<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>1688-0390</journal-id>
<journal-title><![CDATA[Revista Médica del Uruguay]]></journal-title>
<abbrev-journal-title><![CDATA[Rev. Méd. Urug.]]></abbrev-journal-title>
<issn>1688-0390</issn>
<publisher>
<publisher-name><![CDATA[Sindicato Médico del Uruguay]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S1688-03902019000200127</article-id>
<article-id pub-id-type="doi">10.29193/rmu.35.2.6</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Sistematización de los abordajes en las fracturas del platillo tibial]]></article-title>
<article-title xml:lang="en"><![CDATA[Systematization in the approach to tibial plateau fractures]]></article-title>
<article-title xml:lang="pt"><![CDATA[Sistematização da abordagem nas fraturas do platô tibial]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Casales]]></surname>
<given-names><![CDATA[Nicolás]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Maquieira]]></surname>
<given-names><![CDATA[Jorge]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Universidad de la República Clínica de Ortopedia y Traumatología ]]></institution>
<addr-line><![CDATA[Montevideo ]]></addr-line>
<country>Uruguay</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Centro de Asistencia Médica de Young (CAMY) Servicio de Traumatología ]]></institution>
<addr-line><![CDATA[Young ]]></addr-line>
<country>Uruguay</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>06</month>
<year>2019</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>06</month>
<year>2019</year>
</pub-date>
<volume>35</volume>
<numero>2</numero>
<fpage>127</fpage>
<lpage>148</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.edu.uy/scielo.php?script=sci_arttext&amp;pid=S1688-03902019000200127&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.edu.uy/scielo.php?script=sci_abstract&amp;pid=S1688-03902019000200127&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.edu.uy/scielo.php?script=sci_pdf&amp;pid=S1688-03902019000200127&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen: En nuestro país las fracturas del platillo tibial han aumentado en frecuencia y complejidad debido sobre todo a los accidentes de moto. La tomografía ha contribuido en gran medida a la interpretación del patrón fracturario. Como objetivo de este trabajo se propone la utilización de una cuadrícula que toma en cuenta las distintas imágenes y permite realizar un mapeo de los diferentes trazos de fractura. Así podemos definir el o los tipos de abordajes a utilizar, la posición del paciente en la mesa de operaciones y la elección de los implantes. Se hace hincapié en los abordajes posteromedial y posterolateral de reciente utilización en nuestro medio. En el Centro de Asistencia Médica de Young (CAMY) de Young, departamento de Río Negro, entre enero de 2015 y junio de 2017 se trataron 16 pacientes con fractura del platillo tibial estudiados con radiografías simples y tomografía computada. Se utilizó la clasificación de Schatzker pero ampliada, teniendo en cuenta las lesiones en el plano axial. Fue necesario recurrir al abordaje posteromedial en nueve casos y al posterolateral en dos. Todas las fracturas consolidaron y la movilidad articular fue completa en todos los casos. Dos pacientes tuvieron infección profunda y uno de ellos quedó con una parálisis definitiva del nervio ciático poplíteo externo. Como conclusión, la cuadrícula propuesta nos resultó muy útil para el análisis previo de estas lesiones y se destaca la importancia de los abordajes posterolateral y posteromedial en los compromisos posteriores de la meseta tibial.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract: Tibial plateau fractures have increased in our country in terms of frequency and complexity, mainly due to motorbike accidents. CT scans have generally contributed to interpreting the fracture pattern. The study aims to use a grid that includes the different images and allows for the mapping of the different fracture traces. In this way we may define the kind or kinds of approaches to the fracture, the patient&#8217;s position on the surgical table and the selection of implants. We emphasize on the posteromedial and posterolateral approaches, recently used in our country. 16 patients with tibial plateau fractures were treated at CAMY health care institution in the city of Young, between January 2015 and June 2017, having studied them with simple x-rays and CT scans. The Schatzker classification was used, although a wider one, which also considered axial plane lesions. In 9 cases it was necessary to perform a posteromedial approach and in 2 cases a posterolateral approach was the one used. All fractures consolidated and articular mobility was complete in all cases. Two patients suffered a deep infection and one of them presented a final external popliteal sciatic nerve paralysis. To conclude, the grid proposed was very useful for the preliminary analysis of these lesions and we point out the importance of the posterolateral and posteromedial approaches when the tibial plateau is compromised.]]></p></abstract>
<abstract abstract-type="short" xml:lang="pt"><p><![CDATA[Resumo: As fraturas do platô tibial aumentaram em frequência e complexidade no Uruguai sobretudo devido aos acidentes com motocicletas. A tomografia contribuiu em grande parte à interpretação do padrão da fratura. Como objetivo propõe-se a utilização de uma quadrícula que inclui as diferentes imagens e permite realizar o mapeamento dos diferentes traços da fratura. Dessa forma é possível definir o tipo de abordagem, a posição do paciente na mesa de operação e a seleção dos implantes. Destacam-se as abordagens póstero-medial e póstero lateral de recente utilização no nosso meio. Entre janeiro de 2015 e junho de 2017, em CAMY, instituição de assistência à saúde da cidade de Young, 16 pacientes com fratura do platô tibial foram estudados com radiografias simples e tomografia computada. A classificação de Schatzker ampliada considerando as lesoes no plano axial foi empregada. Em 9 casos foi necessário fazer a abordagem póstero-medial y em 2 a póstero lateral. Todas as fraturas consolidaram e a mobilidade articular foi completa em todos os casos. Dois pacientes apresentaram infecção profunda sendo que um ficou com paralisia definitiva do nervo ciático poplíteo externo. Conclui-se que a quadricula proposta foi muito útil para a análise prévia destas lesões e destaca-se a importância das abordagens póstero lateral e póstero-medial nos compromissos posteriores do platô tibial.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Fracturas del platillo tibial]]></kwd>
<kwd lng="es"><![CDATA[Fragmento posteromedial]]></kwd>
<kwd lng="es"><![CDATA[Clasificación de Schatzker]]></kwd>
<kwd lng="en"><![CDATA[Tibial plateau fractures]]></kwd>
<kwd lng="en"><![CDATA[Posteromedial fragment]]></kwd>
<kwd lng="en"><![CDATA[Schatzker classification]]></kwd>
<kwd lng="pt"><![CDATA[Fraturas do planalto tibial]]></kwd>
<kwd lng="pt"><![CDATA[Fragmento posteromedial]]></kwd>
<kwd lng="pt"><![CDATA[Classificação do Schatzker]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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