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Introduction: The objective of this study was to make an update on the different strategies in the blood saving in prosthetic primary knee surgery, through a bibliographical review; As well as to know what strategies are followed in different hospitals in our field, through a survey. Material and methods: We carried out a descriptive transversal observational study based on a survey of 64 surgeons and a bibliographical research on the different aspects included in the survey. Results: Surgeons refer that they have presurgical blood-saving protocols implanted in their Hospital at 48.4%. The use of tranexamic acid (ATX) is quite widespread 71.9% of respondents (46/64). It is administered intravenously prior to surgery in 26.6% of cases, intraarticularly by 21.9% and in a combination of both in 23.4%. The preferred time for the placement of ischemia by surgeons is 57.8% prior to painting the field, while a 39.1% prefer to place it in sterile conditions. 3.1% of surgeons claim to implant the prosthesis without using ischemia in surgery. Discussion: The use of ATX as the primary blood-saving strategy in TKR is being imposed. There is No consensus as to the optimal dose or its route of administration. The efficacy of the ATX is influencing the elimination of post-surgical drainage and the implementation of early rehabilitation programs. [ABSTRACT FROM AUTHOR]

Tibial pilon fractures are one of the most severe types of fractures, not only due to the complexity of their treatment, but also due to the important sequelae they may cause. Moreover, an important percentage of them are open fractures or importantly involve the soft tissues, thus making treatment even more difficult. Thirty-seven patients with tibial pilon fractures treated surgically were included in this study. The results of the FREMAP functional assessment scale were analyzed together with Burwell-Charnley's radiographic criteria. Although there is no consensus on which is the best treatment, it is evident that combined treatment including external and internal fixation with a plate provides the best results. [ABSTRACT FROM AUTHOR]

Introduction: the objective of this study was to analyze the incidence and predisposing factors in subtrochanteric fractures on hips previously treated with cannulated screws after suffering a subcapital fracture, based on eight cases registered in the last 20 years., Material and Methods: this is a retrospective observational study on a series of patients with a diagnosis of subtrochanteric hip fracture, who have been treated in recent months for a subcapital fracture of the same hip by osteosynthesis with cannulated screws. The study period was 20 years (2000-2020)., Results: of the eight cases, five were women and three were men, with a mean age of 75.12 years (range 59-87 years). In all cases, the subtrochanteric fracture occurred within a year after the first fracture, the time elapsed between the two fractures was four months on average (range 1-9 months). Regarding the disposition of the cannulated screws, most of the 7/8 cases were in the shape of an upper vertex triangle, and only one case was in the shape of an inverted triangle or lower vertex. The entry point into the femoral external cortex was at the level of the lesser trochanter in six cases, and in two cases this entry was distal to the lesser trochanter., Conclusion: in our experience, in the etiology of subtrochanteric fractures, the introduction of screws distal to the lesser trochanter, and the distribution of the screws in a triangular shape are the two main objective predisposing factors.

Introduction: The objective of this study was to make an update on the different strategies in the blood saving in prosthetic primary knee surgery, through a bibliographical review; As well as to know what strategies are followed in different hospitals in our field, through a survey., Material and Methods: We carried out a descriptive transversal observational study based on a survey of 64 surgeons and a bibliographical research on the different aspects included in the survey., Results: Surgeons refer that they have presurgical blood-saving protocols implanted in their Hospital at 48.4%. The use of tranexamic acid (ATX) is quite widespread 71.9% of respondents (46/64). It is administered intravenously prior to surgery in 26.6% of cases, intraarticularly by 21.9% and in a combination of both in 23.4%. The preferred time for the placement of ischemia by surgeons is 57.8% prior to painting the field, while a 39.1% prefer to place it in sterile conditions. 3.1% of surgeons claim to implant the prosthesis without using ischemia in surgery., Discussion: The use of ATX as the primary blood-saving strategy in TKR is being imposed. There is No consensus as to the optimal dose or its route of administration. The efficacy of the ATX is influencing the elimination of post-surgical drainage and the implementation of early rehabilitation programs.

Tibial pilon fractures are one of the most severe types of fractures, not only due to the complexity of their treatment, but also due to the important sequelae they may cause. Moreover, an important percentage of them are open fractures or importantly involve the soft tissues, thus making treatment even more difficult. Thirty-seven patients with tibial pilon fractures treated surgically were included in this study. The results of the FREMAP functional assessment scale were analyzed together with Burwell-Charnley's radiographic criteria. Although there is no consensus on which is the best treatment, it is evident that combined treatment including external and internal fixation with a plate provides the best results.

Background: Hip fracture incidence has been estimated in our country over short time periods without evaluating the changes in trend and seasonality over the course of time. This study is aimed at estimating hip fracture incidence in a Health District in the Autonomous Community of Valencia throughout a seven-year period (1994-2000), delving into its trend, seasonality and the geographical changes by health districts and whether a rural or urban population is involved., Methods: Descriptive study of the cases of HF among individuals over 45 years of age. The patients not residing within the District, the pathological fractures and those due to traffic accidents were not included. The time-related and geographical changes in the incidence were estimated by Poisson regression., Results: The overall incidence of hip fractures among individuals over 45 years of age was 274 cases/100000 inhabitants/year (CI 95% 259-288). The incidence among males was 149 cases/100,000 inhabitants/year; being 383 cases/100,000 inhabitants/year for females. The time-related distribution show a positive, although non-significant trend, with an average 0.04% monthly increase in the incidence. This trend was greater among males than among females. A clear seasonality, with relatively lower incidences during the spring and summer months, were found to exist. The incidences did not vary significantly among health districts nor by the type of urban or rural population involved., Conclusions: HF incidence is similar to although somewhat higher than that of other Spanish provinces. A discreet positive trend and a clear seasonality were found, without any significant geographical changes.