Introduction: Ankle fractures are usually frequent in emergency departments worldwide, with an incidence of 187/100,000 inhabitants per year. Especially the type B fracture according to Webers classification, which may lead to long-term osteoarthritis in approximately 14%. It is essential to recognize that stability in the ankle joint is the fundamental pillar in the correct treatment strategies in ankle trauma. Objective: to describe current information related to ankle bone fractures, etiology, anatomy, epidemiology, mechanism of action, presentation, classification, evaluation, prognosis, treatment and complications of ankle fractures. Methodology: a total of 38 articles were analyzed in this review, including review and original articles, as well as clinical cases, of which 26 bibliographies were used because the other articles were not relevant to this study. The sources of information were PubMed, Google Scholar and Cochrane; the terms used to search for information in Spanish, Portuguese and English were: ankle fracture, fractura do tornozelo, ankle, tibia, fibula, ankle fracture. Results: Bimalleolar ankle fractures occur in a quarter of the patients and trimalleolar fractures in the remaining 5% to 10%. The incidence of ankle fractures is close to 187 per 100,000 inhabitants per year. Open fractures are infrequent, representing only 2 % of all fractures of the ankle joint. In children, these injuries are also frequent, occupying the second place after hand and wrist injuries, especially in those between 10 and 15 years of age. Likewise, pediatric ankle fractures occur in a 2:1 male to female ratio, representing 5% of all fractures in children and approximately 9% to 18% of all fissure injuries. Conclusions: the ankle joint is complex, in gynglimus, formed by the fibula, the tibia and the talus and also deeply related to the ligamentous complexes. The bony anatomy that provides stability is formed by the distal part of the tibia and fibula, its articulation with the talus and with each other. Generally ankle fractures are caused by different trauma mechanisms such as impact, twisting and crushing injuries. Ankle injury depends on several factors such as mechanism, chronicity, bone quality, patients age, magnitude, direction, impact velocity and foot position. A complete and comprehensive medical history is essential in the medical evaluation. X-rays are the first-line adjunctive tests that aid in the evaluation of an injury that impacts the ankle. The classification system is important for the treatment decision. The treatment of fractures of the ankle bones can be performed conservatively or surgically, depending on certain criteria, and immobilization should be performed afterwards to reduce the risk of complications. It is essential to follow the ATLS scheme in order to define and manage any alteration that may be life-threatening for the patient. Ankle fracture-dislocation requires urgent manipulation to recover the ankle mortise. KEY WORDS: fracture, ankle, tibia, fibula, bones.

La hepatitis crónica se define como una enfermedad hepática crónica difusa que existe durante al menos 6 meses dejando como secuela la cirrosis. Es de etiología múltiple, por lo que es fundamental la realización de una biopsia hepática para el diagnóstico y pronóstico. La hepatitis crónica relacionada con la hepatitis B es de progresión lenta. No se recomienda la terapia con corticoides, en este caso, la terapia antiviral actual convierte al paciente positivo al antígeno e de la hepatitis B en anti-HBe en aproximadamente un 50%. La hepatitis crónica relacionada con la hepatitis por virus no A y no B carecen de la falta de un marcador de diagnóstico, sin embargo, se tiene que ninguna terapia actual tiene beneficios comprobados. Esta enfermedad presenta un cuadro bioquímico e inmunológico muy activo, es también relacionada con fármacos por lo cual se recomienda la retirada de la droga para la recuperación del paciente, ya que, las muertes generalmente se producen debido a la continuación de la misma. Se detallan las indicaciones de progresión a un estado terminal con probabilidad de supervivencia de menos de 6 meses. Estos son útiles para decidir sobre el trasplante hepático antes de que el paciente esté moribundo.

