Transferencia tendinosa del tibial posterior en pie caído por lesión del nervio peroneo común / Tendon transfer of the posterior tibial in fallen foot due to lesion of the common peroneal nerve i:en

Se describe el caso clínico de un paciente de 34 años de edad, con antecedente de salud, atendido en la consulta intermunicipal de II Frente, provincia de Santiago de Cuba, por presentar, desde hacía 8 meses, una lesión en el nervio peroneo común, en la cara lateral del tercio superior de la pierna derecha, a causa de una mordida de cerdo, la cual no fue diagnosticada inicialmente, sino que se trató como una herida sin lesión neurológica. Se realizó proceder quirúrgico, consistente en una transposición tendinosa del músculo tibial posterior. Se inmovilizó el pie con una férula de yeso por 15 días, se le retiró la sutura a las 6 semanas y se indicó rehabilitación. A las 12 semanas comenzó a caminar sin dificultad y logró reincorporarse a sus actividades cotidianas.

The case report of a 34 years patient with health history is described. He was assisted in the intermunicipal visit of II Frente, province of Santiago de Cuba, due to a lesion in the common peroneal nerve during 8 months, in the lateral face of the superior third of the right leg, because of a pig bite, which was not diagnosed initially, but instead it was treated as a wound without neurological lesion. A surgical procedure was carried out, with a tendon transposition of the posterior tibial muscle. The foot was immobilized with a plaster splint for 15 days, the suture was removed 6 weeks later and rehabilitation was indicated. Twelve weeks later he began to walk without difficulty and he was able to return to his daily activities.

Lesión del nervio mediano por cuerpo extraño metálico en un adulto joven / Lesion of the median nerve due to metallic strange body in a young adult

Se describe el caso clínico de un paciente de 36 años de edad, quien acudió a la consulta de Ortopedia y Traumatología del Hospital General Docente Dr. Juan Bruno Zayas Alfonso de Santiago de Cuba, con un alambrón oxidado, encarnado en la cara palmar de la muñeca derecha, con parestesias en la zona de inervación del nervio mediano. La radiografía reveló que dentro de las estructuras de la muñeca había 10 cm del alambrón, con la porción distal doblada en forma de gancho, por lo cual se le realizó intervención quirúrgica de urgencia. Se utilizó anestesia regional, sedación e isquemia y se extrajo el cuerpo extraño en sentido contrario a la curvatura que presentaba. Luego de pasar el efecto anestésico persistían las parestesias en el pulpejo del índice, que desaparecieron completamente a los 4 meses del accidente. Se incorporó a sus labores habituales a los 2 meses de operado.

The case report of a 36 years patient is described. He went to the Orthopedics and Traumatology Service of Dr. Juan Bruno Zayas Alfonso Teaching General Hospital in Santiago de Cuba, with a rusty big wire, ingrowing in the right wrist palmar face, with paresthesias in the innervation area of the median nerve. The x-ray revealed that inside the wrist structures there was 10 cm of the big wire, with the distal portion bent in hook form, reason why an emergency surgical intervention was carried out. Regional anesthesia, sedation and ischemia were used and the strange body was removed in sense contrary to the bend that presented. After the anesthetic effect eased the paresthesias of the index finger tip persisted that disappeared completely 4 months after the accident. He went back to his usual works 2 months after the operation.

Estabilizador Endodóntico en Fractura Complicada de Raíz en visita única / Endodontic Stabilizer in Complicated Root Fracture in a single visit

