SIGN

Es tracta d'una iniciativa molt interessant que porta ja uns 3 anys funcionant a 2 dels continents més desfavorits. Aquesta gent es dedica a dissenyar implants que puguin posar-se sense l'ús d'escòpia (les reduccions per tant han de ser a focus obert) i a baix cost. És una ONG nord-americana a la que us podeu apuntar per si volen fer-vos servir per anar a fer de "profes" als llocs on han introduït el projecte: Myanmar, Cambodja, Tanzania, Kenya i alguns països més. Adjunto la direcció: www.sign-post.org/home.htm

Upon a follow-up visit to an Indonesian orthopaedic ward in the 1990s, Dr. Zirkle witnessed a patient lying in traction from a femur fracture. This man lay in traction for three years because his fracture had not healed. Although surgeons in this hospital had the knowledge and skill to treat the fracture, the patient could not afford the implant so surgery could not take place. It was in that moment he realized that teaching fracture care must be accompanied by an ongoing supply of implants appropriate for use in local conditions

CALENDARIS DE JUNY

He refet els calendaris de Juny i Juliol. Mireu-ho.

RESILIENCIA

Para otros usos de este término, véase Resiliencia (desambiguación).
En psicología, el término resiliencia se refiere a la capacidad de los sujetos para sobreponerse a períodos de dolor emocional. Cuando un sujeto o grupo animal es capaz de hacerlo, se dice que tiene resiliencia adecuada, y puede sobreponerse a contratiempos o incluso resultar fortalecido por los mismos. El concepto de resiliencia se corresponde con el término entereza.
Esa capacidad de resistencia se prueba en situaciones de fuerte y prolongado estrés, como por ejemplo el debido a la pérdida inesperada de un ser querido, al maltrato o abuso psíquico o físico, al abandono afectivo, al fracaso , a las catástrofes naturales y a la pobreza extrema.

Ahi es nada colegas!

Fractures Cap Humer

http://frachum.blogspot.com Ja em direu si pot ser util

CAP de RESIDENTS

Bona sort al Dr. Peñalver com adjunt de Trauma i benvinguda a la Dra. Morales com a nou cap de residents. Agraïm des de aqui la tasca del Dr. Peñalver en uns moments delicats del grup de residents i la tutoria. Desitjem que faci moltes coses en la seva vida com a Traumatòleg.

Salut

Adeu al Dr. Esteban

Digamelon?

No vull entrar en els detalls que han fet pendre la decisió de deixar-nos per mi ha sigut un molt bon col.laborador, amable i sobretot amb el speed suficient per fer-me il.lusionar amb la tutoria. Us recordo lo lluny que estic de les guàrdies i els tQ3 on us hi passeu la vida... tenir una persona com ell ha sigut un bon recolzament.

Bona sort Pedro.

Stand by

Hola nois cambiarem de Direcció i , com sabeu, el responsable docent del servei es el seu cap , per aquest motiu molt possiblement quan vingui tindrem canvis en aquest tema. Mentre tant aixo no sigui efectiu es possible que necessitem mes que mai treballar junts per resoldre els temes importants relacionats amb la docència. He parlat amb la direcció executiva del Hospital per tal de fer efectiva la meva promesa de deixar la tutoria pero , m'ha fet prometre que aguantaria el tema fins la vinguda del nou cap. Per aixo crec que cal seguir treballant.

Salut a tots

NOUS CALENDARIS DE SESSIONS

IMPORTANT:

1.- A PARTIR DEL MES D'ABRIL LES SESSIONS DEL DIMARTS AL MATI PASSARAN DE 7.30 A INICIAR-SE A LES 8.30 ( DESPRES DE LA SESSIO DE TRAUMA)

2.-A PARTIR , TAMBE, DEL 9 D'ABRIL S'INICIEN LES SESSIONS BIBLIOGRÀFIQUES CADA DUES SETMANES , ELS DIVENDRES A LA TARDA.

3.- PENDENT DE CONFIRMAR PELS RESPECTIUS SERVEIS, LA RESTA DE SESSIONS DELS DIVENDRES A LA TARDA.

E-llibre del resident

Hola a tots. El e-llibre el repassarem tots plegats en la sessió de servei del dia 1 d'abril vol dir que ha d'estar ple.