Introduction: Spinal muscular atrophy (SMA) is a complex neuromuscular disorder, it is the most usual autosomal recessively inherited lethal neuromuscular disease in pediatrics, it presents a defective alteration in the survival motor neuron 1 (SMN1) gene. Spinal muscular atrophy clinically shows progressive weakness of skeletal and respiratory muscles. In recent years, drugs with encouraging results from phase II and III clinical trials have been presented. Objective: to detail current information related to spinal muscular atrophy, clinical features, classification, natural history, genetics, diagnosis, complications and treatment of the disease. Methodology: a total of 40 articles were analyzed in this review, including review and original articles, as well as clinical cases, of which 31 bibliographies were used because the other articles were not relevant to this study. The sources of information were PubMed, Google Scholar and Cochrane; the terms used to search for information in Spanish, Portuguese and English were: spinal muscular atrophy, Spinal Muscular Atrophy, spinal muscular atrophy and spinal muscular atrophy. Results: About 95 % of the occurrences of spinal muscular atrophy are generated by homozygous deletions. Individuals with 5q mutation make up 95% of cases of spinal muscular atrophy and the remaining 5% are generated by mutations in 5q1-5. Targeted treatments may prevent or delay the progression of some symptoms of spinal muscular atrophy. Conclusions: Spinal muscular atrophy (SMA) is an autosomal recessive neuromuscular disease characterized by muscle atrophy and weakness resulting from irreversible loss and progressive degeneration of the brainstem nuclei and anterior horn cells in the spinal cord (lower motor neurons). Clinically it presents with symmetrical proximal limb weakness that also impacts the axial muscles, intercostal and bulbar musculature and is progressive, and the classification protocol is important in genetics, as well as providing prognostic and clinical information. The natural history of the disease is variable and complicated. It is made by demonstrating a history of proximal muscle weakness, motor difficulties or regression, diminished or absent deep tendon reflexes. Among the most frequent complications in unsupported individuals are those previously mentioned such as poor weight gain with growth retardation, scoliosis, restrictive lung disease, joint contractures and sleep difficulties. In terms of treatment, several different compounds have been investigated in recent years, focused on increasing muscle strength and function. Proactive supportive treatment involving a multidisciplinary team is paramount to decrease the severity of symptoms. KEY WORDS: muscle atrophy, spine, spinal, spinal cord, motor neuron.

Introduction: Open fractures of the pelvis represent one of the most fatal injuries within musculoskeletal trauma so they must be treated correctly, adjusting to a multidisciplinary approach to achieve the well-being of the affected person, in addition to restoring homeostasis and normal pathophysiology related to the mechanical stability of the pelvic ring. Objective: to detail current information related to pelvic fractures, epidemiology, anatomy, mechanism of injury, classification, imaging presentation, clinical presentation, management and complications. Methodology: a total of 27 articles were analyzed in this review, including review and original articles, as well as clinical cases, of which 20 bibliographies were used because the other articles were not relevant for this study. The sources of information were PubMed, Google Scholar and Cochrane; the terms used to search for information in Spanish, Portuguese and English were: fracturas de pelvis, fraturas do anel pelvico, anatomy of the pelvis, fractures of the pelvis. Results: Most cases of pelvic fractures occur in young people due to high-energy mechanisms, although injuries can also be generated by low-energy mechanisms and can cause fractures of individual bones. Mortality is higher in individuals with hemodynamic instability. The standard imaging examinations in trauma are anteroposterior projections of the thorax, lateral cervical spine and anteroposterior projections of the pelvis; special projections of the pelvis include the oblique alar and obturator projections. The severity of pelvic fractures is closely related to the associated injuries. Conclusions: Knowledge of anatomy is a fundamental piece in the treatment of pelvic fractures and associated injuries. There are several systems for classifying pelvic fractures, according to anatomical patterns, mechanisms of injury, resulting instability requiring surgery. The most frequently used is that of Young and Burgess. For evaluation, one should start with the ABCDE, airway, breathing, circulation, disability, and exposure and integrate a complete traumatologic evaluation. To determine whether there is pelvic instability, the anteroposterior and lateral compression test is performed for one occasion, generating internal and external rotation of the pelvis. The spine and extremities should be well assessed with an adequate neurovascular examination and a thorough neurological examination. In pelvic fractures, management and treatment begins with ABCDE. Followed by stabilization of the patient, a multidisciplinary approach is required. External or internal fixation can be performed to stabilize the pelvis, its use and recommendation usually vary according to the characteristics of each fracture, the associated injuries and the instability of the pelvic ring. Pelvic trauma with involvement of the acetabulum and injuries to the genitourinary system should not be underestimated. Complications include infection, thromboembolism, malunion and pseudarthrosis. KEY WORDS: fracture, pelvis, pelvic ring, pelvic trauma.