Periprosthetic fracture management of the proximal femur.

The most common periprosthetic fractures occur around the hip. The most widely used classification is the Vancouver classification, and management requires careful planning and skill in both arthroplasty and fracture surgery. This article presents an overview of the diagnosis, classification, and management of periprosthetic fractures of the proximal femur. This work represents a summary review from Latin American Society Members of the International Orthopaedic Trauma Association.

A Latin American consensus meeting on the essentials of mixed pain.

OBJECTIVES: The term "mixed pain" has been established when a mixture of different pain components (e.g. nociceptive, neuropathic, and nociplastic) are present. It has gained more and more acceptance amongst pain experts worldwide, but many questions around the concept of mixed pain are still unsolved. The sensation of pain is very personal. Cultural, social, personal experiences, idiomatic, and taxonomic differences should be taken into account during pain assessment. Therefore, a Latin American consensus committee was formed to further elaborate the essentials of mixed pain, focusing on the specific characteristics of the Latin American population. METHODS: The current approach was based on a systematic literature search and review carried out in Medline. Eight topics about the definition, diagnosis, and treatment of mixed pain were discussed and voted for by a Latin American consensus committee and recommendations were expressed. RESULTS: At the end of the meeting a total of 14 voting sheets were collected. The full consensus was obtained for 21 of 25 recommendations (15 strong agreement and 6 unanimous agreement) formulated for the above described 8 topics (7 of the 8 topics had for all questions at least a strong agreement - 1 topic had no agreement for all 4 questions). CONCLUSION: In a subject as complex as mixed pain, a consensus has been reached among Latin American specialists on points related to the definition and essence of this pain, its diagnosis and treatment. Recommendations for diagnosis and treatment of mixed pain in Latin America were raised.

Orthopaedic trauma care during the COVID-19 Pandemic: the Latin American perspective.

At first glance, the COVID-19 pandemic and the field of orthopaedics and traumatology do not appear to be related. Although orthopaedists are not considered front-line personnel in the fight against the pandemic, the role of the surgeon as part of the overall health care team is crucial. The specialty of orthopaedics and orthopaedic trauma, due to its extraordinary scope, affects individuals of all ages and timely care affects patients' long-term function and quality of life. Therefore, positioning the type and timing of care for musculoskeletal injuries and conditions, while maintaining the safety of the patient and healthcare providers, is essential. This article reviews the initial approaches to orthopaedic trauma care during the COVID-19 pandemic as established by 4 representative countries in Latin America: Mexico, Argentina, Colombia, and Brazil.

[Type V floating elbow with type III A3 exposure and nerve injury. Initial and definitive treatment with a minimally invasive technique. A case report]. / Codo flotante tipo V con exposición tipo III A3 y lesión nerviosa. Tratamiento inicial y definitivo con técnica minima invasiva. Reporte de un caso.

BACKGROUND: The increased number of high energy accidents has led to the occurrence of several injuries in a single extremity, particularly among youths. Stanitski and Micheli defined the floating elbow as a forearm fracture plus an ipsilateral supracondylar fracture. Its incidence ranges from 3% to 13%, predominant ages are 7 to 11 years, with a 2:2 male:female ratio. The mechanism of injury is as follows: fall from a height with elbow hyperextension and wrist dorsiflexion and pronation of the forearm. OBJECTIVE: To present the case of a child with a type V left open floating elbow injury, severe soft tissue injury and median and radial nerve injury. CLINICAL CASE: A 12-year-old male weighing 70 kg and a height of 170 cm fell from a height of around 50 cm while riding on a skateboard and sustained a type V floating elbow injury. He was managed with a double antibiotic regimen, decontaminating wound care and fracture stabilization with a minimally invasive approach, using crossed Kirschner nails in the elbow, and centromedullary and retrograde nails in the radius and ulna. He underwent early rehabilitation. The patient resumed his usual activities at month 3 and was assessed using the DASH scale. The nerve injury was classified as neurapraxia. RESULTS: The skin healed at ten days. Passive motion of the elbow and wrist was started at week 2. Bone healing of the radio-ulna occurred at 35 days and of the humerus at 30 days. The nerve injury evolved properly without leaving any sensory or motor sequelae. According to the DASH Scale, the functional course was appropriate; the patient resumed his usual activities at month 3. No infection or compartmental syndrome occurred. CONCLUSIONS: The early and thorough washing of these injuries is an important factor to decrease the risk of infection. The minimally invasive approach is perfect to treat these injuries in children; it is less aggressive and preserves the integrity of soft tissues. Early rehabilitation and the prompt management of the nerve injury are fundamental to the functional result. The DASH Scale identifies the functional course, is easy to use and convenient for the patient.