Description and post-operative evaluation of tie-in technique in tibial osteosynthesis in dogs / Descrição e avaliação pós-operatória de técnica de osteossíntese com tie-in em tíbia

The aim of this study was to describe and analyse the adaptability and functionality of tie-in configuration in tibial osteosynthesis in dogs. Twenty dogs with tibial fracture were included in this study. An orifice was made on the proximal tibial fragment, on the medial side, close to the tibial crest. The drill piece was angled at 45º and projected into the same orifice on the distal sense of the bone. Others orifices made with the aid of a low rotation drill and drill piece with diameter smaller than the chosen implant. After 10 days post-operative, the animals were evaluated. X-ray analysis was performed at the time of clinical examination; immediate post-operative period; and at 30, 60, 90, and 120 days post-surgery. A questionnaire was given to the owners to provide details on the post-operative period. There were no trans-operative complications or suture dehiscence up to the day of suture removal. Partial development of bone callus was observed in 20 dogs within a mean period of 76 days. Three animals showed bone consolidation within 35 days, nine by 60 days, three by 90 days, and 5 by 120 days post-operative. Dynamization was carried out in 9 animals. The surgical access to the tibial medullary canal through the orifice at the proximal medial face, by the tibial tuberosity, enables the insertion of IMP without risks to articular and peri-articular lesions in the knee in dogs.(AU)

O objetivo deste trabalho foi descrever e analisar a funcionalidade da configuração tie-in na ostessíntese de tíbia em cães. Foram usados 21 cães com fratura de tíbia da rotina clinica do hospital veterinário. Somente a primeira cortical (Sis) foi perfurada, em seguida a broca foi inclinada a 45o e projetada no mesmo orifício no sentido distal do osso. foram confeccionados outros orifícios com auxílio de furadeira de baixa rotação e broca cujo diâmetro era menor que o implante escolhido. Os procedimentos radiográficos foram realizados no momento do atendimento clínico, no período pós-operatório imediato e aos 30, 60, 90 e 120 dias pós-cirúrgico. Não houve nenhuma complicação transoperatória, tão pouco deiscência de sutura até o momento da retirada dos pontos de cútis. A formação parcial de calo ósseo foi evidenciada em 20 cães com tempo médio de 76 dias. Três cães obtiveram consolidação óssea em 35 dias, nove aos 60 dias, três aos 90 dias e cinco aos 120 dias de pós-operatório. Dinamizações foram realizadas em nove animais. Após a confirmação radiográfica de consolidação óssea, os implantes dos 20 animais foram totalmente removidos. Concluiu-se que o acesso cirúrgico ao canal medular da tíbia canina por meio de orifício na face medial proximal, junto à tuberosidade da tíbia, permite a inserção do PIM sem risco de lesões articulares e periarticulares no joelho.(AU)

Osteossíntese de fêmur e tíbia em veado-catingueiro (Mazama gouazoubira): relato de caso / Osteosynthesis of the femur and tibia of a brown brocket deer (Mazama gouazoubira): case report

O presente estudo relata o caso de um veado-catingueiro jovem, provindo de vida livre e com histórico de atropelamento. Posteriormente à realização de exames, o animal foi diagnosticado com fratura exposta distal de tíbia (Salter-Harris tipo I) e fratura cominutiva de metáfise distal de fêmur, ambas em membro pélvico esquerdo. Para a osteossíntese da tíbia, foram utilizados pinos intramedulares de Steinmann inseridos pelos maléolos lateral e medial, de forma cruzada. A osteossíntese do fêmur foi realizada com associação de dois pinos de Steinmann, conforme técnica modificada de Rush, e placa de compressão dinâmica. As técnicas cirúrgicas adotadas foram satisfatórias para estabilização, consolidação de ambas as fraturas e retorno funcional do membro. Após 90 dias da cirurgia, o animal foi reintroduzido à natureza.(AU)

