[Clinical and functional assessment in the treatment of os calcis fractures. Open and closed reduction]. / Evaluación clínica y funcional en el tratamiento de fracturas de calcáneo. Reducción cerrada y abierta.

In this prospective, longitudinal, comparative, observational study 15 patients with 17 fractures were reviewed from September 1st 2006 to December 31st 2007 and followed-up by the outpatient service at 4, 8, 12, 16 and 20 weeks and at one year. All patients were assessed with the Maryland functional scale. These fractures were more frequent among males, 94%, and mean age was 35 years. The main cause was falls from a height of more than 2 meters. The left side was the most frequently involved (59%). Fractures were classified according to Sanders tomography classification system. Open reduction and internal fixation were performed with a specialized os calcis plate in 7 cases; 5 were treated with closed reduction and internal fixation with a cannulated screw, and 5 with a long leg cast device. The most common complication was wound dehiscence that occurred in 10% of the cases. The assessment with the Maryland scale was done at 20 weeks with the following results: 4 excellent (23.5%), 3 good (17.6%), 6 fair (35.3%), and 4 poor (23.5%). The objective of this paper was to make a clinical and functional comparison among the 3 treatment modalities in patients with os calcis fracture.

[Amputation as a treatment for complications on a traumatic dislocations of the knee. Case report]. / Amputación como tratamiento de complicaciones de la luxación traumática de rodilla. Presentación de un caso.

INTRODUCTION: Vascular lesion associated with knee dislocation represents a common and potentially devastating complication. A delay in revascularization that exceeds 8 hours can lead to amputation of the extremity. Therefore it is mandatory to do an immediate examination and an effective diagnosis to rule out this complication. CASE REPORT: A 19-year-old male was struck by a motor vehicle and caused traumatic dislocation of the left knee as observed on X-rays. The knee was reduced immediately. At 12 hours, the patient presented edema on the extremity and was then stabilized with external fixators. On the third day the patient developed a compartmental syndrome and artery obstruction, and required fasciotomies and revascularization of the popliteal artery. Twenty four hours later, again the artery was obstructed, conducing to supracondylar amputation. DISCUSSION: The purpose of this article is to show that a knee dislocation, with vascular complications, may lead to extremity amputation as a drastic treatment. It is important to emphasize that vigilance of vascular permeability has to be followed every 2-3 hours, for at least 72 hours after the injury, and assisted with Doppler study. And if needed, at the moment when a pulse abnormality is detected an arteriography study must be realized.

Valoración endoscópica del daño producido por AINE sobre la mucosa gástrica: estudio prospectivo, controlado, comparativo / Endoscopic valoration of the effect on gastric mucosa of aceclofenac and naproxen given by oral route

El objetivo de este estudio fue comparar el impacto sobre la mucosa gástrica de dos AINE a las dosis usuales: aceclofenaco y naproxén en 45 pacientes con problemas dolorosos y/o inflamatorios osteoarticulares estudiados bajo diseño prospectivo, aleatorio, longitudinal, simple ciego, controlado. Durante 4 semanas consecutivas, 21 y 24 pacientes recibieron aceclofenaco y napoxén respectivamente; la mucosa gástrica fue estudiada por endoscopia y evaluada con la escala de Lanza (0, sin lesiones a 4, úlcera invasiva) antes de la administración del medicamento y 4 semanas después. Ambos grupos resultaron comparables y el daño gástrico fue significativamente menor en el grupo aceclofenaco (p<0.05); once pacientes presentaron síntomas calificados como eventos adversos del tubo digestivo y de ellos, diez pertenecieron al grupo naproxén y el restante recibió aceclofenaco. Cuarenta y un pacientes cumplieron el periodo de estudio (91.1 por ciento); un paciente fue excluido por gastralgia atribuida a naproxén y los otros tres no concluyeron el tiempo de observación por razones no identificadas