COVID-19 pandemic in prisons in Spain: characteristics of cases and implemented control measures, March 2020-June 2022.

OBJECTIVES: Our aim was to describe the epidemiological characteristics of COVID-19 cases in prison inmates in Spain and the control measures implemented to response to this public health challenge. STUDY DESIGN: Retrospective observational study. METHODS: All COVID-19-confirmed cases reported to the Spanish information system in prisons between March 2020 and June 2022 were analyzed. Prevention plans and protocols established by penitentiary and health authorities were reviewed. Likewise, information on vaccines administered to prison inmates was described. RESULTS: A total of 8500 COVID-19 cases were reported to penitentiary public health surveillance. The overall cumulative incidence (CI) was 2054.18 cases per 10,000 inmate population. By epidemic periods, the average weekly CI was 1.15 per 10,000 inmate population during the first period, 6.91 during the second, 25.18 during the third, 3.53 during the fourth, 23.27 during the fifth, 34.72 during the sixth and 25.68 during the seventh period. The median age of cases was 49.2 years, 69.1% was born in Spain, 64.1% was asymptomatic and 16 cases died. Ninety-four percent were vaccinated. Control measures such as lockdown, suspending visitation rights and confining inmates in their cells were adopted at the beginning of the pandemic. These measures changed in accordance with the COVID-19 situation in the general population with a view to restoring the inmates' rights. CONCLUSION: The COVID-19 pandemic has had a moderate incidence in Spanish prisons. Hospitalization and CFR were lower than the general population. The control measures adopted against COVID-19 have contributed to preventing and controlling the number of cases in prisons.

Biomechanical Behavior of Dynamic vs. Static Distal Locking Intramedullary Nails in Subtrochanteric Femur Fractures.

OBJECTIVE: Hip fractures are one of the most frequent fractures presenting to the emergency department and orthopedic trauma teams. The aim of this study was to determine the best indication and therapeutic technique for subtrochanteric fractures and unifying criteria when choosing the most suitable type of nail. MATERIALS AND METHODS: To analyze the influence of the material and the type of distal locking of intramedullary nails (static or dynamic), a femur model with a fracture in the subtrochanteric region stabilized with a long Gamma intramedullary nail was applied using finite element method (FEM) simulation. RESULTS: The mechanical study shows that titanium nails allow for greater micromobility at the fracture site, which could act as a stimulus for the formation of callus and consolidation of the fracture. In the mechanical study, the type of distal locking mainly affects mobility at the fracture site and stress in the cortical bone around the distal screws, without in any case exceeding values that may compromise the viability of the assembly or that may result in detrimental effects (in terms of mobility at the fracture site) for the consolidation process. CONCLUSION: Subtrochanteric fractures treated with titanium nail and static distal locking is safe and does not hinder consolidation.

Surgical treatment of congenital pseudoarthrosis of the clavicle: Our 22-year, single-center experience.

OBJECTIVES: This study reports the surgical outcomes in a patient cohort with congenital pseudarthrosis of the clavicle (CPC). PATIENTS AND METHODS: A total of nine pediatric patients (5 males, 4 females; mean age: 4.43 years; range, 2 to 12 years) who were diagnosed with CPC and treated surgically with a minimum one-year follow-up between January 1996 and December 2018 were retrospectively analyzed. The patients were divided into two groups according to the fixation method as the Kirschner wire (K-wire; Group A, n=2) or stabilization with a plate (Group B, n=7). The physical function and symptoms were evaluated using the Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) scale. RESULTS: The mean age at the time of diagnosis was 2.95 (range, 0 to 12) years. Six cases were atrophic pseudarthrosis and three cases were hypertrophic. Radiographic consolidation occurred in all cases with a mean duration of 103.8±39.1 days, indicating no significant difference between the groups (p>0.05). Complications registered were a K-wire breakage in a patient in Group A and an internal fixation plate loosening in a patient in Group B. The mean postoperative follow-up was 2.98±1.82 years. The QuickDASH score was 0 points in all patients. CONCLUSION: The early surgical indication based on refreshment of the pseudarthrosis focus, with bone autograft interposition when a failure exists to restore adequate clavicular length, and fixation are reliable alternatives with favorable clinical and radiological results in the mid- and long-term with fewer complications.