Cirugía mínima invasiva del Calcáneo y los avances en Osteotomías
Aware.Doctor
[{'start': '2.799', 'end': '6.099', 'text': "Well, another indication\nthat we haven't mentioned regarding"}, {'start': '6.166', 'end': '9.933', 'text': 'minimally invasive surgery\nand that is very popular is'}, {'start': '9.933', 'end': '13.833', 'text': 'all the calcaneal osteotomies, and people are\neven'}, {'start': '13.833', 'end': '17.966', 'text': 'starting to talk about\npercutaneous supramalleolar osteotomies.'}, {'start': '18.066', 'end': '21.066', 'text': 'If one of those is also just starting.'}, {'start': '21.199', 'end': '24.699', 'text': 'Personally, I was\nlooking for a'}, {'start': '24.699', 'end': '28.766', 'text': 'supramalleolar subtraction osteotomy, but I\nmay still consider it.'}, {'start': '28.766', 'end': '30.566', 'text': 'Some addiction osteotomies.'}, {'start': '30.566', 'end': '35.533', 'text': "Well, you don't think about it anymore\nbecause you put in the graft, right?"}, {'start': '35.600', 'end': '38.600', 'text': 'Personally, I find it hard to'}, {'start': '38.799', 'end': '42.399', 'text': 'believe that we can\ncorrect that'}, {'start': '42.399', 'end': '46.566', 'text': 'precise angle that we calculated\non an X-ray with a drill.'}, {'start': '46.566', 'end': '50.366', 'text': "But hey, it's true that there are surgeons\nwith extensive experience"}, {'start': '50.466', 'end': '54.600', 'text': 'who also have much\nmore mastery of the technique than I do.'}, {'start': '54.600', 'end': '55.833', 'text': 'Calcaneal osteotomies.'}, {'start': '55.833', 'end': '61.000', 'text': 'Since we may not be that precise,\nI see it as perhaps a better indication.'}, {'start': '61.000', 'end': '63.866', 'text': "What does the bibliography tell us,\nEva?  Well, it's a topic"}, {'start': '63.866', 'end': '66.566', 'text': "that's starting to get published\nmore and more, isn't it?  It's"}, {'start': '66.566', 'end': '66.933', 'text': 'true'}, {'start': '66.933', 'end': '70.599', 'text': "that we're still talking about\nsix articles about this in 2021,"}, {'start': '70.733', 'end': '72.633', 'text': 'but the articles, for example,\nin'}, {'start': '72.633', 'end': '74.333', 'text': '2022 in Foot & Ankle Orthopaedics.'}, {'start': '74.533', 'end': '79.700', 'text': 'Yes, they say it is\na method for selected'}, {'start': '79.799', 'end': '82.200', 'text': 'high-risk patients in whom we want to perform\nthis type of osteotomy.  It'}, {'start': '82.200', 'end': '87.099', 'text': 'would be a good indication to\ndo this type of osteotomy.'}, {'start': '87.166', 'end': '88.000', 'text': 'There are other articles.'}, {'start': '88.000', 'end': '91.333', 'text': 'What they do in cadaver studies'}, {'start': '91.400', 'end': '94.900', 'text': 'is assess the direction of our drill'}, {'start': '94.966', 'end': '98.633', 'text': 'so that it slides better, for example,\nin this osteotomy.'}, {'start': '98.733', 'end': '102.466', 'text': "No, it's not the same\nto make it completely transversal"}, {'start': '102.466', 'end': '106.000', 'text': 'as to tilt it a little\nso that it slides a little more.'}, {'start': '106.066', 'end': '111.099', 'text': "So it's patient selection,\nnot starting with patients who are going to have skin complications or if you"}, {'start': '111.166', 'end': '116.700', 'text': "know they're going to have\nskin complications, but starting with the best."}, {'start': '116.799', 'end': '117.766', 'text': 'First, training, let'}, {'start': '117.766', 'end': '123.299', 'text': 'me not forget, and then we start\nwith complex patients.'}, {'start': '123.400', 'end': '125.766', 'text': 'That is, we would have to\nhave it in our therapeutic algorithm.  We'}, {'start': '125.766', 'end': '127.299', 'text': 'should have it, I think.'}, {'start': '127.299', 'end': '129.933', 'text': 'And we summarize it with two screws.\nObviously.'}, {'start': '129.933', 'end': '133.966', 'text': "Well, or with a plate, but well,\nif you're doing percutaneous surgery,"}, {'start': '133.966', 'end': '136.366', 'text': 'I think the best thing\nwould be two screws.  