Minimally invasive approach in radio distal end fractures, three different types of incisions.

Two techniques are described to treat distal radius fractures: conventional (Henry approach) and minimally invasive plate osteosynthesis. The latter technique has been described by different authors such as Imatani et al. and Zenke et al. This was a descriptive retrospective study, analyzing 26 adult patients with unstable distal radius fracture, extra-articular type A or partially intra-articular type B according to AO. The approaches used were: (i) single longitudinal palmar incision; (ii) double T-incision (horizontal and vertical) and (iii) double position II. Ages were between 21 and 78 years. Most affected hand was the right. Most common fracture was 23B2 (AO classification). In total, 84.6% of the patients did not present complications. According to the functional evaluation of the wrist by the Mayo Clinic, 31% showed excellent results, 42% showed good results, 27% showed fair results. The techniques had satisfactory results for the osteosynthesis with more aesthetic and less invasive approach.

First Study of the Prevalence and Characterization of Brachial Plexus Injuries in Guatemala.

Objective This study aimed to estimate the prevalence of brachial plexus injuries and to characterize clinically and epidemiologically patients with brachial plexus injury. Materials and Methods In this cross-sectional descriptive study, 2,923 medical records of patients aged 1 to 64 years who presented at outpatient peripheral nerve unit of the Orthopedic Surgery Department of Hospital Roosevelt, Guatemala, from January 2017 to December 2017, were prospectively analyzed to identify the prevalence and factors associated with brachial plexus injuries. Results The prevalence rate of brachial plexus injuries in patients was 5.74%. This injury is more common in men (90.5%) aged 24 to 64 years. Brachial plexus injuries occurred secondary to motorcycle accident in 72% of the cases, with the majority affecting the dominant upper extremity. In addition, 64.28% of the patients took 1 to 6 months to seek consultation, whereas only 16.07% requested medical assistance <1 month from the onset of symptoms, and this result was associated with early diagnosis and adequate recovery during follow-up. Furthermore, 66.67% presented upper brachial plexus injury with no associated fractures or vascular injury, manifesting distress while performing daily activities that required hand, arm, and elbow movements. Conclusion The risk of suffering BPIs in Guatemala increases in economically active male patients that use motorcycles as main mode of transportation. Patients should consult immediately after injury onset to optimize management results. For this reason, hospitals must develop specialized clinical guidelines to speed up the identification and treatment of BPI injuries.

Functional outcome after hand replantation in Guatemala.

Amputations of a traumatic origin are very frequent in developing countries, in the case of Guatemala these are a result of work accidents very closely related to poor work conditions existing for manual workers, as well as social violence and the lack of security that governs society. The present case shows a patient that suffered a left hand amputation at wrist level. Amputated hand was transported swiftly and in adequate conditions, maintaining cold chain at all times until arrival at Hospital for replantation. After 14 months, patient has evolved satisfactorily and obtained functional result of the hand.