Revista Espanola de Cirugia Ortopedica y Traumatologia最新文献

{"title":"Can 3D-printed patient-specific instruments improve local control and overall survival in pelvic sarcoma? A clinical validation study.","authors":"T Fernández-Fernández, L Mediavilla-Santos, M Cuervo-Dehesa, E Gómez-Larrén, R Pérez-Mañanes, J Calvo-Haro","doi":"10.1016/j.recot.2024.07.013","DOIUrl":"10.1016/j.recot.2024.07.013","url":null,"abstract":"<p><strong>Background and objectives: </strong>3D-printed patient-specific instruments (PSIs), also known as 3D guides, have been shown to improve accuracy in resection of pelvic tumors in cadaver studies and achieve better surgical margins in vivo. This study evaluates the clinical impact of 3D-printed guides on medium-term local and distant disease control, as well as disease-free and overall survival in patients.</p><p><strong>Material and methods: </strong>A cohort study included 25 patients with primary pelvic or sacral sarcomas: 10 in the 3D group and 15 in the control group, with a median follow-up of 47 months. Demographic and clinical data, including tumor histology, stage, resection technique, associated reconstruction, adjuvant therapies, and complications, were evaluated. Surgical margins (free, marginal, and contaminated) and relapse-free and overall survival curves were analyzed.</p><p><strong>Results: </strong>The 3D group achieved a higher rate of free margins (80% vs 66.7%, p = 0.345). Local recurrence (50% vs 60%, P=.244) and distant disease relapse (20% vs 47%, p = 0.132) rates were lower in the 3D group. At the end of the follow-up, the 3D group had a higher overall survival rate (60% vs 40%, p = 0.327). The complication rate was similar in both groups, with a deep infection rate of 40%.</p><p><strong>Conclusions: </strong>The use of 3D guides in resecting primary pelvic tumors not only achieves a higher rate of free margins compared to conventional techniques but also shows a trend towards higher local, distant, and overall disease-free survival. Further studies with larger sample sizes and higher levels of evidence are necessary to validate these clinical trends.</p>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141727941","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Arthroscopic fibroarthrolysis and mobilization under anesthesia is a simple, reproducible, and satisfactory method for the treatment of patients with severe post-traumatic arthrofibrosis of the knee.","authors":"N Franulic, J Laso, C Del Pino, C Brito, R Olivieri, N Gaggero","doi":"10.1016/j.recot.2024.07.008","DOIUrl":"10.1016/j.recot.2024.07.008","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the range of motion (ROM) of the knee in patients with severe post-traumatic knee arthrofibrosis after being treated with arthroscopic fibroarthrolysis (AFA) and manipulation under anesthesia (MUA).</p><p><strong>Methods: </strong>Case series of patients with severe post-traumatic knee arthrofibrosis who underwent AFL+MUA in a national referral center. The primary outcome to be assessed was ROM before and after surgery and then at 3-month intervals until a minimum follow-up of one year was completed.</p><p><strong>Results: </strong>51 patients were included. The main injuries preceding the stiffness were tibial plateau fracture (37.3%), distal femur fracture (27.5%), and femoral shaft fracture (15.7%). Forty-five patients had severe flexion deficits with a median preoperative flexion of 70°. Intraoperative flexion significantly improved to 110°. Significant loss of flexion was observed at 3 and 6 months, however, patients regained ROM in the 9 and 12-month follow-ups. At discharge, 80% of the patients achieved flexion of 90° or more. There were 4 intraoperative complications and 3 reinterventions were performed.</p><p><strong>Conclusion: </strong>AFA+MUA can help patients with severe post-traumatic knee arthrofibrosis to recover ROM in most cases. However, this procedure is not without risks and complications, therefore, careful consideration should be given to its indication and execution.