At an average follow-up of 6.8 years there have been good functional results in almost all patients (91.1), with better results in patients under 13 years of age particularly with less residual displacement or angulation. Since there is a greater occurrence of residual deformity and symmetria and limitation of motion in older patients, a more aggressive approach to correct the initial displacement and angulation is warranted in those over the age of 13 years.

Adolescent↗