Papers by Leonardo López Almejo
Orthotips AMOT, Jun 24, 2020
Orthotips AMOT, 2014
The carpal tunnel syndrome is caused by increased pressure on the median nerve at the wrist. Gene... more The carpal tunnel syndrome is caused by increased pressure on the median nerve at the wrist. Generating venous stasis, increased vascular permeability, edema and fibrosis followed nerve, continuing degeneration of the myelin sheath to the interruption of nerve conduction occur. Variable causes the carpal tunnel syndrome over whites is presented, with an average of 53 years old, with ratio 3-10 women for every man. On labor issues, prolonged postures in extreme flexion or extension of the wrist, the repetitive use of the flexor muscles, and vibration exposure are some of the risk factors for presentation. The diagnosis is clinical, supported by nerve conduction studies and image. For carpal tunnel syndrome there are different treatments, ranging from resting splints, use of medications taken and infiltration with corticosteroids, to surgery, which can be used conventional open surgery or endoscopic techniques to the opening of the flexor retinaculum carpal.
Orthotips AMOT, 2014
Syndrome idiopathic radial nerve entrapment is rare, representing approximately 0.7% of non-traum... more Syndrome idiopathic radial nerve entrapment is rare, representing approximately 0.7% of non-traumatic injuries of the upper extremity. The most common site of entrapment of the radial nerve is at the proximal edge of the supinator arcade Frohse thereby affecting the posterior interosseous nerve (PIN), motor branch of the radial nerve. The clinical diagnosis is often difficult because of the overlapping symptoms especially when there is associated epicondylitis. Additional tests are needed to make a correct differential diagnosis. The electrophysiological study, electromyogram, is the best method to locate PIN lesions. Conservative treatment options include observation in partial lesions, non-progressive and not related to a tumor. Suggested observation periods ranging from 4 to 12 weeks. Surgical treatment is indicated in cases that do not respond to conservative treatment and where there are tumors, in addition to resect the tumor should be performed decompression of any structure that can compress the nerve. Surgery should also be considered in cases of inveterate dislocation of the radial head or in cases of articular synovitis in rheumatoid arthritis.
Orthotips AMOT, 2014
Morton's neuroma is a compressive neuropathy affecting the common digital nerves of the lower ext... more Morton's neuroma is a compressive neuropathy affecting the common digital nerves of the lower extremities; is a relatively common disease prevalent in females, whose clinical diagnosis and treatment must be mastered in order to improve the functionality of patients suffer. Below we present an overview of this entity for their understanding in a simple way.
Orthotips amot, 2022
Introducción: La gonartrosis es de las principales causas de dolor musculoesquelético que conllev... more Introducción: La gonartrosis es de las principales causas de dolor musculoesquelético que conlleva discapacidad. Gran porcentaje se acompaña de genu varo. La artroplastia total de rodilla (ATR) no es opción en pacientes jóvenes y la osteotomía tibial alta (OTA) aunque es aceptada en jóvenes, no está exenta de complicaciones. La diafisectomía de peroné (DP) es un método simple y seguro que puede aliviar el dolor y mejorar la función. Objetivos: Describir resultados clínicos y radiográficos en pacientes con gonartrosis grado II-III de Kellgren-Lawrence y genu varo tratados mediante DP. Material y métodos: Se incluyeron pacientes sometidos a DP para la gonartrosis del compartimento medial. Se evaluó dolor y funcionalidad prequirúrgico, postquirúrgico inmediato y a los tres, seis, 12, 18 y 24 meses. Radiográficamente la altura articular medial, lateral, proporción del espacio articular, así como ángulo fémoro-tibial y cóndilo meseta fueron evaluados en el prequirúrgico, a las 24 horas y a los 24 meses. Se consideró un valor de p < 0.05 como significativo. Resultados: Se analizaron 20 pacientes. El dolor (EVA 7 [6-8] vs 3 [3-3] prequirúrgico y postquirúrgico inmediato p ≤ 0.001), la funcionalidad (KSS 45 [40-49] vs 74 [66-78] prequirúrgico y postquirúrgico inmediato, p = 0.001 y WOMAC 59 ± 3 vs 12 ± 1 prequirúrgico y postquirúrgico inmediato, p ≤ 0.001). A los 24 meses tuvieron incremento de la altura del compartimento medial en comparación con el prequirúrgico (2.5 ± 0.5 vs 2.2 ± 0.6 mm, p = 0.004). El ángulo fémoro-tibial (174 ± 1 vs 178 ± 1 grados, prequirúrgico y postquirúrgico inmediato p ≤ 0.001). Conclusiones: La DP puede mejorar significativamente el dolor y la funcionalidad en pacientes con gonartrosis grado II-III de Kellgren-Lawrence y genu varo.
