The results of this technique compare favorably with those of other methods. The percentage of success and the strength of elbow flexion restored were increased without any morbidity. This technique will probably reduce the need for secondary procedures to augment elbow flexion. The authors propose double nerve transfer as a standard procedure in C5-C6 and C5-C6-C7 injuries.
Se determinó la calidad del agua en puntos afluentes del rio Cesar como el río Calenturitas, Maracas y Tucuy, utilizando macro invertebrados acuáticos como bioindicadores y aplicando el índice BMWP/Col adaptado para Colombia por Roldan (Biological Monitoring Working Party score). Se establecieron cinco estaciones y dos jornadas de muestreo (periodo seco y de lluvias). Se colectaron muestras de agua para análisis fisicoquímicos e identificación de macro invertebrados que fueron contados e identificados mediante estereomicroscopio y claves taxonómicas. En total se identificaron 1025 organismos, 589 en periodo seco y 436 en periodo de lluvias, pertenecientes a 2 phylum, 3 clases, 9 órdenes, 24 familias y 37 géneros. El valor promedio del índice BMWP/Col define la calidad del agua de la estación 1 (E1) como agua ligeramente contaminada, de calidad aceptable, E2-E3-E4 y E5 como agua moderadamente contaminada, de calidad dudosa. Agua de la estación E5 presenta el puntaje más bajo de todas las estaciones y las variables fisicoquímicas y microbiológicas más altas.
The volar V-Y flap is used in transverse or dorsal oblique amputations in fingertip injuries; however, its use is contraindicated in patients with volar oblique amputations and cannot advance distally enough to cover the defect. The aim of this report is to describe a technique of double V-Y flap to cover fingertip defects in which a simple V-Y flap is not enough. This technique allows advancement between 30% and 50% farther than the original, simple V-Y flap. Report of cases a series of fingertip amputation covered with this technique. This technique was performed in 7 patients between 25 and 64 years old, with transverse, volar and dorsal oblique defects in the fingertip. The advancing of the flap was between 3 and 5 mm. There were no infections or necrosis of the flaps. In all patients there were acceptable aesthetic results with 2-point discrimination between 4 and 6 mm in the proximal flap and up to 10 mm in the distal flap with a minimum follow-up of 6 months. With this double V-Y flap, we have seen a good coverage even in volar oblique amputation. In addition, it is possible to advance up to 5 mm more with this second V-Y flap without compromising the vitality of the flap. It is a simple and reproducible technique that can be used on any finger, with good results, without flap necrosis.
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