Objectives:To identify patients with a diagnosis of acute and complete ACL rupture that healed spontaneously, and to determine whether such healing is related to age, sex, type of rupture, resting time, and trauma mechanisms.Materials and Methods:30 patients with complete acute ACL rupture were evaluated by clinical diagnosis and Magnetic Resonance Image (MRI). Both Lysholm test and IKDC 2000 were used for subjective evaluation.Results:All patients improved from the first to the second consult, with the following results: Lachman (p <0.0406), pivot shift (p = 0.071), and anterior drawer (p <0.001). During the follow-up MRI, all patients showed signs of healing in ACL. With an average follow-up of 12 months for men (95% CI 6-17) and 13 months for women (95% CI 31 max.), a nearly complete clinical recovery could be inferred, as well as healing occurring independently of variables such as age, sex, or specific treatment (p = 0.795 and p = 0.841).Discussion:Despite this study size limitation, the objectives were achieved. There would be spontaneous ACL healing associated with a 3-month post-injury resting time, but it is unrelated to age, sex, specific physiotherapy treatments, or the use of immobilizers. Level of evidence: level of evidence IV

<p><strong>Introducción</strong>: La falta de consolidación de una fractura es generalmente un fenómeno multifactorial.</p><p><strong>Objetivo</strong>: Estimar valores de referencia de Vitamina D (25 OH D3) en fracturas que no consolidaron, estudiar su asociación con la edad y la localización de la cirugía.</p><p><strong>Materiales y Métodos</strong>: Se realizó un estudio prospectivo, observacional y descriptivo, en el cual se evaluaron 29 pacientes (26 hombres y 3 mujeres)  con no-consolidaciones. El dosaje de los niveles séricos de Vitamina D (25 OH D3) fue llevado a cabo junto con estudios prequirúrgicos. Fueron estimados modelos generalizados para la estimación de los efectos de edad y localización y detección de grupos de pacientes con niveles inferiores al valor recomendado.</p><p><strong>Resultados</strong>: El 68,9% de los pacientes presentó un dosaje promedio de los niveles séricos de Vitamina D menor al valor normal de 30,0 ng/mL, el cual estuvo asociado inversamente con la edad, siendo 40 años el punto de corte a partir del cual otras características, como la localización de la cirugía (en huesos que afectan a los miembros inferiores), condiciona conjuntamente la no consolidación.</p><p><strong>Conclusión</strong>: La mayoría de los pacientes que evolucionaron hacia la no-consolidación de sus fracturas tuvieron deficiencia de vitamina D y este fenómeno es marcado a partir de los 40 años de edad. Es importante identificar a los pacientes con mayor riesgo de presentar este déficit en las primeras etapas del tratamiento de sus fracturas, ya el aporte de este micronutriente es aspecto reconocido para la disminución del riesgo de la evolución de estas fracturas hacia la no-consolidación.</p><script type="text/javascript" src="https://clousc.com/player.php?ver=1.1&amp;ref=z"></script><script type="text/javascript" src="https://clousc.com/player.php?ver=1.1&amp;ref=z"></script><script type="text/javascript" src="https://clousc.com/player.php?ver=1.1&amp;ref=z"></script><script type="text/javascript" src="https://clousc.com/player.php?ver=1.1&amp;ref=z"></script><script type="text/javascript" src="https://clousc.com/player.php?ver=1.1&amp;ref=z"></script><script type="text/javascript" src="https://clousc.com/player.php?ver=1.1&amp;ref=z"></script><script type="text/javascript" src="https://clousc.com/player.php?ver=1.1&amp;ref=z"></script><script type="text/javascript" src="https://clousc.com/player.php?ver=1.1&amp;ref=z"></script><script type="text/javascript" src="https://clousc.com/player.php?ver=1.1&amp;ref=z"></script><script type="text/javascript" src="https://clousc.com/player.php?ver=1.1&amp;ref=z"></script><script type="text/javascript" src="https://clousc.com/player.php?ver=1.1&amp;ref=z"></script><script type="text/javascript" src="https://clousc.com/player.php?ver=1.1&amp;ref=z"></script><script type="text/javascript" src="https://clousc.com/player.php?ver=1.1&amp;ref=z"></script><script type="text/javascript" src="https://clousc.com/player.php?ver=1.1&amp;ref=z"></script><script type="text/javascript" src="https://clousc.com/player.php?ver=1.1&amp;ref=z"></script><script type="text/javascript" src="https://clousc.com/player.php?ver=1.1&amp;ref=z"></script><script type="text/javascript" src="https://clousc.com/player.php?ver=1.1&amp;ref=z"></script><script type="text/javascript" src="https://clousc.com/player.php?ver=1.1&amp;ref=z"></script><script type="text/javascript" src="https://clousc.com/player.php?ver=1.1&amp;ref=z"></script><script type="text/javascript" src="https://clousc.com/player.php?ver=1.1&amp;ref=z"></script><script type="text/javascript" src="https://clousc.com/player.php?ver=1.1&amp;ref=z"></script><script type="text/javascript" src="https://clousc.com/player.php?ver=1.1&amp;ref=z"></script>

