Acute Osteomyelitis of the Pubic Symphysis: A Case Report.

Pubis osteomyelitis is an uncommon disease, accounting for less than 1% of all bone infections. It occurs secondarily to hematogenous bacterial planting or direct inoculation. Clinically, it presents with intense acute pubic pain, limited mobility, and high fever, so it is rarely suspected initially. Its diagnosis can be easily confused with pubalgia, that do not respond to treatment. We present the case of a 17-year-old patient who sought consultation for three weeks of coxalgia associated with general discomfort and fever. Following a laboratory and imageological study, the diagnosis of acute pubis osteomyelitis was determined, which required surgical intervention and a subsequent pharmacological therapy for six weeks.

Fractura de cuello femoral en trauma de alta energía: ¿podemos confiar en la tomografía computarizada multicorte? caso clínico / High energy femoral neck fracture: can we trust the computerized tomography scan? case report

Las fracturas asociadas de diáfisis y cuello femoral son lesiones infrecuentes. A pesar de ser una asociación conocida, es pasada por alto entre un 19-31% de las veces. A continuación presentamos un caso de una fractura de diáfisis femoral en la cual la tomografía computarizada inicial no evidenció ningún rasgo a nivel del cuello femoral; sin embargo, este rasgo se hizo presente en las imágenes de control. Existen diversos exámenes para reconocer las fracturas de cuello femoral asociadas a diáfisis femoral, como la radiografía y la tomografía computarizada. Sin embargo, a pesar de estas imágenes, pueden no ser diagnosticadas. Con este caso reafirmamos la necesidad del uso de imágenes preoperatorias e intraoperatorias en pacientes con fracturas de diáfisis femoral de alta energía y que la tomografía computarizada multicorte de ingreso puede no evidenciar fracturas mínimamente desplazadas del cuello femoral.

Simultaneous fractures of the neck and shaft of the femur are uncommon injuries. Despite it being a known combination, it is overlooked in between 19 and 31% of cases. This case report describes a femoral shaft fracture in which the initial computed tomography did not show the femoral neck fracture, although it was present in the follow-up images. There are different imaging techniques to recognise femoral neck fractures associated with femoral shaft fractures, such as radiography and computed tomography. However, despite these images, they cannot be diagnosed. This case re-affirms the need for using imaging techniques before and during the operation in patients presenting with high energy femoral shaft fractures, in order to look for an associated femoral neck fracture. Although the use of fine-cut computed tomography scan may improve the diagnostic accuracy of this test, some femoral neck fractures will still go under-diagnosed.

Epidemiología del trauma ocular en el Hospital Clínico Regional de Concepción / Epidemiology of ocular trauma at the Hospital Clínico Regional de Concepción

Objetivo: Analizar epidemiología del trauma ocular. Materiales y método: Estudio descriptivo retrospectivo de hospitalizaciones por trauma ocular en Hospital Regional de Concepción entre 2004 y 2005 según clasificación BETT. Resultados: De 12.280 urgencias oftalmológicas realizadas, 153 (1,2 por ciento) requirieron hospitalización. 85 por ciento fueron varones y 80 por ciento menores de 40 años. El lugar del trauma fue el hogar (30,4 por ciento) y trabajo (29,6 por ciento). El 54 por ciento fue trauma cerrado (contusión: 34 por ciento) y el 46 por ciento abierto (penetrante 22 por ciento, CEIO: 11 por ciento), resultando en amaurosis 83 por ciento de heridas perforantes y 81,8 por ciento de roturas oculares. Egresaron 410 pacientes de otros servicios con códigos asociados a trauma ocular como: trauma oculorbitario (55 por ciento), fractura de órbita (19,2 por ciento), cuerpo extraño (10 por ciento), herida palpebral (9 por ciento) entre otros. La incidencia de hospitalización por trauma ocular fue 33,2 casos/100.000 habitantes/año. Conclusiones: El trauma ocular afecta a hombres jóvenes laboralmente activos. Su impacto social-laboral hace necesaria la prevención y educación. La clasificación BETT es necesaria para estandarizar trabajos.

Objective: To analyze epidemiology of ocular trauma. Materials and methods: Retrospective descriptive study of hospitalizations secondary to ocular trauma in Regional Hospital of Conception between 2004 and 2005 according to classification BETT. Results: Out of 12,280 ophthalmologic urgencies, 153 (1.2 percent) required hospitalization. 85 percent were men and 80 percent were 40 years old or less. The place where the trauma occured was home (30.4 percent) and work (29.6 percent). 54 percent were closed ocular trauma (contusion: 34 percent) and 46 percent open ocular trauma (penetrating 22 percent, IOFB: 11 percent), amaurosis was a consecuence in 83 percent of perforating wounds and 81.8 percent of ocular breakage. 410 patients withdrew from other clinical services with associated codes to ocular trauma like: orbit-ocular trauma (55 percent), orbit fractures (19.2 percent), ocular foreign body (10 percent), palpebral wound (9 percent) among others. The incidence of hospitalization by ocular trauma was 33.2 cases/100.000 inhabitants/year. Conclusions: The ocular trauma affects working active young men. Its social-labor impact makes the prevention and education necessary. BETT classification is necessary to standardize studies.

Arthroscopic reduction and percutaneous fixation of a radial neck fracture in a child.

Radial neck fractures are frequent lesions in the developing elbow. For important angular displacement higher than 60 degrees, there are several alternative treatments. We present an unpublished technique of reduction with arthroscopic assistance and percutaneous stabilization that allows one to perform direct pressure to the radial head, better intra-articular evaluation, reduction control, with minimal soft tissue lesion, and reduce the need for intraoperative fluoroscopy.