Fracturas de pilón tibial: estado actual de pacientes que ingresaron al Instituto Autónomo Hospital Universitario de Los Andes entre 1998-2007 aplicando la AOFAS: estudio observacional analítico prospectivo no concurrente / Tibial pilon fractures: currents status of patients admitted to the Instituto Autónomo Hospital Universitario de Los Andes between 1998-2007 using the AOFAS: prospective observacional study non-concurrent

Las fracturas de tibia distal han sido consideradas de difícil manejo debido a los resultados desalentadores descritos hasta el año de 1963 situación que comienza a cambiar a mediados de 1968 cuando se promulgan los principios de ORIF de la AO, sin embargo, actualmente sigue constituyendo un verdadero reto para el cirujano traumatólogo. En el presente estudio prospectivo no concurrente se evaluarán los pacientes adultos (mayores de 16 años de edad) que ingresaron al servicio de Ortopedia y Traumatología del Instituto Autónomo Hospital Universitario de Los Andes (IAHULA) entre 1998 y 2007 con fracturas de tibia distal (pilon tibial), constituyendo en total una población de 80 pacientes de la cual se toma una muestra de 40 pacientes. Para efectos de este estudio obtuvimos para las fracturas tipo A según la AO/ASIF un total de 33,3 por ciento de excelentes resultados, 33,3 por ciento de regulares resultados y 33,3 por ciento de malos resultados. Para las fracturas tipo B 71 por ciento de excelentes resultados, 15 por ciento de regulares resultados y 14 por ciento de malos resultados; mientras que para las fracturas de tipo C fue un 27 por ciento de excelentes resultados, 27 por ciento de regulares resultados y 46 por ciento de malos resultados, todos evaluados según la escala de evaluación de la AOFAS. A la luz de los estudios consultados, resulta evidente establecer como aspectos pronóstico determinantes el estado de las partes blandas la afectación metafisiaria y/o articular, así como la asociación a una lesión de peroné.

Distal tibia fracture have been considered difficult to use because of the disappointing results described until the years 1963 which begins to change in mid-1968 when it enacted the principles of ORIF of AO, however, currently still be a real challenge to the trauma surgeon. This prospective study will assess the concurrent non-adult patients (older than 16 years of age) who entered the service of Orthopedics and Traumatology Institute of the University Hospital of Los Andes (IAHULA) between 1998 and 2007 with fractures distal tibia (tibia pylon), constituting a total population of 80 patients of which took a sample of 40 patients. For purposes of this study, we obtained for type A fractures according to AO/ASIF a total of 33,3 percent of excellent results, 33,3 percent of regular results, and 33,3 percent poor results. For fractures type B 71 percent of excellent results, 15 percent regular results, and 14 of poor results, whereas for type C fractures was 27 percent excellent results, 27 percent of regular results, and 46 percent of poor results all assessed according to the scale of assessement of the AOFAS. In light of the studies consulted, as is evident establish prognostic determinants respects the status of soft tissue involvement, metaphyseal and/or joints, as well as the association of a fibula injury.

Bronchial carcinoid tumours in southern Saudi Arabia.

Clinical presentation, pathology, surgical management and follow-up of ten bronchial carcinoid tumour (BCT) patients are described. There were five male and five female patients with age range between 5 to 85 years (mean 39.2 +/- 21.5, SD). Pathology revealed BCT on the right side in seven and on left side in three patients. The tumour was an incidental finding in four while the other six had respiratory symptoms. Cough was present in all of the later group and hemoptysis was present in four patients. Recurrent chest infections were seen in two patients. Symptoms ranged from 1 week to 15 years. Successful surgical resection was done in nine with the longest follow-up of 80 months (mean: 23 months +/- 26.3, SD) without recurrence or metastasis. Histopathological examination of these tumours revealed classical morphological features in all but one case. Grimelius stain positivity for argyrophilia confirmed the diagnosis in all the patients in this study. Electron microscopic examination was done in patient no. 9 which showed atypical morphological features and neurosecretory granules. BCT may present like pneumonias or bronchial asthma. Although BCTs have low-grade malignancy, early diagnosis and surgical resection yield curative results almost in all cases.