Experiencia en el uso de colgajo de Becker para manejo de defecto de cobertura en aspecto dorso-cubital de la mano: análisis retrospectivo de 5 casos / Experience in the use of the Becker flap to manage coverage defects in the dorso-ulnar aspect of the hand: retrospective analysis of 5 cases

INTRODUCTION: Coverage defects of the hand and wrist are usually secondary to high-energy trauma, these must be resolved quickly to protect the underlying vital structures, preserve hand functions and allow early rehabilitation. The dorsal ulnar artery flap (Becker flap), in addition to being a non-demanding surgical technique, has the main advantage of preserving the main vascular axes of the forearm. MATERIALS AND METHOD: Retrospective descriptive study in patients with post-traumatic coverage defect in the dorsum-ulnar aspect of the hand, who were managed with a Becker flap between January 2015 and December 2018.Was analyzed age, sex, mechanism of injury, surgical time, size of the defect, type of donor site closure, complications, and functional outcomes/pain/satisfaction/range of motion with the Mayo Modified Wrist score. RESULTS: In total there were 5 cases, all male, with an average age of 53 (31-58) years, who suffered a high-energy trauma. There were 2 complications, one partial epidermolysis and one deep infection with loss of the flap. Follow-up time was 12 weeks for all cases. The results of the Mayo Modified Wrist Score on average were 72 points. CONCLUSION: The Becker flap is a reproducible, rapid dissection, non-demanding, and one-stage technique. The early use of this flap allows the preservation of vital structures, decreases morbidity, allowing early rehabilitation and an early return to work.

Tumor de nervio periférico: una localización poco habitual / Peripheral nerve tumor: an unusual location

Benign tumors of peripheral nerves called Schwannomas or neurilemomas, correspond to a rare pathology, represent 5% of all tumors of the upper extremity, and affects, mainly, the ulnar nerve. The incidence of Schwannoma in the literature for the radial nerve is not clearly established given the infrequency of its presentation, there are only reports of isolated cases The following publication presents the case of a male patient with a radial nerve schwannoma. Clinically, presents increased painful volume on palpation, well delimited, of soft consistency in the distal third of the right arm of 3 years of evolution, without history of previous trauma, without irradiation, or paresthesia, with preservation of motor and sensory function of radial, median and ulnar nerve. Considering that the involvement of the radial nerve is very low frequency, a review is carried out in PubMed, in the last 10 years, there are only 9 studies, grouped in case reports and imaging studies for diagnosis.

Tendinitis cálcica atraumática de tendón extensor común del dedo medio: un caso infrecuente de dolor metacarpofalángico / Atraumatic calcium tendonitis of common extensor tendon of the middle finger: a rare case of metacarpophalangeal pain

Calcific tendinitis is a pathology characterized by the deposits of periarticular hydroxyapatite. Its pathophysiology is not completely known. It is clinically characterized by important inflammatory changes with incapacitating pain. It most commonly affects the shoulder joint and it rarely affects the hand and wrist. Given the unusual nature of this localization, we present the clinical case of a woman who developed calcific tendinitis of the third metacarpophalangeal muscle. We present the clinical evolution of the case, the treatments carried out, and a review of the literature related to this unusual localization of calcific tendinitis.

No todo dolor de codo es epicondilitis / Not every elbow pain is epicondylitis

Pain located in the lateral aspect of the elbow is a common cause of consultation in the trauma consultation. The most common cause is "lateral epicondylitis," however there are several differential diagnoses that may require different management. There is a case of radial tunnel syndrome secondary to extrinsic compression, with an emphasis on its diagnosis and surgical technique.

Resultados a tres años de seguimiento de Fasciotomía percutánea con aguja en enfermedad de Dupuytren / Results after three years of follow-up of percutaneous fasciotomy with needle in Dupuytren's disease

Dupuytren's disease is the abnormal and progressive proliferation of the palmar fascia, its etiology remains unknown. Percutaneous needle fasciotomy is a minimally invasive procedure, where hypodermic needles are used as a scalpel blade to break the pathological cord in Dupuytren's disease. OBJECTIVE: To evaluate the results of percutaneous needle fasciotomy in patients with 3-year follow-up METHODS: Percutaneous needle fasciotomy was performed in patients from the regional hospital of Talca from January 2014 to January 2017, pre and post-procedure contracture measurement was performed, followed up at 6 weeks, 3 months and annually up to three years. there was a registry of complications, recurrence and functional results with the QuickDASH scale. RESULTS: Of the 17 patients chosen, 13 completed the follow-up. 15 fingers (5 little fingers, 9 ring fingers, 1 middle) and 23 joints. The metacarpophalangeal joints achieved an immediate correction of 89%, maintaining a correction of 48% at three years. The proximal interphalangeal joint achieved a correction of 62%, maintaining 32% at the end of the follow-up. The QuickDash managed to descend from 39.4 to 21.5 points. There was recurrence of 35.7% in the metacarpophalangeal joints and 42.8% in proximal interphalangeal joints. We found that percutaneous fasciotomy is a treatment option.