</p>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141601953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Artículo traducido] Clavo corto versus clavo largo en la fractura intertrocantérica de cadera: metaanálisis","authors":"P. Domenech ,&nbsp;G. Mariscal ,&nbsp;V. Marquina ,&nbsp;F. Baixauli","doi":"10.1016/j.recot.2024.01.023","DOIUrl":"10.1016/j.recot.2024.01.023","url":null,"abstract":"<div><h3>Objective</h3><p>To compare short versus long intramedullary nails for intertrochanteric hip fractures in terms of efficacy and safety.</p></div><div><h3>Methods</h3><p>We included cohort studies and randomized clinical trials. The methodological quality of the studies was assessed by the Newcastle-Ottawa Scale. The meta-analysis was performed using the Review Manager 5.4. Heterogeneity was checked with the <em>I</em>^<em>2</em> test. A fixed effects model was adopted if there was no heterogeneity.</p></div><div><h3>Results</h3><p>Twelve studies were included. The reoperations rate was lower in the short nail group (OR: 0.58, 95%CI: 0.38-0.88) and there were no differences regarding the peri-implant fracture rate (OR: 1.77, 95%CI: 0.68-4.60). Surgery time and blood loss was significantly higher in the long nail group (MD: −12.44, 95%CI: −14.60 −10.28) (MD: −19.36, 95%CI: −27.24 −11.48). There were no differences in functional outcomes.</p></div><div><h3>Conclusions</h3><p>The long nail showed a higher reoperation rate, blood loss and surgery time compared to the short nail.</p><p>Level of evidence: III.</p></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"68 4","pages":"Pages T373-T382"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S188844152400050X/pdfft?md5=6933a313df11f3c4f8b15d37096ecdf9&pid=1-s2.0-S188844152400050X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139703645","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Artículo traducido] Sangrado oculto intraoperatorio en cirugía mínimamente invasiva de fracturas vertebrales osteoporóticas","authors":"V. Martín-Gorgojo ,&nbsp;S. Burguet Girona ,&nbsp;S. Muñoz Donat","doi":"10.1016/j.recot.2024.03.006","DOIUrl":"10.1016/j.recot.2024.03.006","url":null,"abstract":"<div><h3>Introduction and aim</h3><p>Minimally invasive surgery (MIS) of the spine prevents the collapse of osteoporotic vertebral fractures (OVF) with lower complication and bleeding rates than open surgery. However, the possibility of hidden blood loss (HBL) has been recently described, referring to the loss of blood diffused into tissues and lost through hemolysis. This study aimed to estimate the postoperative impact of HBL in patients undergoing MIS for OVF.</p></div><div><h3>Materials and methods</h3><p>This was a retrospective study of a series of patients who had MIS for OVF. A descriptive analysis of recorded variables was performed, and total blood volume, total bleeding, HBL, and hemoglobine drop were calculated. This was followed by a comparative analysis between HBL (&lt;500<!--> <!-->ml vs. ≥500<!--> <!-->ml) and the variables of hospital stay and postoperative evolution. Binary logistic regression models were performed to rule out confounding factors.</p></div><div><h3>Results</h3><p>A total of 40 patients were included, 8 men and 32 women, with a mean age of 76.6 years. The mean HBL was 682.5<!--> <!-->ml. An HBL greater than 500<!--> <!-->ml is found to be an independent risk factor for torpid postoperative evolution (<em>P</em> <!-->=<!--> <!-->0.035), while it does not predict a longer hospital stay (<em>P</em> <!-->=<!--> <!-->0.116). In addition, a higher HBL was observed in surgeries of greater technical complexity and longer surgical time.</p></div><div><h3>Conclusions</h3><p>Although MIS techniques have shown less intraoperative bleeding than open surgery, HBL should be diagnosed because it is associated with a torpid evolution. The use of a diagnostic and therapeutic algorithm may help minimize its impact.