Revista de la Sociedad Andaluza de Traumatología y Ortopedia

Historical Traumatology: The role of Andalusian Traumatology as an Innovator in the Specialty. An analysis based on four biographical profiles

Antonio David Sánchez González, Joaquin Prados Moreno, Héctor Manuel Pérez Díaz — Sat, 31 Jan 2026 00:00:00 +0100

Andalusian traumatology has always played a significant role in the scientific development of our specialty. It has contributed not only distinguished experts and specialists to the national landscape, but also pioneering methods and advances in both the medical and surgical management of musculoskeletal disorders. Many of these notable figures may have been overlooked, but now it is only fair to recognize them for their invaluable contributions. The list of noteworthy individuals is extensive; therefore, this article aims to open the door to remembering the human and professional profiles of the specialist physicians who preceded us and proved essential in our training and in the shaping of our identity as recognized professionals. In this work, we include several names for whom information was readily accessible due to proximity, but we encourage the acknowledgement of others—put forward by colleagues—who were true architects of the specialty’s progress in Andalusia

Bone Defects in Revision Total Knee Arthroplasty: Classification and Treatment Options

Sat, 31 Jan 2026 00:00:00 +0100

Revision total knee arthroplasty is a challenge for the surgeon. It is a procedure that requires adequate exposure, careful implant removal, and correction of bone loss, which provides joint stability and prevents soft tissue insufficiency, in order to achieve a stable and long-lasting reconstruction of the knee joint.
This review article summarizes and updates the types of bone defects that may be encountered, as well as the various treatment options.

Clinical study on internal fixation with cephalomedullary nail with and without anti-rotational device in pertrochanteric fractures

Sat, 31 Jan 2026 00:00:00 +0100

Objectives
Our objective is to determine if the use of an additional anti-rotation system reduces the incidence of mechanical complications in pertrochanteric fractures treated with intramedullary nails, also to evaluate the relationship between biometric variables, the quality of reduction and mechanical complications.
Material and method
We carried out a clinical study in which we compared two osteosynthesis systems: Gamma3 (Stryker) and Affixus (Zimmer-Biomet) with anti-rotation screw. We performed controls with postoperative tomography and x-rays, clinical follow-up was 1 year (minimum 6 months). The variables recorded were: AO/OTA classification, reduction criteria (Baumgaertner-Fogagnolo), TAD (tip-apex distance), Cal-TAD (tip-apex distance in relation to the calcar), Parker's Ratio Method and Cleveland zones
Results
We observed 4.47% cut-out (head screw protrusion) (3/67), 11.94% back-out (head screw slippage) (8/67), 5.97% contralateral fractures (4/67). 67). We observed that the quality of the reduction (p=0.01) and the increase in Parker's anteroposterior ratio (p:0.002) influence mechanical complications.
Conclusions
In our study, the mechanical complications in pertrochanteric fractures treated with intramedullary nails do not decrease with the use of an additional anti-rotational system, but they do with the correct reduction of the fracture and the placement of the cephalic screw close to the calcar in anteroposterior projection.

Comparative study between tapes and threads for the suture of the rotator cuff in double row

Sat, 31 Jan 2026 00:00:00 +0100

Introduction
Rotator cuff sutures can be performed with or without knots, with a greater risk of retear with knots, p = 0.00094. The use of tapes would allow the compression to be distributed over a larger surface, preventing re-breakage. Our objective was to assess our experience in cuff suturing, comparing double row, with fiberwire and medial knots, versus double row, with tapes, and without knots.
Material and methods
A longitudinal, prospective, analytical and observational cohort study. Level of evidence II. Comparison between two types of double row suture: knotted threads, versus knotless tapes. Variables: filiation data, surgery, rehabilitation, Constant, V.A.S. and complications.
Results
57 patients. Age: 52.7 +/- 6.4 years. Surgery time: 91.4 +/- 23.2 minutes. Rehabilitation: 4.1 +/- 1 months. Constant final of 72.9 +/- 15.6 points. Rehabilitation time, post-surgical stiffness and reoperation rate was less when tapes (p = 0.02), (22.6% Vs 42.3%, p = 0.9), (6.5% Vs 15.4%, p = 0.39), respectly, achieving greater job reincorporation (61.3% Vs 37.55, p = 0.14).
Conclusions
Double row suture, supported by tapes without knots), would mean less rehabilitation time, stiffness and need of reoperation than when using knotted threads, with earlier return to the previous functional level, although without influence the Constant´s test.

