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Background: The acromioclavicular joint injury is one of the most common injuries, perhaps by subcutaneous position and the relative scarcity of muscles that protect Objective: To determine whether there are differences between open and arthroscopic surgery on patients with acromioclavicular dislocation. Material and methods: An observational retrospective study which included 162 patients with acromioclavicular dislocation were treated at the Military Central Hospital in the period from June 1, 2012 to June 1, 2014 the constant scale was obtained at 4, 8 and 12 weeks of the 62 patients who received management via open and arthroscopic fitness for repair. Results: 86% of patients undergoing open ACI had good to excellent functional results (84.3±5.2points, p <0.001) which means that although there is advantage of arthroscopic technique, the results of technical open are also excellent Arthroscopic surgery had more cases due to the technical difficulty to perform the procedure. Cases of operations of surgical complications due representing anchoring of the implants, while open surgery only presented a case of migration, which did not left painful consequences for the patient. Conclusions: The Central Military Hospital is the main referral center for trauma of the military system, casuistry of this study provides a comprehensive overview of management in this institution. [ABSTRACT FROM AUTHOR]

Background: The use of negative-pressure wound therapy (NPWT) has been an important adjunct to the management of traumatic wounds and surgical incisions related to musculoskeletal trauma. NPWT mechanisms of action include stabilization of the wound environment, reduction of wound edema, improvement of tissue perfusion, and stimulation of cells at the wound surface. NPWT stimulates granulation tissue and angiogenesis and may improve the likelihood of primary closure and reduce the need for free tissue transfer. Objective: To report the experience with the application of VAC system in the treatment of wounds due to traumatism by gunshot wounds. Material and method: An observational retrospective study was performed, from January 1st 2011 to January 1st 2014, in which patients, admitted for the first time to the Hospital Central Militar, diagnosed with extremity gunshot wounds and treated with surgical cleaning and VAC system. Results: 28 patients (active military) who entered to the hospital with gunshot wounds in extremities and were submitted to surgical cleaning and VAC system were analyzed. Mean hospital stay of patients with gunshot wounds treated with VAC system was of 82 days (16-207 days), 31.7 days (5-46 days) receiving this therapy, with five of the system. Conclusions: NPWT results in an increase in blood flow to the wounds, bettering on wounds for its secondary closure, decrease of infection rates, among others. [ABSTRACT FROM AUTHOR]

There is no accurate statistics about the patients treated for traumatic orthopedic injuries at the Emergency Department of the Central Military Hospital regarding the diagnosis, treatment instituted, prognosis or monitoring, and cost effective analysis of the same. Material and methods. We conducted a retrospective observational study which included the 280 patients with 285 fractures admitted to the Central Military Hospital and required surgical management of the same. Performing a database by the principal investigator. Subsequently classified by consensus of the three researchers, each of the fractures according to the main alphanumeric classification used internationally for the "long bone fractures", then a descriptive statistical analysis was appled. Results. From January to June 2011 were received with 285 fractures 280 patients admitted to the Central Military Hospital and required surgical management in the same age range of 15 to 95 years with a mean of 36.5 years. Young adults are the age group most commonly affected especially within the male population in the 20 to 29 years with a male/female ratio of 8:1, and in the group of 30-39 years with a ratio of 6:1. This ratio tends to equalize as one ages, which could be explained by the fact that in this age of man labor activity decreases and increases the incidence of fall injuries at home, this is happening more often in females , becoming up to 1.2:1 ratio for groups over 60. The surgical sites most often affected are shown in detail in the tables 1-5. Conclusions. The Central Military Hospital is the main referral center for military system. Using the AO classification system is now possible to accurately define the location and complexity of each fracture accurately defining the first contact with the patient requiring definitive management in addition to their prognosis and care. [ABSTRACT FROM AUTHOR]

Introduction: The anterior cruciate ligament (ACL) provides posteroanterior stability to the knee. The incidence of ACL ruptures is 1/3,000. The gold standard in diagnosis is diagnostic arthroscopy. Arthroscopic reconstruction offers the best results. Objective: To verify that the functional results in postoperative patients of arthroscopic reconstruction of the ACL with the all-inside® technique are good to excellent using the Lysholm functional evaluation scale. Material and methods: The scores obtained on the Lysholm scale prior to surgery were reviewed at two, six, 10 and 15 postoperative weeks of patients diagnosed with ACL lesion undergoing arthroscopic reconstruction using the all-inside® technique from August 1st, 2016 to August 1st, 2017. The results of the Lysholm functional scale were statistically compared using the Friedman test, and the range of mobility, with the ANOVA and Tukey tests. Results: A sample of 34 patients was recruited. The average obtained in the Lysholm scale was 87.82 at the 15th postoperative week. There was a statistically signifi cant difference in score of the Lysholm scale and the range of mobility when comparing the score prior to surgery with 10 and 15 postoperative weeks. Conclusions: All-inside® technique is an adequate therapeutic option for patients with ACL tears that allows good results in short-term follow-up. [ABSTRACT FROM AUTHOR]