Introducción: La fractura complicada de raíz del tercio medio es una entidad compleja de pronóstico mayormente desfavorable y curso sintomático, donde el éxito clínico en no pocas oportunidades se convierte en una utopía, dado que la estabilidad en el afrontamiento de los bordes libres de los fragmentos fracturados es difícil de lograr. En este sentido el estabilizador edodóntico busca garantizar un anclaje bilateral satisfactorio, que posibilite unificar en una consulta los tiempos operatorios necesarios para un tratamiento exitoso. Objetivo: Describir la factibilidad del uso de un estabilizador endodóntico en el manejo de una fractura complicada de raíz del tercio medio en una visita. Presentación del caso: Paciente de 60 años, femenina que acude a consulta tras sufrir traumatismo dentoalveolar consistente con fractura complicada de raíz del tercio medio en 21; a los rayos X se observa ligero ensanchamiento periodontal y bordes discontinuos. Se realiza tratamiento edodóntico radical mediante la aplicación de un estabilizador intraconducto en la reducción de la fractura. Conclusiones: El uso de un estabilizador endodóntico en el manejo de una fractura complicada de raíz del tercio medio realizado en una sola visita es una alternativa factible de realizar en el tratamiento mediato e inmediato, ya que supone una rápida recuperación de las funciones buco-dentales del paciente(AU)

Introduction:The complicated fracture of the medium third of the root is a complex entity, particularly with an unfavorable prognosis and a symptomatic course in which the clinical success becomes a utopia in not just a few opportunities because the stability by confrontation of the free edges of the fractured fragments is difficult to achieve. In this respect, the endodontic stabilizer is used to guarantee a satisfactory bilateral anchorage that gives the possibility to unify, in a single visit, the necessary operation times for a successful treatment. Objective: To describe the feasibility of the use of an endodontic stabilizer in the management of a complicated fracture of the medium third of the root in a single visit. Case presentation: Female 60-year-old patient who comes to the consulting room after suffering from a consistent dentoalveolar trauma with a complicated fracture of the medium third of the root in tooth no.21; radiograph reveals a slight periodontal widening, and discontinuous edges. Radical endodontic treatment is performed with the placement of an intraductal stabilizer in the reduction of the fracture. Conclusions: The use of an endodontic stabilizer in the management of a complicated fracture of the medium third of the root in a single visit to the dentist is a feasible alternative in the mediate and immediate treatment seeing that it supposes a fast recovery of the bucco-dental functions of the patient(AU)

Traumatismo dentario en atletas santiagueros de alto rendimiento / Dental traumatism in high-performance athletes from Santiago

Se efectuó un estudio descriptivo y transversal de 124 atletas de alto rendimiento, de la provincia de Santiago de Cuba, desde febrero hasta septiembre del 2009, con vistas a caracterizar desde el punto de vista clinicoepidemiológico los afectados con trauma dentario. En la casuística prevalecieron los deportistas con algún tipo de lesión traumática en sus dientes (60,5 %) y la fractura no complicada de corona (55 dientes afectados) como la más frecuente. Tuvieron mayor afectación el incisivo central superior (88,9 %) y la arcada superior (82,8 %), así como los deportes de lucha (78,1 %) y hockey sobre césped (63,9 %). Se concluyó que 6 de cada 10 atletas presentaron alguna lesión traumática en su dentadura.

A descriptive and cross-sectional study of 124 high-performance athletes in Santiago de Cuba province was carried out from February to September, 2009, aimed at characterizing the affected athletes with dental traumatism from the clinical and epidemiological points of view. Sportsmen with some type of traumatic lesion in their teeth (60.5 %) prevailed in the case material, and the non complicated fracture of crown (55 affected teeth) prevailed as the most frequent. The superior central incisive (88.9 %) and the superior dental arcade (82.8%) were more affected, as well as the sports wrestling (78.1 %) and hockey (63.9 %). It is concluded that 6 every 10 athletes presented some traumatic lesion in their dentition.

Extravasated Mucocele On Lower Lip- A Case Report.

Mucoceles can appear as Extravasation or Retention type. Lower lip is the most common site for Extravasation type. Mucoceles are usually painless but sometimes they may cause difficulty in speaking and chewing. Their sudden appearance often makes the patients anxious. Simple surgical excision when done with care is the best treatment alternative that can relieve the patients fear and anxiety. Here we present a case report of 19-year-old boy with mucocele of extravasation type on lower lip treated with surgical excision.

