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.

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.

Introduction: In 1876 American surgeon Thomas George Morton first detailed compressive neuropathy of the interdigital nerve of the forefoot. Mortons neuropathy occurs mostly. The condition is generated secondary to repeated pressure or irritation that leads to thickening of the nerve, located in the second or third intermetatarsal space. It is suggested that the use of pointed heel shoes could be a triggering factor for the development of this pathology due to the increased pressure on the forefoot. Objective: to describe the current information related to Mortons neuroma etiology, epidemiology, presentation, diagnosis, management and treatment. Methodology: a total of 39 articles were analyzed in this review, including review and original articles, as well as clinical cases, of which 29 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: Morton, neuroma, neuritis, neuralgia, interdigital. Results: it is more frequently present in the female sex, presenting a female:male ratio of 4:1 in some bibliographies and 5:1 in others. The average age at the time of surgery is 50 years old. In 21% of the cases the neuroma is bilateral, in 66% of the cases it is related to the third space, 2% to the fourth and 32% to the second. A study showed that the average diameter of Mortons neuroma was 4.1 mm in the asymptomatic staff versus 5.3 mm in the symptomatic group. Conclusions: This condition is certainly not a neuroma as it is a degenerative rather than neoplastic condition due to fibrosis of the digital nerve. The diagnosis is primarily clinical, where there may be altered sensation and a dorsal bulge. Examinations, investigations and non-surgical treatment are the same as those used in a primary neuroma. The use of orthoses and footwear modifications is indicated for conservative treatment. For surgical treatment, dorsal and plantar approaches are used, each with their advantages and disadvantages. The dorsal incision should be extended proximally to observe the residual limb, however sometimes exposure becomes difficult. The plantar approach provides better exposure for the nerve to be easily identified and resected, however the presence of painful scarring is notable. Other complications that may occur are atrophy, recurrence and chronic pain. KEY WORDS: Morton, neuroma, neuritis, neuritis, neuralgia, interdigital.

Las Urgencias, Emergencias y Cuidados Críticos son todas acepciones muy próximas en cuanto tienen en común al enfermo crítico. No deseamos buscar las diferencias sino la confluencia en la ayuda al mismo paciente. En la medida que su asistencia sea, en verdad, integral, continuada y eficaz habremos cumplido nuestro cometido profesional y razón de ser social. La urgencia médica implica situaciones de evolución de un estadio agudo a uno crónico; con tratamiento no necesariamente inmediato. Toda situación que implique compromiso de la función orgánica y el posterior deterioro de las funciones vitales básicas constituye una emergencia a resolver en el menor tiempo posible. La actividad quirúrgica ha cobrado un notable papel dentro del área de atención al paciente con situaciones cuyo peligro para la vida esinmediato o no.

Ya desde los albores de la humanidad, los procesos infecciosos representaban importantes causas de morbilidad y mortalidad. La gente moría joven, fundamentalmente por traumas e infecciones. El descubrimiento de los agentes causales de estas últimas, el desarrollo de vacunas, y luego de fármacos potentes y efectivos, permitieron considerar como posible su conquista y entrever el comienzo de su erradicación. Sin embargo, se estaba lejos de lograr esa meta. Las grandes epidemias que diezmaron las poblaciones de Europa, Asia, África y hasta la misma América, constituyen solo un fragmento del sufrimiento de la humanidad, historia que corre paralela con las grandes conquistas en los campos de saneamiento ambiental, de las inmunizaciones y del tratamiento específico de las enfermedades infecciosas. La mayor supervivencia del hombre, lograda gracias a mejores condiciones ambientales, las más adecuadas normas higiénicas y nutricionales, entre otras, ha resultado en una población con características diferentes, necesitada de otro tipo de manejo: trasplantes, quimioterapia y cirugía de cáncer, cirugías mayores para el paciente politraumatizado; procedimientos que prolongan más la vida, pero que traen consigo mayor susceptibilidad a gérmenes usuales y otros menos comunes, que se aprovechan del huésped debilitado.