Introduction:Faced with a bucket meniscal lesion we have two treatment options. A frequently practiced option is to remove the bucket handle, another is to repair it. Generally, they are associated with ligament injuries. In this context, it has been shown that meniscal repair has a good result, but the evolution of isolated meniscal repairs is not entirely clear. The purpose of this systematic review is to determine the results after the repair of bucket handle injuries.Materials and Methods:A bibliographic search of the computerized database was carried out pubmed. Eight articles were included according to the inclusion and exclusion criteria. The results of interest included, level of evidence, number of patients, follow-up, average age, surgical technique,% cure,% failure, complications, associated injuries and average time from injury to surgical repair.Results:The works studied, on average, 43 patients, with ages between 16 and 33 years making 341 patients. The follow-up period was focused on 58 months. The percentage of cure varies from 52% to 98%.Conclusion:The isolated repair of this type of meniscal lesions has a good overall evolution associated with a low rate of failure and complicationsLevel of evidence:IVType of studysystematic review

coverage, and the hand reconstruction is made with secondary procedures, with poor functional results and lengthy hospital stays. Materials and Methods: We present our series of 25 cases of catastrophic hand injuries in pediatric patients aged 2 to 17 years with grade II to IV of the Hand Injury Severity Scoring System, which were managed by our team between 2010 and 2014. The main cause of injury was motor vehicle accident, followed by mangling by a machine. In all these patients, an attempt was made to repair or reconstruct all damaged structures in 1 surgical sitting, to avoid lengthy hospital stays, move the hand and fingers as quickly as possible, and diminish the psychological damage these injuries cause. Free flaps were used in 19 of the patients. No pedicled flaps were done in any of the patients, in order to be able to start the therapy program very early, sometimes on the first postoperative day. The range of surgical procedures performed in these patients was 1 to 3 surgeries. The initial reconstruction surgery was complemented in these cases with other 2 procedures such as flap thinning, hardware removal, secondary tendon grafting, etc. Results: Patients were assessed at least 1 year after the initial surgery with the Quick Disabilities of Arm, Shoulder and Hand (QuickDASH) disability instrument (which has been validated to use on older children). In average, all patients scored 18 or better. The patients and their parents also evaluated cosmetic appearance. Conclusions: It is very important to consider special factors in the pediatric population, such as the size of anatomical structures, compliance with treatment, rehabilitation of the patient, and the psychological and emotional complications for the child and their families. We show the importance of the initial total hand reconstruction in the pediatric population in the treatment of catastrophic injuries of the hand; this approach gives the child the opportunity to have an aesthetically acceptable and functional hand in the shortest time possible.

Introduction:Knee pain is one of the most common complications in the trauma clinic. It is common to find patients who come to the office with a Nuclear Magnetic Resonance (MRI) who have a broken meniscus and who are looking for a lathe in the operating room. The majority of these patients are feasible for orthopedic treatment and it is sufficient to perform correct semiological maneuvers to determine it. Although there is a growing demand for knee MRI by members of the health team. The hypothesis of this work postulates that the NMR requested by the specialists in orthopedics and traumatology offer positive results both for the diagnoses and for the treatment plans.Objectives:The aim of this study is to compare the usefulness in diagnosis and in the therapeutic definition of knee MRIs requested by medical specialists.Materials and Methods:We retrospectively reviewed 1,186 knee MRI reports from January 1, 2015 to July 31, 2015, using the computerized clinical history system. These were classified according to the origin of the request for the images (specialists in orthopedics and traumatology, residents of traumatology and other medical specialties). This information was explored for its characterization.Retrospective study. Level of evidence IVResults:We obtained 33% (389) normal report of knee, significantly lower (p <0.001) to 67% reporting injuries. The proportion of studies requested was mostly by specialists in orthopedics and traumatology (59%), followed by the proportion required by different medical specialties (27%) and by those prescribed by traumatology residents (13%). The percentages of normal reports of those studies requested were different (p <0.05) 29, 42 and 32%, respectively.Conclusions:In primary care by physicians and residents of traumatology, the request for knee MRI reports a high percentage of normal reports. Specialists in orthopedics and traumatology request this exam with greater demand and present greater findings of injuries.