Revista Espanola de Cirugia Ortopedica y Traumatologia最新文献

{"title":"[Translated article] Approach and management of patients injured by bullfighting trauma","authors":"A. Martínez-Hernández ,&nbsp;G. Jara-Benedetti ,&nbsp;C. Roig-Martí ,&nbsp;C. Ordóñez-Urgiles ,&nbsp;J.M. Laguna-Sastre","doi":"10.1016/j.recot.2024.11.006","DOIUrl":"10.1016/j.recot.2024.11.006","url":null,"abstract":"<div><h3>Introduction</h3><div>Bullfighting festivals are attributed to the cultural idiosyncrasies of the Ibero-American people, posing an extreme risk to the physical integrity of the participants. Spain is considered the country with the highest number of bull-related celebrations worldwide and, therefore, with the highest number of patients injured by bullfighting trauma treated, thus justifying a public health problem. The generalities associated with this type of trauma define the people injured as polytraumatised patients. In addition, it is important to know the kinematics of the injuries and their specific characteristics, in order to implement quality medical–surgical care.</div></div><div><h3>Methods</h3><div>Scientific review of the literature to promote a comprehensive guide for the medical–surgical management of patients injured by bullfighting trauma.</div></div><div><h3>Results</h3><div>We described the guidelines to standardise protocols for in-hospital approach of patients injured by bullfighting trauma.</div></div><div><h3>Conclusions</h3><div>Bullfighting trauma is considered a real health problem in the emergency departments of the ibero-Americans countries, especially in Spain, where bullfighting is part of the national culture. The inherent characteristics of these animals cause injuries with special aspects, so it is important to know the generalities of bullfighting trauma. Because of the multidisciplinary approach, these guidelines are adressed to all healthcare providers involved in the management of these patients. It is essential to establish particular initial care for this type of injury, specific therapeutic action and follow-up based on the medical–surgical management of the trauma patient in order to reduce the associated morbidity and mortality.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"69 1","pages":"Pages T27-T37"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142630270","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":"Retrospective survival analysis of the use of uncemented modular tapered stems for revision in periprosthetic Vancouver B-type fractures. Is instability a threat to survival?","authors":"J. Lixa,&nbsp;P. Vieira,&nbsp;P. Pereira,&nbsp;A. Pinho,&nbsp;M. Seara,&nbsp;A. Sousa,&nbsp;L. Vieira","doi":"10.1016/j.recot.2024.03.010","DOIUrl":"10.1016/j.recot.2024.03.010","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>Periprosthetic hip fractures show increasing incidence and complexity, representing a challenge for the surgeon. We aimed to evaluate the survival of uncemented modular tapered stems in the treatment of periprosthetic Vancouver B2 and B3 type fractures and review the main complications and factors associated with decreased survival.</div></div><div><h3>Materials and methods</h3><div>We performed a retrospective study of patients submitted to revision arthroplasty for treatment of periprosthetic femoral stem Vancouver B2 and B3 type fractures with an uncemented modular fluted tapered stem (MRP-Titan). Demographic and radiographic parameters were analyzed. The survival rate (free of reoperation) was calculated at 2- and 5-years using the Kaplan–Meier survivorship analysis.</div></div><div><h3>Results</h3><div>Thirty-nine patients were included with a mean age of 73.5 years and a mean follow-up of 5 years. Arthroplasty survivorship at 2 years was 73.7% and at 5 years was 67.5% (mean 8.4 years; range 6.7–10.2). Survivorship was inferior in the patients with episodes of instability (mean 2.5 years; range 0–5.42) (<em>p</em> <!-->&lt;<!--> <!-->0.001). At least one episode of instability occurred in 26.3% of patients and 60% of these patients had a femoral head size 32<!--> <!-->mm or lower. At least one episode of instability occurred in 71.4% of patients with a greater trochanter fracture (<em>p</em> <!-->=<!--> <!-->0.008). The consolidation rate was 90.6% and the mortality rate was 23.7%. In the group of patients that died, 55.6% were submitted to at least one revision surgery (<em>p</em> <!-->=<!--> <!-->0.044).</div></div><div><h3>Conclusion</h3><div>Survivorship of an uncemented modular stem (MRP-Titan) in revision for PHF is significantly reduced by episodes of instability.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"69 1","pages":"Pages 2-8"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140194736","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":"Correspondence “Exploring the potential of artificial intelligence in traumatology: Conversational answers to specific questions”","authors":"H. Daungsupawong ,&nbsp;V. Wiwanitkit","doi":"10.1016/j.recot.2024.06.004","DOIUrl":"10.1016/j.recot.2024.06.004","url":null,"abstract":"","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"69 1","pages":"Pages 104-105"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141327969","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] Surgical treatment of ipsilateral bifocal tibial fractures: A challenge for the surgeon","authors":"A. Ortega-Yago,&nbsp;M. Barrés-Carsí,&nbsp;A. Balfagón-Ferrer","doi":"10.1016/j.recot.2024.11.011","DOIUrl":"10.1016/j.recot.2024.11.011","url":null,"abstract":"<div><h3>Introduction</h3><div>The association of ipsilateral tibia fractures has a low incidence, being up to 3.2% of total tibia fractures. Currently there is no gold standard regarding the ideal surgical treatment.