[Translated article] Type III acromioclavicular dislocation: Mid term results after operative and non-operative treatment.

INTRODUCTION: Controversy exists in the literature about the best treatment for type III acromioclavicular dislocations. The aim of this study is to compare functional results between surgical and conservative treatment in type III acromioclavicular joint dislocations. MATERIAL AND METHOD: We retrospectively evaluated the records of 30 patients from our area with acute type III acromioclavicular dislocations that were treated from January 1st, 2016 to December 31st, 2020. Fifteen patients were treated surgically and 15 conservatively. Follow-up mean time was 37.93 months in operative group and 35.73 months in non-operative group. Results obtained on the Constant score was the main variable analysed and results obtained on the Oxford score and the Visual Analogue Scale for pain were the secondary variables. Epidemiological variables were analysed, as well as range of mobility in injured shoulder and subjective and radiological variables (distance between the superior border of the acromion and the superior border of the clavicle's distal end and presence of osteoarthritis in the acromioclavicular joint). RESULTS: Functional evaluation scores did not show differences between the two groups (Constant: operative 82/non-operative 86.38, p 0.412; Oxford: operative 42/non-operative 44.80, p 0.126) nor did Visual Analogue Scale (operative 1/non-operative 0.20, p 0.345). Subjective evaluation of the injured shoulder was excellent or good in 80% of the patients in both groups. Measurement of the distance between the superior border of the acromion and the superior border of the clavicle's distal end were significantly higher in non-operative group (operative 8.95/non-operative 14.21, p 0.008). CONCLUSIONS: Although radiographic results were better in the surgical treatment group, functional evaluation scores did not show significant differences between the two groups. These results do not support the routine use of surgical treatment for grade III acromioclavicular dislocations.

Type III acromioclavicular dislocation: Mid term results after operative and non-operative treatment. / Luxación acromioclavicular grado III. Resultados a medio plazo tras tratamiento conservador y quirúrgico.

INTRODUCTION: Controversy exists in the literature about the best treatment for type III acromioclavicular dislocations. The aim of this study is to compare functional results between surgical and conservative treatment in type III acromioclavicular joint dislocations. MATERIAL AND METHOD: We retrospectively evaluated the records of 30 patients from our area with acute type III acromioclavicular dislocations that were treated from January 1st, 2016 to December 31st, 2020. Fifteen patients were treated surgically and 15 conservatively. Follow up mean time was 37.93 months in operative group and 35.73 months in non-operative group. Results obtained on the Constant score was the main variable analysed and results obtained on the Oxford score and the Visual Analogue Scale for pain were the secondary variables. Epidemiological variables were analysed, as well as range of mobility in injured shoulder and subjective and radiological variables (distance between the superior border of the acromion and the superior border of the clavicle's distal end and presence of osteoarthritis in the acromioclavicular joint). RESULTS: Functional evaluation scores did not show differences between the two groups (Constant: operative 82/non-operative 86.38, p 0.412; Oxford: operative 42/non-operative 44.80, p 0.126) nor did Visual Analogue Scale (operative 1/non-operative 0.20, p 0.345). Subjective evaluation of the injured shoulder was excellent or good in 80% of the patients in both groups. Measurement of the distance between the superior border of the acromion and the superior border of the clavicle's distal end were significantly higher in non-operative group (operative 8.95/non-operative 14.21, p 0.008). CONCLUSIONS: Although radiographic results were better in the surgical treatment group, functional evaluation scores did not show significant differences between the two groups. These results do not support the routine use of surgical treatment for grade III acromioclavicular dislocations.

Estudio epidemiológico de las fracturas de la extremidad distal de radio en el área sanitaria de Vigo / Epidemiological study of distal radius fractures in the sanitary area of Vigo

Introducción: Las fracturas de la extremidad distal de radio (FEDR) representan una carga cada vez mayor para los recursos sanitarios debido a los cambios demográficos de la población y a las estrategias de gestión, por lo que la comprensión precisa de su epidemiología es esencial. Presentamos un estudio epidemiológico de FEDR y lo comparamos con otras áreas de la península y Europa. Método: Se recogieron todas las FEDR de nuestra área sanitaria registradas en 2017 y 2018 en pacientes mayores de 18años de forma retrospectiva y observacional agrupándolos según la clasificación de AO-OTA. Se analizaron las variables de edad, sexo, época del año, mecanismo de fractura, presencia de lesiones asociadas y tratamiento realizado. Resultados: Registramos 1.121 FEDR en 1.108 pacientes, 903 mujeres (81,5%) y 205 varones (18,5%). En 612 casos se vio afectado el lado izquierdo (54,6%) y en 509 el lado derecho (45,4%). La edad media de la muestra fue de 65,9años (IC95%: 65-66,9años). La tasa de incidencia de FEDR fue de 158,5 fracturas por 100.000 habitantes/año. El 49,2% se clasificaron como tipo A de AO-OTA y se intervinieron quirúrgicamente un 19%. Conclusión: La incidencia de FEDR alcanza un máximo en la sexta década tanto en hombres como en mujeres. Las fracturas de tipo A de la clasificación AO-OTA son las más frecuentes. La mayoría se trataron de forma conservadora. El patrón de paciente tratado quirúrgicamente con más frecuencia es el de una mujer mayor de 50años con FEDR articular compleja.(AU)

