Post-operative lumbar pain is related to alterations in the sagittal and spinopelvic parameters. A lumbar fusion that fails to maintain, or that worsens the physiological lordosis alters the sagittal balance. Objective: To analyze spinopelvic variation in different surgical positions. Methods: A prospective, analytical and comparative study of spinograms, lumbosacral radiographs in the surgical position over a 4-pole quadratus lumborum, and lumbosacral radiographs with quadratus lumborum and support in the knees. A sample of 129 patients, of both sexes, aged between 18 and 60 years, and presenting with lower back pain. Lumbar Lordosis (LL), Pelvic Tilt (PT), Pelvic Incidence (PI) and Sacral Slope (SS) were measured. Results: PI was the most stable parameter. With quadratus lumborum, a slight increase in PT, a decrease in SS and a significant reduction in LL were found. With quadratus lumborum and support in the knees, a decrease in PT and a slight increase in SS were found, while the LL value remained similar to that of the spinogram. Conclusion: The intraoperative position with hip flexion of between 40° and 45° over quadratus lumborum reduced LL to 10.52° in men and 16.21° in women, increased PT, and decreased SS. The intraoperative position with hip flexion of between 0° and 10° showed the same values as the reference spinogram. Level of Evidence II; Prospective comparative study.

Objetivo: Determinar si los resultados clínicos y radiográficos difieren después del tratamiento conservador y el tratamiento quirúrgico para las fracturas de la estiloides cubital asociadas a fracturas inestables del radio distal tratadas mediante placa volarbloqueada.Materiales y Métodos: Estudio multicéntrico, retrospectivo y descriptivo que incluye pacientes operados en cuatro instituciones, entre 2009 y 2012. Todos tenían fracturas de la estiloides cubital en el contexto de una fractura del radio distal. Las fracturas de la estiloides cubital fueron tratadas de forma conservadora (grupo I) o con cirugía (grupo II).Resultados: El seguimiento promedio fue de 56 meses. Se evaluó a 57 pacientes; grupo I (29 casos) y grupo II (28 casos). Los pacientes del grupo II tuvieron 2,76 veces (IC95% 1,086; 8,80) más posibilidades de lograr una consolidación que aquellos del grupo I. El puntaje DASH  el dolor, tanto en reposo como en actividad, no presentaron diferencias significativas (p = 0,276 y p = 0,877). La desviación cubital y la fuerza obtuvieron mejores resultados en el grupo I (p = 0,0194 y p = 0,024).Conclusiones: Aunque los pacientes con estabilización quirúrgica de la estiloides cubital tuvieron 2,76 más posibilidades de lograr la consolidación que aquellos del grupo I, no hubo diferencias significativas en la evaluación subjetiva (DASH y dolor) entre ambos grupos. Tampoco hubo diferencias significativas cuando se consideró el grado de compromiso de la estiloides cubital, pero la fuerza y la desviación cubital presentaron mejores resultados en el grupo sin fijación de la estiloides cubital. AbstractObjectives: To evaluate potential differences in clinical and radiological outcomes after surgical versus conservative management of ulnar styloid fractures associated with unstable distal radius fractures treated by locked volar plating. Materials and Methods: This was a multicenter, retrospective and descriptive study including surgical patients treated at four different institutions between 2009 and 2012 for ulnar styloid fractures associated with unstable distal radius fractures. Ulnar styloid fractures were treated conservatively in group I and surgically in group II. Results: The average follow-up was 56 months. The study included 57 patients divided into two groups (group I [29 cases] and group II [28 cases]). Patients in group II had 2.76 times (95% CI: 1.086; 8.80) more chances of achieving bone union than those in group I. DASH and pain scores, both at rest and during activity, did not show significant differences between the two groups (p = 0.276 and p = 0.877). Group I presented milder ulnar deviation and better strength (p = 0.0194 and p = 0.024). Conclusions: Although patients who underwent surgery for ulnar styloid fractures had 2.76 more chances of achieving bone union than those who received conservative management, there were no significant differences between both groups in subjective evaluations (DASH and pain scores) or when considering the degree of ulnar styloid involvement. However, the parameters of strength and ulnar deviation were better in the conservative management group.

Introduction:Indications in the treatment of rotator cuff lesions are widely discussed and not standardized. The aim of this study is to evaluate the variability among Argentinean orthopedic surgeons regarding the indications of treatment in different rotator cuff lesions.Methods:A questionnaire was designed based on the study carried out by Dunn et al. (JBJS Am 2005). Its aim was to gather the opinion of Argentine orthopedic surgeons on decision making concerning different rotator cuff lesions. Surgeons were divided into general orthopedic surgeons or shoulder specialists according to the number of shoulders treated surgically in the last year. The questionnaire has two sections: four hypothetical clinical cases and 11 questions about factors that could influence treatment selection.Results:Out of 556 questionnaires sent, 162 were completed, 117 by orthopedic surgeons and 45 by shoulder specialists. The specialists reported mostly arthroscopic repairs (57%), orthopedic surgeons reported repairing these lesions mainly by mini open or open technique (48% and 21% respectively). The highest agreement between both groups was evidenced in case number 1 (traumatic partial injuries in young patients (70% in favor of rotator cuff repair)). There was also agreement in the contraindication of the use of corticosteroids before surgery (p = 0.74), and in the repair of rotator cuff as a factor to prevent osteoarthritis (p = 0.27). Rotator cuff repair failure rate was considered to be 20%, not evidencing differences between groups.Conclusions:This study evidences the variation in indications between Argentinean surgeons in the treatment of rotator cuff lesions. The variability in the management of these patients, makes it difficult to establish protocols of treatment, or consensus guidelines to help standardize treatments for these injuries

Introduction:Knee pain is one of the most common complications in the trauma clinic. It is common to find patients who come to the office with a Nuclear Magnetic Resonance (MRI) who have a broken meniscus and who are looking for a lathe in the operating room. The majority of these patients are feasible for orthopedic treatment and it is sufficient to perform correct semiological maneuvers to determine it. Although there is a growing demand for knee MRI by members of the health team. The hypothesis of this work postulates that the NMR requested by the specialists in orthopedics and traumatology offer positive results both for the diagnoses and for the treatment plans.Objectives:The aim of this study is to compare the usefulness in diagnosis and in the therapeutic definition of knee MRIs requested by medical specialists.Materials and Methods:We retrospectively reviewed 1,186 knee MRI reports from January 1, 2015 to July 31, 2015, using the computerized clinical history system. These were classified according to the origin of the request for the images (specialists in orthopedics and traumatology, residents of traumatology and other medical specialties). This information was explored for its characterization.Retrospective study. Level of evidence IVResults:We obtained 33% (389) normal report of knee, significantly lower (p <0.001) to 67% reporting injuries. The proportion of studies requested was mostly by specialists in orthopedics and traumatology (59%), followed by the proportion required by different medical specialties (27%) and by those prescribed by traumatology residents (13%). The percentages of normal reports of those studies requested were different (p <0.05) 29, 42 and 32%, respectively.Conclusions:In primary care by physicians and residents of traumatology, the request for knee MRI reports a high percentage of normal reports. Specialists in orthopedics and traumatology request this exam with greater demand and present greater findings of injuries.