Complex dorsal dislocation of the metacarpophalangeal joint of the long fingers: case report and literature review

Dorsal dislocations of the metacarpophalangeal joint of the fingers are rare injuries that are seen more frequently in young patients secondary to trauma due to forced hyperextension of the finger on the extending hand. They are classified as simple when closed reduction is possible, or complex when reduction by closed methods is not possible given the interposition of peri-articular structures. It is important to distinguish between a simple and complex dislocation because their approach and treatment differ. The objective of this study is to update the clinical approach and the different surgical techniques used in the treatment of complex dislocations. We conducted a bibliographic review on metacarpophalangeal dorsal dislocation of the long fingers, excluding those of the thumb, including the Medline (PubMed interface), SciELO and academic google databases. All the articles reviewed conclude that attempts at closed reduction in these types of injuries are often unsuccessful and often lead to additional complications. Open surgical reduction is the method of choice, allowing joint anatomical recovery with the lowest risk of complications. Postoperative immobilization using a dorsal locking splint is recommended for two weeks followed by rehabilitation by occupational therapy, expecting a normal range of motion at six weeks. The low frequency added to the ignorance of the emergency physician when performing the reduction maneuver can often lead to transform a simple dislocation into a complex one, making it irreducible and injuring adjacent structures, which is why we believe it is essential to know the management of this injury

Cirugía del contorno abdominal en el varón. Detalles técnicos a propósito de un caso

Resumen La cirugía del contorno abdominal en el varón está en aumento dada la mayor demanda estética en el sexo masculino y el incremento de pacientes que consultan para remodelación corporal tras cirugía bariátrica. Las opciones quirúrgicas en el varón no difieren sustancialmente de las técnicas utilizadas para remodelación en mujeres. Sin embargo, deben considerarse algunos aspectos diferenciales entre ambos sexos para obtener un mejor resultado global. Existen pocas publicaciones que describan los detalles técnicos a la hora de buscar un resultado más acorde al género, sino que habitualmente se aborda este tema de forma general. El objetivo de este trabajo es analizar las diferentes opciones de tratamiento de acuerdo a las diferentes situaciones y el análisis de la técnica quirúrgica planteada a propósito de un caso clínico