</div><div>The objective of this study is to analyze the surgical treatment and the radiographic and functional results, as well as the associated complication rate of ipsilateral bifocal tibia fractures.</div></div><div><h3>Material and methods</h3><div>Retrospective observational study in our hospital from 2010 to 2022 of 24 patients who underwent bifocal fracture of the ipsilateral tibia. Demographic and surgical data and complications during follow-up were included.</div></div><div><h3>Results</h3><div>The 24 patients were classified into Group 1 when they presented a fracture of the plateau and distal tibia (25%), Group 2 with a fracture of the plateau and diaphysis (33%) and Group 3 with a fracture of the diaphysis and distal tibia (42%). Three patients underwent surgery with 1 implant and 21 patients with 2 implants. The average follow-up time in outpatient clinics was 2 and a half years. At one year, 22 patients (92%) had full weight bearing and 2 patients had partial weight bearing (8%) due to the sequelae of the fractures. The average time for consolidation of the diaphysis was 7.75<!--> <!-->±<!--> <!-->2 months, with no significant differences observed between Group 2 and Group 3 (<em>p</em> <!-->=<!--> <!-->0.06). The average time for consolidation of the metaphysis was 3.50<!--> <!-->±<!--> <!-->1.5 months, with no significant differences observed between Group 1 and Group 2 (<em>p</em> <!-->=<!--> <!-->0.065). Seven patients (30%) had complications during follow-up.</div></div><div><h3>Conclusions</h3><div>Bifocal tibia fractures can be treated using a combination of intramedullary nailing and plate osteosynthesis with good long-term results, obtaining an optimal union rate and low complications. In addition, it facilitates the reduction of the fracture, thus facilitating the patient's recovery and obtaining good long-term functional results.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"69 1","pages":"Pages T61-T69"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142630276","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":"Abordaje y manejo médico-quirúrgico del paciente herido por traumatismo taurino","authors":"A. Martínez-Hernández ,&nbsp;G. Jara-Benedetti ,&nbsp;C. Roig-Martí ,&nbsp;C. Ordóñez-Urgiles ,&nbsp;J.M. Laguna-Sastre","doi":"10.1016/j.recot.2024.05.003","DOIUrl":"10.1016/j.recot.2024.05.003","url":null,"abstract":"<div><h3>Introduction</h3><div>Bullfighting festivals are attributed to the cultural idiosyncrasies of the Ibero-American people, posing an extreme risk to the physical integrity of the participants. Spain is considered the country with the highest number of bull-related celebrations worldwide and, therefore, with the highest number of patients injured by bullfighting trauma treated, thus justifying a public health problem. The generalities associated with this type of trauma define the people injured as polytraumatised patients. In addition, it is important to know the kinematics of the injuries and their specific characteristics, in order to implement quality medical-surgical care.</div></div><div><h3>Methods</h3><div>scientific review of the literature to promote a comprehensive guide for the medical-surgical management of patients injured by bullfighting trauma.</div></div><div><h3>Results</h3><div>We described the guidelines to standardise protocols for in-hospital approach of patients injured by bullfighting trauma.</div></div><div><h3>Conclusions</h3><div>Bullfighting trauma is considered a real health problem in the emergency departments of the ibero-Americans countries, especially in Spain, where bullfighting is part of the national culture. The inherent characteristics of these animals cause injuries with special aspects, so it is important to know the generalities of bullfighting trauma. Because of the multidisciplinary approach, this guidelines are adressed to all healthcare providers involved in the management of these patients. It is essential to establish particular initial care for this type of injury, specific therapeutic action and follow-up based on the medical-surgical management of the trauma patient in order to reduce the associated morbidity and mortality.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"69 1","pages":"Pages 27-37"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141088883","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":"Prevalencia de reamputación en amputaciones menores del pie en pacientes con pie diabético, estudio de corte transversal","authors":"C.A. Sánchez Correa ,&nbsp;I. Briceño Sanín ,&nbsp;J.J. Bautista Valencia ,&nbsp;M.E. Niño ,&nbsp;J. Robledo Quijano","doi":"10.1016/j.recot.2024.06.009","DOIUrl":"10.1016/j.recot.2024.06.009","url":null,"abstract":"<div><h3>Introduction</h3><div>Reported prevalence for reamputation in diabetic foot is diverse, risk factors are not clear for minor amputations. This study aims to determine the prevalence for reamputation in diabetic foot from minor amputations and to evaluate associated factors for such outcome.