These results indicate a role for this laser in the treatment of onychomycosis, regardless of degree of severity. Ease of delivery and the lack of a need to monitor blood chemistry are attractive attributes.
Resumen. El Hallux Rígidus (HR) afecta a la primera articulación metatarsofalángica (AMTF) entre el 35% y el 60% de la población mayor de 65 años y existen múltiples vías de tratamiento. En función del estadio radiológico en el que se encuentre la deformidad, se determina el procedimiento a realizar; en los estadios iniciales se realiza las técnicas de queilectomia y osteotomías correctoras mientras que en las clasificaciones más avanzadas, el cirujano escoge entre las técnicas consideradas destructivas como la artrodesis y la artroplastia. Este trabajo de fin de grado tiene como objetivo centrarse en las técnicas destructivas en 1 AMTF, para aclarar cuál de los procedimientos genera mejores resultados según una serie de parámetros; los resultados de la escala American Orthopaedic Foot and Ankle Society-Hallux Metatarsophalangeal Interphalangeal scale (AOFAS), rango de movimiento (ROM) de la 1ºAMTF, clasificación radiológica. En cuanto a la técnica de artroplastias por implante, este artículo nos ofrece información sobre el material y diseño qué genera mejores resultados relacionándolo con las características del paciente como la edad, la presencia de patologías inflamatorias articulares, la viabilidad y la durabilidad del implante. La conclusión obtenida en esta revisión es que los valores obtenidos en la artrodesis según AOFAS disminuyen debido a la pérdida de movilidad, pero ambas técnicas presentan valores similares de efectividad y concluye con la decisión de que la técnica a utilizar se determina teniendo en cuenta varios factores y características del paciente. Palabras clave: Hallux rígidus; Hallux rígidus y tratamientos quirúrgicos; Hallux rígidus y Artrodesis; Hallux rígidus y Artroplastia; Hallux rígidus (Artroplastia y Artrodesis).[en] Hallux rigidus: Arthroplasty or arthrodesis. What technique produces better results?Abstract. Hallux rígidus (HR) affects the first metatarsophalangeal joint (MTPJ) between 35% and 60% of the population over 65 years and there are multiple ways of treatment. Depending on the radiological stage where you find the deformity determines the procedure to be performed; in the early stages cheilectomy techniques and corrective osteotomy is performed while the more advanced ratings, the surgeon chooses destructive techniques considered as arthrodesis and arthroplasty. This final of degree project aims to focus on 1 MTPJ destructive techniques to clarify which of the procedures generates better results by a number of parameters; outcomes of the American Orthopaedic Foot scale and Ankle Society Hallux metatarsophalangeal Interphalangeal-scale (AOFAS), range of motion (ROM) of the 1ºAMTF, radiological classification. As for the implant arthroplasty technique, this article offers information on material and design that generates better relating to patient characteristics such as age, inflammatory joint diseases, viability and durability of the implant results. The conclusion from this review is that the values obtained in the arthrodesis according AOFAS decrease due to loss of mob...
A biologically active human skin allograft, currently distributed under the brand name TheraSkin(®), was examined for safety and efficacy in the treatment of venous leg ulcers (VLUs) and diabetic foot ulcers (DFUs). The objective was to determine if TheraSkin could serve as a safe and effective alternative to bioengineered skin substitutes such as Apligraf(®) and Dermagraft(®). The authors conducted a retrospective study of 214 consecutive patients seen at the Inova Wound Center (Mt Vernon, Virginia), with either a DFU or a VLU. After excluding patients who did not meet the study criteria, the final eligible cohort consisted of 188 subjects, with 134 VLUs and 54 DFUs. Multivariate logistic regression was used to evaluate the relationship between baseline wound size and the proportion of healed wounds after 12 and 20 weeks from initial allograft application. The authors found that by the 12th week, DFUs closed 60.38% of the time and VLUs closed 60.77% of the time. After 20 weeks, the number of closed DFUs increased to 74.1% and the number of VLUs increased to 74.6%. The mean wound size in the DFU group was 6.2 cm(2) (±11.8) and 11.8 cm(2) (±22.5) in the VLU group. The mean number of TheraSkin allografts required ranged from 1 to 8, with an average of 2.03 (±1.47) at the 12-week point and an average of 3.23 (±2.77) at the 20-week point. Multivariate logistic regression was used to calculate the odds of wound healing by week 12 and week 20 in each group. The authors also analyzed adverse events and found TheraSkin to be noncontributory to any adverse events, verifying the safety of TheraSkin in this study population. In this study, TheraSkin has been shown to be highly effective for the treatment of both VLUs and DFUs with an acceptable safety profile.
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