Enfermedad por Coronavirus - 2019 (COVID-19) y Traumatología: Revisión de la literatura / Coronavirus Disease - 2019 (COVID-19) and Traumatology: Review of Literature

The Coronavirus pandemic (COVID-19) triggered a global health emergency, and as a response, institutions and medical services have implemented different measures regarding the management of these patients in order to maintain medical care, and reduce the spread of the virus in patients and medical staff. The following review aims to present the current recommendations made by international, national and local societies regarding medical action from Traumatology and Orthopaedics. A literature review was done on Medline / Pubmed platforms, The Journal Bone and Joint Surgery (JBJS), Journal of the American Academy of Orthopedic Surgeons (JAAOS), Sociedad Chilena de Ortopedia y Traumatología (SCHOT). The literature was in Spanish and English, comparing it with reality on a local level. The current COVID-19 pandemic led to the complete reform of the trauma care units, starting with the development of subspecialty teams that rotate periodically, which are in charge of the emergency area, treating patients with all personal protection elements (PPE) and categorizing those patients who require emergency trauma surgery, from those that can be managed in a delayed manner. Regarding patients who are hospitalized, a COVID-19 PCR (Polymerase Chain Reaction) test is taken as screening, except for emergency surgeries where all intraoperative protection measures are taken. In addition, for greater safety, all elective surgery was suspended, which reduces the flow of patients in the ward and in the inpatient unit. Outpatient care was optimized in order to protect patients in their periodic check-ups.

Medicolegal Identification of Medical Malpractices in Orthopaedic Surgery / 法医学杂志

OBJECTIVES@#To analyze the characteristics of medical malpractices in orthopaedic surgeries, to explore principles and methods in medical legal identification, and to provide basic data for uniform medicolegal standard for the future medical identification.@*METHODS@#A retrospective analysis was conducted on 100 cases of medical malpractices in orthopaedic surgery, among the 364 cases archived in Medicolegal Expertise Center of Xi'an Jiaotong University during 2002-2015.@*RESULTS@#In the 100 cases of orthopedic medical malpractices, with 104 hospitals involved in, 95 cases were judged with medical errors and the other 9 cases with no error. The top 3 reasons for errors were （1） inadequate observation or estimation of diseases （27.9%）, （2） intraoperative improper operation （17.3%）, and （3） delayed or missed diagnosis and treatment （12.5%）. The consequences of medical malpractices were mostly disability （61%）, followed by prolonged diseases （31%） and death （8%）. With regard to the causal relationship between medical errors and consequences, 95 cases （91.4%） were with causality and the other 9 cases （8.6%） with no causality. Specifically, 56 cases （53.9%） were with medical errors as the secondary causes accounting for 25% causative potency, and 20 cases （19.2%） were with medical errors as the major causes accounting for 75% causative potency.@*CONCLUSIONS@#It is pivotally important for determining the causative potency of medical errors to analyse the causes of damages in orthopaedic surgery and to distinguish subjective factors from objective ones of medical errors.

Experiência com a modelagem nasoalveolar precoce em um recém-nascido portador de fissura lábio-alveolar / Experience with early nasoalveolar molding in a clefted child

O tratamento das fissuras lábio-palatinas evoluiu muito nas últimas décadas. O tratamento atual da deformidade inclui técnicas ortopédicas de modelagem nasoalveolar como a Modelagem Nasoalveolar Passiva (MNA), que tem por objetivo a redução da largura da fissura alveolar e do palato, bem como da modelagem da região nasal afetada, logo após o nascimento. A MNA é iniciada na primeira semana de vida e se continua durante os primeiros meses, até a data do fechamento cirúrgico do lábio. O presente artigo relata o caso de um recém-nascido com diagnóstico ultrassonográfico de fissura lábio-alveolar. O diagnóstico precoce possibilitou o encaminhamento para o especialista, de tal forma que o tratamento foi iniciado logo após o nascimento. Ao final da MNA, a operação de correção da fissura nasoalveolar determinou o fechamento completo do defeito, e o aspecto da região tratada se assemelhava ao do lado não afetado.

The care of lip and palate clefts has progressed a lot in the last decades. Current treatment of the deformity includes orthopedic techniques of nasoalveolar molding such as the passive Nasoalveolar Molding (NAM), which is intended to reduce the width of the alveolar and palate cleft, as well as reshaping the affected nasal area, soon after birth. NAM is indicated to be performed in the first week of life and be continued over the next months, up to the eventual surgical closure of the lip. The present paper reports the case of a newborn with an ultrasonographic diagnosis of cleft alveolus and lip. Early diagnosis made it possible to promptly refer the patient to a specialist, so that treatment began soon after birth. At the end of NAM, the procedure to correct the nasoalveolar cleft determined the complete closure of the defect, and the aspect of the treated area can be appreciated.

El valor del consentimiento informado en el Hospital de Ortopedia "Victorio de la Fuente Narváez" / The usefulnes of informed consent in the hospital \"Victorio de la Fuente Narváez\"

Se trata de una encuesta descriptiva y prospectiva realizada en 246 pacientes admitidos para someterse a cirugía ortopédica, llevada a cabo de febrero a julio de 1998, la finalidad de identificar la calidad de la comprensión de las explicaciones impartidas para obtener su consentimiento informado en forma previa a la realización de la cirugía. Los resultados mostraron compresión íntegra del tratamiento en el 4.0 por ciento, comprensión parcial en el 66.6 por ciento y pobre comprensión en el 29.2 por ciento.