The present study reports the case of a juvenile wild brown brocket deer, with car accident history. After a complete examination, the animal was diagnosed with open distal tibial fracture (Salter-Harris type I) and comminuted fracture of the distal metaphysis of the femur, both in the left hindlimb. For the tibial osteosynthesis, Steinmann pins were used intramedullary, inserted by the lateral and medial malleolus, crosswise. The osteosynthesis of the femur was performed with a combination of two Steinmann pins, as modified Rush technique, and a dynamic compression plate. The surgical techniques used were satisfactory for stabilization, consolidation of both fractures and function return of the member. Ninety days after surgery the animal was reintroduced to nature.(AU)

Perfil epidemiológico dos pacientes portadores de fraturas de face / Epidemiological profile of patients with facial fractures

Fraturas faciais foram provocadas principalmente por acidentes de trânsito (37,3%), e por agressões físicas (33%), vitimando predominantemente pacientes do gênero masculino (83,7%).Ocorreram mais frequentemente na faixa etária entre 21 e 30 anos (38,2%). A frequência de homens e mulheres vitimados entre a primeira e a terceira décadas de vida foi bastante similar.As fraturas mandibulares isoladas foram significativamente predominantes (48%), seguidas pelas zigomáticas (19,7%) e pelas nasais (19,7%). As agressões físicas foram mais frequente mente responsáveis pelas fraturas mandibulares, zigomáticas, nasais, maxilares e frontais, enquanto as fraturas pan faciais e Le Fort resultaram mais frequentemente de acidentes de trânsito.

Facial fractures were mainly caused by traffic accidents (37.3%) and physical abuse (33%), victimizing mostly male patients (83.7%). Occurred more frequently in the age group between21 and 30 years (38.2%). The frequency of men and women victimized between the first and third decades of life was very similar. Isolated mandibular fractures were significantly predominant(48%), followed by zygomatic (19.7%) and the nose (19.7%). The assaults were mostoften responsible for mandibular fractures, zygomatic, nasal, maxillary and frontal, while the panfaciais fractures and Le Fort resulted more often aciteeth transit.

Fractura de cadera: caracterización epidemiológica de egresos quirúrgicos, Hospital de Victoria, Chile 2009-2013 / Hip francture: epidemiological characterization of surgical discharges: Hospital of Victoria, Chile 2009-2013

INTRODUCCIÓN: La fractura de cadera (FC) es la causa más frecuente de hospitalización en servicios de urgencia ortopédicos. La mayoría ocurre en pacientes ancianos con mala calidad ósea y trauma menor. La pérdida de los reflejos protectores y reducción de la fortaleza ósea son factores de riesgo. OBJETIVO: Caracterizar epidemiológicamente los egresos quirúrgicos por FC en Hospital de Victoria 2009-2013, respecto a antecedentes nacionales, no existen registros previos, así generar información cuantitativa para decisiones administrativas. MATERIALES Y MÉTODO: Estudio cuantitativo, descriptivo y retrospectivo de corte transversal, realizado en Hospital de Victoria, Chile, durante enero-febrero 2014. Se utiliza la tabla digitalizada de Diagnósticos de Egresos Quirúrgicos entre 2009-2013. Para los criterios de inclusión, se usa la Clasificación Internacional de EnfermedadesCIE-10, seleccionando Coxartrosis, Fractura del cuello femoral, pertrocanteriana, subtrocanteriana;de los cuales los intervenidos quirúrgicamente, excluyendo los no quirúrgicos. El análisis se realizacon Microsoft Office Excel© 2007 y EPIDAT© 3,1. El estudio es aprobado por el Comité de Ética de la Universidad Mayor, Temuco, Chile. RESULTADOS: Se obtiene N= 204 con promedio de 75años, la mayoría mujeres. Del total, el 75 por ciento son fracturas del cuello femoral, y en la mayoría se usa osteosíntesis. Por otro lado, el 22 por ciento se diagnostica de coxartrosis, y todas reciben endoprótesis. DISCUSIÓN: Existe un incremento del grupo de adultos mayores como de incidencia de FC. La incidencia total a nivel países de riesgo bajo, y a nivel provinciales moderado. Determina que la patología es de mayor riesgo en Malleco respecto al nacional

