While treatment of keloids and hypertrophic scars normally shows modest results, we found that treatment with bleomycin was more promising. The present study was divided into two parts. In the first part the aim was to show the results using a combination of bleomycin and triamcinolone acetonide per cm2 (BTA). In the second part the objective was to determine the response to both drugs in large keloids that were divided into 1 cm2 squares, treating each square with the dose previously used. In the first part of the study, the clinical response of 37 keloids ranging from 0.3 to 1.8 cm2 treated with BTA were followed up over a period of 1- 2 years. 0.375 IU bleomycin and 4 mg triamcinolone acetonide were injected every 3 months. In the second part of the study we reviewed the clinical response in six patients with large keloids. The monthly dose administered never exceeded 3 IU of bleomycin. The first study showed 36 keloids (97.29%) softening after the first dose. In the second study, 5 showed different responses (the response was complete in the four smaller keloids). The largest keloid needed 9 doses to achieve an improvement of 70%. In conclusion, combined treatment with 0.375 IU of bleomycin and 4mg of triamcinolone acetonide to 1 cm2 was considered to be an acceptable procedure for the treatment of keloids. The best results were obtained in keloids over 1 cm2 or when divided into 1 cm2 square areas. Larger series need to be performed in order to confirm these results..

Este es un artículo Open Access bajo la licencia CC BY-NC-ND (www.creativecommons.org/licenses/by-nc-nd/4.0/). FS Introducción La sindesmosis es una estructura anatómica compleja muy importante para la estabilidad y la transmisión de cargas a través del tobillo (1). Las lesiones agudas son muy comunes, estando asociadas en un 5-10% a esguinces y en un 23% a fracturas del tobillo (2). Debemos tener un alto índice de sospecha, ya que la identificación de estas lesiones es de gran importancia para evitar la morbilidad a largo plazo. Son complejas de diagnosticar e, incluso cuando se identifican, un tratamiento incorrecto puede provocar una degeneración articular precoz con malos resultados funcionales (1) .