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Introduction: Localized scleroderma is the most common form of sclerosis in children; it has an incidence of 2.7 per 100,000 inhabitants, with a predilection for the Caucasian and female races of 2.4 to 4.1 per male. The common denominator is the connective tissue-level condition, causing a variety of clinical presentation ranging from localized sclerotic circumscribed plaques affecting the skin, to deeper conditions that attack muscle and bone tissue, leaving aesthetic consequences and/or disabling deformities in the patient., Objective: Case presentation and surgical management. The data presented were obtained from the physical and electronic clinical record, direct interview with patients and family members and monitoring and evaluation of radiographic studies, from January 2012 to November 2017., Discussion: Surgical treatment is indicated when deformities and contractures condition incapacity in the patient. The best results will be obtained once the disease has stopped progressing.

Introduction: It is essential that orthopaedic resident physicians be highly proficient in all aspects, considering the balance between supply, demand, need and context. Fundamental to identify the capacity and quality installed for their training in Mexico., Material and Methods: Observational Study, transverse, non-probabilistic sampling-conglomerates, in two phases. The instrument has 8 domains, 57 variables and 4,867 items. 60 graduate professors of 20 states, 50 hospital sites, 22 university programs., Results: 1,038 years of experience (collective intelligence), 17 years of experience/teacher (01 to 50 years). Identified: acute pathology 30 (2 to 90%), chronic pathology 30 (5 to 96%), patients 15 years, 10 (3 to 30%), patients between 15 and 65 years, 47 (2 to 78%), patients 65 years, 20 (2 to 60%), number of beds/seat 20 (2 to 510), number of clinics 3 (1 to 48), number of surgical procedures/headquarters per year at the national level, was 960 (50 to 24,650). The national average per resident doctor is 362 surgeries/year with 1,450 surgical times/year., Conclusions: The needs and resources for the training of physicians specializing in orthopedics/traumatology are highly heterogeneous, so it should be adapted to the epidemiological needs of the region of influence, in an area of epidemiological transition. 62.2% expressed not having or have bad academic and scientific infrastructure at its headquarters, more than 50% without rotation overseas and 90% without regular scientific production.

Introduction: Congenital dislocation of the Radial head is a condition that has been described in a few cases in the international literature, the anterior and lateral dislocation were the less frequent forms of presentation with 15% of cases, each, and the posterior dislocation the most frequent with 70% of the total cases reported. However, this pathology is considered the most frequent congenital pathology of the elbow in children. The present study describes the case of a patient with congenital dislocation of elbow anterior variety and another case with dislocation lateral variety, both diagnosed at an early age, in which it has been decided for conservative management and an annual follow-up. A bibliographic review of the subject is also carried out., Discussion: The congenital elbow dislocation usually has a benign evolution, being painless and not very limiting for the patient, so it can be managed conservatively. Pain and limited movement are indicative of surgical treatment. There are multiple surgical treatments for this entity, however they are not widely accepted due to the complications and poor results presented by them.

Congenital analgesia is a rare condition, reporting in the international literature in rare cases since 1932, when it was first described. Its cause has been the subject of development of multiple theories and studies through the years. Currently various studies and experiments as its origin point mutation in the gene encoding SC9NA sodium channels, which have an important role in nociceptive transmission signals in the human body. The purpose of this study is to present two cases that were valued in the department of pediatric orthopedics at UMAE HTYOLV, patients whose insensitivity to pain has produced significant injuries that were once cause for valuation of the hospital.

Introduction: Avulsions of the anterior tibial tuberosity are infrequent lesions that nevertheless have long-term functional repercussions as a result of the lesion itself and of the treatment provided., Material and Methods: A series of 12 patients treated surgically from January 2008 to March 2012 was reviewed. Their diagnosis was Watson-Jones types II and III lesions; they were assessed by applying the Kujala functional scale and radiographically by measuring the tibial tuberosity index. The statistical analysis was done with central trend measurements and non-parametric tests., Results: All patients were male and right knee lesions were slightly predominant. All of them participated in sports activities and the predominant mechanism of injury was forced knee hyperflexion. The evaluation using the Kujala scale showed excellent results. The tibial tuberosity index was not statistically significant with respect to the implants used., Discussion: This type of injuries warrants surgical management to restore the function of the knee extensor mechanism.

The most frequent foot and ankle anatomical alterations in the pediatric population are found in the little toes. Several treatments are proposed for these conditions, ranging from total phalangeal resections, phalangeal osteotomies, osteosynthesis, and soft tissue management. We propose a surgical technique based on the diaphysectomy of the proximal phalanx and the release of soft tissues that are under tension. The purpose is to assess the functional foot results after surgical treatment consisting of proximal phalanx diaphysectomy and soft tissue release using the functional AOFAS scale in pediatric patients. A prospective, longitudinal, descriptive, non-comparative clinical study was conducted from March 2008 to December 2010, with a follow-up of up to six months. Twenty patients (35 toes) were included; 15 females and five males, with a mean age of 14.65 years. Fifteen (30 toes) had bilateral involvement; 88.56% had greater involvement of the fifth toe. The surgical indication was determined based on the degree of functional disability for gait and the type of footwear. The functional assessment was conducted using the AOFAS criteria and a subjective assessment scale with a total score of 100 to assess the metatarsophalangeal and the interphalangeal joints of the smallest toes. Scores were as follows: < 50 points, poor; 51-70 points, fair; 71-90, good, and > 91, excellent. The assessment was done preoperatively and at postoperative month six. The mean preoperative score was 73.55 and the mean postoperative score was 85.75, with a 12.2 point difference (p > 0.5). Results were: 11 excellent, seven good and two fair. There were four relapses, so a salvage procedure was performed with the Ruiz-Mora technique; excellent results were obtained in all four. One case had soft tissue infection. Proximal phalanx diaphysectomy and soft tissue release provides appropriate alignment of the affected toes and relief of soft tissues under tension, thus avoiding broad resections leading to both esthetic and functional alterations. This is a simple and effective technique for the treatment of little toe deformities as it improves function and alignment.

