<?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>2306-4102</journal-id>
<journal-title><![CDATA[Acta ortopédica mexicana]]></journal-title>
<abbrev-journal-title><![CDATA[Acta ortop. mex]]></abbrev-journal-title>
<issn>2306-4102</issn>
<publisher>
<publisher-name><![CDATA[Colegio Mexicano de Ortopedia y Traumatología A.C.]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S2306-41022019000500292</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Inestabilidad residual de tobillo en pacientes con lesión de la sindesmosis sin fractura tratados con tornillos situacionales]]></article-title>
<article-title xml:lang="en"><![CDATA[Residual ankle instability in patients with syndesmosis lesions without fracture treated with situational screws]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Castro-Guerrero]]></surname>
<given-names><![CDATA[DE]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Rosas-Medina]]></surname>
<given-names><![CDATA[JA]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Instituto Mexicano del Seguro Social Hospital General Regional Núm. 2 ]]></institution>
<addr-line><![CDATA[Ciudad de México ]]></addr-line>
<country>Mexico</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Instituto Mexicano del Seguro Social Hospital General Regional Núm. 2 Servicio de Miembro Pélvico]]></institution>
<addr-line><![CDATA[Ciudad de México ]]></addr-line>
<country>Mexico</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>10</month>
<year>2019</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>10</month>
<year>2019</year>
</pub-date>
<volume>33</volume>
<numero>5</numero>
<fpage>292</fpage>
<lpage>296</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_arttext&amp;pid=S2306-41022019000500292&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_abstract&amp;pid=S2306-41022019000500292&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_pdf&amp;pid=S2306-41022019000500292&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen:  Introducción:  La lesión de la sindesmosis tibioperonea se presenta por lo regular acompañada de la fractura de los maléolos ya sea medial o lateral, muy rara vez la sindesmosis puede lesionarse sin que exista una fractura de alguna de las estructuras óseas que conforman el tobillo, representa alrededor de 1% de todas las lesiones. Al ser muy raras, no se diagnostican en el evento agudo y suelen tratarse como un simple esguince de tobillo.  Material y métodos:  Serie de casos con lesión de la sindesmosis sin fractura de tobillo, tratadas con colocación de doble tornillo situacional, apoyo diferido y retiro de los implantes a los dos meses. Posteriormente, a los seis meses de la cirugía inicial se aplica el test de inestabilidad de tobillo de Cumberland (CAIT), el cual cuenta con nueve reactivos donde se mide el grado de inestabilidad del tobillo.  Resultados:  Durante un año se detectaron cuatro casos de lesión de la sindesmosis sin fractura de un total de 349 casos quirúrgicos tratados en el hospital, exclusivamente en pacientes masculinos, todos ellos menores de 40 años. Seis meses después de la cirugía se aplicó el CAIT encontrando una inestabilidad residual en 100% de los casos tratados, algunos en mayor medida que los demás.  Discusión:  Este resultado es poco alentador y nos hace reconsiderar el tratamiento establecido para mejorar la estabilidad final del tobillo.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract:  Introduction:  The lesion of the distal tibiofibular syndesmosis is commonly accompanied by the fracture of the maleollus either medial or lateral, rarely, the syndesmosis can be injured without there being a fracture of any of the bone structures that make up the ankle, accounting for about 1% of all injuries. Being very rare, they are not diagnosed at the acute event, and are usually treated as a simple sprained ankle.  Material and methods:  Series of cases with ankle fractureless syndesmosis lesion, treated with situational double screw placement, deferred support and implant removal at two months. After six months of initial surgery, the Cumberland ankle instability (CAIT) test is applied which measures the degree of ankle instability.  Results:  For one year, 4 cases of fractureless synosmosis lesions were found out of a total of 349 surgical cases treated in the hospital, exclusively in male patients, all under the age of 40. Six months after surgery, CAIT was applied, encountering residual instability in 100% of treated cases.  Discussion:  This result is unencouraging and makes us reconsider the treatment established to improve the final stability of the ankle.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Tobillo]]></kwd>
<kwd lng="es"><![CDATA[sindesmosis]]></kwd>
<kwd lng="es"><![CDATA[tratamiento]]></kwd>
<kwd lng="es"><![CDATA[lesión]]></kwd>
<kwd lng="es"><![CDATA[tornillo]]></kwd>
<kwd lng="en"><![CDATA[Ankle]]></kwd>
<kwd lng="en"><![CDATA[syndesmosis]]></kwd>
<kwd lng="en"><![CDATA[treatment]]></kwd>
<kwd lng="en"><![CDATA[injury]]></kwd>
<kwd lng="en"><![CDATA[screw]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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