INTRODUCTION: Hip fracture (HF) is the most frequent cause of hospitalization in emergency orthopedic services. They usually occur in elderly patients with poor bone quality and lower trauma. The loss of protective and reduced bone strength reflexes are risk factors. OBJECTIVE: To characterize the epidemiological profile of surgical discharges with diagnosis of HF, Hospital of Victoria, 2009-2013, regarding national background, of which there are no previous records, thus generate quantitative information for making management decisions. MATERIALS AND METHODS: a quantitative, descriptive and retrospective cross-sectional study, carried out in Hospital of Victoria, Chile, during January February 2014. It is used the digitalized Table of Diagnostics of Surgical Expenses of 2009-2013. The International Classification of Diseases ICD-10 is used for the inclusion criteria, and are selected: Coxarthrosis, Fracture of the femoral neck, pertrochanteric, and subtrochanteric; of which only surgically. Excluding non-surgical. The analysis is performed with Microsoft Office Excel 2007 and EPIDAT © © 3.1. The study is approved by the Ethics Committee of the Universidad Mayor, Temuco, Chile. RESULTS: N= 204 is obtained, mostly women, mean 75.5 years. Of the total, 75.5 percent are femoral neck fractures, of which67.5 percent is used osteosynthesis. Furthermore, 22.1 percent were diagnosed with coxarthrosis, and all of them receiving endoprosthesis. DISCUSSION: There is a constant increase in the elderly group and incidence of HF. The national overall incidence was set as low risk, but atlocal level, it is moderate. It determines that the condition is riskier in the Province of Malleco rather than the national level

Tratamiento de Fracturas Distales del Radio con Técnica de Reducción abierta y Fijación Interna con Placa Volar / Treatment of Distal Radius Fractures with Open Reduction and Internal Fixation with Volar Plate Technical

Introducción: La evolución de las placas para fijación interna ha incrementado la preferencia por el tratamiento quirúrgico de las fracturas distales del radio. Objetivos: Determinar los resultados anatómicos y funcionales en pacientes con fracturas distales del radio tratados con la técnica de reducción abierta y fijación interna (RAFI) con placa volar, operados en el Hospital Central del Instituto de Previsión Social (HC-IPS) en los meses de junio a agosto de 2013. Metodología: Diseño observacional, descriptivo y prospectivo. Se realizaron mediciones radiológicas posquirúrgicas inmediatas y a los tres meses para valorar el grado de restablecimiento anatómico logrado con la técnica de RAFI con placa volar en 32 pacientes, utilizando la Escala de Castaing. A los tres meses del tratamiento se utilizó la Escala funcional de Gartland y Werley, y se valoró el efecto de la fisioterapia mediante la Escala de Evaluación de Lesiones de Muñeca. Resultados: En relación al restablecimiento anatómico posquirúrgico inmediato, fueron valorados como excelentes el 15,63%, buenos el 43,75%, regulares el 37,50% y malos el 3,13%, sin presentar modificaciones a los tres meses. La valoración funcional fue mala en 28,13%, regular en 43,75% y buena en 28,13%, sin resultados excelentes. La fisioterapia mejoró la funcionalidad en cuanto a rango de movimientos y actividades realizadas (p<0,001), pero la disminución del dolor no fue significativa a los tres meses (p=0,2561). Conclusión: Los resultados denotan la influencia de la fisioterapia en la recuperación funcional a corto plazo, siendo necesario un seguimiento a mayor plazo para evidenciar los beneficios del grado de restablecimiento de la anatomía normal. Palabras clave: Radio/Anatomía - Fracturas del Radio - Fijación Interna de Fracturas.