</div></div><div><h3>Methods</h3><div>Cross sectional study developed in 2<!--> <!-->hospitals. Patients hospitalized for diabetic foot ulcer requiring a minor amputation were included. A descriptive analysis of all variables is presented, as well as prevalence ratios (PR) and a multivariate logistic regression.</div></div><div><h3>Results</h3><div>The prevalence was of 48% for 15 years. Toes were the most frequent minor amputation that required reamputation and above the knee amputation was the most frequent reamputation level (45%). Variables whose PR was associated to reamputation risk were: smoking history (PR 1.32, CI 95%: 1.02-1.67, <em>P</em> <!-->=<!--> <!-->0.03), vascular occlusion in doppler (PR 1.47, CI 95%: 1.11-1.73, <em>P</em> <!-->=<!--> <!-->0.01), revascularization (PR 1.73, CI 95%: 1.31-2.14, <em>P</em> <!-->=<!--> <!-->0.00002), Wagner<!--> <!-->&gt; 3 (PR 1.75, CI 95%: 1.16-1.84, <em>P</em> <!-->=<!--> <!-->0.01) and leucocytosis<!--> <!-->&gt; 11,000 (PR 1.39, CI 95%: 1.07-1.68, <em>P</em> <!-->=<!--> <!-->0.01).</div><div>Leucocytosis<!--> <!-->&gt; 11,000, Wagner<!--> <!-->&gt; 3, vascular occlusion in doppler and revascularization were the variables that best predicted the outcome. Furthermore, leucocytosis was the best variable for predicting reamputation (OR 2.4, CI 95%: 1.1-5.6, <em>P</em> <!--> <!-->=<!--> <!-->0.04).</div></div><div><h3>Conclusions</h3><div>Reamputation prevalence was 48%. The toes were the minor amputation more frequently requiring reamputation and above the knee was the most frequent reamputation level. Risk for reamputation was associated with variables related to vascular compromise and infection.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"69 1","pages":"Pages 70-76"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141443484","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] Analysis of machine learning algorithmic models for the prediction of vital status at six months after hip fracture in patients older than 74 years","authors":"I. Calvo Lorenzo,&nbsp;I. Uriarte Llano,&nbsp;M.R. Mateo Citores,&nbsp;Y. Rojo Maza,&nbsp;U. Agirregoitia Enzunza","doi":"10.1016/j.recot.2024.11.008","DOIUrl":"10.1016/j.recot.2024.11.008","url":null,"abstract":"<div><h3>Background and objective</h3><div>The objective is to develop a model that predicts vital status six months after fracture as accurately as possible. For this purpose we will use five different data sources obtained through the National Hip Fracture Registry, the Health Management Unit and the Economic Management Department.</div></div><div><h3>Material and methods</h3><div>The study population is a cohort of patients over 74 years of age who suffered a hip fracture between May 2020 and December 2022. A warehouse is created from five different data sources with the necessary variables. An analysis of missing values and outliers as well as unbalanced classes of the target variable (“vital status”) is performed. Fourteen different algorithmic models are trained with the training. The model with the best performance is selected and a fine tuning is performed. Finally, the performance of the selected model is analysed with test data.</div></div><div><h3>Results</h3><div>A data warehouse is created with 502 patients and 144 variables. The best performing model is Linear Regression. Sixteen of the 24 cases of deceased patients are classified as live, and 14 live patients are classified as deceased. A sensitivity of 31%, an accuracy of 34% and an area under the curve of 0.65 is achieved.</div></div><div><h3>Conclusions</h3><div>We have not been able to generate a model for the prediction of six-month survival in the current cohort. However, we believe that the method used for the generation of algorithms based on machine learning can serve as a reference for future works.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"69 1","pages":"Pages T47-T54"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142630269","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] Thrombotic event prevention in patients undergoing posterior lumbar arthrodesis: Our experience. A retrospective case series study","authors":"M. Desviat Ruiz,&nbsp;P. Jordà Gómez,&nbsp;K. Ramón López,&nbsp;J.M. Romero Martínez,&nbsp;J.J. Valls Vilalta,&nbsp;N. Fernández Fernández,&nbsp;Á. Chulvi Gimeno,&nbsp;L. Cuñat Navarro,&nbsp;J. Poyatos Campos","doi":"10.1016/j.recot.2024.11.009","DOIUrl":"10.1016/j.recot.2024.11.009","url":null,"abstract":"<div><h3>Introduction</h3><div>There is no generalised consensus regarding perioperative prophylaxis of venous thromboembolism (VTE), either on using or timing it in patients undergoing spine surgery. VTE is a current concern because, even though being an uncommon event, it can cause serious complications. The aim of the present study is to propose guidelines for the prevention of thrombotic events in posterior spinal surgery, either as deep vein thrombosis or pulmonary thromboembolism. If the number of patients getting prophylaxis drugs is reduced a subsequent reduction of the incidence of epidural haematoma can be expected.