La configuración de los tornillos en la osteosíntesis de las fracturas del cuello femoral no influye en los resultados funcionales ni mecánicos / The configuration of the screws in the osteosynthesis of fractures of the femoral neck does not influence the functional or mechanical outcomes

Antecedentes y objetivo: La síntesis con tornillos canulados es uno de los métodos aceptados en las fracturas de cuello femoral, aunque su óptima disposición es un tema en continuo debate. El objetivo principal fue comparar los resultados del paciente con fractura de cuello de fémur fijada con tres tornillos en configuración triangular y en triángulo invertido en el plano frontal. Materiales y métodos: Estudio retrospectivo y comparativo de 53 pacientes con fractura de cuello femoral intervenidos entre 2015 y 2022 mediante fijación con tres tornillos canulados: 22 conformados en triángulo (grupo triángulo) y 31 en triángulo invertido (grupo triángulo invertido). Se evaluó la funcionalidad mediante la escala modificada de Merlé d’Aubigné, la capacidad para la deambulación con la escala de Koval, así como las complicaciones postoperatorias. Resultados: En la escala de Merlé d’Aubigné la puntuación media fue de 16,7 en el grupo triángulo y de 16,1 en el grupo triángulo invertido (p=0,259). En la escala de Koval se observó una disminución significativa, pasando de 1,6 de media preoperatoria a 2,2 tras la cirugía (p=0,000), no hallando diferencias entre grupos. Hubo seis complicaciones postoperatorias en el grupo triángulo y tres en el grupo triángulo invertido (p=0,140). Conclusión: La configuración de los tornillos en el cuello femoral, tanto en forma de triángulo como en triángulo invertido, no influyó en los resultados funcionales ni mecánicos de los pacientes con fractura de cuello de fémur fijada mediante tres tornillos canulados.(AU)

Background and objective: Synthesis with cannulated screws is one of the accepted methods in femoral neck fractures, although its optimal configuration is a subject in continuous debate. The main objective was to compare the results of the patient with a femoral neck fracture fixed with three screws in triangle and inverted triangle configuration in the frontal plane. Materials and methods: Retrospective and comparative study of 53 patients with femoral neck fracture, operated between 2015 and 2022 with fixation with three cannulated screws, 22 with a triangle configuration (triangle group) and 31 in an inverted triangle (inverted triangle group). Functionality was evaluated using the modified Merlé d’Aubigné scale, walking ability using the Koval scale, as well as postoperative complications. Results: On the Merlé d’Aubigné scale, the mean score was 16.7 in the triangle group and 16.1 in the inverted triangle group (P=.259). On the Koval scale, a significant decrease was observed, going from 1.6 preoperative mean to 2.2 after surgery (P=.000), finding no differences between groups. There were six postoperative complications in the triangle group and three in the inverted triangle group (P=.140). Conclusion: The configuration of the screws in the femoral neck, both in the form of a triangle and an inverted triangle, did not influence the functional or mechanical outcomes of the patients with a femoral neck fracture fixed with three cannulated screws.(AU)

[Translated article] The configuration of the screws in the osteosynthesis of fractures of the femoral neck does not influence the functional or mechanical outcomes / La configuración de los tornillos en la osteosíntesis de las fracturas del cuello femoral no influye en los resultados funcionales ni mecánicos

Antecedentes y objetivo: La síntesis con tornillos canulados es uno de los métodos aceptados en las fracturas de cuello femoral, aunque su óptima disposición es un tema en continuo debate. El objetivo principal fue comparar los resultados del paciente con fractura de cuello de fémur fijada con tres tornillos en configuración triangular y en triángulo invertido en el plano frontal. Materiales y métodos: Estudio retrospectivo y comparativo de 53 pacientes con fractura de cuello femoral intervenidos entre 2015 y 2022 mediante fijación con tres tornillos canulados: 22 conformados en triángulo (grupo triángulo) y 31 en triángulo invertido (grupo triángulo invertido). Se evaluó la funcionalidad mediante la escala modificada de Merlé d’Aubigné, la capacidad para la deambulación con la escala de Koval, así como las complicaciones postoperatorias. Resultados: En la escala de Merlé d’Aubigné la puntuación media fue de 16,7 en el grupo triángulo y de 16,1 en el grupo triángulo invertido (p=0,259). En la escala de Koval se observó una disminución significativa, pasando de 1,6 de media preoperatoria a 2,2 tras la cirugía (p=0,000), no hallando diferencias entre grupos. Hubo seis complicaciones postoperatorias en el grupo triángulo y tres en el grupo triángulo invertido (p=0,140). Conclusión: La configuración de los tornillos en el cuello femoral, tanto en forma de triángulo como en triángulo invertido, no influyó en los resultados funcionales ni mecánicos de los pacientes con fractura de cuello de fémur fijada mediante tres tornillos canulados.(AU)

