Fracturas segmentarias de tibia / Segmental tibial fractures

Fundamento: las fracturas segmentarias de la diáfisis tibial (FSDT) son afecciones causadas por trauma de alta energía y están por lo general, asociadas a otras lesiones de partes blandas y óseas, que empeoran su pronóstico y hacen más difícil el tratamiento.Objetivo: profundizar en los elementos esenciales y características de pacientes que sufren de fracturas segmentarias de la diáfisis tibial.Métodos: se realizó una revisión bibliográfica de un total de 400 artículos publicados en Pubmed, Hinari y Medline, mediante el localizador de información Endnote, de ellos se utilizaron 51 citas seleccionadas para realizar la revisión, 47 de ellas de los últimos cinco años, además se incluyeron cuatro libros.Desarrollo: se describen los mecanismos de producción más frecuentes, así como las principales diferencias entre las fracturas segmentarias y no segmentarias. En relación a la clasificación, se describió la propuesta por el grupo de Asociación para la Osteosíntesis (AO) en especial la del tipo C y la aplicación de la clasificación de Winquist R y Hansen S. Se hace referencia a los traumas asociados y las complicaciones reportadas en la literatura. Los tipos de tratamientos son por lo general quirúrgicos y pueden ser mediante enclavijado intramedular, uso de fijadores externos y placas subcutáneas. Conclusiones: las fracturas segmentarias de la diáfisis tibial son lesiones graves, que necesitan de acciones inmediatas, para prevenir o aminorar las complicaciones inmediatas y tardías características de esta lesión(AU)

Background: segmental tibial shaft fractures are affections caused by high energy traumatisms and are generally associated to other lesions of soft and osseous parts that make worse the prognosis and more difficult the treatment.Objective: to deepen in the essential elements and characteristics of patients who suffer from segmental tibial shaft fractures.Methods: a bibliographic review of 400 articles published in Pubmed, Hinari and Medline was made by means of the reference management software Endnote. Fifty-one references were selected for making the review, 47 of them were from the last five years and four books were included.Development: the most frequent mechanisms of production are described, as well as the main differences between segmental and non-segmental fractures. Regarding the classification, the proposal described by the Osteosynthesis Association, especially type C was described, as well as the application of the classification by Winquist R and Hansen S. The traumas associated and the complications reported in the literature are mentioned. The types of treatment are generally surgical and can be conducted by means of intramedullar nailing, external fixators and subcutaneous plates.Conclusions: segmental tibial shaft fractures are serious lesions that need to be treated immediately to prevent or reduce the instant complications and the belated characteristics of this lesion(AU)

[Prognostic value of Lauge-Hansen and Danis-Weber classification in nonoperative and operative tibia ankle fracture treatment]. / Wartosc prognostyczna klasyfikacji Laugego-Hansena i Danisa-Webera w leczeniu nieoperacyjnym i operacyjnym zlaman kostek goleni.

Tibia ankle fractures and traumatic injuries of the ankle-tibia joint area are one of the most intractable problems in orthopedic and traumatic surgery. Because of the displacement of these fractures they require precise opening of the joint surface area to undertake the early repositioning in order to gain eficient walk. The objective of this paper was to evaluate and compare the final results of nonoperative and operative treament methods, specificlly the two most common prognosis values of tibia ankle fracture clasifications by Danis-Weber and Lauge-Hansen. This is the prognositic marking in the range of functional and radiological results dependant upon the method beeing applied. The repetetiveness and accordance of these two classifications has been evaluated as well. This research was conducted on the retrospective evalutaion based on the X-rays of 61 patients (28 women and 33 men) between the ages of 20-76 making the average age 49.5. The definition of accordance and repetitivenes was conducted by three doctors, who evaluated the x-rays from the standard fornt, back, and side projection of relaxed joint ankle.