It takes care of shoulder, elbow, wrist and hand pathologies.

• Intra- and extra-articular pathology of the shoulder. Arthroscopic and open repair techniques for tendinous involvement of the rotator cuff, shoulder joint instability and joint stiffness among other pathologies.
• Surgery of fractures and dislocations of the upper limb. Osteosynthesis and arthroplasties.
• Surgery for the sequelae of fractures (osteotomies and arthroplasties).
• Degenerative arthrosis and inflammatory pathology. Joint prostheses.
• Revision surgery for prosthetic replacements and periprosthetic fractures.
• Traumatic and degenerative elbow surgery. Osteosynthesis and arthroplasties.
• Elbow instability: surgery for acute and chronic instabilities.
• Muscle injuries. Surgery for epicondylitis and epitrochleitis.
• Elbow stiffness: arthrolysis.
• Traumatic and degenerative wrist and hand surgery. De Dupuytren's disease, tendon injuries, rhizarthrosis.
• Treatment of infections.
• Peripheral nerve compression release surgery. Carpal tunnel syndrome, ulnar algoparesis, etc.
• Soft tissue surgery. Synovial cysts, tendinopathies, synovectomies, etc.
• Osteotomies for correction of deformities.
• Pseudoarthrosis surgery
• Arthrodesis and arthroplasties of the wrist joints of the hand
• Wrist instability and pathology of the distal radioulnar joint.
• infiltrations
• Treatment with 3D guides for glenoid defects in total shoulder prostheses.
• Treatment of pseudarthrosis with vascularized bone graft microsurgery.

It is responsible for the care of degenerative and traumatic pathologies of the spine.

• Lumbar disc herniation
• Lumbar disc degeneration
• Lumbar spinal canal stenosis
• Instability (traumatic or degenerative)
• Spondylolisthesis
• Fractures of the lumbar spine or thoracolumbar joint
• Depending on each pathology, different surgical techniques are performed to decompress and stabilize the affected spinal segments:
  • discectomy
  • Spinal canal decompression
  • Posterolateral arthrodesis (fixation with pedicle screws and provision of bone grafts) and in some cases with interbody arthrodesis (PLIF, TLIF).

It deals with the diagnosis and treatment of pathologies affecting the hip joint (femoral lameness).

• Uncemented, hybrid or cemented total hip arthroplasty for the treatment of coxarthrosis or joint degeneration due to inflammatory arthritis.
• Perforations or arthroplasty to treat avascular necrosis of the femoral head.
• Arthroplasty to treat sequelae of hip dysplasia.
• Prosthetic revision surgery of high complexity of hip in 1 or 2 times for loosening or infection.
• Open and arthroscopic hip surgery for femoroacetabular impingement and labrum injuries.
• Treatment of hip, pelvis and acetabulum fractures.
• Infiltrations, aspirations and joint drainage.

It deals with the diagnosis and treatment of pathologies affecting the knee joint.

• Osteoarthritis surgery: femoral and tibial osteotomies, total knee replacement, unicompartmental prostheses.
• Prosthetic surgery with personalized guides.
• Prosthetic surgery with Augmented Reality.
• Prosthetic surgery with Navigation.
• Distal femoral and proximal tibial osteotomies with customized guides.
• Osteochondral lesions (articular cartilage): mosaicoplasty, microfractures, acellular collagen implant.
• Ambulatory arthroscopic surgery: meniscal repair (meniscal suture), partial meniscectomy, joint cleaning free bodies, ligamentous reconstruction of ACL, LCP and acute and chronic lateral ligaments. Extraarticular plastics.
• Pathology of the patella: instability of the patella and recurrent dislocation of the patella. External patellar hyperpressure syndrome
• Traumatology: multiligamentary injury, knee dislocations.
• Extra-articular deformities. Axial alterations of the axes of the lower limbs. Genu Valc. Genu Varus
• Aseptic prosthetic revision surgery.
• Revision prostheses and tumor patella.

The Ankle and Foot Unit assesses and treats degenerative and/or traumatic pathologies that affect this anatomical location. He routinely uses open and minimally invasive (percutaneous) surgery, personalizing the treatment according to the pathology and needs of each patient. One of the important activities is the collaboration with the Multidisciplinary Diabetic Foot Unit and the surgical treatment of Charcot's foot of great significance due to its high social and economic cost and with a significant decrease in the quality of life of these patients .