</p></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"68 4","pages":"Pages T322-T327"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1888441524000687/pdfft?md5=c604a96bb8d04683b87a7a40d5888086&pid=1-s2.0-S1888441524000687-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140176971","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Artículo traducido] Lesiones vertebrales por proyectil de arma de fuego: estudio de cohorte retrospectivo, multicéntrico","authors":"G. Ricciardi ,&nbsp;J.P. Cabrera ,&nbsp;Ó. Martínez ,&nbsp;J. Cabrera ,&nbsp;J. Matta ,&nbsp;V. Dávila ,&nbsp;J.M. Jiménez ,&nbsp;H. Vilchis ,&nbsp;V. Tejerina ,&nbsp;J. Pérez ,&nbsp;R. Yurac","doi":"10.1016/j.recot.2024.01.022","DOIUrl":"10.1016/j.recot.2024.01.022","url":null,"abstract":"<div><h3>Introduction and objective</h3><p>To describe the demographic and clinical characteristics and treatment of patients with spinal gunshot wounds across Latin America.</p></div><div><h3>Material and methods</h3><p>Retrospective, multicenter cohort study of patients treated for gunshot wounds to the spine spanning 12 institutions across Latin America between January 2015 and January 2022. Demographic and clinical data were recorded, including the time of injury, initial assessment, characteristics of the vertebral gunshot injury, and treatment.</p></div><div><h3>Results</h3><p>Data on 423 patients with spinal gunshot injuries were extracted from institutions in Mexico (82%), Argentina, Brazil, Colombia, and Venezuela. Patients were predominantly male civilians in low-risk-of-violence professions, and of lower/middle social status, and a sizeable majority of gunshots were from low-energy firearms. Vertebral injuries mainly affected the thoracic and lumbar spine. Neurological injury was documented in 320 (76%) patients, with spinal cord injuries in 269 (63%). Treatment was largely conservative, with just 90 (21%) patients treated surgically, principally using posterior open midline approach to the spine (79; 87%). Injury features distinguishing surgical from non-surgical cases were neurological compromise (<em>P</em> = 0.004), canal compromise (<em>P</em> &lt; 0.001), dirty wounds (<em>P</em> &lt; 0.001), bullet or bone fragment remains in the spinal canal (<em>P</em> &lt; 0.001) and injury pattern (<em>P</em> &lt; 0.001). After a multivariate analysis through a binary logistic regression model, the aforementioned variables remained statistically significant except neurological compromise.</p></div><div><h3>Conclusions</h3><p>In this multicenter study of spinal gunshot victims, most were treated non-surgically, despite neurological injury in 76% and spinal injury in 63% of patients.</p></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"68 4","pages":"Pages T328-T335"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1888441524000493/pdfft?md5=31407c644507d29f6c6fa41b45efe2f7&pid=1-s2.0-S1888441524000493-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139703681","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Translated article] Vancomycin powder in the prevention of infection in primary knee and hip arthroplasty: Case–control study with 1151 arthroplasties","authors":"X. Paredes-Carnero ,&nbsp;J. Vidal-Campos ,&nbsp;F. Gómez-Suárez ,&nbsp;H. Meijide","doi":"10.1016/j.recot.2024.03.007","DOIUrl":"10.1016/j.recot.2024.03.007","url":null,"abstract":"<div><h3>Background and objective</h3><p>Vancomycin powder (VP) has been positively used in spinal surgery to reduce the rate of infections. Hardly any data have been published on hip and knee joint replacement surgery, and its usefulness is questioned. Our objective was to investigate the effectiveness of VP in reducing prosthetic infection and its possible complications.</p></div><div><h3>Methods</h3><p>Primary hip (THA) and knee (TKA) arthroplasties were reviewed, performed by five surgeons in one hospital centre, between 2017 and 2018. One gram of VP was used on the implant prior to surgical closure based on the surgeon's preferences. With a 5-year follow-up in which the infection rate and local complications were analysed.</p></div><div><h3>Results</h3><p>One thousand one hundred and fifty-one arthroplasties were performed, 748 were TKA and 403 were THA. Nine patients were diagnosed with prosthetic infection, of which five received VP and four did not (<em>p</em> <!-->=<!--> <!-->0.555). Likewise, another 15 patients suffered wound complications, of which 11 received VP and 4 did not (<em>p</em> <!