Introduction: The evolution of internal fixation plates has increased the preference for the surgical treatment of distal radius fractures. Objectives: To determine the anatomic and functional results in patients with distal radius fractures treated with the technique of open reduction and internal fixation (ORIF) with volar plate operated in the Central Hospital of the Institute of Social Welfare in the months of June to August 2013. Methodology: Observational, descriptive and prospective design. Immediate postoperative and three months later radiographic measurements were made to valorate the level of anatomical restoration achieved with the technique of ORIF with volar plate in 32 patients, using the scale of Castaing. After three months of treatment the functional scale of Gartland and Werley was used, and the effect of physiotherapy was assessed by the scale of Patient Rated Wrist Evaluation. Results: Regarding the immediate postoperative anatomic restoration, were rated as excellent 15,63%, good 43,75%, regular 37,50% and bad 3,13%, without submit changes at three months. Functional assessment was bad in 28,13%, regular in 43,75% and good in 28,13%, without excellent results. Physiotherapy improved functionality in terms of range of movement and activities performed (p <0,001), but the decrease in pain was not significant at three months (p = 0,2561). Conclusion: The results show the influence o f physiotherapy on functional recovery in the short term, a longer follow up would be necessary to evidence benefits of the level of restoration of normal anatomy. Keywords: Radius - Radius Fracture - Fracture Fixation, Internal.

Indicators of outcome after internal fixation of complex acetabular fractures

Complex acetabular fractures are not uncommon injuries in Egypt. The aim of surgical treatment is to preserve hip mobility and to avoid post-traumatic arthritis. The aim of this study was to evaluate the clinical results of patients presented by displaced complex acetabular fractures and treated by open reduction and internal fixation. Factors affecting these results were to be determined. Displaced acetabular fractures involving the both columns were included. Initial assessment and treatment were directed towards the patient's general condition. Posterior hip dislocation was reduced as fast as possible. Standard X-ray views and CT cuts were done for every patient. The definite surgery was done through an ilio-inguinal, a Kocher-Langenbeck or combined approaches. Postoperatively, the residual displacement was recorded together with the head roof relationship. Using Matta radiological and modified clinical grading, a correlation between radiological and clinical results was made. Factors affecting the outcome were defined. The study involved 55 patients between May 2007 and December 2010. The mean follow-up period was 29.62 +/- 7.19 months with a minimum of 12 months and a maximum of 43 months. Excellent to good results were achieved in 38 cases, 69.1%, while fair to poor results were obtained in 17 cases, 30.9%. Anatomical reduction and/or restoration of perfect head/roof congruency were strongly associated with better outcome. Beside this there was significant relation between good clinical outcome and the utilisation of the anterior approach. On the other hand bad outcome was associated with these factors: [1] associated pelvic ring injury, [2] fracture of the posterior wall, [3] articular surface comminution and [4] the presence of intra-articular fragments. Fracture personality and not the fracture type is the main determinant of its complexity. Surgical experience is required to achieve the best reduction while avoiding complications

Estudio descriptivo del sistema hospitalario en relación a pacientes sometidos a tratamiento quirúrgico por trauma facial en el Hospital Hernán Henríquez Aravena de Temuco, Chile / Descriptive study of hospital system in relation to patients undergoing surgical treatment of facial trauma in the Hernan Henriquez Aravena Hospital of Temuco, Chile

El trauma maxilofacial conforma una serie de lesiones que involucran tejidos óseos y blandos, provocando alteraciones funcionales y estéticas. El objetivo de este trabajo es determinar el perfil de pacientes que son sometidos a tratamiento quirúrgico por trauma maxilofacial en los pabellones del Hospital Regional de Temuco. De la base de datos del centro de estadísticas del Hospital Regional Hernán Henríquez Aravena, se obtuvieron un total de 145 sujetos con trauma maxilofacial entre los años 2008 y 2009. De la misma base de datos se obtuvieron los datos con los que se determinó la frecuencia según año, etnia, sexo, edad, sistema de previsión, mes, jornada, servicio, diagnóstico de fractura, manejo de tejidos blandos y tratamiento. En este estudio se encontraron 28 casos no diagnosticados (19,3 por ciento), 35 fracturas de cigomático (24,1 por ciento), 17 fracturas de piso de orbita (11,7 por ciento), 22 fracturas de otros huesos del cráneo (15,2 por ciento), 21 fracturas de mandíbula (14,5 por ciento), 11 fracturas múltiples faciales (7,6 por ciento), 3 fracturas de base de cráneo (2,1 por ciento) y 8 otros (5,5 por ciento). Como conclusión podemos decir que las fracturas de cigomático es la más prevalente. Respecto al tratamiento más realizado en el trauma es la reducción con osteosíntesis múltiple.