Foot and ankle traumatic pathology surgery and sequelae.

Forefoot surgery:

• Hallux valgus
• Hallux rigidus
• 5th varus ("tailor's wheel")
• Small finger deformities (hammer fingers...)
• Metatarsalgias
• Release of peripheral neurological compressions: Morton's neuroma, etc.

Midfoot surgery:

• Mid-tarsal arthrosis
• Release of peripheral neurological compressions

Hindfoot surgery:

• Flat foot equal to the adult
• hollow foot
• Ankle arthrosis
• Subtalar arthrosis
• Tarsal tunnel syndrome.
• Ankle instability
• Chronic tendinopathies: Pathology of the peroneal tendons, Achilles tendon, gastrocnemius release etc.
• Osteochondral lesions of talus.

Ankle surgery:

• arthroscopy
• Total ankle arthroplasty
• arthrodesis
• Osteotomies
• Acute / chronic ligament injuries.

Articular and peritendinous infiltrations

• Growth factors
• Hyaluronic acid
• Corticosteroids

Diabetic foot surgery (deformities, Charcot foot, etc.).

• Preventive surgeries with bone and tendinous corrections
• Complex reconstructions for Charcot neuroarthropathy
• Debridement and treatment of diabetic foot ulcers

The Traumatology unit is in charge of the diagnosis, treatment and follow-up of fractures and dislocations in an urgent or deferred manner on an ongoing basis. This treatment can be surgical or conservative (plaster, orthosis, etc.). The main fractures of long bones (humerus, ulna and radius, hand, femur, tibia and fibula, foot, pelvis and acetabulum) and the increasingly frequent fractures that occur in the vicinity of bones bearing previous implants (periprosthetic fractures). Gives care to polytraumatized patients.

If necessary, they carry out joint treatment with plastic surgery practitioners for the skin coverage of those open lesions that require it. The unit has high experience in the provision of bone grafts for the treatment of fractures and pseudarthrosis.

For the treatment of these injured patients, different techniques and implants are used, customized to the patient and their injury. Minimally invasive procedures are used in the treatment of many fractures, being for this reason a leading unit at state level.

The Orthogeriatrics unit is a multidisciplinary unit that coordinates doctors from the following services: Orthopedic Surgery and Traumatology, Internal Medicine and Geriatrics, Nursing, Social Work and Rehabilitation and Physiotherapy. The aim of the unit is the comprehensive management in the pre- and post-operative period of patients over 75 years of age, affected by fractures due to fragility of the femur or related complications. These patients, due to their characteristics, present great fragility and medico-social complexity and therefore require optimal and urgent optimization and stabilization (which in most cases includes a surgical intervention) in order to recover the functionality prior to the fracture as soon as possible, and try to avoid complications associated with functional decline and immobilization, as well as correct pain management. The multidisciplinary approach to these patients is essential to achieve all these objectives.

This unit is responsible for the diagnosis, treatment and follow-up of all infections affecting the locomotor system. Given that these are very complex and potentially serious pathologies that do not only require the approach of TOC, the unit is part of a larger multidisciplinary unit (Septic Pathology Unit of the Locomotor System) integrated by other specialties such as microbiology, internal medicine, infectious diseases, nursing, plastic surgery...etc. This allows, in accordance with the values ​​of our institution, to put the patient at the center of the care process and offer him a comprehensive and personalized approach.

Although there is a wide range of infectious pathologies of the locomotor system, the main ones that the unit responds to are:

• Acute prosthetic infection (API) – treatment of choice Debridement with mobile component replacement (DAIR)
• Chronic prosthetic infection (IPC) – treatment of choice replacement in 1 stage (R1T) or replacement in two stages (R2T).
• Chronic osteomyelitis – radical debridement + reconstruction (this second point is sometimes carried out together with the plastic surgery service).
• Acute infection associated with fractures – debridement +/- fixation replacement
• Septic pseudoarthrosis - radical debridement + fixation.
• Septic arthritis in native joint – debridement.
• Abscess or soft tissue infection – debridement
• Necrotizing fasciitis – debridement, fasciotomy and in extreme cases amputation