David González-Martín

Origen, Grupo Recoletas, Valladolid

Background It is recommended revision for Periprosthetic hip fractures (PPHF) with a loose stem. However, several authors have argued that under certain conditions, this fracture could be treated using osteosynthesis. The aim is to compare stem revision versus internal fixation in the treatment of PPHF with a loose stem. Methods All patients with...

Bone marrow edema (BME)is an imaging diagnosis defined by an abnormal accumulation of intraosseous interstitial fluid within a bone on magnetic resonance imaging (MRI)investigation. The aim of this study was to determine the prevalence of BME in patients with foot and/or ankle pain studied using MRI. This was a retrospective observational work on p...

Introduction The COVID-19 pandemic has led to the confinement of approximately one third of the world population, causing a drastic change in the activities of daily life with many repercussions at the health, economic and social levels. Objectives The objective of the present work is to present the epidemiological variations in the production of...

Introduction There is currently great controversy about the ideal treatment of intraarticular calcaneal fractures. The objective of this study is to determine the usefulness of postoperative computed tomography (CT). Material and Methods We conducted a retrospective descriptive study of patients operated on in the period 2007–2015 in our center. E...

The most frequent etiology of ankle osteoarthrosis is posttraumatic, affecting a population younger than that affecting the hip or knee. These patients usually wish to maintain their mobility and refuse an ankle fusion or even a total ankle replacement, which is why this pathology poses a challenge for the orthopedic surgeon. Within the concept of...

Multidirectional shoulder instability represents an ongoing challenge for orthopaedic surgeons, and multiple techniques have been described to treat this condition. Posterior glenoid dysplasia is a known risk factor for posterior instability as well as persistent or recurrent instability following posterior stabilization procedures. Recurrent shoul...

Background The incidence of all periprosthetic fractures (PPF), which require complex surgical treatment associated with high morbidity and mortality, is predicted to increase. The evolving surgical management has created a knowledge gap regarding its impact on immediate outcomes. This study aimed to describe current management strategies for PPF a...

Resumen: La tendinopatía rotuliana cursa como un cuadro de dolor anterior de rodilla localizado fundamentalmente en el polo inferior de la patela. La causa principal de esta condición degenerativa son los movimientos repetitivos que generan una carga excesiva del tendón, particularmente durante los deportes que impliquen cambios rápidos de direcci...

Several arthroscopic techniques to treat anterior shoulder instability have been described. Bankart repair may be insufficient in cases with some degree of bone loss, and arthroscopic Latarjet is technically challenging. It is not rare to find at the time of surgery a more extensive labral tear (SLAP lesion) or an insufficient anterior capsulolabra...

Differentiating subtalar and ankle instability in the clinical setting is challenging. This study aims to analyze the rotational laxity of the subtalar joint bilaterally in patients with asymptomatic and symptomatic ankle instability under simulated load and stress-induced position of the subtalar joint. A case–control study was conducted using an...

Introduction: Calcifying tendinopathy (CT) of the shoulder is a condition where calcium deposits form in the rotator cuff tendons, leading to pain and limited shoulder function. While conservative treatments have high success rates, some patients may require arthroscopic removal of the calcific deposit. The question of whether to repair the remain...

Massive irreparable cuff tears may represent as many as 20% to 40% of total cases of operated rotator cuff tears and can be a challenging clinical problem. Many treatment options have been proposed for their treatment. Among these options, latissimus dorsi tendon transfer can be considered a good alternative, especially in young patients before the...

Anterior shoulder instability remains one of the main indications for shoulder surgery. We present a modified way of treating anterior shoulder instability in the beach-chair position from an anterior arthroscopic approach through the rotator interval. This technique opens the rotator interval, which increases the working area and allows us to work...

Background: Determining the treatment of subtalar joint (STJ) instability requires a better understanding of the biomechanical principles underlying the condition and, a proper diagnosis. This study aimed to analyze "in vivo" the range of motion of the subtalar joint (STJ) measured on two (2D) and three dimensions (3D) image-based on CT Scan using...

Multidirectional shoulder instability represents an ongoing challenge for orthopaedic surgeons, and multiple techniques have been described to treat this condition. We present a modified anterior shoulder ligamentoplasty, in which we perform an inferior glenohumeral ligament (IHGL) anteroinferior and posteroinferior plication and, subsequently, an...

