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  • 1
    Online Resource
    Online Resource
    Unstable PIP Fracture-Dislocations : A Biomechanical Comparison of Volar Plate Arthroplasty Versus Hemihamate Arthroplasty
    SAGE Publications ; 2016
    In:  HAND Vol. 11, No. 1_suppl ( 2016-09), p. 120S-120S
    Details
    In: HAND, SAGE Publications, Vol. 11, No. 1_suppl ( 2016-09), p. 120S-120S
    Abstract: Purpose: Multiple techniques exist as part of the armamentarium for the management of Proximal Interphalangeal (PIP) joint fracture-dislocations. Of these, unstable lesions with hard reduction are the most complicated to handle. This study aims to compare the biomechanical results obtained with volar plate arthroplasty (VPA) and the hemihamate arthroplasty (HHA). Materials and Methods: We used 20 fingers from 8 cadaveric hands. We created a 50% defect on the base of the middle phalanges to simulate an unstable fracture-dislocation. The 2 techniques were assigned randomly to the different fingers (10 for each technique). A biomechanical harness was used to carry all PIP joints from extension to complete flexion. The amount of dorsal translation of the subluxation was recorded digitally at full extension. We recorded the angle at which subluxation occurred for each specimen. Results: The average of dorsal displacement of the middle phalanx did not show statistical significant difference (0.02 mm for the HHA and 0.01 mm for the VPA). All the fingers with VPA coursed with flexion contracture as opposed to the HHA. Conclusions: The VPA and the HHA are current techniques used for the management of unstable PIP fracture-dislocations. The 2 procedures manage to maintain reduction throughout the range of flexo-extension. Surgeons must choose between a little more invasive technique with double incision, hamate block bone graft with potential discomfort in the donor area and screw fixation on the recipient middle phalanx not leading to flexion contracture (HHA); versus a single surgical approach technique -dorsal or ventral- which provides stability but may course with certain flexion contracture.
    Type of Medium: Online Resource
    ISSN: 1558-9447 , 1558-9455
    URL: Article
    DOI: 10.1177/1558944716660555ic
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2016
    detail.hit.zdb_id: 2316440-2
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  • 2
    Online Resource
    Online Resource
    La Enseñanza de Medicina en Relación con los Problemas de Salud Pública, en el Perú
    Universidad Nacional Mayor de San Marcos, Vicerectorado de Investigacion ; 2014
    In:  Anales de la Facultad de Medicina Vol. 49, No. 2 ( 2014-04-09), p. 203-
    Details
    In: Anales de la Facultad de Medicina, Universidad Nacional Mayor de San Marcos, Vicerectorado de Investigacion, Vol. 49, No. 2 ( 2014-04-09), p. 203-
    Abstract: La concentración de los médicos en las grandes ciudades y la baja proporción de los mismos en las zonas rurales, constituyen un problema que es general a los países no desarrollados y que afecta de manera particular al nuestro. En efecto, de acuerdo al Censo de Recursos Humanos de Salud de 1964 (1) en el Perú existen 5,061 médicos lo que da una relación de un médico por cada 2,144 habitantes; pero la distribución de estos profesionales en el territorio nacional no es homogénea, ya que, mientras que en un departamento como Lima y la provincia constitucional del Callao hay un médico por 756 y 840 habitantes, respectivamente, encontramos que, en departamentos como Apurímac y Huancavelica, sólo se cuenta con un médico por cada 20,000 o más habitantes (Cuadro 1); otros departamentos como Cajamarca, Ayacucho y Puno cuentan, en promedio, con un médico por cada 14,000 habitantes.
    Type of Medium: Online Resource
    ISSN: 1609-9419 , 1025-5583
    URL: Article
    DOI: 10.15381/anales.v49i2.5571
    Language: Unknown
    Publisher: Universidad Nacional Mayor de San Marcos, Vicerectorado de Investigacion
    Publication Date: 2014
    detail.hit.zdb_id: 2120049-X
    detail.hit.zdb_id: 2059662-5
    SSG: 7,36
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  • 3
    Online Resource
    Online Resource
    Investigación de toxoplasmosis en cincuenta niños con enfermedades neurológicas
    Sociedad Chilena de Pediatria ; 1955
    In:  Revista chilena de pediatría Vol. 26, No. 9 ( 1955-10)
    Details
    In: Revista chilena de pediatría, Sociedad Chilena de Pediatria, Vol. 26, No. 9 ( 1955-10)
    Type of Medium: Online Resource
    ISSN: 0370-4106
    URL: Article
    DOI: 10.4067/S0370-41061955000900003
    Language: English
    Publisher: Sociedad Chilena de Pediatria
    Publication Date: 1955
    detail.hit.zdb_id: 2058985-2
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