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Copyright of Acta Ortopédica Mexicana is the property of Sociedad Mexicana de Ortopedia, AC and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Acta Ortopédica Mexicana is the property of Sociedad Mexicana de Ortopedia, AC and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: The objective of this study is to compare the outcomes of using the Femoral Neck System (FNS) (DePuy Synthes®) versus the use of cannulated screws (CS) in the surgical treatment of non-displaced subcapital hip fractures., Materials and Methods: A retrospective cohort study was conducted on non-displaced subcapital hip fractures treated with CS or FNS between 2020 and 2023, with a minimum follow-up of one year. A total of 28 patients were included, 14 treated with CS and 14 with FNS. Demographic, radiological, clinical, and functional variables were analyzed., Results: In the CS group, 64% were male, with a mean age of 66.5 years (SD 14.9) and an average follow-up of 22 months (range, 12-36 months). In the FNS group, 57% were male, with a median age of 60.8 years (SD 13.78) and an average follow-up of 16 months (range, 12-24 months). Regarding functional outcomes, no significant differences were found between FNS and CS in the Harris scale: 94.21±11.55 for FNS and 96.50±6.9 for CS (p=0.618). The total postoperative complications (FNS/CS) were 7.1% versus 43%, and implant failure with conversion to total hip replacement was 0% versus 43%, both significantly higher in the CS group (p=0.047; p=0.016, respectively). The FNS also presented a lower rate of avascular necrosis (0% versus 11.1%, p=0.391) and nonunion (0% versus 20%, p=0.163), although these differences did not reach statistical significance., Conclusions: Although both treatment methods, cannulated screws and the FNS, showed similar short-term functional outcomes in the management of undisplaced subcapital femoral fractures, the FNS demonstrated a significantly lower rate of complications and reoperations. These results suggest that the FNS could be considered a safer and more effective option compared to cannulated screws., (Copyright © 2024. Publicado por Elsevier España, S.L.U.)

Introduction: Proximal humeral fractures (PHFs) often occur in elderly patients with osteoporosis and associated comorbidities. These patients constitute a special risk group. This study aimed to identify associations between comorbidities, treatment type, and mortality risk., Patients and Methods: We conducted a retrospective chart review of a cohort of 350 patients with a diagnosis of PHF and a mean follow-up of 4.5 years. We analysed the 19 prefracture comorbidities included in the Charlson Comorbidity Index (CCI), haemoglobin (Hb) levels, blood transfusion needs, and treatment administered (surgery versus conservative). The nonparametric Kaplan-Meier method and Cox proportional hazards model were used to estimate the mortality risk., Results: Over a 4.5-year average follow-up of 350 patients, primarily elderly females, with proximal humerus fractures, several factors were associated with increased mortality. The Charlson Comorbidity Index (CCI) was a significant predictor, with patients having a CCI > 5 facing higher mortality risks, especially if they underwent surgery. Additionally, osteosynthesis was linked to a lower mortality rate compared to arthroplasty. Age, dementia, medical complications, and postfracture Hb level also influenced mortality rates. CONCLUSIóN: These findings emphasize the importance of considering comorbidities, specifically the Charlson Comorbidity Index (CCI), in determining patient outcomes, especially amongst elderly patients with proximal humerus fractures. Factors like age, dementia, and postfracture Hb level also play a crucial role in influencing mortality rates., Trial Registration: The study received written approval from the regional Ethics Committee for Clinical Research (code 2016/125)., Competing Interests: Declaration of competing interest The authors declare no potential conflicts of interest with respect to the research, authorship, and/or publication of this article, (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Spinal metastases represent a significant burden on the quality of life in patients affected by active oncological disease due to the high incidence of pain syndromes, spinal deformity, and neurological impairment. Surgery plays a decisive role in improving quality of life by controlling pain, restoring neurological function and maintaining spinal stability, as well as contributing to the response to medical therapy. Minimally invasive surgery (MIS) is a treatment option in certain patients with high surgical risk since it has a low rate of complications, intraoperative bleeding, hospital stay, and offers similar results to open surgery. In this review, we present the role of MIS in this pathology and some cases treated in our hospital., (Copyright © 2023 SECOT. Publicado por Elsevier España, S.L.U. All rights reserved.)