Background and objective: Synthesis with cannulated screws is one of the accepted methods in femoral neck fractures, although its optimal configuration is a subject in continuous debate. The main objective was to compare the results of the patient with a femoral neck fracture fixed with three screws in triangle and inverted triangle configuration in the frontal plane. Materials and methods: Retrospective and comparative study of 53 patients with femoral neck fracture, operated between 2015 and 2022 with fixation with three cannulated screws, 22 with a triangle configuration (triangle group) and 31 in an inverted triangle (inverted triangle group). Functionality was evaluated using the modified Merlé d’Aubigné scale, walking ability using the Koval scale, as well as postoperative complications. Results: On the Merlé d’Aubigné scale, the mean score was 16.7 in the triangle group and 16.1 in the inverted triangle group (P=.259). On the Koval scale, a significant decrease was observed, going from 1.6 preoperative mean to 2.2 after surgery (P=.000), finding no differences between groups. There were six postoperative complications in the triangle group and three in the inverted triangle group (P=.140). Conclusion: The configuration of the screws in the femoral neck, both in the form of a triangle and an inverted triangle, did not influence the functional or mechanical outcomes of the patients with a femoral neck fracture fixed with three cannulated screws.(AU)

The configuration of the screws in the osteosynthesis of fractures of the femoral neck does not influence the functional or mechanical outcomes. / La configuración de los tornillos en la osteosíntesis de las fracturas del cuello femoral no influye en los resultados funcionales ni mecánicos.

BACKGROUND AND OBJECTIVE: Synthesis with cannulated screws is one of the accepted methods in femoral neck fractures, although its optimal configuration is a subject in continuous debate. The main objective was to compare the results of the patient with a femoral neck fracture fixed with three screws in triangle and inverted triangle configuration in the frontal plane. MATERIALS AND METHODS: Retrospective and comparative study of 53 patients with femoral neck fracture, operated between 2015 and 2022 with fixation with three cannulated screws, 22 with a triangle configuration (triangle group) and 31 in an inverted triangle (inverted triangle group). Functionality was evaluated using the modified Merlé d'Aubigné scale, walking ability using the Koval scale, as well as postoperative complications. RESULTS: On the Merlé d'Aubigné scale, the mean score was 16.7 in the triangle group and 16.1 in the inverted triangle group (P=.259). On the Koval scale, a significant decrease was observed, going from 1.6 preoperative mean to 2.2 after surgery (P=.000), finding no differences between groups. There were six postoperative complications in the triangle group and three in the inverted triangle group (P=.140). CONCLUSION: The configuration of the screws in the femoral neck, both in the form of a triangle and an inverted triangle, did not influence the functional or mechanical outcomes of the patients with a femoral neck fracture fixed with three cannulated screws.

[Translated article] The configuration of the screws in the osteosynthesis of fractures of the femoral neck does not influence the functional or mechanical outcomes.

