BACKGROUND:Active unilateral condylar hyperplasia (AUCH) leads to progressive facial asymmetry and occlusal imbalance and may coexist with preexisting skeletal discrepancies. In such cases, a single-stage approach combining condylectomy and orthognathic surgery can address both pathological growth and the associated dentofacial deformity. PURPOSE:The aim of this study was to present a treatment protocol and surgical algorithm for simultaneous orthognathic surgery and condylectomy in subjects with AUCH and to evaluate clinical outcomes in a retrospective case series. STUDY DESIGN, SETTING, AND SAMPLE:This retrospective case series included 24 adult subjects with AUCH treated between 2012 and 2018 in Santiago, Chile. Diagnosis was based on clinical evaluation, cone beam computed tomography, and single-photon emission computed tomography demonstrating ≥55% condylar activity. All subjects had completed growth and presented AUCH associated with dentofacial deformities requiring orthognathic correction, including maxillary hypoplasia, reduced upper airway, or mandibular advancement. PREDICTOR/EXPOSURE/INDEPENDENT VARIABLES:Not applicable. OUTCOME VARIABLES:Primary outcomes included postoperative occlusal stability (achievement and maintenance of Class I occlusion), facial symmetry (clinical and patient-reported), temporomandibular joint symptoms, mouth opening, complications, and need for reintervention. COVARIATES:Covariates included age, sex, follow-up duration, type of condylectomy (high or adapted), type of mandibular osteotomy, surgical sequence, and concomitant procedures, all determined through virtual surgical planning. ANALYSES:Descriptive statistics were used to summarize subject characteristics and outcomes. No inferential analyses were performed. RESULTS:Twenty-four subjects (mean age 20.8 ± 3.6 years; 66.7% female, 33.3% male) were included, with a median follow-up of 6 years. All subjects achieved stable Class I occlusion and satisfactory facial symmetry. No temporomandibular joint symptoms or reinterventions were observed. The mean mouth opening was 45 mm. Minor complications (transient facial paresis) occurred in 12.5% of subjects. CONCLUSIONS AND RELEVANCE:Simultaneous orthognathic surgery and condylectomy is an effective approach for managing AUCH associated with dentofacial deformities, providing stable functional and aesthetic outcomes. Virtual surgical planning enables a structured surgical algorithm, guiding both the surgical sequence and the selection of the appropriate type of condylectomy, and may reduce the need for more invasive mandibular procedures.
BACKGROUND:Tibial plateau fractures (TPF) are complex injuries associated with significant soft tissue and periarticular complications. Although vascular injuries are well described in lower limb trauma, their incidence in tibial plateau fractures has not been clearly established. METHODS:Retrospective cohort study including patients with surgically treated TPF at a level I trauma center between 2016 and 2024. CTA was selectively performed based on clinical judgment. Post hoc descriptive risk scenarios were constructed to organize observed fracture patterns. Analysis was primarily descriptive. RESULTS:539 surgically treated TPF were included. Mean age was 43.7 years (18-75), 73.84% were male. Left knee was affected in 54.92%. High-energy trauma accounted for 70.87%. The CTA yield was 3.66% (6/164), corresponding to an overall observed incidence of 1.11% (6/539). Certain fracture patterns and clinical scenarios were more frequently observed among cases with arterial injury; however, these observations are based on very few events and should be interpreted cautiously as descriptive findings only. CONCLUSION:The CTA-detected incidence of arterial injury in this series of surgically treated tibial plateau fractures was 1.11%. Certain fracture patterns and clinical contexts were observed among the small number of cases with arterial injury; however, these findings are descriptive and should be interpreted as hypothesis-generating.
Facatativá y Cartagenita en el departamento de Cundinamarca Colombia, han venido enfrentando desafíos relacionados con la violencia en diversas formas. A partir de ese problema se formuló el siguiente objetivo: identificar los tipos de violencia generados en la población y conocidos por las autoridades en Facatativá y Cartagenita durante los años 2022-2023, a través de un estudio sociodemográfico y datos de las autoridades locales, para identificar los patrones causantes de violencia. La metodología se realizó basada en un diseño no experimental de tipo descriptivo, con un enfoque mixto a través del método inductivo, utilizando instrumento encuesta y formato de recolección de datos. La población fue N = 107.516 personas de 19 a 99 años y la muestra fue de X̅ = 384, con un nivel de confianza del 95% y un margen de error del 0,5. En los resultados se evidenció mayor participación de mujeres que de hombres. Su nivel de formación osciló entre técnico y tecnológico, predominando familias conformadas por padre, madre e hijos, con ingresos de uno a dos salarios mínimos, residentes en los sectores del uno al seis. Finalmente, se concluyó que los tipos de violencia más frecuentes fueron: social 23%, género 17%, intrafamiliar 13%, política 11%, económica 7%, por desplazamiento forzado 5%, escolar 4%, digital y racial 3%. En 2022 y 2023, la personería municipal reportó 4,625 casos, el ICBF 1,083 y las comisarías de familia dos 514 y la uno 394 casos de violencia respectivamente, sobresaliendo la violencia intrafamiliar y de género.