Introduction: Gunshot Wounds (GW) are to date a public health problem worldwide. In United States, each year from 30,000 to 50,000 people die secondary to a gunshot wound, making gunshot wounds the leading cause of death in the age group between 1-19 years of age, it is also estimated that for every death there are at least three disabling injuries resulting in approximately 150,000 injuries caused by firearm projectiles each year. In Mexico, the epidemiology of these injuries is unknown. The Military Central Hospital has no record of what could provide us some information to make it better to understand the magnitude of this problem in our environment and thereby take medical decisions best suited to the survival of our beneficiaries. Objective: To analyze the epidemiology of injuries by firearm projectile. Materials and Methods: We conducted a retrospective observational study of six years from January fist 2006 to December 31, 2011, in which 246 patients who first entered the Central Military Hospital in Mexico with a diagnosis of "Gunshot wound injury" according to their clinical record, subsequently clinical records were obtained of the Central Military Hospital archive, proceeding to the database filling with the parameters set by the researchers. Taking the patient dependent variables such as: age, sex, status in the army, hierarchy in the army (in case of being army man); were subjected to the clinical description of the injury, including anatomic site, fracture, production time between injury and admission to the emergency room and fist diagnosis, also the circumstances of injuries were described, including the place of injury, use of body armor, the caliber of the projectile and the number of impact. Variables during hospitalization were taken such as hospital days, surgical procedures, the use of hyperbaric chamber, antibiotic therapy, the number of specialties involved in the care of these patients, the use of blood transfusions, infections according to the medium culture, their complications and readmissions and the degree of disability certification for employment as military. Then, we made tables and statistical analysis of descriptive data, expressing the results in graphs and thus drawing conclusions. Results: From January the first 2006 to December 31ST 2011 we received a total of 246 patients with the diagnosis of "Gunshot wound injury" in the emergency department of the Central Military Hospital in Mexico with a total of 313 bullets, the male sex was predominant with 93% of the lesions, most patients were military (81%) and troop mainly (56%), the main circumstance in which our patients were injured by firearms was the street (56%) followed by confrontation with armed group (22%), 9 mm weapons are primarily used to produce these lesions, generating between 1 and 6 impacts per patient, mostly 2. The main affected anatomical site was lower limb, followed by chest and upper extremities, generating aggregate fractures in the 45%. While in emergency management, 16% required blood transfusion. During hospitalization most patients required one (39%) to two antibiotics (43%), being required hyperbaric chamber therapy in 5%. During follow-up, 19% of patients had a readmission for treating gunshot injuries. Conclusions: The management of these patients is a public health problem in the military population and an important issue to consider because of the large number of human and material resources for the management of these lesions resources, considering that the 246 patients were 877 performed several surgeries and that the average length of stay was 21days alert us because of the number of specialists needed to meet these demands. [ABSTRACT FROM AUTHOR]

Background: The high frequency of injuries by gun fire in the spine and the resulting spinal injuries, as well as prolonged and severe disability caused by them have improved their classification and study methods. The etiology of spinal cord injury according to U.S. statistics are car accidents most than 50%, falls 20%, sports injuries 10% and wound either by knife or gunshot 10%. Objective: To determine the epidemiology of wounds by gun fire in spine in a military population. Material and method: An observational retrospective study of five years from January 1st 2009, to December 31st 2013, in which 14 patients with the diagnosis of spinal cord injury were included. Results: 14 patients were included; the most affected was the male gender 13m /1f . 85% of cases were recorded during the years 2010, 2011 and 2013. The average age was 26.85 years with a range of 17-37. The states with the highest number of cases were: Tamaulipas (35%), Nuevo León (14%) and Guerrero (14%). Conclusions: Injuries by gun fire of spine are becoming more common in the military population. These lesions are associated with a high degree of sequels whose care requires a multidisciplinary hospital management for long time with high costs for the Military Health Service. [ABSTRACT FROM AUTHOR]