[Long-term results of the treatment of Lisfranc fracture dislocation]. / Resultados a largo plazo del tratamiento de la fractura-luxación tipo Lisfranc.

We conducted an ambispective cohort study of 83 patients with a diagnosis of Lisfranc fracture dislocation from 1993 to 2008. The lesions were classified into two groups: pure dislocations and fracture dislocations of the Lisfranc joint using the Hardcastle-Reschamer classification. The results included the following data: sociodemographic and epidemiologic variables, lesion-related variables, clinical parameters, and the following clinical and functional assessment scales: Baltimore Painful Foot Score, Creighton-Nebraska Health Foundation, American Orthopaedic Foot and Ankle Society (AOFAS), and Hannover Scoring System. Sixty-three patients were treated surgically. Closed reduction and minimally invasive fixation with Kirschner nails were performed in 53 patients (63.9%), and open reduction with a dorsal approach and fixation with Kirschner nails in 10 cases (15.2%). In 46 cases de medial column was fixed, in 61 cases the intermediate column, and in 42 the lateral column. Sixty-six (79.5%) of the patients had complications including both acute and late ones. Regardless of the technique used, the purpose of treatment was the anatomical reduction of the involved joints. Based on our experience, we think that the use of Kirschner nails is effective, as it provides enough stiffness and stability. In general terms, this injury is not as disabling as it had been considered in the literature. Patients consider their discomfort as tolerable and compatible with the demands of their activities of daily living and they may perform their work considering the time limitations.

[Anterolateral ankle pain: differential diagnosis and approach. A case report]. / Dolor anterolateral de tobillo, diagnóstico diferencial y abordaje. Presentación de un caso.

The ankle soft tissue pathology represents a very painful disorder for patients who, often times, are not precisely diagnosed. Anterolateral ankle impingement is a condition that occurs in young people and athletes due to a plantar flexion-inversion mechanism. We report a case of anterolateral ankle impingement describing the arthroscopic technique and making the differential diagnosis considering other conditions.

Luxación intra-articular de rótula / Intraarticular dislocation of patella

Se presenta el caso de una paciente de 75 años de edad que, tras caída sobre rodilla, sufrió una luxación intraarticular de rótula. La luxación presentó una incarceración del polo proximal rotuliano en el surco intercondíleo femoral. Se realizó una reducción abierta bajo anestesia comprobando la integridad del aparato extensor. Tras dos semanas de inmovilización reinició movilidad sin recidiva ni otro tipo de complicaciones (AU)

The case of a patient aged 75 years who,following a fall,suffered an acute intraarticular dislocation in the knee is presented. This dislocation presented incarceration of the proximal kneecap pole in the femoral intercondylar groove. An open reduction was carried out under general anaesthetic . This surgical check ruled out associated lesions to the extensor apparatus. Following two weeks of immobilisation the patient restarted mobility without relapse or other type of complication (AU)

[Benefit of the stabilization of long-bone fractures in polytraumatized patients]. / Beneficio de la estabilización de fracturas de huesos largos en politraumatizados.

INTRODUCTION: Early fracture fixation is increasingly common in medical practice, and femur shaft fractures are the perfect prototype of the lesion warranting early surgery in polytraumatized patients. Damage control orthopedics (DCO) is defined as the minimally-traumatic interventions intended to provide quick stabilization of orthopedic injuries to minimize the systemic inflammatory response. MATERIAL AND METHODS: By means of an evidence-based medicine tool (CAT) we approach the benefit of long-bone fracture stabilization in polytraumatized patients trying to answer a specific clinical question from a concrete situation: What is the evidence of the safety and benefit of early stabilization of long-bone fractures in polytraumatized patients? RESULTS: The patient group whose fractures were stabilized after 48 hours had more clinical complications, alterations of lung parameters and a longer hospital stay. There is no complete evidence showing that early stabilization of long bones in patients with moderate or severe head trauma worsens or improves the outcomes. CONCLUSIONS: Urgent fracture stabilization should be an adjuvant to resuscitation. Early fracture stabilization contributes to reducing the ICU stay, the incidence of acute respiratory distress syndrome (ARDS), multiple organ failure (MOF) and sepsis, thus improving patient survival.

Dolor anterolateral de tobillo: diagnóstico diferencial y abordaje terapéutico / Anterolateral ankle pain: differential diagnosis and therapeutic approach

La patología de partes blandas del tobillo supone trastornos muy dolorosos para los pacientes que en muchas ocasiones carecen de diagnóstico preciso. El pinzamiento anterolateral de tobillo es una patología que aparece en gente joven y deportistas por mecanismo de flexión plantar-inversión. Se presenta un caso de pinzamiento anterolateral de tobillo, describiendo la técnica artroscópica y planteando el diagnóstico diferencial con otras patologías (AU)

Diseases of the ankle soft tissues are very painful disorders for patients for whom many times there is no accurate diagnosis. Anterolateral ankle impingement is a condition occurring in young people and athletes for plantar-inversion flexion mechanism. We report the case of anterolateral ankle impingement with a description of the arthroscopic technique and considering the differential diagnosis with other diseases (AU)

Core decompression and arthroscopic bone grafting for avascular necrosis of the knee.

We report a case of spontaneous avascular necrosis of the knee successfully treated with core decompression and arthroscopic bone grafting with a bone plug of autogenous graft obtained from the iliac crest. A 2-year follow-up shows excellent clinical and magnetic resonance imaging results.