Introduction: in March 2020, lockdown was established in Spain because of the COVID-19 pandemic. The aim of this study is to assess its impact on pain and quality of life in patients with musculoskeletal pain., Material and Methods: prospective study including 490 individuals grouped in: 140 people without pain, 140 people with musculoskeletal pain but without any related pathology diagnosed, 140 patients diagnosed for a musculoskeletal condition and 70 patients in surgical waiting list (SWL) for a musculoskeletal condition. Data regarding pain, physical activity and quality of life (EuroQol-5D) was collected at the beginning of lockdown and one year after (March 2021)., Results: mean age was 53 ± 17.5 years old (18-88) and 51.3% were women. Patients in SWL referred significantly more pain than the rest of groups (p < 0.001), with a score in the visual analogue scale of 6.3 ± 1.9. Groups 3 and 4 suffered a significant increase of their pain from 2020 to 2021 (p < 0.001), while decreasing in group 2 (p < 0.001). Analgesics intake grew from 2020 to 2021 (39.9% versus 44.3%, p = 0.007). 70.2% experienced a worsening of at least one dimension of EuroQol-5D over last year, with patients in SWL being the most affected (p < 0.001)., Conclusion: lockdown has caused in patients with musculoskeletal conditions a greater aggravation of pain and deterioration of quality of life than in the general population, especially in patients in SWL, translating in an increase in analgesics intake.

Introduction: The deforming condition of the navicular bone known as Müller-Weiss disease (MWD) is a rare disease. Patients present with chronic pain in the talonavicular joint and a paradoxical flat foot with a varo hindfoot., Objective: To analyze the clinical results of a lateral osteotomy of calcaneus applied to patients with MWD., Material and Methods: Retrospective observational study carried out in two hospitals. The series consists of nine cases in eight patients, all of them with symptomatic Müller-Weiss disease, treated by lateral osteotomy of the calcaneus between 2012 and 2017, obtaining an average follow-up of 4 years (2-6). The mean age was 62 years (50-75). In all patients, Costa-Bartani angles (CB), Kite angle and Calcaneal Inclination (CI) were measured. In addition, the Manchester Oxford Scale (MO) to measure the post-surgical satisfaction of patients., Results: All patients report having improved their pain by obtaining a postoperative score on the mean Manchester Oxford scale of 32.54 points (15.62-53.75). In 66% of patients the CB angle improves, the Kite angle in 89% and the CI in 33%., Conclusion: The improvement in the pain of the patients in our series is not accompanied by radiological changes in the same proportion, it is a simple and uncomplicated technique in our follow-up.

Background: Recently published data suggest that showing patients operated on for adolescent idiopathic scoliosis or kyphosis their preoperative and postoperative photographs may enhance their satisfaction and self-image as measured by Scoliosis Research Society Health-Related Quality of Life Questionnaire (SRS-22) scores. No data exist for adult spinal deformity (ASD) surgery. The aim of this study is to determine the effect on patient postoperative satisfaction and self-image of showing adult deformity patients their preoperative and postoperative whole body photographs., Methods: This was a nonconcurrent prospective study. Patients operated on for ASD with a minimum 2-year postoperative follow-up who had preoperative full-body photographs taken by a professional photographer were included. Two follow-up visits were arranged 7 days apart. In the first visit, patients completed the SRS-22 questionnaire, and full-body standing photographs were taken. In the second visit, patients were asked to complete again questions 4, 6, 10, 14, 19 (self-image), 21, and 22 (satisfaction) of the SRS-22 after seeing their preoperative and postoperative full-body photographs., Results: Thirty patients (28 female) were included. The median age at surgery was 50 years (26-76). The median follow-up was 51 months (24-120). SRS-22 results at first visit were: activity 2.79 ± 0.75; self-image 2.71 ± 0.82; pain 2.53 ± 1.10; mental health 3.08 ± 0.77; satisfaction 3.46 ± 1.20; global 2.74 ± 0.72. SRS22 results at second visit were: self-image 2.9 ± 0.75; satisfaction 4.02 ± 0.97. After seeing the preoperative and final follow-up photographs, patients experienced an improvement in SRS-22 self-image ( P = .000) and satisfaction domains ( P = .011)., Conclusions: In patients operated on for ASD, showing preoperative and postoperative photographs improves patient satisfaction with surgery and self-image., Level of Evidence: 3., Clinical Relevance: Our results could be a starting point for introducing full-body clinical photographs as a routine clinical tool in adult deformity patients undergoing surgery., (This manuscript is generously published free of charge by ISASS, the International Society for the Advancement of Spine Surgery. Copyright © 2020 ISASS.)