Orthotips AMOT, 2014
In the rehabilitation of neuropathic syndromes in the lower limbs is important to know the most c... more In the rehabilitation of neuropathic syndromes in the lower limbs is important to know the most common entrapment neuropathies of the lower limb to help improve mobility and pain in these diseases and postoperative conservatively. It rests with superfi cial heat, deep, electro-stimulus to maintain tropism for analgesia, massage sliding, active-assisted, active-resisted, passive exercises, strengthening, cycling and gait training.
Orthotips AMOT, 2014
Compressive neuropathy of the femoral nerve is a pourly recognized clinical entity which is large... more Compressive neuropathy of the femoral nerve is a pourly recognized clinical entity which is largely surpassed by the traumatic or secondary pathology of this nerve. It is characterized by numbness or neuropathic pain in the anterior thigh and knee as well as on the anteromedial aspect of the leg. In severe cases, weakness of knee extension and hip fl exion may be present. Symptoms tend to increase with hip extension and diminish with external rotation. It has been suggested that compression occurs underneath the iliopectineal ligament. When these cases require a surgical treatment, it consists in cutting this ligament by a retroperitoneal approach or by laparoscopy.
Orthotips amot, 2022
La investigación médica, parte esencial de la salud en nuestro país Medical research, an essentia... more La investigación médica, parte esencial de la salud en nuestro país Medical research, an essential part of health in our country
Orthotips AMOT, 2014
Pyramidal syndrome is a pathology included within nerve compressive syndromes where the protagoni... more Pyramidal syndrome is a pathology included within nerve compressive syndromes where the protagonists are compressed the sciatic nerve by the piriformis muscle, provides clinically similar to sciatica symptoms, which can be confused with a radicular pathology. Treatment of these patients is usually enough with drugs and physical therapy; however, some cases result in invasive procedures such as infi ltration and surgical treatment of piriformis muscle tenotomy. The purpose of this article is to review literature regarding the anatomical arrangement, diagnosis and treatment of this disease has been underdiagnosed by health professionals and requiring diagnostic and therapeutic accuracy for proper resolution.
Orthotips amot, 2023
Introducción: la lesión del ligamento cruzado anterior (LCA) representa más de la mitad de todas ... more Introducción: la lesión del ligamento cruzado anterior (LCA) representa más de la mitad de todas las lesiones de la rodilla, en la literatura médica se describen diferentes técnicas quirúrgicas y variantes en su reconstrucción. Objetivo: conocer la tendencia actual en la reconstrucción de ligamento cruzado anterior (LCA) en México. Material y métodos: se aplicó una encuesta a través de la Federación Mexicana de Colegios de Ortopedia y Traumatología con respuestas de opción múltiple, a cirujanos en traumatología y ortopedia que realizan reconstrucción de LCA en México. Resultados: 373 cirujanos respondieron la encuesta de 14 preguntas acerca del tratamiento de la rotura de LCA encontrando los siguientes datos: el tiempo promedio para realizar la reconstrucción de LCA es mayor de cuatro semanas en 45.6% de los casos; 39.9% de los cirujanos encuentra lesiones meniscales asociadas en más de 50% de los casos; 76% de los encuestados utilizan injerto isquoitibiales en reconstrucciones primarias de LCA y en cirugías de revisión 38.9% utilizan aloinjerto versus 38.1% injerto hueso tendón hueso. El método de fijación femoral que se utiliza con mayor frecuencia es el sistema de corticosuspensión por 72% de los cirujanos y para la fijación en tibia 81.2% usa tornillos bioabsorbibles. La tendencia actual en la perforación para el túnel femoral es por vía anteromedial en 47.7% y 37.5% de los cirujanos no dejan rodillera en el postoperatorio. Conclusión: en este estudio se reporta la tendencia actual en la reconstrucción de ligamento cruzado anterior en México en diferentes aspectos de la técnica quirúrgica. Palabras clave: ligamento cruzado anterior, reconstrucción del ligamento cruzado anterior, autoinjerto, lesiones de rodilla, México.
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Papers by Leonardo López Almejo