[Traumatic spondyloptosis of L4-L5. A case report and literature review]. / Espondiloptosis traumática de L4-L5. Reporte de un caso y revisión de la literatura.

The term Spondyloptosis is used to describe a grade V spondylolisthesis, being a subluxation bigger than 100%. The trauma spondyloptosis binding L5-S1 is reported the most prevalent. It is rare in the cephalad lumbar segment to the lumbosacral junction. Two cases of spondyloptosis of L4-L5 have been reported until August 2010, caused by high energy trauma, both with the L4 vertebral body presented an anterior displacement of the vertebral body of L5. We report a patient with traumatic spondyloptosis of L4-L5 caused by a high-energy mechanism. The mechanism of injury and surgical management are described and the clinical evaluation is performed with a minimum follow-up of 8 months.

[CT scan evaluation of the syndesmotic diastasis in AO/OTA B and C ankle fractures]. / Evaluación por tomografía computarizada de diastasis de la sindesmosis en fracturas de tobillo tipo B y C de AO/OTA.

BACKGROUND: There are anatomical variants of the tibiofibular syndesmosis that lead to changes in the radiographic criteria applied to its injury. OBJECTIVE: To determine the syndesmotic diastasis using CAT scan in B and C (AO/OTA) ankle fractures and relate the anatomical variants of the tibial incisure with the separation from the fibula. MATERIAL AND METHODS: Comparative, cross-sectional and prolective screening that included all patients with B and C (AO/OTA) ankle fractures who completed their X-ray and CAT scan assessment. The radiographic parameters included the tibiofibular clearance, tibiofibular overlapping and the internal clearance. The length, depth and shape of the tibial incisure were measured with CAT scan. The statistical method used was the chi2. RESULTS: The total number of patients was 17:8 females (47%) and 9 males (53%), with a mean age of 41 years. Fourteen (82%) had a syndesmotic fracture and 3 had suprasyndesmotic fractures. The CAT scan found 10 concave incisures, 4 irregular and 3 flat ones. The mean depth of the incisure was 2.82 +/- 0.89 mm, and the mean width was 22.18 +/- 3.04. No syndesmotic diastasis was detected radiographically in 6 cases (35.2%); the CAT scan only detected 3 of them (17.7%). The diagnosis of syndesmotic diastasis was made with plain X-rays in 11 cases (64.8%) and with CAT scan in 14 (82.3%) (p = 0.043). CONCLUSION: The X-rays are questionable to define the syndesmotic diastasis, so the CAT scan should be considered in cases of a doubtful diagnosis.