{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,7]],"date-time":"2025-05-07T21:10:08Z","timestamp":1746652208594,"version":"3.40.5"},"reference-count":24,"publisher":"Universidad del Valle","issue":"4","license":[{"start":{"date-parts":[[2024,12,30]],"date-time":"2024-12-30T00:00:00Z","timestamp":1735516800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0"}],"content-domain":{"domain":["colombiamedica.univalle.edu.co"],"crossmark-restriction":true},"short-container-title":["Colomb Med"],"abstract":"<jats:p>Descripci\u00f3n del casoPaciente masculino de 23 a\u00f1os quien recibi\u00f3 contusi\u00f3n directa en los miembros inferiores a nivel de los muslos durante accidente laboral.\nHallazgos cl\u00ednicosHallazgos cl\u00ednicos y radiogr\u00e1ficos compatibles con fracturas sub-trocant\u00e9ricas bilaterales conminutas, encontr\u00e1ndose en ambas, extensi\u00f3n hacia la di\u00e1fisis, con un \u00cdndice de Severidad del Trauma de 16.\nTratamiento y resultadosResultado cl\u00ednico y radiol\u00f3gico favorable tras estabilizaci\u00f3n quir\u00fargica definitiva temprana de ambas extremidades con clavos cefalomedulares, rehabilitaci\u00f3n con terapia f\u00edsica y seguimiento cl\u00ednico.\nRelevancia cl\u00ednicaLos traumatismos de alta energ\u00eda, por diferentes causas, constituyen un reto para todo el personal sanitario debido a las propias condiciones del paciente, la respuesta inflamatoria individual y las lesiones musculoesquel\u00e9ticas asociadas, algunas no detectadas inicialmente, y adem\u00e1s en otros sistemas. Los pacientes con fracturas bilaterales de f\u00e9mur pueden presentar las condiciones mencionadas, lo que requiere la identificaci\u00f3n temprana de los riesgos de insuficiencia respiratoria y multiorg\u00e1nica, el conocimiento de su estado metab\u00f3lico y la definici\u00f3n de su situaci\u00f3n cl\u00ednica, considerada potencialmente o verdaderamente cr\u00edtica. Incluso con un tratamiento oportuno, se observan cifras de mortalidad del 6.9% al 27%. Seg\u00fan par\u00e1metros definidos, se puede realizar una osteos\u00edntesis temprana y definitiva de las fracturas, pero sus caracter\u00edsticas pueden dificultar la planificaci\u00f3n quir\u00fargica.<\/jats:p>","DOI":"10.25100\/cm.v55i4.6078","type":"journal-article","created":{"date-parts":[[2025,5,7]],"date-time":"2025-05-07T16:41:25Z","timestamp":1746636085000},"page":"e5006078","update-policy":"https:\/\/doi.org\/10.25100\/cm.crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Predicci\u00f3n del tama\u00f1o del clavo intramedular mediante la longitud de la f\u00edbula en fracturas bilaterales de f\u00e9mur"],"prefix":"10.25100","volume":"55","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3975-3021","authenticated-orcid":false,"given":"Ruben Dar\u00edo","family":"Hern\u00e1ndez Salazar","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-3755-9913","authenticated-orcid":false,"given":"Andr\u00e9s Felipe","family":"Rivera","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-0176-6697","authenticated-orcid":false,"given":"Nathaly","family":"Pati\u00f1o Vargas","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-3570-1665","authenticated-orcid":false,"given":"Juan Pablo","family":"Lopez Garcia","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"10728","published-online":{"date-parts":[[2024,12,30]]},"reference":[{"key":"93080","doi-asserted-by":"crossref","unstructured":"Kobbe P, Micansky F, Lichte P, Martin SR, Pfeifer R, Dombroski D, et al. 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