Examinando por Autor "Ruiz Riquelme, Pablo"

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    The Akin osteotomy without fixation in open hallux abducto-valgo correction surgery: A single center retrospective analysis of 286 cases
    (Elsevier, 2023-01-06) Testa, Enrique Adrián; Porreca, Annamaria; Ruiz Nasarre, Alberto; Poggio Cano, Daniel; Alvarez Goenaga, Fernando; Ledermann, Gerardo; Baduell, Albert; Ruiz Riquelme, Pablo
    Between 2011 and 2018, 222 patients, 286 feet (147 left, 139 right) met the inclusion criteria. We found an average difference between pre-op and post-op at 3 months of distal articular set angle (DASA) of 7.0 degrees and average interphalangeal joint obliquity angle (IPOA) of 12.0 degrees (p < 0.001). All cases achieved fusion but in 5.9 % (17/289 cases) of cases, we observed delayed consolidation. The average union time in these cases was 22.1 weeks. Hyperextension of the distal fragment (mal union in plantar flexion) was observed in 7 cases (2.4 %). None of the 7 cases required correction. Out of 286 surgeries, 8 (2.7 %) required reoperation, but only one case for a hypocorrection required Akin's re osteotomy. Regarding the inter- and intra-observer correlations, good and excellent reliability are observed for all parameters under consideration. Conclusion The absence of internal fixation would appear not to impair osteotomy healing and complication rates compared with techniques with fixation would not appear to be worse. The results are encouraging; nevertheless, we believe that further studies need to be performed in order to confirm the data.
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    Cobertura de partes blandas del Pulgar. Guía en la toma de decisiones
    (Elsevier, 2021-02-27) Ruiz Riquelme, Pablo; Urrutia Hoppe, Esteban
    Resumen Las lesiones digitales son extremadamente frecuentes y cuando estas involucran al pulgar pueden comprometer importantemente la función de la mano, tanto así que su amputación afecta hasta un 50% la función global de la mano y disminuye su fuerza hasta en un 20%. Para poder mantener el largo del pulgar en muchas ocasiones se requiere de cobertura mediante el uso de colgajos, los cuales no siempre son realizados por un cirujano de mano. La elección correcta del colgajo es esencial para evitar la restricción de movilidad y limitación funcional del dedo lesionado, existiendo múltiples alternativas descritas, que varían en su capacidad de cobertura y complejidad, haciendo difícil una adecuada elección. Nuestro objetivo es resumir y entregar una estrategia de análisis de lesiones del pulgar que permita comprender el tipo de lesión y objetivos del tratamiento quirúrgico, para así optimizar la cobertura según cada caso y los resultados a largo plazo. Nivel de Evidencia: IV
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    Qué hay de nuevo en el estudio y manejo de las fracturas de tobillo: revisión de literatura
    (Medwave, 2021-03-19) Ruiz Riquelme, Pablo; Filippi, Jorge
    El conocimiento acerca del manejo de las fracturas de tobillo ha tenido un gran crecimiento los últimos años. La tomografía axial computarizada y el mejor entendimiento biomecánico han renovado conceptos tanto del diagnóstico como del tratamiento. Pese a ello, actualmente existen consideraciones sobre el manejo de fracturas maleolares sin consenso. Esta revisión pretende actualizar conceptos sobre el estudio y manejo de las fracturas de tobillo. Serán discutidos los conceptos de estabilidad, estudios radiológicos, uso de tomografía axial computarizada, manejo de lesiones ligamentarias asociadas (ligamento deltoideo y sindesmosis) y manejo de fracturas del maléolo posterior. Se planteará la opinión de los autores y la evidencia en la literatura para cada pregunta propuesta.
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    Results of prophylactic simple fasciocutaneous advancement in the initial management of acute ankle fractures with high risk of operative wound complication
    (Elsevier, 2023-09-04) Becerra, Eduardo; Castro, Magdalena; Ruiz Riquelme, Pablo
    Ankle fracture is the third most prevalent fracture in older adults. Wound dehiscence is the most frequent complication. Our objective is to determine the operative wound complication rate in patients with unstable ankle fracture in whom a prophylactic simple fasciocutaneous advancement was used. Prophylactic fasciocutaneous advancement at the beginning of traumatological surgery is technically simple, reproducible, cheap and with low complications.
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    Ultrasound evaluation of a new surface reference line to describe sural nerve location and safe zones to consider in posterior leg approaches
    (Springer, 2022-12-26) Ruiz Riquelme, Pablo; Poggio Cano, Daniel; Sala Blanch, Xavier; Cuéllar Bernal, Daniel; Baduell, Albert; García Elvira, Rubén; Testa, Enrique Adrián
    Purpose Several authors have described methods to predict the sural nerve pathway with non-proportional numerical distances, but none have proposed a person-proportional, reproducible method with anatomical references. The aim of this research is to describe ultrasonographically the distance and crossing zone between a surface reference line and the position of the sural nerve. Methods Descriptive cross-sectional study, performed between January and April 2022 in patients requiring foot surgery who met inclusion criteria. The sural nerve course in the posterior leg was located and marked using ultrasound. Landmarks were drawn with a straight line from the medial femoral condyle to the tip of the fbula. Four equal zones were established in the leg by subdividing the distal half of the line. This way, areas based on simple anatomical proportions for each patient were studied. The distance between the marking and the ultrasound nerve position was measured in these 4 zones, creating intersection points and safety areas. Location and distances from the sural nerve to the proposed landmarks were assessed. Results One- hundred and four lower limbs, 52 left and 52 right, assessed in 52 patients were included. The shortest median distance of the nerve passage was 2.9 mm from Point 2. The sural nerve intersection was 60/104 (57.7%) in Zone B, 21/104 (20.1%) in Zone C and 19/104 (18.3%) in Zone A. Safety zones were established. Average 80.5% of coincidence in sural nerve localization was found in the distal half of the leg, in relation to the surface reference line when comparing both legs of each patient. Conclusions This study proposes a simple, reproducible, non-invasive and, for the frst time, person-proportional method, that describes the distance and location of the main areas of intersection of the sural nerve with points and zones (risk and safe zones) determined by a line guided by superfcial anatomical landmarks. Its application when surgeons plan and perform posterior leg approaches will help to avoid iatrogenic nerve injuries. Level of evidence IV.