<?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>1025-0255</journal-id>
<journal-title><![CDATA[Revista Archivo Médico de Camagüey]]></journal-title>
<abbrev-journal-title><![CDATA[AMC]]></abbrev-journal-title>
<issn>1025-0255</issn>
<publisher>
<publisher-name><![CDATA[Universidad de Ciencias Médicas de Camagüey]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S1025-02552019000400515</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Fracturas múltiples de la tibia: a propósito de un caso]]></article-title>
<article-title xml:lang="en"><![CDATA[Multiple fractures of the tibia: a case report]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Álvarez-López]]></surname>
<given-names><![CDATA[Alejandro]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Soto-Carrasco]]></surname>
<given-names><![CDATA[Sergio Ricardo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[García-Lorenzo]]></surname>
<given-names><![CDATA[Yenima de la Caridad]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Universidad de Ciencias Médicas de Camagüey Hospital Universitario Manuel Ascunce Domenech Servicio de Ortopedia y Traumatología]]></institution>
<addr-line><![CDATA[ Camagüey]]></addr-line>
<country>Cuba</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Facultad de Medicina Asociación Chilena de Seguridad (ACHS) Servicio de Cirugía]]></institution>
<addr-line><![CDATA[ Chillán]]></addr-line>
<country>Chile</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Universidad de Ciencias Médicas de Camagüey Policlínico Universitario Tula Aguilera Departamento de Medicina General Integral]]></institution>
<addr-line><![CDATA[ Camagüey]]></addr-line>
<country>Cuba</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>08</month>
<year>2019</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>08</month>
<year>2019</year>
</pub-date>
<volume>23</volume>
<numero>4</numero>
<fpage>515</fpage>
<lpage>521</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_arttext&amp;pid=S1025-02552019000400515&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_abstract&amp;pid=S1025-02552019000400515&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_pdf&amp;pid=S1025-02552019000400515&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[RESUMEN  Fundamento: las fracturas múltiples son lesiones infrecuentes provocadas por mecanismos tanto únicos como combinados. En la actualidad su incidencia va en aumento debido a la complejidad y alta energía de los traumatismos.  Objetivo: conocer un paciente con fractura múltiple de la tibia y la conducta tomada con este enfermo, que logró recuperar su capacidad funcional.  Presentación del caso: paciente femenina de 60 años de edad, blanca, sin antecedentes mórbidos de salud, la cual sufre accidente al bajarse de un carruaje y es traída al servicio de urgencias de Ortopedia y Traumatología por presentar dolor a nivel de la pierna izquierda, que le impedía la marcha y los movimientos de la zona afectada. Al examen radiográfico se detectó fractura de la meseta tibial lateral y oblicua larga de la tibia que necesitó de intervención quirúrgica mediante la colocación de placa subcutánea a través de dos incisiones.  Conclusiones: las fracturas múltiples son lesiones infrecuentes, más aún cuando se presentan en el mismo hueso por mecanismos de producción distintos. Al ser enfermedades atípicas, la conducta es basada en las características propias de las lesiones asociadas.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[ABSTRACT  Background: multiple fractures are uncommon injuries caused by isolated or combined mechanisms. Nowadays, its incidence grows up due to high energy trauma and complex lesions.  Objective: to show a patient with a multiple fracture of the tibia, the used treatment modality to ensure functional recovery.  Case report: a 60 years old white female patient without morbid antecedents, was taken to the emergency services of Orthopedic and Traumatology complaining of pain, swelling and limitation of movement of the left leg after falling from a carriage. X-rays showed a tibia plateau fracture associated to oblique diaphyseal tibia fracture. Surgical treatment was needed to reduce and fix fractures; a subcutaneous plate was used by two small incisions.  Conclusions: multiple fractures are unusual lesions, even more when the same bone is affected due to different mechanisms. As being atypical lesions treatment is based on fractures features.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[FRACTURAS DE LA TIBIA/diagnóstico por imagen]]></kwd>
<kwd lng="es"><![CDATA[FRACTURAS DE LA TIBIA /cirugía]]></kwd>
<kwd lng="es"><![CDATA[FRACTURAS MÚLTIPLES/epidemiología]]></kwd>
<kwd lng="es"><![CDATA[FRACTURAS MÚLTIPLES/diagnóstico por imagen]]></kwd>
<kwd lng="es"><![CDATA[INFORMES DE CASOS]]></kwd>
<kwd lng="en"><![CDATA[TIBIAL FRACTURES/diagnostic imaging]]></kwd>
<kwd lng="en"><![CDATA[TIBIAL FRACTURES/surgery]]></kwd>
<kwd lng="en"><![CDATA[FRACTURES, MULTIPLE/epidemiology]]></kwd>
<kwd lng="en"><![CDATA[FRACTURES, MULTIPLE/diagnostic imaging]]></kwd>
<kwd lng="en"><![CDATA[CASE REPORTS]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<label>1</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Egol]]></surname>
<given-names><![CDATA[KA]]></given-names>
</name>
<name>
<surname><![CDATA[Koval]]></surname>
<given-names><![CDATA[KJ]]></given-names>
</name>
<name>
<surname><![CDATA[Zuckerman]]></surname>
<given-names><![CDATA[JD]]></given-names>
</name>
</person-group>
<source><![CDATA[Handbook of Fractures]]></source>
<year>2015</year>
<edition>5</edition>
<publisher-loc><![CDATA[Philadelphia ]]></publisher-loc>
<publisher-name><![CDATA[Wolters Kluwer]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B2">
<label>2</label><nlm-citation citation-type="book">
<collab>ATLS: Advance Trauma Life Support</collab>
<source><![CDATA[]]></source>
<year>2018</year>
<edition>10</edition>
