Browsing by Author "Toro Saelzer, Felipe"
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Item Arthroscopic‑assisted latissimus dorsi transfer for irreparable posterosuperior cuf tears: Clinical outcome of 15 patients(2021) Reinares, Felipe; Calvo, Andrés; Bernal, Nazira; Lizama, Pedro; Valenti, Philippe; Toro Saelzer, FelipeObjective We analyzed the clinical and functional results of patients with irreparable posterosuperior rotator cuf tears treated with arthroscopic-assisted latissimus dorsi transfer and the clinical relevance of the addition of partial repair of the remaining cuf to the transfer. Methods This was a prospective cohort study that included patients diagnosed with irreparable massive rotator cuf tears treated by arthroscopic-assisted latissimus dorsi transfer between 2015 and 2018. Demographic characteristics, clinical and functional outcomes (Constant-Murley (CS) score and subjective shoulder value (SSV)), and the incidence of complications were evaluated. Clinical outcomes were compared between patients treated with transfer alone and transfer with partial cuf repair. Results Fifteen patients were included, with an average follow-up of 37±16 months. The median duration of symptoms before surgery was 66 weeks (24–208). A signifcant increase in forward elevation of 52° (p<0.003) and abduction of 48° (p<0.001) was obtained. The CS score increased by 48 points (p<0.001), and the SSV changed from 29% preoperatively to 70% postoperatively (p<0.001), with a signifcant decrease in the visual analog pain score from 7 to 1 (p<0.001). In 10 patients, partial repair of the rotator cuf was also performed. No statistically signifcant diferences were found in these patients compared with patients treated with transfer alone. Two patients presented complications, including transient sensitive neuropraxia of the axillary nerve and seroma, which were managed conservatively and did not afect the outcomes. Conclusion Arthroscopic-assisted latissimus dorsi transfer is a safe technique that signifcantly improves clinical and functional outcomes in selected patients. Longer follow-up and comparison with other treatment options are needed to confrm these excellent results in this group of difcult-to-treat patients.Item Fracture Dislocation of the Glenoid Fossa With Open Physis: A Case Report(2010) Toro Saelzer, Felipe; Vaisman, Alex; Villalon, Ignacio E.; Calvo, RafaelBackground: Scapular fractures are uncommon injuries that account for 1% of all fractures. Ten percent of these lesions involve the glenoid fossa and intraarticular displacement is rare, not exceeding 10% of the cases. The classification of intraarticular glenoid fractures was described by Ideberg on the basis of his findings in 100 patients with this type of injury. His classification, however, does not include a dislocation of the glenoid fossa without displacement of the humeral head. Methods: We report the case of a fracture dislocation of the glenoid fossa without displacement of the humeral head in a patient with open physis. Our surgical approach and results after 6 years of follow-up. Results: Six years postoperatively the patient has minimal occasional discomfort and a full range of motion and strength, even in external rotation. Shoulder stability is also normal. Her Constant score is 97. The fracture is actually healed clinically and radiographically with no evidence of post traumatic articular degenerative disease or avascular changes. Conclusions: The fracture/dislocation of the glenoid fossa is an uncommon injury that can be effectively treated by open reduction and internal fixation. A posterior surgical approach was useful to achieve anatomic reduction and strong fixation in this case presentation.Item Ruptura del manguito rotador: Correlación de hallazgos ultrasonográficos y artroscópicos(2011) Toro Saelzer, Felipe; Meleán, Patricio; Moraga Huerta, C; González Foretic, FObjetivo: Analizar los hallazgos ultrasonográficos (US) de hombro preoperatorios en pacientes con diagnóstico de lesión del manguito rotador (MR), correlacionándolos con los hallazgos artroscópicos. Métodos: Análisis retrospectivo de una serie consecutiva de pacientes con diagnóstico de patología del MR, en los que se solicitó una US y fueron operados (artroscopía de hombro). Los hallazgos US/artroscópicos fueron correlacionados con pruebas de Fisher y c2 . Resultados: Fueron 53 pacientes en donde identificamos concordancia US/ artroscopía en 22/34 casos para rupturas totales (64.7%) y 7/19 casos para las rupturas parciales (36.8%) (p = 0.048). La concordancia global (totales y parciales) fue de 29/53 pacientes (54.7%). De los 24 pacientes sin correlación, 11 (45.8%) presentaron informes ecográficos de tendinitis; 75% de los casos de este grupo presentaron roturas parciales del supraespinoso durante la artroscopía (p = 0.006). Conclusión: La US presenta una adecuada correlación en el diagnóstico de RT del MR confirmada por artroscopía, siendo significativamente menor para las RP. Cuando enfrentamos una lesión diagnosticada con ecografía como tendinitis, la mayoría de los casos presentaron una RP durante la artroscopía.Item Transferencia artroscópica del trapecio inferior en pacientes con rotura irreparable del manguito rotador posterosuperior. Resultados preliminares de ocho pacientes(2021) Calvo, Andrés; Lecaros, Juan José; Rojas, Nicolás; Paccot, Daniel; Toro Saelzer, Felipe; Reinares, FelipeIntroduction: the purpose of this study is to compare clinical and functional outcomes of patients with irreparable posterosuperiorrotator cuff tears treated by arthroscopic assisted lower trapezius transfer. Materials and methods: retrospective cohort design of patients with irreparable rotator cuff tear, treated by arthroscopy-assisted lower trapezius transfer. The clinical evolution was evaluated according to the gain in the range of shoulder movement and the decrease of pain. Functional outcomes were evaluated using the Constant-Murley score and the subjective shoulder value (SSV). Results: eight patients were included, with average follow-up of twenty-two months. We obtained a statistically significant gain in active external rotation of 32°, 5-point decrease in the pain scale (VAS), a 31-point increase in the Constant score, and a 38% increase in SSV. There was a 12° increase in active forward elevation, however this was not statistically significant. Two patients had a seroma at the trapezius harvest site, which resolved with conservative treatment. Conclusion: arthroscopically assisted lower trapezius transfer in patients with irreparable posterosuperior rotator cuff tears were a safe technique that significantly improves external rotation and functional scores in patients. Type of study: Case series (IV