BACKGROUND AND OBJECTIVE: Synthesis with cannulated screws is one of the accepted methods in femoral neck fractures, although its optimal configuration is a subject in continuous debate. The main objective was to compare the results of the patient with a femoral neck fracture fixed with three screws in triangle and inverted triangle configuration in the frontal plane. MATERIALS AND METHODS: Retrospective and comparative study of 53 patients with femoral neck fracture, operated between 2015 and 2022 with fixation with three cannulated screws, 22 with a triangle configuration (triangle group) and 31 in an inverted triangle (inverted triangle group). Functionality was evaluated using the modified Merlé d'Aubigné scale, walking ability using the Koval scale, as well as postoperative complications. RESULTS: On the Merlé d'Aubigné scale, the mean score was 16.7 in the triangle group and 16.1 in the inverted triangle group (p=.259). On the Koval scale, a significant decrease was observed, going from 1.6 preoperative mean to 2.2 after surgery (p=.000), finding no differences between groups. There were six postoperative complications in the triangle group and three in the inverted triangle group (p=.140). CONCLUSION: The configuration of the screws in the femoral neck, both in the form of a triangle and an inverted triangle, did not influence the functional or mechanical outcomes of the patients with a femoral neck fracture fixed with three cannulated screws.

Hiperactividad paroxística simpática secundaria a una encefalitis herpética / Paroxysmal sympathetic hyperactivity after herpetic encephalitis

INTRODUCCIÓN: La hiperactividad simpática paroxística (HSP) es un síndrome caracterizado por episodios repetidos de aumento de actividad simpática (taquicardia, taquipnea, hipertensión arterial, fiebre, sudoración) y actividad motora (distonía, hiperextensión) en pacientes con un daño cerebral adquirido. CASO CLÍNICO: Presentamos el caso de un lactante con HSP secundaria a una encefalitis aguda por el virus del herpes simple tipo 1. CONCLUSIÓN: La HSP es una entidad infradiagnosticada, cuyo tratamiento, basado en la combinación de fármacos, debe ser precoz para evitar comorbilidades y mejorar su pronóstico

INTRODUCTION: Paroxysmal sympathetic hyperactivity (PSH), previously known as dysautonomia or sympathetic storming, is a syndrome characterized by repeated episodes of increases in sympathetic activity (tachycardia, tachypnoea, hypertension, fever and sweating) and motor activity (dystonia, hyperextension) in patients with an acquired brain injury. CASE REPORT: We present the case of a toddler with PSH after acute encephalitis by herpes simplex virus 1. CONCLUSIONS: The PSH is an underdiagnosed entity whose treatment, based on the combination of different drugs, must be premature to avoid comorbidities and to improve its prognosis

Colestasis postinfección por virus de Epstein-Barr sin elevaciónde gamma glutamil transpeptidasa / Post-infection cholestasis due to Epstein-Barr virus infection without elevation of gamma glutamyl transpeptidase

El virus de Epstein-Barr es el agente responsable de la mayoría de los casos de mononucleosis infecciosa, síndrome linfoproliferativo que suele ser benigno y autolimitado, aunque puede acompañarse en ocasiones de complicaciones neurológicas, respiratorias o hematológicas. A la sintomatología clínica habitual, caracterizada por fiebre, malestar general, odinofagia y adenopatías generalizadas, es frecuente que se asocie una hepatopatía subclínica, caracterizada en el niño por un leve y transitorio aumento de las transaminasas. A diferencia del adulto, en el niño, la existencia de un síndrome colestásico es excepcional. Presentamos el caso clínico de una niña de 6 años que presenta una colestasis clínico-bioquímica en el curso de una infección aguda por el virus de Epstein-Barr, en la que destaca la normalidad de las cifras de gamma glutamil transpeptidasa durante toda la evolución de su proceso (AU)

The Epstein-Barr virus is the responsible agent for most of the cases of infectious mononucleosis, a lymphoproliferative syndrome that is generally benign and self-limited, although it may sometimes be accompanied by neurological, respiratory or hematological complications. Frequently, it is frequent to find that subclinical liver disease, characterized in the child by mild and transitory increase of transaminasesis associated to the usual clinical symptoms, characterized by fever, general malaise, odinophagia and generalized abnormal lymph nodes. On the contrary to the adult, the existence of a cholestatic syndrome in the child is rare. We present the case of a 6-year old girl who presented a clinical biochemical cholestasis during an acute infection due to Epstein-Barr virus in which the normality of the gamma glutamyl transpeptidase values during the entire course stands outs (AU)