Objective: To observe the course of pediatric patients with femur shaft fractures managed with elastic titanium nails., Methods: A descriptive, longitudinal, ambispective study was conducted at UMAE HTYOLV analyzing femur fractures in patients from one and a half to 16 years of age who were managed with elastic titanium nails during a 5-year period. Bone healing, complications, hip and knee ranges of motion, and gait were assessed., Results: Seventy-one fractures were found in 70 patients. Clinical and radiographic bone healing was observed at a mean of 8.13 weeks, regardless of the type and location of the fracture, and patient age and weight. Two patients had delayed bone healing and one patient progressed to pseudoarthrosis. Among the 70 patients, 54 (77.6%) did not have any complications, and 16 (22.4%) had complications. Sixty-seven patients (95.9%) had full knee and hip mobility without gait alterations; 2 (2.7%) required 3 months of special physical rehabilitation, and one (1.4%) continued having hip and knee stiffness and could not walk., Conclusions: Elastic titanium nails represent an alternative for the management of femur shaft fractures in pediatric patients. Adherence to the technique and indications for their use yields better results and results in fewer complications.

Objective: To report the patellar dislocation recurrence in patients ages 9 to 16 years treated surgically with the Green technique or an arthroscopic approach., Material and Methods: A prospective, longitudinal study was conducted with patients ages 9 to 16 years who presented at the pediatric orthopedics and arthroscopy service at IMSS "Lomas Verdes" UMAE Orthopedics and Traumatology Hospital with a diagnosis of patellar dislocation from January 1st 2003 to December 31st 2006. The patellar dislocation recurrences were recorded., Results: Twenty patients and 24 knees were included; 13 females and 7 males; mean age was 14.3 years +/- 1.75. The dislocations prior to surgical treatment occurred at a mean of 5.5 +/- 2.57 dislocation events, with a range of 2 to 10 events. As regards the side involved, 40% had involvement of the left side, 40% of the right side, with 8 patients each, and 20% were bilateral dislocations. No significant differences were found in the clinical course of the patients treated with the Green technique compared with the arthroscopic surgery group (p = 0.371)., Conclusions: The number of dislocation recurrences after the surgical procedure was not related with the age, gender, number of prior dislocations or surgical technique. No significant difference was found between both groups.

Patellar osteochondral lesions are difficult to diagnose, there must be a high index of suspicion in order to treat them timely. We present this case to point the keys of an early diagnosis and to expose Pritsch technique, which consists in suturing the osteochondral fragment to the anterior surface of the patella. It is an easy procedure and available to the orthopedist, we also present the functional result that was satisfactory in this case.

A detailed knowledge of the consumer's preferences for the different classes of common bean is useful to define objectives in bean breeding and quality projects in a given region or country and it is also a valuable tool to design marketing strategies. The present work consisted on the application of a survey to 1514 common bean consumers in 14 states of Mexico. To facilitate the interpretation of the results the country was divided in four regions: North East, North West, Center and South. In the North West region, 98% of the surveyed individuals eat the "Azufrado" types (sulphur yellow); in the North East, 70% of the consumers prefer "pinto" (beige with brown mottles) and "Bayo" (cream) types; in the South, 90% of the consumers prefer the "Black" type; and in the Center of the country, all commercial classes are consumed. Within a commercial class, specific characteristics are demanded. For instance, in the black type, small and opaque seeds are preferred while in the "Flor de mayo" (Beige with pink mottles) type medium to large seeds having bright seed coat are preferred. The main characteristics utilized by consumers to select a given bean type are cooking time and flavor. It was observed that preferential classes are well established among the consumers since 70% responded that they would not change the preferred class even if the alternative class was sold to a lower price. Consumers do not soak the beans, because it changes the flavor and the aspect of the cooked beans and they do not add salt at the beginning of the cooking process due to the same reason. Organoleptic studies conducted in the laboratory confirmed that soaking of beans or addition of salts in the soaking water or at the beginning of the cooking process negatively affected acceptability of cooked beans by panelists. In this paper aspects related to ways of processing and consuming common beans as well as marketing aspects are discussed.

The present research consisted of an evaluation of five genotypes harvested from six growing locations. Variables of sensory properties, cooking quality and nutritional characteristics were determined. Genotype with longer cooking time was BV which also present hard shell. Those of shorter cooking time were FMB and PV. In Calera frosting during pod filling, drastically reduced cooking time, sensory properties and tannins. Taking this location off, the analysis show little effect of genotype or growing location in regard to determined properties. The genotypes with lower content of tannins were PV and BV. The content of lectins were in general low for all samples and the diferences between genotypes were not statistically significant (p<0.05) but they did for growing location.