Caracterización epidemiológica de pacientes operados por fractura de escápula en Hospital Traumatológico de Concepción durante los años 2019-2022 / Epidemiological characteristics of patients operated for scapular fracture at Hospital Traumatologico de Concepción during the years 2019-2022

Introducción: Las fracturas de escápula tienen una baja frecuencia, se presentan mayoritariamente en población joven tras traumatismos de alta energía. Su tratamiento historicamente ha sido conservador, sin embargo, el tratamiento quirúrgico ha demostrado mejores resultados funcionales en pacientes seleccionados, siendo la indicación quirúrgica aún controversial. La literatura sobre los pacientes tratados de forma quirúrgica es escasa. Objetico general: Caracterizar a los pacientes operados por fractura de escapula en Hospital Traumatológico de Concepción durante los años 2019-2022. Materiales y métodos: Estudio descriptivo que incluye a pacientes operados por fractura de escápula en el Hospital Traumatológico de Concepción durante los años 2019 al 2022, considerando las variables sexo, edad, lateralidad, mecanismo de lesión y lesiones asociadas. Resultados: Se estudiaron 20 pacientes de los cuales 90% fueron hombres, registrándose un promedio de edad de 41 años, sin diferencias significativas en su lateralidad. Los principales mecanismos de lesión fueron accidentes de tránsito y caídas de altura, existiendo lesiones asociadas sólo en 45% de los casos. Conclusión: Las fracturas de escápula tienen alto impacto en la funcionalidad de la extremidad afectada, por lo que su tratamiento hoy en día esta evolucionando hacia uno quirúrgico en pacientes seleccionados, con el fin de obtener mejores resultados funcionales. Los pacientes operados son mayoritariamente adultos de edad media de sexo masculino, con fracturas secundarias a traumatismos de alta energía y presencia de lesiones asociadas de baja morbimortalidad.

Introduction: Scapula fractures have a low frequency. They occur mainly in the young population after high-energy trauma. Its treatment has historically been conservative; however, surgical treatment has shown better functional results in selected patients, the surgical indication being still controversial. The literature on patients treated surgically is scarce. General Objective: Characterize the patients operated on for scapular fracture at the Hospital Traumatológico de Concepción during the years 2019-2022. Materials and methods: Descriptive study that includes patients operated on for scapula fracture at the Concepción Trauma Hospital during the years 2019 to 2022, considering the variables sex, age, laterality, mechanism of injury and associated injuries. Results: Twenty patients were studied, of whom 90% were men, recording an average age of 41 years, with right scapula fracture being slightly more frequent than left. The main mechanisms of injury were traffic accidents and falls from a height, with associated injuries only in 45% of the cases. Conclusion: Scapula fractures have a high impact on the functionality of the affected limb, so their treatment today is evolving towards surgery in selected patients, in order to obtain better functional results. The patients operated on are mostly middle-aged male adults, with fractures secondary to high-energy trauma and the presence of associated lesions with low morbidity and mortality.

Reverse Allograft-Prosthesis Composite with Pectoralis Major Transfer After Shoulder Osteosarcoma: A Case Report.

CASE REPORT: We present a case of a 30-year-old man with proximal humerus osteosarcoma and periarticular soft-tissue involvement. Severe humeral and glenoid bone loss was observed, with nonfunctional deltoid after limb-sparing resection and a failed attempt of stabilization. The shoulder was reconstructed using a reverse allograft-prosthesis composite, with deltoid reconstruction by pectoralis major transfer. CONCLUSIONS: To the best of our knowledge, this is the first time that this reconstruction technique has been reported in an oncological patient. Favorable clinical and radiological results were achieved at the 24-month follow-up.

Patellar calcar: morphometric analysis by knee magnetic resonance imaging and three-dimensional reconstruction software-assisted.

PURPOSE: Patellar calcar corresponds to a greater trabecular bone density area in the patella lateral facet, whose morphometry is uncertain. This study aimed to describe patellar calcar morphometry by knee MRI and develop a 3D reconstruction software-assisted. MATERIALS AND METHODS: Consecutive adult patients, submitted to knee MRI, between 2014 and 2017, were entered in IMPAX software. Exclusion criteria are history of patellar surgical intervention, trauma, chondromalacia, bone edema or bipartite patella. All MRI images were retrospectively reviewed by three readers. MRI patellar calcar measurements are height, width, thickness and posterior distance. 3D model protocol reconstruction: 3D Slicer software was used to design a preliminary model for each patient, and then all were automatically merged into one, which was finalized using the software segmentation tools. For 3D patellar calcar location, the transpolar axis was designed. RESULTS: 250 MRI were analyzed, patellar calcar was present in 208 (83.2%); 101 men and 107 women. Mean age was 44.3 ± 15.6 years. MEASUREMENTS: height 13.84 ± 2.42 mm (male: 14.50 ± 2.42; female: 13.21 ± 2.26) (p < 0.0001), width 12.21 ± 2.26 mm (male 13.14 ± 2.22; female 11.33 ± 1.93) (p < 0.0001). No statistically significant difference of thickness 0.56 ± 0.22 mm (male: 0.56 ± 0.25; female: 0.56 ± 0.20) and posterior distance 2.37 ± 0.80 mm (male: 2.46 ± 0.89; female: 2.29 ± 0.69) between genders was found. 3D model results: transpolar axis went through the patellar calcar in all the cases. CONCLUSIONS: This study shows in a 3D model reconstruction, what was previously described in the literature, determining for the first time the patellar calcar morphometry in the knee MRI and identifying it as a regular finding in this imaging test.