Report of ESTES 2022 Congress Grant Winner David González-Martín

There is currently a debate on whether all Vancouver B2 periprosthetic hip fractures should be revised. The aim of our work was to establish a decision-making algorithm that helps to decide whether open reduction and internal fixation (ORIF) or revision arthroplasty (RA) should be performed in these patients. Relative indications in favour of ORIF...

Good to excellent results at long-term follow-up have been published for anterior cruciate ligament reconstruction with bone-tendon-bone graft. Despite improvements in fixation devices, concerns regarding the stability of graft fixation on the tibial side remain. We present supplementary tibial fixation for anterior cruciate ligament reconstruction...

Purpose Several studies comparing osteosynthesis and stem revision in Vancouver B2 (VB2) periprosthetic hip fractures (PPHF) have been published. This work aims to be the first systematic review and meta-analysis to include only studies involving statistical comparison between the two techniques. Methods MEDLINE, EMBASE, Cochrane Library, and Web...

Ankle osteoarthritis (OA) is much less frequent than knee or hip OA, but it can be equally disabling, greatly affecting the quality of life of the patients. Approximately 80% of ankle OA is post-traumatic, mainly secondary to malleolar fractures, being another of the main causes untreated in chronic instability. The average age of the patient affec...

Hill-Sachs lesions (HSLs) can be present after a primary shoulder dislocation and may go unrecognized; this can alter the necessary bony constraint within the glenohumeral joint. To deal with HSLs, remplissage is a safe procedure with low complication rates, low recurrent instability rates, and good patient outcome scores compared with many of the...

Introduction: Hip replacement is one of the most successful operations in orthopaedic surgery. Periprosthetic hip fractures (PPHF) have very serious consequences for the patient, and they also entail a very important economic impact on healthcare systems. The aim of the study was to provide the first detailed cost analysis of PPHF in a traumatology...

Osteoporotic ankle fractures result from mechanical forces that would not ordinarily result in fracture, known as ‘low-energy’ trauma, such as those equivalent to a fall from a standing height or less. Osteoporotic ankle fractures in frail patients are becoming more and more frequent in daily practice and represent a therapeutic challenge for ortho...

Background: Open lower extremity fractures are severe, life-changing events, however no previous studies have reported how these injuries are treated from a global perspective. Methods: An international, multi-centric, retrospective cohort study was designed to identify disparities in management and outcomes of open lower limb fractures in differ...

Introduction Hip replacement is one of the most successful operations in orthopaedic surgery. Periprosthetic hip fractures (PPHF) have very serious consequences for the patient, and they also entail a very important economic impact on healthcare systems. The aim of the study was to provide the first detailed cost analysis of PPHF in a traumatology...

Hip fracture is the most feared complication of osteoporosis, producing up to 30% mortality at the first year. With the aging of society, it is increasingly common to deal with ethical dilemmas that involve decision making in the elderly patient with a hip fracture. The objectives of the present work are to describe the main bioethical dilemmas in...

Surgical treatment usually is indicated for the management of acromioclavicular fracture-dislocations. These are unstable injuries and have shown a high rate of nonunion when managed conservatively. However, surgical strategies often require a second surgery for hardware removal. We describe an arthroscopic-assisted technique to repair the acromioc...

Introduction Hallux valgus (HV) deformity affects the orientation of the metatarsophalangeal (MTP) joint in three planes. Displacement in the coronal plane results in axial rotation of the first metatarsal, with progressive subluxation of the first MTP joint. Multiple techniques have been described to correct the malrotation itself. However, none o...

This study proposes an update on conservative treatment of hallux rigidus based on scientific evidence. This is a narrative review of 19 articles that analyzed conservative treatment of hallux rigidus in its different modalities. Conservative treatment is effective in approximately half of the patients with hallux rigidus, and footwear modification...

This study performs a literature review on the treatment of hallux rigidus and proposes a treatment algorithm. This literature systematic review expanded a similar study conducted in 2014 by the authors and analyzed the levels of recommendation according to scientific evidence. Most articles found in the search present scarce evidence (level IV or...

Although stem revision is recommended for Vancouver B2 periprosthetic hip fractures (PPHFs), there has recently been a debate whether, under certain conditions, they could be treated by osteosynthesis alone. This study aimed to describe the medium-term clinical and radiological results of several patients with V-B2 fractures treated via osteosynthe...