Maxillofacial trauma constitutes a series of injuries involving bone and soft tissues, causing functional and aesthetic alterations. The aim of this study is to determine the profile of patients subject surgical treatment for maxillofacial trauma in the halls of the Regional Hospital in Temuco. From the central database of statistics Hernan Henriquez Aravena Regional Hospital we obtained a total of 145 patients with maxillofacial trauma between 2008 and 2009. In the same database the data was obtained to determine the frequency by year, ethnicity, sex, age, form of payment, month, day, service, diagnosis of fracture, soft tissue management and treatment. In this study we found 28 cases diagnosed (19.3 percent), 35 fractures of zygomatic (24.1 percent), 17 orbital floor fractures (11.7 percent), 22 fractures of other bones of the skull (15, 2 percent), 21 fractures of the mandible (14.5 percent), 11 multiple facial fractures (7.6 percent), 3 fractures of the skull base (2.1 percent) and 8 others (5.5 percent). In conclusion we can say that zygomatic fractures is the most prevalent, and treatment performed most frequently is the reduction with multiple fixations.

Mandibular fractures: a comparative analysis between young and adult patients in the southeast region of Turkey

OBJECTIVE: The purpose of this study was to review and compare the differences between mandibular fractures in young and adult patients. MATERIAL AND METHODS: Patients treated at the Oral and Maxillofacial Department of Dicle University during a five-year period between 2000 and 2005 were retrospectively evaluated with respect to age groups, gender, etiology, localization and type of fractures, treatment methods and complications. RESULTS: 532 patients were included in the study, 370 (70 percent) males and 162 (30 percent) females, with a total of 744 mandibular fractures. The mean age of young patients was 10, with a male-female ratio of 2:1. The mean age of adult patients was 28, with a male-female ratio of 3:1. The most common causes of injury were falls (65 percent) in young patients and traffic accidents (38 percent) in adults. The most common fracture sites were the symphysis (35 percent) and condyle (36 percent) in young patients, and the symphysis in adults (36 percent). Mandibular fractures were generally treated by arch bar and maxillomandibular fixation in both young (67 percent) and adult (39 percent) patients, and 43 percent of the adult patients were treated by open reduction and internal fixation. CONCLUSION: There was a similar gender, monthly and type of treatment distribution in both young and adult patients in the southeast region of Turkey. However, there were differences regarding age, etiology and fracture site. These findings between young and adult patients are broadly similar to those from other studies. Analysis of small differences may be an important factor in assessing educational and socioeconomic environments.

Epidemiology of mandibular fractures treated in a Brazilian level I Trauma Public Hospital in the city of São Paulo, Brazil

This article reviews cases of mandibular fractures treated at the Service of Oral and Maxillofacial Surgery of the Hospital Complex of Mandaqui (SUS/SP), which is a reference hospital complex for trauma in the northern area of the city of São Paulo, Brazil. Ninety-eight patients with mandibular fractures were seen at the hospital between January and December, 2001. Out of this total, 91 cases whose files were deemed adequate in terms of data accuracy and completeness were reviewed. The following data were collected for the study: age, gender, etiology, anatomical fracture site, treatment modality, relation to other facial bone fractures, hospitalization time and posttrauma complications. Motorcycle accident was the major cause of mandibular fractures followed by physical aggression and height fall. The mandibular anatomical sites of higher fracture incidence were: body, symphysis and condyle. The most commonly performed treatment modes were conservative approach or open reduction and intraosseous fixation. In conclusion, motorcycle accidents were associated with a larger number of facial fractures and most predominantly affect 21-30 year-old males. On the average, motor vehicle accident victims had more (and more severe) fractures than physical aggression victims. Complications were mostly associated with angle fractures and hospitalization period. Polytraumatized patients presented greater morbidity for complications.

