Introduction There is a high incidence of hand fractures, and a high percentage of them require surgical treatment. The functional result depends, to a large extent, on the technique used. The use of retrograde intramedullary screws allows for early mobilization and minimal dissection of soft tissues. The objective of the present study is to analyze the clinical results and complications with this type of osteosynthesis. Methods A total of 96 fractures in 81 patients were analyzed. There were 62 metacarpal fractures, 60% of which involved the 5th finger, 29% involved the 4th, 5% involved the 3rd, and 6% involved the 2nd finger. There were 34 fractures of the phalanxes, 27 of which (79.5%) involved the proximal phalanx, and 20.5% involved the middle phalanx. The range of active mobility, the time spent at work, and intraoperative complications were assessed. Results The average active mobility obtained was 260° (230–270°). Patients resumed their normal activity within an average time of 5 weeks (between 3 and 32 weeks). There was a 6% rate of intraoperative complications and a 13% rate of postoperative complications in the metacarpals, and an 8% rate of intraoperative complications and 11% of postoperative complications in the phalanxes. Conclusion The use of cannulated screws is a safe and effective option for the treatment of different types of fractures, obtaining a good range of mobility, early reintegration, and with an acceptable number of complications.

Teleconsulta como sistema de información en el cuidado de pacientes con deterioro de la integridad cutánea Teleconsultation as an information system in the care of patients with cutaneous integrity deterioration ABSTRACTObjectives: To evaluate the benefits of teleconsultation compared to the conventional face-to-face consultation in patients with cutaneous integrity deterioration. Methodology: Pilot study of controlled, randomized, open intervention. Subjects of study: patients with deterioration of the cutaneous integrity belonging to the urban health centers. Two groups were created, one on which the intervention will be carried out through teleconsultation and another control group where the consultation and assessment was done in person. Collection of data through observation, interviews, questionnaires and validated scales. Results: A total of 31 consultations were carried out from the health centers, 12 of which were in person (38.7%) and 19 through teleconsultation (61.3%). The lesions consulted are mostly of venous origin. These patients present altered quality of life. A mean improvement of 6 points is obtained in the PUSH scale in the face-to-face modality versus 8 points in the teleconsultation, the time in which the epithelialization of the lesions in the latter is achieved. Conclusions: Teleconsultation is emerging as a new organizational system, a new way of organizing and managing the provision of health services for the benefit of patients, professionals and the health system in general. Establishing a fast, fluid, effective and efficient communication channel that has a direct impact on the patient, reducing time for the resolution of his health problem, avoiding unnecessary movements and reducing costs.

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Incompetence of the volar plate of the proximal interphalangeal (PIP) joint can cause instability in the sagittal plane, repetitive dorsal dislocations, pain, and functional disability. The authors herein present five cases of repeated dorsal dislocations of the PIP joint secondary to rupture and incompetence of the volar plate. The patients were aged between 17 and 45 years, and the time elapsed from injury to intervention ranged from 16 weeks to 14 years. Volar plate repair was possible in all cases, resulting in joint stabilization. The mean postoperative follow-up period was of 18 months. Of the five cases, the outcomes were excellent in three, good in one, and fair in one, according to the Catalano et al.2 criteria. Direct volar plate repair is a reliable technique to treat volar plate incompetence resulting in repeated dorsal dislocation of the PIP joint, regardless of the time from injury to intervention.

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