Dr Michell Ruiz

Dr Michell Ruiz
Cirugía de hombro y del Manguito rotador

miércoles, 30 de julio de 2014

Hombro y paciente deportista: manguito rotador


martes, 29 de julio de 2014

Ream and run for B2 glenoid - beach smashball at 13 weeks

http://shoulderarthritis.blogspot.mx/2014/07/ream-and-run-for-b2-glenoid-beach.html


Ream and run for B2 glenoid - beach smashball at 13 weeks

A man in his late 40s had a ream and run for the bad arthritic triad (BAT) which developed after a previous repair for anterior instability ( = capsulorrhaphy arthropathy). His preoperative films showed complete loss of the joint space and the arthritic triad: a biconcave glenoid, glenoid retroversion and posterior subluxation of the humeral head on the face of the glenoid.


Thirteen weeks ago, he had a ream and run with a 56 21 anteriorly eccentric head and a rotator interval plication.

His postoperative films show centering of the humeral head on the glenoid.


He recently send a video of his playing smashball on the beach 13 weeks after surgery - possibly a new way to rehabilitate a shoulder.


lunes, 28 de julio de 2014

Patologías del hombro


Propionibacterium in a primary arthroplasty after a Latarjet procdure, seeing what you look for





Monday, July 28, 2014

Propionibacterium in a primary arthroplasty after a Latarjet procdure, seeing what you look for

A man is his early twenties presented with pain and stiffness in the shoulder after two prior instability procedures, the last being a Latarjet in 2012.




He had a primary hemiarthroplasty with removal of the screw, the head of which was rubbing on his humeral head. Because of the global loss of cartilage seen on his preoperative films, we obtained cultures before administering antibiotics.

At surgery there was no obvious evidence of infection. The humeral head showed global loss of cartilage as shown here.
His postoperative films are shown here.


After surgery he was started on the 'yellow' antibiotic protocol. Range of motion exercises were started on day one and he had 150 degrees of motion on discharge two days later.

Five days after surgery, the cultures grew out coagulase negative staph in one specimen and Propionibacterium in three (capsule, humeral head #1 and humeral head #2). At that time a PICC line was plaeced and he was converted to the 'red' antibiotic protocol.

Comment: It would have been easy to miss this infection. Our index of suspicion was heightened by the generalized destruction of the joint surface in contrast to the local destruction that would be expected from contact of the humeral head with the screw.

http://shoulderarthritis.blogspot.mx/2014/07/propionibacterium-in-primary.html

sábado, 26 de julio de 2014

Una de manguitos, para que os ahoguéis. ‪#‎xtensal‬ ‪#‎anatomía‬ ‪#‎hombro‬


jueves, 24 de julio de 2014

Shoulder resurfacing hemiarthroplasty with caution in young patients


http://ote.healio.com/i/337565/75



martes, 22 de julio de 2014

What's the difference between a reverse total shoulder and a CTA prosthesis

http://shoulderarthritis.blogspot.mx/2011/10/whats-difference-between-reverse-total.html


Wednesday, October 26, 2011

What's the difference between a reverse total shoulder and a CTA prosthesis

This question is asked often. Here are the 'cliff notes'.
Both are used to help manage the combination of shoulder arthritis and rotator cuff deficiency or rotator cuff tear arthropathy.
A CTA prosthesis is a resurfacing of the upper humerus that requires an intact coracoacromial arch for stability and active elevation of over 90 degrees before surgery.


A reverse total shoulder is a constrained shoulder that fixes the fulcrum for the deltoid when the shoulder is unstable or has pseudoparalysis (it cannot be elevated away from the side).


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