O artigo tem como objetivo revisar casos de fraturas de mandíbula atendidos no Serviço de Cirurgia Bucomaxilofacial do Conjunto Hospitalar do Mandaqui (SUS/SP), hospital de referência para trauma na região norte de cidade de São Paulo. De janeiro a dezembro de 2001, foram atendidos 98 pacientes com fraturas de mandíbula no hospital. Dentre estes, 91 casos que dispunham de dados suficientes em prontuários foram analisados. Para o estudo foram considerados: idade, gênero, etiologia, local anatômico da fratura, modalidade de tratamento, relação com fraturas de outros ossos faciais, tempo de hospitalização e complicações. Acidente motociclístico foi a principal causa de fraturas mandibulares, seguido de agressão e queda de altura. Os três locais anatômicos de maior incidência foram: corpo, sínfise e côndilo. O modo de tratamento consistiu de abordagem conservadora ou redução aberta e fixação interna. Conclui-se que acidentes motociclísticos estão associados a um maior número de fraturas mandibulares com predominância em homens de 21 a 30 anos. Vítimas de acidentes com veículos apresentaram, em média, mais fraturas do que vítimas de agressões. As complicações mostraram-se associadas ao maior período de hospitalização e fraturas de ângulo mandibular, e tiveram maior incidência em pacientes politraumatizados.

Fracturas mandibulares: experiencia en un hospital de trauma / Mandibular fractures: experience of a trauma hospital

Background: Facial trauma has reached a peak in the last decades in the world; however, scanty epidemiological information is available in Chile. Aim: To report the experience in the treatment of mandibular fractures in the maxillofacial unit at Hospital del Trabajador, Santiago. Patients and methods: A retrospective study of patients with mandibular fractures treated in a seven years period (1990-1996). Demographic and clinical aspects of the patients are analyzed, with emphasis in causes of trauma, anatomic distribution of the fractures, treatment and complications. Results: One hundred and sixty patients (aged 14 to 65 years old) sustained 245 mandibular fractures. Road traffic accidents were the most common cause of fractures (46 percent). The most common mandibular fracture was subcondylar. Thirty eight patients (24 percent) presented with associated facial fractures, while 34 (21 percent) had also other non-facial fractures. Open reduction and internal fixation was performed in 88 subjects. Complications occurred in 60 patients (38 percent). Conclusions: Road traffic accidents are the main cause of mandibular fractures in this series of patients. The most common mandibular fracture is subcondylar, which can be linked to the high rate of occlusal complications observed

Revisión epidemiológica del tratamiento quirúrgico de las fracturas subtrocántereas / Epidemiologic review of surgical treatment for subtrochanteric fractures

Este es un estudio observacional, descriptivo y prospectivo; se capturaron 26 pacientes en el periodo comprendido de enero de 1999 a enero del 2000, 17 hombres y 9 mujeres; 17 casos correspondieron al lado derecho y el restante al izquierdo. El implante más colocado fue el Dinamic Hip Screw (DH). Se hace hincapié en una correcta planeación preoperatoria.

Manejo de las fracturas del complejo órbito-cigómato-malar en 70 pacientes / Management of orbitozygomatic fractures in 70 patients

En esta comunicación preliminar se relata la experiencia clínica del manejo de las fracturas órbito-cigomático-malar en el Hospital Instituto de Seguridad del Trabajo, entre los años 1989 y 1995. Se consideran 70 pacientes y se analizan: 1º Tipos de accidentes; 2º Criterios para intervenir quirúrgicamente. En general descrito en la literatura; 3º Frecuencia de los distintos tipos de fracturas; 4º Vías de abordaje. Se discuten: el uso de los diferentes tipos de materiales de osteosíntesis, oportunidad de la intervención quirúrgica y, por último, se concluye que el tratamiento ideal debe ser lo más conservador posible y el trabajo en un equipo multidisciplinario

Trauma facial: a propósito de 125 casos tratados / Facial trauma: a series of 125 cases

Se presenta la experiencia de 125 casos de traumatismo cráneo-maxilo-facial, tratados durante los últimos 4 años. El pilar del tratamiento fue la utilización de la fijación rígida con mini y micro placas de Titanio; la reconstrucción del piso, techo y paredes laterales de la órbita, se realizó principalmente con malla de Titanio. Los resultados funcionales y estéticos fueron satisfactorios. La principal complicación fue el enoftalmos tardío que se diagnosticó en 4 casos