Yes.'}, {'start': '136.366', 'end': '140.300', 'text': 'You consider a plate if you do the same\napproach, not in the same approach.'}, {'start': '140.300', 'end': '144.300', 'text': 'Well, yeah,\nmaybe a plate with or without a link.'}, {'start': '144.333', 'end': '145.933', 'text': 'And does it make any difference whether they are osteotomies'}, {'start': '145.933', 'end': '149.033', 'text': 'with varicose vein effect\nor valgus effect, in this case Laia?'}, {'start': '149.033', 'end': '150.733', 'text': 'There are some of them\nthat you have to be much'}, {'start': '150.733', 'end': '152.866', 'text': 'more precise and exact in their correction.'}, {'start': '152.866', 'end': '155.433', 'text': 'In this article he talks about what Zadek does.'}, {'start': '155.433', 'end': '157.633', 'text': 'Zadek too.'}, {'start': '157.633', 'end': '158.633', 'text': 'Yes, Zadek and all.'}, {'start': '158.633', 'end': '162.000', 'text': 'With the panic\nwe have that he will overdo it.'}, {'start': '162.000', 'end': '165.566', 'text': "Well, it's a subtraction osteotomy."}, {'start': '165.766', 'end': '170.366', 'text': "So there, of course, it's easier to\neat this wedge with the strawberry,"}, {'start': '170.466', 'end': '171.533', 'text': 'right?'}, {'start': '171.533', 'end': '174.000', 'text': 'But here in this article, they do everything.'}, {'start': '174.000', 'end': '176.300', 'text': 'I mean, what else did they do?'}, {'start': '176.300', 'end': '180.166', 'text': 'The Dwayer with custom effect\nand you end up eating.'}, {'start': '180.166', 'end': '181.533', 'text': 'Yes, it is true that it is.'}, {'start': '181.533', 'end': '185.199', 'text': 'If you use\nminimally invasive surgery, or percutaneous surgery,'}, {'start': '185.266', 'end': '189.300', 'text': "you'll use different drills\nand you can work with them."}, {'start': '189.400', 'end': '189.766', 'text': 'And I say.'}, {'start': '189.766', 'end': '193.533', 'text': 'But what they do always conclude\nis that they should be'}, {'start': '193.533', 'end': '197.366', 'text': 'high-risk patients who you think are\nreally going to have problems.'}, {'start': '197.366', 'end': '201.666', 'text': 'Another topic\nthat has also come up at several conferences'}, {'start': '201.666', 'end': '205.900', 'text': 'is the whole issue of resection\nof the posterior superior tuberosity.'}, {'start': '205.900', 'end': '209.333', 'text': "An insertional Achilles tendinopathy\nor a Haglund's"}, {'start': '209.433', 'end': '212.633', 'text': 'that can be performed\nby minimally invasive arthroscopy.'}, {'start': '212.666', 'end': '213.366', 'text': 'An endoscopy.'}, {'start': '213.366', 'end': '214.666', 'text': 'With endoscopic assistance.'}, {'start': '214.666', 'end': '219.266', 'text': 'But it can also be done percutaneously without\nor without that help with beam control.'}, {'start': '219.400', 'end': '220.633', 'text': "What's the problem?"}, {'start': '220.633', 'end': '223.633', 'text': 'Manuel Monteagudo always\nexplains it very well:'}, {'start': '223.666', 'end': '226.666', 'text': 'the Achilles, not the\nfan-shaped insertion.'}, {'start': '226.766', 'end': '230.133', 'text': 'If you enter, for example,\nfrom the side, which is where they'}, {'start': '230.133', 'end': '234.566', 'text': "normally do the reaming, you\ndon't control the medial Achilles tendon."}, {'start': '234.766', 'end': '238.266', 'text': 'Exact.  And the risk of injuring him.'}, {'start': '238.300', 'end': '239.233', 'text': "It's a bit of a"}, {'start': '239.233', 'end': '242.833', 'text': 'problem with minimally\ninvasive surgery for plantar fasciitis,'}, {'start': '242.900', 'end': '244.333', 'text': 'the sectioning of the fascia.'}, {'start': '244.333', 'end': '248.300', 'text': "In this case, the problem is that you don't have control\nbecause the ray doesn't let us, it does"}, {'start': '248.300', 'end': '252.166', 'text': "n't let us see the bone,\nbut not the tendons."}]