Injury epidemiology of Galician Rink Hockey teams

Andrea Fidelina Vázquez Vilela, Marc Godayol Prada, José Ramón Caeiro Rey — Sat, 31 Jan 2026 00:00:00 +0100

bjective
Roller Hockey is a minority sport in Spain and, therefore, there are few publications about its most common injuries and their underlying causes. It is crucial to expand this knowledge to better understand the injury pattern of this sport.
Aim
Describe the injury epidemiology in roller hockey players to analyse the influence of various factors and be able to establish a solid basis for developing specific prevention plans.
Methods
A retrospective study was carried out on injuries that occurred during the 2021/2022 and 2022/2023 seasons in four professional and semi-professional Roller Hockey teams in Galicia. 38 athletes were studied, using a strict definition of time-loss injuries and a standardized injury registration system.
Results
A total of 46 injuries were recorded, with an overall incidence of 0,61 ± 0,98 injuries per player and season. Muscle injuries were the most common (n= 14, 30,4%), with the adductor longus being the most affected muscle. Most injuries occurred progressively without contact (n=26, 56,5%) and in the last phase of the season (n= 16, 34,8%). The median return-to-play was 21,39 ± 37,98 days.
Conclusions
Most injuries in rink hockey are acute and occur without contact, especially at the end of the season. Muscle injuries, particularly in the adductors, are confirmed as the most frequent. Therefore, it would be crucial to carry out more epidemiological research in order to establish specific preventive measures for this type of injuries.

Femoral Fracture in Elderly Patients: A Review of 550 Cases Over One Year of Clinical Activity in a Tertiary Care Hospital — Our Experience

Sat, 31 Jan 2026 00:00:00 +0100

Objective
Pelvic and femoral fractures in the elderly represent a silent pandemic. The objective of this study is to analyze the management of these cases over the past year of clinical activity.
Materials and methods
A descriptive, retrospective, and analytical study was conducted on a series of 550 patients, with a mean age of 81.6 years (range: 65-102), who were admitted in 2023. Demographic variables were collected, as well as data on etiology, hospital stay, clinical course, medical and surgical complications, and their respective treatments, along with short- to medium-term survival, all evaluated through a multidisciplinary approach.
Results
A total of 550 patients were included, with a mean follow-up of 8.7 months (range: 3-12). The most frequent fracture type remained pertrochanteric (43.92%). Surgical intervention was performed in 97.7% of cases after an average hospital stay of 3.01 days, with a mean hospital stay of 6.4 days (range: 3-80), and an inpatient mortality rate of 10.1%, with 67.3% of deaths occurring before and 23.7% after definitive surgery. While 49.0% of patients experienced medical complications, only 22.2% developed surgical complications. The overall readmission rate was 22.7%, and the six-month survival rate was 67.7%.
Conclusions
Elderly patients continue to pose a significant challenge in our hospitals. Multidisciplinary management is key to improving survival rates.

Level of evidence: IV. Descriptive, retrospective, and analytical study. Case series.

La técnica MIPO en las fracturas extraarticulares del húmero distal: una revisión sistemática

Hermenegildo Cañada-Oya, Cristina Zarzuela Jiménez, Alberto D. Delgado-Martinez — Sat, 31 Jan 2026 00:00:00 +0100

Introducción

Las fracturas extraarticulares del húmero distal suponen un reto quirúrgico debido a la limitada longitud del fragmento distal disponible para la fijación y a la estrecha relación con el nervio radial. La osteosíntesis mínimamente invasiva mediante placa (MIPO) ha demostrado preservar la biología de la fractura y reducir complicaciones, aunque no existe consenso sobre qué abordaje mínimamente invasivo ofrece mejores resultados.

Objetivo

Identificar la bibliografía existente sobre técnicas mínimamente invasivas con placas, que emplean tan solo dos incisiones y exclusivamente en fracturas extraarticulares del tercio distal. Además, comparar críticamente los resultados clínicos y radiológicos, prestando especial atención a la tasa de parálisis radial, el principal caballo de batalla de este tipo de cirugía.

Beyond climbing: Management and outcome of a multiple flexor pulley injury in an atypical

Nuria López Olivencia, Francisco Garrillo Murillo, Juana Díaz del Río — Sat, 31 Jan 2026 00:00:00 +0100

Objective
To present an unusual case of multiple flexor pulley ruptures in a non-climber patient, highlighting the importance of timely diagnosis and individualized surgical management.
Material and methods
A 37-year-old male manual laborer presented with progressive flexion contracture of the fourth finger following mechanical strain. Physical examination revealed a bowstringing deformity, suggestive of flexor pulley rupture. Magnetic resonance imaging confirmed complete rupture of the A2, A3, and A4 pulleys, along with signs of tendinosis of the deep flexor tendon. The A2 and A4 pulleys were reconstructed with autologous tendon grafts, applying the classic techniques described by Bunnell and Kleinert, with the aim of restoring the anatomy and function of the flexor apparatus.
Results
The postoperative course was favorable. At the two-month follow-up, the patient demonstrated an adequate range of motion without complications, with a Total Active Motion (TAM) of 88.5% of the expected normal value.
Conclusions
Complex pulley injuries can occur outside of athletic contexts. Early diagnosis and an individualized surgical approach can lead to excellent functional outcomes.

Posterior Migration of Titanium trabecular cages: Revision Spinal Surgery

Javier Guerrero Mera — Sat, 31 Jan 2026 00:00:00 +0100

Interbody fusion cages are commonly used in lumbar degenerative disease surgery to enhance spinal stability and fusion rates. However, complications such as cage migration, though rare, can lead to neurological deficits and require revision surgery.
We present the case of a 67-year-old male who developed posterior cage migration months after L1-L5 arthrodesis.
We further discuss preventive measures, key precautions, and surgical techniques that may assist other surgeons in managing this complication.