-->=<!--> <!-->0.412). There were no differences, either, in the rest of the complications depending on the use or not of VP (<em>p</em> <!-->=<!--> <!-->0.101). Likewise, the number of patients who needed reintervention was similar (<em>p</em> <!-->=<!--> <!-->0.999).</p><p>No systemic complications were detected due to the use of VP.</p></div><div><h3>Conclusions</h3><p>It has not been possible to demonstrate that the use of VP reduces the rates of prosthetic infection in the hip and knee, so we cannot recommend its use.</p></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"68 4","pages":"Pages T344-T350"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1888441524000699/pdfft?md5=be999d56a1a88f0c7d3d1640003a4789&pid=1-s2.0-S1888441524000699-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140176972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Artículo traducido] Predictores de las complicaciones postoperatorias en el primer año tras la fijación de fracturas de tobillo de baja energía. Estudio de cohortes retrospectivo sobre 663 fracturas intervenidas consecutivamente en un único centro","authors":"J.-V. Andrés-Peiró ,&nbsp;O. Pujol ,&nbsp;M. Altayó-Carulla ,&nbsp;S. Castellanos-Alonso ,&nbsp;M.-M. Reverté-Vinaixa ,&nbsp;J. Teixidor-Serra ,&nbsp;J. Tomàs-Hernández ,&nbsp;J. Selga-Marsà ,&nbsp;Y. García-Sánchez ,&nbsp;V. Molero-García ,&nbsp;N. Joshi-Jubert ,&nbsp;J. Minguell-Monyart","doi":"10.1016/j.recot.2024.01.029","DOIUrl":"10.1016/j.recot.2024.01.029","url":null,"abstract":"<div><h3>Introduction</h3><p>Rotational ankle fractures are common, have diverse personalities and affect both robust and fragile patients. Postoperative complications are frequent, creating a sizeable economic burden. The primary purpose of this study was to expand current knowledge on predictors of postoperative complications after low-energy ankle fracture fixation.</p></div><div><h3>Materials and methods</h3><p>A retrospective single-center cohort study was completed of patients undergoing internal fixation OF low-energy ankle fractures. The primary outcome was first-year postoperative complications, classified as major (surgical) or minor (non-surgical). Data on patients, their injuries, and treatments were collected. To identify potential predictors of outcomes, logistic regression methods were used, with a backward-stepwise method used for model fitting.</p></div><div><h3>Results</h3><p>In total, 663 patients of median age 59 years were analysed. We found a high rate of complications (28.4%), with wound-healing issues and infections predominant. Overall, 14.8% had minor complications, while 13.6% required an unplanned reoperation. On multivariable analysis, the most consistent predictors of complications were older age (OR: 1.02 per year), longer operating time (3.32 per hour), and smoking (2.91).</p></div><div><h3>Conclusions</h3><p>Older patients and smokers who sustain fractures requiring more complex surgery are at higher risk of postoperative complications.</p></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"68 4","pages":"Pages T363-T372"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1888441524000560/pdfft?md5=d01408a4b8dee17585eb0b427f2468cc&pid=1-s2.0-S1888441524000560-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139703644","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inteligencia artificial: futuro y desafíos en la medicina moderna","authors":"D. Aedo-Martín","doi":"10.1016/j.recot.2023.03.015","DOIUrl":"10.1016/j.recot.2023.03.015","url":null,"abstract":"","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"68 4","pages":"Pages 428-429"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1888441523001091/pdfft?md5=3277c4fc95ae18ccc71294214c591402&pid=1-s2.0-S1888441523001091-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9348763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spinal gunshot wounds: A retrospective, multicenter, cohort study","authors":"G. Ricciardi ,&nbsp;O. Martinez ,&nbsp;J. Cabrera ,&nbsp;J. Matta ,&nbsp;V. Davila ,&nbsp;J.M. Jimenez ,&nbsp;H. Vilchis ,&nbsp;V. Tejerina ,&nbsp;J. Perez ,&nbsp;J.P. Cabrera ,&nbsp;R. Yurac","doi":"10.1016/j.recot.2023.07.001","DOIUrl":"10.1016/j.recot.2023.07.001","url":null,"abstract":"<div><h3>Introduction and objective</h3><p>To describe the demographic and clinical characteristics and treatment of patients with spinal gunshot wounds across Latin America.