Es tracta de presentar-ho al Servei per veure la trajectòria de la vostre docència. Sera un "entrenament" de la sessió del Juny que farem conjuntament amb el servei de Cirurgia General.

AAOS guia del Tunel Carpia

American Academy of Orthopaedic Surgeons Clinical Practice Guideline on The Treatment of Carpal Tunnel Syndrome

Michael Warren Keith, et al.

Summary of Recommendations

The following is a summary of the recommendations in the AAOS' clinical practice guideline, The Treatment of Carpal Tunnel Syndrome. This summary does not contain rationales that explain how and why these recommendations were developed nor does it contain the evidence supporting these recommendations. All readers of this summary are strongly urged to consult the full guideline and evidence report for this information. We are confident that those who read the full guideline and evidence report will also see that the recommendations were developed using systematic evidence-based processes designed to combat bias, enhance transparency, and promote reproducibility. This summary of recommendations is not intended to stand alone. The American Association of Neurological Surgeons and the Congress of Neurological Surgeons have endorsed this guideline.

Recommendation 1 A course of non-operative treatment is an option in patients diagnosed with carpal tunnel syndrome. Early surgery is an option when there is clinical evidence of median nerve denervation or the patient elects to proceed directly to surgical treatment. (Grade C, Level V)

Recommendation 2 We suggest another non-operative treatment or surgery when the current treatment fails to resolve the symptoms within 2 weeks to 7 weeks. (Grade B, Level I and II)

Recommendation 3 We do not have sufficient evidence to provide specific treatment recommendations for carpal tunnel syndrome when found in association with the following conditions: diabetes mellitus, coexistent cervical radiculopathy, hypothyroidism, polyneuropathy, pregnancy, rheumatoid arthritis, and carpal tunnel syndrome in the workplace. (Inconclusive, No evidence found)

Recommendation 4a Local steroid injection or splinting is suggested when treating patients with carpal tunnel syndrome, before considering surgery. (Grade B, Level I and II)

Recommendation 4b Oral steroids or ultrasound are options when treating patients with carpal tunnel syndrome. (Grade C, Level II)

Recommendation 4c We recommend carpal tunnel release as treatment for carpal tunnel syndrome. (Grade A, Level I)

Recommendation 4d Heat therapy is not among the options that should be used to treat patients with carpal tunnel syndrome. (Grade C, Level II)

Recommendation 4e The following treatments carry no recommendation for or against their use: activity modifications, acupuncture, cognitive behavioral therapy, cold laser, diuretics, exercise, electric stimulation, fitness, graston instrument, iontophoresis, laser, stretching, massage therapy, magnet therapy, manipulation, medications (including anticonvulsants, antidepressants and NSAIDs), nutritional supplements, phonophoresis, smoking cessation, systemic steroid injection, therapeutic touch, vitamin B6 (pyridoxine), weight reduction, yoga. (Inconclusive, Level II and V)

Recommendation 5 We recommend surgical treatment of carpal tunnel syndrome by complete division of the flexor retinaculum regardless of the specific surgical technique. (Grade A, Level I and II)

Recommendation 6 We suggest that surgeons do not routinely use the following procedures when performing carpal tunnel release:skin nerve preservation (Grade B, Level I)epineurotomy (Grade C, Level II)The following procedures carry no recommendation for or against use: flexor retinaculum lengthening, internal neurolysis, tenosynovectomy, ulnar bursa preservation (Inconclusive, Level II and V).

Recommendation 7 The physician has the option of prescribing preoperative antibiotics for carpal tunnel surgery. (Grade C, Level III)

Recommendation 8 We suggest that the wrist not be immobilized postoperatively after routine carpal tunnel surgery (Grade B, Level II).We make no recommendation for or against the use of postoperative rehabilitation. (Inconclusive, Level II).

Recommendation 9 We suggest physicians use one or more of the following instruments when assessing patients' responses to CTS treatment for research:

Boston Carpal Tunnel Questionnaire (disease-specific)

DASH – Disabilities of the arm, shoulder, and hand (region-specific; upper limb)

MHQ – Michigan Hand Outcomes Questionnaire (region-specific; hand/wrist)

PEM (region-specific; hand)

SF-12 or SF-36 Short Form Health Survey (generic; physical health component for global health impact) (Grade B, Level I, II, and III)