Distal femur pseudoarthrosis also called «distal femur non-union» (DFNU) represents a rare complication associated with a fracture caused by high-energy trauma; its treatment is controversial, as there is a wide variety of surgical techniques that can be implemented, from open reduction plus internal fixation with plates, to the use of fixed angle plates combined with bone autograft. We expose the case of a 24-year-old man who shows up for consultation with the history of having presented a left femoral supracondylar fracture with a year of evolution, treated by osteosynthesis of the distal femur with dynamic condylar screws (DCS plate); developed a torpid evolution with severe pain in the distal third of the left thigh and functional limitation, developed a progressive varus deformity of the left thigh that caused a shortening of 3.8 cm of the limb. A focus of pseudoarthrosis was identified, which was surgically removed, the intramedullary canal was recanalized, and a lateral closed wedge osteotomy was performed to correct the angulation and allow reduction. 5.5 mm (three proximal and three distal) hydroxyapatite screws and an external fixator were placed. https://www.selleckchem.com/products/kaempferide.html In addition, a review of the literature focused on the use of external fixation was carried out as a treatment for the pseudoarthrosis of the distal femur.
The epidemiology of diseases allows the generation of preventive measures, for the modification of their natural evolution or to prevent their appearance. In second-level hospitals of care, most of the pathologies of each medical specialty are treated. Therefore, knowing the main reasons for external consultation in orthopedics and their seasonal predominance is a tool for implementing strategies for the benefit of patients.

Observational study carried out with the patient population of the external orthopedic consultation service of a second-level hospital of care, from January to December 2017. Patients over the age of 18 who first attended consultation were included.

11,704 consultations granted in the period, 7,862 (67.17%) women and 3,842 (32.82%) men. The average age of patients was 51.84 ± 0.14. The most common cause of consultation was arthropathies (47.65%). During the autumn, the largest number of consultations (32.33) were granted.

Arthropathies, specifically gonarthrosis, were the main reason for external consultation, accounting for nearly half of the consultations granted. It is transcendental to identify the modifiable risk factors of these pathologies with the aim of reducing the negative impact it generates at the functional, economic and quality of life level. Clinical relevance Further epidemiological studies on orthopedic pathologies will improve preventive strategies and optimize resources to improve patient care.
Arthropathies, specifically gonarthrosis, were the main reason for external consultation, accounting for nearly half of the consultations granted. It is transcendental to identify the modifiable risk factors of these pathologies with the aim of reducing the negative impact it generates at the functional, economic and quality of life level. Clinical relevance Further epidemiological studies on orthopedic pathologies will improve preventive strategies and optimize resources to improve patient care.
Joint affection is a frequent complication of hemophilia. Virtual reality programs offer the patient a dynamic plan with maximum functional benefit. The objective of this work is to evaluate the effect of a rehabilitation program combined with conventional therapy and virtual reality on joint function, in patients with hemophilic arthropathy and the impact on the gait.

Eleven pediatric patients with hemophilia and history of hemophilic arthropathy grade I or II were evaluated. An 8-week rehabilitation program was carried out with Xbox KinectTM and mechanotherapy. Movement analysis laboratory to evaluate the gait pattern and the Joint Health Scale was performed at the beginning and end of the program.

A reduction of 50% (p = 0.000), 68% (p = 0.016) and 48% (p = 0.000) were observed in the Total Joint Health score (STA), Global Gait Score (PMG) and Total Score of the Joint Health Scale (P-HJHS-T) respectively. There is a decrease in the support phase and right stride, and increase in cadence, step length, left stride and swing phase.

The overall improvement of the patients makes us conclude that this pilot study opens a window of opportunity to continue the study of an integral rehabilitation program based on the use of virtual reality in pediatric patients with hemophilic arthropathy.
The overall improvement of the patients makes us conclude that this pilot study opens a window of opportunity to continue the study of an integral rehabilitation program based on the use of virtual reality in pediatric patients with hemophilic arthropathy.
Multiple myeloma represents 1% of all cancers and 10% of hematological cancers. Up to 80-90% of cases will have skeletal involvement and the spine is the most frequently involved site. Any intervention must be aimed to improve the patients functional prognosis and will impact their quality of life.

To describe the clinical presentation of vertebral destruction syndrome due to multiple myeloma and to present the management algorithm used for the study and decision-making in treatment.

Study design Retrospective cross-sectional. A search was made in the hospitals clinical file in search of patients with a histological diagnosis of multiple myeloma attended by the Spinal Surgery Service. Clinical characteristics of the initial presentation were obtained such as presence of pain, ASIA scale and it was categorized according to the Durie-Salmon classification at diagnosis; the levels involved and type of surgery were described.

The study included ten patients with an average age of 61.4 years, 70% were malelinary group for the care of multiple myeloma with vertebral involvement.
Reverse shoulder arthroplasty improves function and pain in patients with glenohumeral osteoarthritis and rotator cuff deficiency. However, it is associated with significant blood loss and postoperative hematoma (PO) formation.

To determine the efficacy of tranexamic acid (ATXM) to decrease perioperative bleeding in patients undergoing primary reverse shoulder arthroplasty.

Cohort of 31 patients undergoing reverse primary arthroplasty, in two groups group A (17 patients) were given 1 g IV of preoperative tranexamic acid and group B (14 patients) to whom it was not administered. Preoperative hemoglobin and hematocrit were recorded and then after 24 hours of surgery, and quantified bleeding in drainage at 24 hours, as well as blood transfusion needs. The changes presented were statistically compared.

Demographic data did not show significant differences between the two groups. There is a tendency to reduce bleeding in surgical drainage in patients with ATXM (115.6 ml vs. 162.65 ml p = 0.0768), in the decrease of hemoglobin (2.