Background: The purpose of this study was to evaluate the relevance of a commonly used morbidity prognostic tool, the Charlson comorbidity index (CCI), in determining the survival rate of patients with isolated proximal humeral fractures (PHFs) and to determine the impact of surgical treatment according to previous comorbidities (measured with CCI)., Materials and Methods: All patients who were treated for a single PHF in our institution for 29 consecutive months were included in this retrospective study, with a minimum follow-up of 24 months (mean 52.8 months). Two groups were established according to the type of treatment received (surgical versus non-surgical). Preinjury comorbidities were identified, and the age-adapted CCI was calculated. All complications and mortality rates were prospectively recorded over the complete follow-up period., Results: Patients with elevated preinjury comorbidities (CCI > 5) demonstrated a significant increase in mortality (HR = 4.64) compared to those with CCI ≤ 5. In addition, patients with high comorbidities (CCI > 5) who underwent surgical treatment demonstrated a statistically significant increase in mortality (HR = 6.92) compared to patients with similarly high comorbidities (CCI > 5) who underwent non-surgical treatment., Conclusions: Patients with high preinjury comorbidities (CCI > 5) experienced an increased mortality risk if they underwent surgical treatment for isolated PHFs. The use of a morbidity prognostic tool, such as the CCI, can help predict the outcome (particularly mortality) in these patients and may aid in making decisions in terms of operative versus non-operative treatment to minimize patient mortality., Level of Evidence: Level III; Retrospective Comparative Study; Treatment Study., (© 2020. Istituto Ortopedico Rizzoli.)

Purpose: The aim of this study is to determine the correlation between photographic sagittal parameters and patient-reported outcome measures (PROM) results in adult patients operated on spinal deformity., Methods: Non-concurrent prospective study., Inclusion Criteria: age at surgery older than 25, minimum 2-year follow-up after a 5 or more level fusion for adult spinal deformity (ASD). Full body lateral standing photographs were taken with adhesive markers placed on ten bony landmarks. SRS-22 and SF-36 questionnaires were completed for every patient. The following photographic parameters were measured: lumbar angle, lumbar curve, thoracic inclination (TI), trunk angle, pelvic tilt, head angle, neck angle, cervicothoracic angle, lumbar vector angle (LVA), dorsal vector angle (DVA), cervical vector angle (CVA), cranial pelvic angle (CrPA), cranial sacral angle (CrSA), fibular inclination angle (FIA) and cranial sagittal vertical axis measured to sacrum (Cr-S), greater trochanter (Cr-GT), knee (Cr-K) and ankle (Cr-A)., Results: 65 patients (58 female) operated on ASD in a single institution were included. Age at surgery was 61 years (26-67). Postoperative follow-up was 53 months (24-120). Spearman rank order test showed several significant (p ≤ 0.01) correlations. After multivariate linear regression analysis age, LVA and TI remained as predictors for SRS image scores (corrected r 2 0.41), LVA for SRS satisfaction (corrected r 2 0.27), CrPA and age for SRS total scores (corrected r 2 0.33), FIA and age for SF36 physical functioning (corrected r 2 0.36) and CrSA for SF36 role physical (corrected r 2 0.14)., Conclusions: Some sagittal photographic parameters may predict mid-term clinical results after ASD surgery.