Introduction: Distal radius fractures (DRF) are being a bigger burden for health resources as changes continue to happen in our population demography and in management strategies, so a precise epidemiologic comprehension is mandatory. We present a DRF epidemiology study and we compared it with other sanitary areas of the Iberian Peninsula and Europe. Method: Every DRF in our sanitary area registered between 2017 and 2018 in patients older than 18 years old were observational and retrospectively recorded and classified using AO-OTA classification. Age, sex, season of the year, mechanism of injury, presence of associated injuries and type of treatment were analysed. Results: 1,121 DRF in 1,108 patients, 903 women (81.5%) and 205 men (18.5%), were registered. Left side was affected in 612 cases (54.6%) and right side in 509 cases (45.4%). The average age of our sample was 65.9 years old (CI95%: 65-67.9 years old). The incidence rate of DRF in our population was 158.5 fractures per 100,000 people-year; 49.2% were classified as type A of AO-OTA classification and 19% were treated surgically. Conclusion: Incidence of DRF had a maximum during males and women sixth decade of age. Type A fractures of AO-OTA classification were the most frequent. Most part of the fractures were treated non-surgically. The usual patient treated surgically was a woman, over 50 years old with a distal radius intraarticular complex fracture.(AU)

Epidemiological study of distal radius fractures in the sanitary area of Vigo / Estudio epidemiológico de las fracturas de la extremidad distal de radio en el área sanitaria de Vigo

Introduction: Distal radius fractures (DRF) are being a bigger burden for health resources as changes continue to happen in our population demography and in management strategies, so a precise epidemiologic comprehension is mandatory. We present a DRF epidemiology study and we compared it with other sanitary areas of the Iberian Peninsula and Europe. Method: Every DRF in our sanitary area registered between 2017 and 2018 in patients older than 18 years old were observational and retrospectively recorded and classified using AO-OTA classification. Age, sex, season of the year, mechanism of injury, presence of associated injuries and type of treatment were analysed. Results: 1,121 DRF in 1,108 patients, 903 women (81.5%) and 205 men (18.5%), were registered. Left side was affected in 612 cases (54.6%) and right side in 509 cases (45.4%). The average age of our sample was 65.9 years old (CI95%: 65-67.9 years old). The incidence rate of DRF in our population was 158.5 fractures per 100,000 people-year; 49.2% were classified as type A of AO-OTA classification and 19% were treated surgically. Conclusion: Incidence of DRF had a maximum during males and women sixth decade of age. Type A fractures of AO-OTA classification were the most frequent. Most part of the fractures were treated non-surgically. The usual patient treated surgically was a woman, over 50 years old with a distal radius intraarticular complex fracture.(AU)

Introducción: Las fracturas de la extremidad distal de radio (FEDR) representan una carga cada vez mayor para los recursos sanitarios debido a los cambios demográficos de la población y a las estrategias de gestión, por lo que la comprensión precisa de su epidemiología es esencial. Presentamos un estudio epidemiológico de FEDR y lo comparamos con otras áreas de la península y Europa. Método: Se recogieron todas las FEDR de nuestra área sanitaria registradas en 2017 y 2018 en pacientes mayores de 18años de forma retrospectiva y observacional agrupándolos según la clasificación de AO-OTA. Se analizaron las variables de edad, sexo, época del año, mecanismo de fractura, presencia de lesiones asociadas y tratamiento realizado. Resultados: Registramos 1.121 FEDR en 1.108 pacientes, 903 mujeres (81,5%) y 205 varones (18,5%). En 612 casos se vio afectado el lado izquierdo (54,6%) y en 509 el lado derecho (45,4%). La edad media de la muestra fue de 65,9años (IC95%: 65-66,9años). La tasa de incidencia de FEDR fue de 158,5 fracturas por 100.000 habitantes/año. El 49,2% se clasificaron como tipo A de AO-OTA y se intervinieron quirúrgicamente un 19%. Conclusión: La incidencia de FEDR alcanza un máximo en la sexta década tanto en hombres como en mujeres. Las fracturas de tipo A de la clasificación AO-OTA son las más frecuentes. La mayoría se trataron de forma conservadora. El patrón de paciente tratado quirúrgicamente con más frecuencia es el de una mujer mayor de 50años con FEDR articular compleja.(AU)

Epidemiological study of distal radius fractures in the sanitary area of Vigo. / Estudio epidemiológico de las fracturas de la extremidad distal de radio en el área sanitaria de Vigo.

INTRODUCTION: Distal radius fractures (DRF) are being a bigger burden for health resources as changes continue to happen in our population demography and in management strategies, so a precise epidemiologic comprehension is mandatory. We present a DRF epidemiology study and we compared it with other sanitary areas of the Iberian Peninsula and Europe. METHOD: Every DRF in our sanitary area registered between 2017 and 2018 in patients older than 18 years old were observational and retrospectively recorded and classified using AO-OTA classification. Age, sex, season of the year, mechanism of injury, presence of associated injuries and type of treatment were analysed. RESULTS: 1,121 DRF in 1,108 patients, 903 women (81.5%) and 205 men (18.5%), were registered. Left side was affected in 612 cases (54.6%) and right side in 509 cases (45.4%). The average age of our sample was 65.9 years old (CI95%: 65-67.9 years old). The incidence rate of DRF in our population was 158.5 fractures per 100,000 people-year; 49.2% were classified as type A of AO-OTA classification and 19% were treated surgically. CONCLUSION: Incidence of DRF had a maximum during males and women sixth decade of age. Type A fractures of AO-OTA classification were the most frequent. Most part of the fractures were treated non-surgically. The usual patient treated surgically was a woman, over 50 years old with a distal radius intraarticular complex fracture.