Pseudoaneurisma post traumático de la arteria pedia: caso clínico / Post traumatic pseudoaneurysm of the pedal artery: case report

Pseudoaneurysm of the pedal artery is an uncommon condition that is usually caused by a traumatic injury or an iatrogenic intervention. The patient usually complains of an enlarging painless, pulsatile mass. We report a previously healthy 49 years old male presenting with a pulsatile mass of his left foot and a history of a traumatic lesion in the zone three months ago. A Doppler ultrasound examination confirmed the presence of a pseudoaneurysm of the pedal artery of 2.6 x 1.5 cm diameter. The patient underwent surgical resection of the mass and suture ligation of the artery. The postoperative period was uneventful.

Los pseudoaneurismas de la arteria pedia son infrecuentes y habitualmente se generan secundariamente a un traumatismo o a una intervención iatrogénica. Presentamos el caso de un paciente sano de 49 años que presenta un aumento de volumen pulsátil 3 meses posterior al traumatismo contuso de su pie izquierdo. En el doppler color se evidencia la presencia de un pseudoaneurisma de la arteria pedia de 2,64 x 1,53 cm. El paciente fue intervenido con resección y ligadura de la arteria con buena evolución postoperatoria.

Queilite angular traumática em eqüinos associada à ingestão de Panicum maximum / Angular cheilitis in horses associated with ingestion of Panicum maximum

Uma condição com aumento da fenda bucal de eqüinos por lesão na comissura labial foi estudada. Este aumento tinha extensão variável e era uni ou bilateral. Na mucosa da bochecha da comissura labial exposta havia pequenas erosões. Durante a mastigação havia perda de pequena quantidade de capim e saliva pela fenda bucal aumentada. Os animais apresentavam bom estado nutricional. O exame histopatológico de tecido retirado da comissura labial revelou epidermite superficial. Nas quatro propriedades onde se verificou o problema, constatou-se que os eqüinos eram mantidos em sistema extensivo de criação em pastagem de Panicum maximum (variedades Tanzânia, Mombaça, Tobiatã e Colonião), com folhas maduras, altas, lignificadas e de bordos cortantes. De acordo com os dados epidemiológicos, com os achados clínicos e histopatológicos, concluí-se que essas lesões foram causadas pela ação cortante das folhas de Panicum maximum, associada à forma de apreensão da pastagem alta e mastigação pelos eqüinos.

A condition with enlargement of the oral cleft in horses was studied. The enlargement of varied extension was uni or bilateral. The cheek mucosa of the labial commissure showed slight erosions. During chewing there was loss of small amounts of grass and saliva through the oral cleft. The affected horses were in good nutritional condition. Histopathological studies of tissues obtained by biopsia, revealed a superficial epidermitis. The pastures consisted of Panicum maximum grass (varieties Tanzânia, Mombaça, Tobiatã and Colonião) which was mature, tall, lignified, with leaves of cutting edges. Based on epidemiological, clinical and histopathological data, it was concluded that the lesions were caused by the hard grass, favored by the way horses pull the tall grass and chew it.

The Huge Epidural Hematoma: Analysis of 39 Cases

The authors analyzed 39 patients with huge epidural hematoma following craniocerebral trauma. Multiple factors such as bleeder, Glasgow Coma Score, hematoma site and its' volume, midline shift, and associated traumatic lesion on initial CT scan appear to expert bad outcome. The initial CT scan findings on admission were assessed and the results obtained are as follows. 1) The outcome harboring huge epidural hematoma is bad in 28% of total 39 patients. 2) The main bleeder is varied in origin according to the hematoma site. 3) The temporo-parietal epidural hematoma affects significantly the Glasgow Coma Scale(GCS) and the patient's outcome, compared with those of frontal and occipital area. 4) The patient's outcome is closely related to the hematoma volume, especially over 16% of total brain volume. 5) The midline shift over 15mm suggests the bad outcome, especially in temporo-parietal epidural hematoma.