</p></div><div><h3>Material and methods</h3><p>Retrospective, multicenter cohort study of patients treated for gunshot wounds to the spine spanning 12 institutions across Latin America between January 2015 and January 2022. Demographic and clinical data were recorded, including the time of injury, initial assessment, characteristics of the vertebral gunshot injury, and treatment.</p></div><div><h3>Results</h3><p>Data on 423 patients with spinal gunshot injuries were extracted from institutions in Mexico (82%), Argentina, Brazil, Colombia, and Venezuela. Patients were predominantly male civilians in low-risk-of-violence professions, and of lower/middle social status, and a sizeable majority of gunshots were from low-energy firearms. Vertebral injuries mainly affected the thoracic and lumbar spine. Neurological injury was documented in <em>n</em> <!-->=<!--> <!-->320 (76%) patients, with spinal cord injuries in 269 (63%). Treatment was largely conservative, with just 90 (21%) patients treated surgically, principally using posterior open midline approach to the spine (<em>n</em> <!-->=<!--> <!-->79; 87%). Injury features distinguishing surgical from non-surgical cases were neurological compromise (<em>p</em> <!-->=<!--> <!-->0.004), canal compromise (<em>p</em> <!-->&lt;<!--> <!-->0.001), dirty wounds (<em>p</em> <!-->&lt;<!--> <!-->0.001), bullet or bone fragment remains in the spinal canal (<em>p</em> <!-->&lt;<!--> <!-->0.001) and injury pattern (<em>p</em> <!-->&lt;<!--> <!-->0.001). After a multivariate analysis through a binary logistic regression model, the aforementioned variables remained statistically significant except neurological compromise.</p></div><div><h3>Conclusions</h3><p>In this multicenter study of spinal gunshot victims, most were treated non-surgically, despite neurological injury in 76% and spinal injury in 63% of patients.</p></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"68 4","pages":"Pages 328-335"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1888441523001650/pdfft?md5=06ee6314969cae766ec2ea8fa3fa2a54&pid=1-s2.0-S1888441523001650-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10024796","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disociación espinopélvica, revisión de conceptos actuales","authors":"M. Hirschfeld,&nbsp;F.J. Pascual-López,&nbsp;E. Guerado","doi":"10.1016/j.recot.2023.09.001","DOIUrl":"10.1016/j.recot.2023.09.001","url":null,"abstract":"<div><h3>Introduction</h3><p>Spinopelvic dissociation is an uncommon injury, but, at the same time, very serious, since it can associate important complications with high morbidity and mortality. Its low frequency means that the experience of the specialists who have to deal with it is often very limited.</p></div><div><h3>Objective</h3><p>To analyze the treatment indications based in classifications and surgery techniques.</p></div><div><h3>Method</h3><p>A search for scientific articles from high-impact journals was performed through international databases, such as Pubmed, Cochrane Library, Scopus, Science Direct and OVID.</p></div><div><h3>Conclusions</h3><p>The management of the injury we are analyzing represents a challenge. The diagnosis is carried out through a meticulous anamnesis and physical examination, supported by imaging tests, where tomography acquires special relevance. The treatment is fundamentally surgical, reserved the conservative option for a few cases. Triangular fixation is nowadays considered the treatment of choice.</p></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"68 4","pages":"Pages 398-408"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1888441523001935/pdfft?md5=9c2d2411f5e10edf031255eb33afa198&pid=1-s2.0-S1888441523001935-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10188727","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}