Study Design: This is nonconcurrent prospective study approved by the Institutional Research Ethics Committee., Objective: The purpose of this study is to determine if the cranial sagittal vertical axis (Cr-SVA) measured in full spine standing radiographs is a better predictor of clinical results than the C7 sagittal vertical axis (C7-SVA) in adult patients operated on spinal deformity with a minimum 2-year follow-up after surgery., Summary of Background Data: The Cr-SVA has recently been described as a better predictor of health-related quality of life outcomes than the C7-SVA for patients with adult spinal deformity (ASD) before undergoing surgery. This has not been confirmed in patients after ASD surgery., Methods: Inclusion criteria were age at surgery more than 25 years and a minimum 2-year follow-up after a ≥5 level fusion for ASD. Full-length standing lateral radiographs (including nasion-inion line, spine, and femoral heads) and Scoliosis Research Society 22 Questionnaire and SF36 questionnaires were available for every patient at the final follow-up. The distance from the Cr-SVA to the posterior corner of S1 (Cr-SVA-S) and to the centers of the hip (Cr-SVA-H) was measured and also the C7-SVA, lumbar lordosis, pelvic incidence, pelvic tilt, and PI-LL., Results: Sixty-five patients (58 female individuals) operated on ASD in a single institution were included. Age at surgery was 61 years (26-67). The mean follow-up was 53 months (24-120). Spearman rank-order test showed several significant correlations. After multivariable analysis, only Cr-SVA-S and age persisted as predictors for Scoliosis Research Society (SRS) image scores, Cr-SVA-H for SRS satisfaction, Cr-SVA-H and age for SRS total scores, Cr-SVA-H and age for SF36 Physical Function, Cr-SVA-S for SF36 Role Physical, Cr-SVA-H for SF36 Bodily Pain, and Cr-SVA-H for SF36 Role Emotional., Conclusions: The Cr-SVA measured in full spine standing radiographs seems to be a better predictor of health-related quality of life outcomes than the C7-SVA for adults operated on spinal deformity >2 years after surgery., Competing Interests: The authors declare no conflict of interest., (Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.)

The aneurysmal bone cyst is a benign rare tumor, which usually develops during childhood and its more often found in limbs. The most accepted treatment consists in curetagge and filling with graft. However, certain locations may be inaccesible for surgery and represent therapeutical challenges. We present the case of an 11 year-old male patient with limping and right hip pain without any traumatic nor infectious record. In the image studies with CT and MRI a lytic and expansive lession was found in the upper part of the right acetabulum and right iliac wing, all of which suggested an aneurysmal bone cyst with an associated acetabular fracture. A biopsy was performed which confirmed the diagnosis. He was treated with a CT-guided embolization and, due to its size, curetagge and allograft filling afterwards. He was asymptomatic after1 year of follow-up.

«Minimally invasive» techniques have been recently been developed in order to achieve good clinical results with a low incidence of complications. The extralateral interbody fusion or direct transpsoas is a minimally invasive anterior arthrodesis. A total of 97 patients with 138 segments received surgery between May 2012 and May 2015. The follow-up was from 12-44 months. The mean age was 68 years (41-86). The most common cause of intervention was the adjacent segment (30%), deformity (22%), and lumbar disc disease (21%). The interbody cage was implanted as: Single (stand-alone) in 33%, and additional fixation was used in the others: Screws, percutaneous unilateral (11%), bilateral (27%), or with a lateral plate (62%). The mean stay was 3.2 days (2-6). The score on a lumbar visual analogue scale decreased from 9 to 4.1, and dropped to 3 after one year. The improvement in disc height was from 8.4mm to 13.8mm, and a larger increase in the foramen diameter from 10.5 to 13.1mm, which were statistically significant. The early major complications recorded were, three motor femoral nerve injuries and retroperitoneal haematoma (4%), and the early minor were: two fractures (2%). As major late complications there was an abdominal hernia, a mobilization of 10mm and three radiculopathy (5%), and as minor late, three fracture, two mobilisations greater than 10mm, four mobilisations of less than 10mm, and one mobilisation of a screw plate (10%). The extralateral interbody fusion technique is a safe and reliable when performing a lumbar fusion by an alternative minimally invasive route., (Copyright © 2016 SECOT. Publicado por Elsevier España, S.L.U. All rights reserved.)

Background: The traditional idea that most fractures of the mid third of the clavicle heal with a good functional outcome after orthopedic treatment is increasingly controversial due to the publication of studies reporting high pseudoarthrosis rates and functional limitations in certain subpopulations. Our objective is to analyze the results obtained with open reduction and internal fixation with low profile plates for the treatment of these fractures., Methods: We conducted an observational, retrospective, cohort study of the patients who underwent surgery for displaced fracture of the mid third between January 2006 and December 2009. They all were radiologically and functionally assessed using the Constant and disabilities of the arm, shoulder and hand scales., Results: Surgical treatment of displaced fractures of the mid third of the clavicle with low profile plates using a meticulous technique results in low intra- and postoperative complication rates, with a mean healing rate of 4 months. The Constant score in the affected arm compared with the healthy one was 93.41% in the subjective assessment and 96% in the objective one., Conclusions: The good functional results obtained lead us to recommend this type of treatment, mainly in certain subpopulations (young and active patients).