[Survey about the impact of COVID-19 on the traumatology and orthopedic surgery departments in Spain]. / Encuesta acerca del impacto de la COVID-19 en los servicios de Cirugía Ortopédica y Traumatología de España.

INTRODUCTION: We designed and conducted a survey to analyze the impact of the COVID-19 pandemic on the operation and performance of the orthopedic departments of the National Health System and private entities. MATERIAL AND METHODS: Descriptive study of a survey is distributed to Spanish Ortohopedic surgeons via Internet. RESULTS: 401 valid responses were obtained, out of these 85.7% had to reduce their surgical activity between 50% and 100%. 46% of the sample were asked to collaborate in other units or services and another 43% felt that their work had been underused. 52% modified the treatment indications in various bone fractures, with variability between centers and communities. 30% reported being satisfied with the management from the state and 60% with that of their province and center. 70% showed little to no satisfaction with the training received on the use of masks and personal protective equipment. An additional of 80% were also unsatisfied with the training received with regard to sample-taking. 65% did not have protective equipment to carry out their work. 46% have been denied protective measures to treat patients with suspected or confirmed infection. CONCLUSION: The COVID-19 pandemic has placed the National Health System in an extremely serious situation. Through the analysis of the results, we can observe an inefficient use of available human resources, a widespread discontent, as well as an absence of means and measures, which has had a direct impact on the number of infected professionals.

Fractura-luxación de Lisfranc pediátrica. A propósito de dos casos / Lisfranc fractures in children. Two clinical cases

Objetivo: Presentamos dos casos clínicos con lesiones de Lisfranc, raras en niños y adolescentes. Aunque clínicamente son sutiles, los casos no tratados pueden predisponer a dolor crónico y discapacidad en el adulto. Material y metodología: Se trataron quirúrgicamente dos lesiones de Lisfranc que se redujeron de forma inmediata en quirófano de urgencias mediante reducción cerrada y fijación interna. Se realizó seguimiento clínicoradiológico, así como un cuestionario final de función y dolor en el pie. Resultados: Se logró reducción anatómica en ambos casos. No se apreció en las revisiones dolor, malestar ni limitación funcional en el pie afectado. Conclusión: La valoración clínica y radiográfica es crucial para detectar lesiones de Lisfranc en niños y adolescentes. El diagnóstico y tratamiento tempranos posibilitan buenos resultados clínicos y radiográficos (AU)

Objective: Lisfranc injuries are rarely seen in children and adolescents. Although clinically subtle, untreated cases can predispose to chronic pain and disability in the adult life. Material and methods: Two Lisfranc injuries of adolescents were treated operatively in Hospital de Basurto in 2012. Both patients were treated immediately in the emergency’s theatre with closed reduction and internal fixation. Clinical and radiological follow-up was done, as well as a final questionnaire concerning the function and pain of the foot. Results: Anatomical reduction was achieved in both cases. None claimed harm, discomfort or physical limitation in the injured foot. Conclusions: Clinical and radiological evaluation is crucial in detecting Lisfranc injuries in children and adolescents. Prompt diagnosis and treatment provide clinical and radiological good results (AU)