</div></div><div><h3>Materials and methods</h3><div>A number of 235 patients who had undergone posterior spinal arthrodesis in the previous five years were studied. Mechanical thromboprophylaxis measures consisting of compression stockings were applied in all of them. Anticoagulant drugs were also applied whenever risk factors for thrombosis were observed. Early weight-bearing was resumed immediately after surgery. Demographic, clinical, and surgical variables were collected, as well as complications appearing during the follow-up period, that was scheduled at one, two, four, six and twelve months after the surgery. Thrombotic events, if present, were diagnosed by clinical and imaging tests such as ultrasound and CT angiography.</div></div><div><h3>Results</h3><div>From the total 235 patients of this series, one hundred and fifty-three cases met the study inclusion criteria. A total of four thrombotic events appeared, one in the form of deep vein thrombosis and other three in the form of pulmonary thromboembolism. These last patients suffering an embolism died because of it. None of the variables studied had statistical significance for the occurrence of a thrombotic event. All four patients who suffered thrombotic events were receiving anticoagulant drugs, in addition to mechanical compression stockings, because of the presence of risk factors for thrombosis.</div></div><div><h3>Conclusions</h3><div>By applying the fore mentioned protocol, adequate prevention of thromboembolic events was achieved in this study population of patients undergoing posterior spinal surgery.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"69 1","pages":"Pages T55-T60"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142630278","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":"Guías impresas en 3D: ¿mejoran el control local y la supervivencia global en el tratamiento de los sarcomas pélvicos? Estudio de validación clínica","authors":"T. Fernández-Fernández ,&nbsp;L. Mediavilla-Santos ,&nbsp;M. Cuervo-Dehesa ,&nbsp;E. Gómez-Larrén ,&nbsp;R. Pérez-Mañanes ,&nbsp;J. Calvo-Haro","doi":"10.1016/j.recot.2024.07.013","DOIUrl":"10.1016/j.recot.2024.07.013","url":null,"abstract":"<div><h3>Background and objectives</h3><div>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.</div></div><div><h3>Material and methods</h3><div>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.</div></div><div><h3>Results</h3><div>The 3D group achieved a higher rate of free margins (80% vs 66.7%, p = 0.345). Local recurrence (50% vs 60%, <em>P</em>=.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%.</div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"69 1","pages":"Pages 83-90"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tratamiento quirúrgico de las fracturas bifocales ipsilaterales de tibia: un reto para el cirujano","authors":"A. Ortega-Yago,&nbsp;M. Barrés-Carsí,&nbsp;A. Balfagón-Ferrer","doi":"10.1016/j.recot.2024.06.005","DOIUrl":"10.1016/j.recot.2024.06.005","url":null,"abstract":"<div><h3>Introduction</h3><div>The association of ipsilateral tibia fractures has a low incidence, being up to 3.2% of total tibia fractures. Currently there is no gold standard regarding the ideal surgical treatment.</div><div>The objective of this study is to analyze the surgical treatment and the radiographic and functional results, as well as the associated complication rate of ipsilateral bifocal tibia fractures.</div></div><div><h3>Material and methods</h3><div>Retrospective observational study in our hospital from 2010 to 2022 of 24 patients who underwent bifocal fracture of the ipsilateral tibia. Demographic and surgical data and complications during follow-up were included.</div></div><div><h3>Results</h3><div>The 24 patients were classified into group 1 when they presented a fracture of the plateau and distal tibia (25%), group 2 with a fracture of the plateau and diaphysis (33%) and group 3 with a fracture of the diaphysis and distal tibia (42%). 3 patients underwent surgery with 1 implant and 21 patients with 2 implants. The average follow-up time in outpatient clinics was 2 and a half years. At one year, 22 patients (92%) had full weight bearing and 2 patients had partial weight bearing (8%) due to the sequelae of the fractures. The average time for consolidation of the diaphysis was 7.75<!--> <!-->±<!--> <!-->2 months, with no significant differences observed between group 2 and group 3 (p<!--> <!-->=<!--> <!-->0.06). The average time for consolidation of the metaphysis was 3.50<!--> <!-->±<!--> <!-->1.5 months, with no significant differences observed between group 1 and group 2 (p<!--> <!-->=<!--> <!-->0.065). 7 patients (30%) had complications during follow-up.</div></div><div><h3>Conclusions</h3><div>Bifocal tibia fractures can be treated using a combination of intramedullary nailing and plate osteosynthesis with good long-term results, obtaining an optimal union rate and low complications. In addition, it facilitates the reduction of the fracture, thus facilitating the patient's recovery and obtaining good long-term functional results.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"69 1","pages":"Pages 61-69"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141327972","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}