Background Treatment of fractures of the humeral head remains controversial. We reviewed the outcome of our treatment of 2-and 3-part fractures of the proximal humerus using external fixation as a way of preventing damage to the vascularity of the humeral head and of reducing the risk of infection associated with open techniques.Method We retrospectively evaluated 2-and 3-part fractures of the humeral head, both clinically and radiographically, in 62 consecutive patients who were treated using external fixation. The mean follow-up time was 1.5 (1-2) years.Results The reduction was considered to be good in 50 cases, and 8 cases were consolidated in varus and 4 cases in valgus. The fracture healed in all patients. Except for 1 case of superficial infection around the screws and 1 redisplacement after a new fall, there were no early complications. Necrosis of the humeral head was not observed. 2 of the patients underwent shoulder replacement because of severe pain. The mean Constant score was 84 points, with satisfactory results (≥ 80 points) in 49 of the 62 patients. Sex, age, side, or type of fracture had no influence on the outcome.Interpretation This procedure provides satisfactory early functional results, simplifies rehabilitation by limiting postoperative motion to a lesser degree than other techniques, is less aggressive than open reduction techniques and osteosynthesis, and leads to few complications.

Thirty-four patients with a Dupuytren's contracture in excess of 70 degrees of the proximal interphalangeal (PIP) joint were treated by preliminary palmar fasciotomy, release of the accessory collateral ligaments and PIP joint distraction using the S-Quattro for 6 weeks. A formal fasciectomy with full thickness skin graft was then performed 2 weeks after removal of the fixator. There was a mean residual flexion deformity of the PIP joint of 22 degrees (mean correction of 67 degrees) at an average follow-up of 30 months. There were no infections or amputations. We recommend this technique for the management of severe Dupuytren's contracture of the PIP joint.

Thirty-four patients with a Dupuytren's contracture in excess of 70 degrees of the proximal interphalangeal (PIP) joint were treated by preliminary palmar fasciotomy, release of the accessory collateral ligaments and PIP joint distraction using the S-Quattro for 6 weeks. A formal fasciectomy with full thickness skin graft was then performed 2 weeks after removal of the fixator. There was a mean residual flexion deformity of the PIP joint of 22 degrees (mean correction of 67 degrees) at an average follow-up of 30 months. There were no infections or amputations. We recommend this technique for the management of severe Dupuytren's contracture of the PIP joint.

<p><strong>Introducción</strong></p><p><strong></strong>Las roturas del tendón de Aquiles han presentado un alza considerable en los últimos años. El tratamiento de estas lesiones puede ser conservador o quirúrgico. A pesar de la amplia literatura, no existe un gold standard en el tratamiento de estas lesiones. Las opciones quirúrgicas incluyen la cirugía abierta, mini-open y técnica percutánea.</p><p>El objetivo de nuestro trabajo es caracterizar la presentación clínica y mostrar resultados quirúrgicos y complicaciones en pacientes con rotura de tendón de Aquiles tratados en forma quirúrgica con técnica percutánea.</p><p><strong>Materiales y métodos</strong></p><p><strong></strong>Se realizó un estudio descriptivo retrospectivo. Se incluyeron  pacientes adultos tratados en la Clínica Universitaria de Puerto Montt y se obtuvieron datos clínicos y epidemiológicos. Todos los pacientes fueron operados con técnica percutánea con raquetas de Dresden.</p><p><strong>Resultados</strong></p><p><strong></strong>Se obtuvieron 60 pacientes. Todos presentaron dolor, asociado a signo de Thompson y gap palpable en el 92% de los casos. En 7 pacientes (12%) se solicitaron imágenes complementarias. El tiempo promedio de espera hasta la cirugía fue 4,28 días. 7 pacientes presentaron complicaciones post operatorias, todas ellas menores.</p><p><strong>Discusión</strong></p><p><strong></strong>Las roturas del tendón de Aquiles va en alza debido a población activa de mayor edad y a deportistas de fin de semana.  El diagnóstico es clínico, sin embargo, algunos pacientes pueden requerir imágenes complementarias para el diagnóstico. La evidencia nos demuestra que el tratamiento quirúrgico es superior al tratamiento conservador clásico. En comparación con la técnica abierta, la técnica percutánea presenta mejores resultados estéticos y menos complicaciones.</p><p> </p><p><strong>Abstract</strong></p><p><strong></strong><br /><strong>Introduction</strong>: Achilles tendon ruptures have increased considerably in recent years. Treatment of these lesions can be either conservative or surgical. Despite extensive literature, no gold standard exists. Surgical options include open surgery, mini-open surgery and percutaneous technique. The objective of this study was to characterize the clinical presentation and to report surgical results and complications in patients with ruptured Achilles tendon treated surgically with percutaneous technique.</p><p><strong>Methods</strong>: A retrospective descriptive study was carried out. Adult patients were included, and clinical and epidemiological data were obtained. All patients were operated on with percutaneous technique using the Dresden Instrument.</p><p><br /><strong>Results</strong>: Sixty patients were enrolled. All presented pain, and 92% had also associated Thompson’s sign and palpable gap. Complementary images were requested in 7 patients (12%). Average time until surgery was 4.28 days. Seven patients presented minor post-operative complications.</p><p><br /><strong>Conclusions</strong>: Achilles tendon ruptures are a prevalent pathology in older active population and weekend athletes. Diagnosis is mostly clinical; however, some patients may require complementary images for diagnosis. Strong evidence in the literature suggests that surgical treatment is superior to the classic conservative treatment. In comparison with open surgery, percutaneous technique has shown better aesthetic results and fewer complications.</p>