Introduction : There is currently a debate on whether all Vancouver type B2 (V-B2) periprosthetic hip fractures (PPHF) should be revised. Vancouver classification takes into account fracture location, implant stability and bone stock, but it does not distinguish between fracture patterns. The aim of our work was to study the different fracture patt...

Despite the disabling nature of ankle osteoarthritis (OA), there is poor scientific evidence for a conservative treatment compared to the hip and knee OA. In this regard, most of the treatment options in use are not based on clinical studies of the ankle, and they are extracted from evidence obtained from clinical studies of other lower limb joints...

Ankle osteoarthritis affects 1% of the population and, unlike gonarthrosis or coxarthrosis, is secondary to previous trauma in more than 75% of cases. Another peculiarity of this disease is that it affects a younger and active population, with socio-occupational implications. Mechanical factors, such as incongruity, instability, malalignment, and i...

The incidence of peripheral neurological injuries related to calcaneal osteotomies reported in the literature is low and often described as occasional. The main objective of this study is to determine the incidence of neurological injuries after calcaneal osteotomies and identify which nerve structures are most affected. This retrospective work inc...

PurposeThe purpose of this study was to demonstrate whether application of the so-called safe incision when performing calcaneal sliding osteotomies reduces the risk of sural nerve injury.Methods Patients who underwent either medial or lateral sliding calcaneal osteotomies between 2010 and 2018 were analysed retrospectively. A thorough neurological...

La artroplastia total de tobillo es una opción de tratamiento cada vez más popular para pacientes con artrosis avanzada de tobillo. Aunque han mejorado los resultados clínicos y radiológicos a corto, medio y largo plazo, la cirugía de revisión continúa siendo necesaria en el contexto de una prótesis dolorosa. Factores como la selección de los paci...

La artrosis de tobillo es una patología degenerativa, progresiva y en ocasiones muy limitante que ofrece un reto quirúrgico para los Cirujanos Ortopédicos, en particular cuando hablamos de la articulación del tobillo tenemos varios procedimientos quirúrgicos de preservación articular entre los que se encuentra la Artrodiastasis o distracción articu...

Las primeras prótesis de tobillo (PTT) se colocaron en los años 70, unos años más tarde que las prótesis de cadera y rodilla. Las peculiaridades anatómicas y biomecánicas de esta articulación, que no se conocían entonces, provocaron que los diseños de primera y segunda generación tuvieran unos resultados muy poco satisfactorios, habiéndose mantenid...

Introduction: The COVID-19 pandemic has led to the confinement of approximately one third of the world population, causing a drastic change in the activities of daily life with many repercussions at the health, economic and social levels. Objectives: The objective of the present work is to present the epidemiological variations in the production...

Resumen Introducción Actualmente existe gran controversia sobre el tratamiento ideal de las fracturas articulares de calcáneo. El objetivo de este estudio es determinar la utilidad de la tomografía computarizada (TC) postoperatoria. Pacientes y métodos Estudio retrospectivo descriptivo de pacientes intervenidos en el período 2007 a 2015 en nuestr...

El término muñeca en spaguetti se ha acuñado para aquellas lesiones profundas de la zona volar de la muñeca (entre el pliegue distal de la mano y la unión musculotendinosa flexora) en las que se afectan un mínimo de 3 estructuras, incluyendo al menos un nervio y una arteria. A menudo estas lesiones son tratadas de manera similar que otras en zona I...

Case history: A healthy 27-year-old male, with no history of interest, suffers a high-energy trauma as a water bottle rushes over his left knee. Clinical findings: Go to the emergency room with pain and functional impotence in the left knee, with its anatomical deformity. Knee X-ray PA and L are performed and the distal pulses that are present are...

Case history: Young male who suffers a traffic accident while driving a quad at 60 km/h on the island of La Palma, where he is treated until his transfer to the University Hospital of Canary Islands for the definitive treatment. Clinical findings: A 24-year-old male, who suffers a closed chest trauma with pneumothorax, right pulmonary contusion and...

Case history: Periprosthetic and periimplant femoral fractures are an increasingly frequent pathology. In many cases they are a challenge with limited or too aggressive therapeutic options. It is important to investigate new approaches that increase the arsenal of the orthopedic surgeon. The recently described MIPO (Minimally Invasive Plate Osteosy...