<publisher-loc><![CDATA[American College of Surgeons ]]></publisher-loc>
<publisher-name><![CDATA[Chicago]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B3">
<label>3</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Court Brown]]></surname>
<given-names><![CDATA[CM]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[The epidemiology of fractures and dislocations]]></article-title>
<person-group person-group-type="editor">
<name>
<surname><![CDATA[Court Brown]]></surname>
<given-names><![CDATA[CM]]></given-names>
</name>
<name>
<surname><![CDATA[Heckman]]></surname>
<given-names><![CDATA[JD]]></given-names>
</name>
<name>
<surname><![CDATA[McQueen]]></surname>
<given-names><![CDATA[MM]]></given-names>
</name>
<name>
<surname><![CDATA[Ricci]]></surname>
<given-names><![CDATA[WM]]></given-names>
</name>
<name>
<surname><![CDATA[Tornetta]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
</person-group>
<source><![CDATA[Rockwood and Green&amp;apos;s Fractures in Adults]]></source>
<year>2015</year>
<edition>8th</edition>
<page-range>82-3</page-range><publisher-loc><![CDATA[Philadelphia ]]></publisher-loc>
<publisher-name><![CDATA[Wolters Kluwer]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B4">
<label>4</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Anandasivam]]></surname>
<given-names><![CDATA[NS]]></given-names>
</name>
<name>
<surname><![CDATA[Russo]]></surname>
<given-names><![CDATA[GS]]></given-names>
</name>
<name>
<surname><![CDATA[Swallow]]></surname>
<given-names><![CDATA[MS]]></given-names>
</name>
<name>
<surname><![CDATA[Basques]]></surname>
<given-names><![CDATA[BA]]></given-names>
</name>
<name>
<surname><![CDATA[Samuel]]></surname>
<given-names><![CDATA[AM]]></given-names>
</name>
<name>
<surname><![CDATA[Ondeck]]></surname>
<given-names><![CDATA[NT]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Tibial shaft fracture: a large-scale study defining the injured population and associated injuries]]></article-title>
<source><![CDATA[J Clin Orthop Trauma]]></source>
<year>2017</year>
<volume>8</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>225-31</page-range></nlm-citation>
</ref>
<ref id="B5">
<label>5</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Boulton]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[O&amp;apos; Toole]]></surname>
<given-names><![CDATA[RV]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Tibial and fibular shaft factures]]></article-title>
<person-group person-group-type="editor">
<name>
<surname><![CDATA[Court Brown]]></surname>
<given-names><![CDATA[CM]]></given-names>
</name>
<name>
<surname><![CDATA[Heckman]]></surname>
<given-names><![CDATA[JD]]></given-names>
</name>
<name>
<surname><![CDATA[McQueen]]></surname>
<given-names><![CDATA[MM]]></given-names>
</name>
<name>
<surname><![CDATA[Ricci]]></surname>
<given-names><![CDATA[WM]]></given-names>
</name>
<name>
<surname><![CDATA[Tornetta]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
</person-group>
<source><![CDATA[Green&amp;apos;s Fractures in Adults]]></source>
<year>2015</year>
<edition>8th</edition>
<page-range>2415-72</page-range><publisher-loc><![CDATA[Philadelphia ]]></publisher-loc>
<publisher-name><![CDATA[Wolters Kluwer]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B6">
<label>6</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Kuhn]]></surname>
<given-names><![CDATA[KM]]></given-names>
</name>
<name>
<surname><![CDATA[Agarwal]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Femoral fractures]]></article-title>
<person-group person-group-type="editor">
<name>
<surname><![CDATA[Cannada]]></surname>
<given-names><![CDATA[LK]]></given-names>
</name>
</person-group>
<source><![CDATA[OKU 11 American Academy of Orthopeadic]]></source>
<year>2014</year>
<page-range>509-20</page-range><publisher-loc><![CDATA[Surgeons ]]></publisher-loc>
<publisher-name><![CDATA[Rosemont]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B7">
<label>7</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Chen]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[Huang]]></surname>
<given-names><![CDATA[X]]></given-names>
</name>
<name>
<surname><![CDATA[Ya]]></surname>
<given-names><![CDATA[Y]]></given-names>
</name>
<name>
<surname><![CDATA[Ma]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[Qian]]></surname>
<given-names><![CDATA[Z]]></given-names>
</name>
<name>
<surname><![CDATA[Shi]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Finite element analysis of intramedullary nailing and double locking plate for treating extra-articular proximal tibial fractures]]></article-title>
<source><![CDATA[J Orthop Surg Res]]></source>
<year>2018</year>
<volume>13</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>12</page-range></nlm-citation>
</ref>
<ref id="B8">
<label>8</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Graham]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Tibial plateau fracture]]></article-title>
<source><![CDATA[Orthop Nurs]]></source>
<year>2017</year>
<volume>36</volume>
<numero>4</numero>
<issue>4</issue>
<page-range>303-5</page-range></nlm-citation>
</ref>
<ref id="B9">
<label>9</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Liu]]></surname>
<given-names><![CDATA[YK]]></given-names>
</name>
<name>
<surname><![CDATA[Zhou]]></surname>
<given-names><![CDATA[ZY]]></given-names>
</name>
<name>
<surname><![CDATA[Liu]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[New developments in treatments of tibial plateau fractures]]></article-title>
<source><![CDATA[Chin Med J (Engl)]]></source>
<year>2017</year>
<volume>130</volume>
<numero>21</numero>
<issue>21</issue>
<page-range>2635-8</page-range></nlm-citation>
</ref>
<ref id="B10">
<label>10</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Andalib]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Sheikhbahaei]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Andalib]]></surname>
<given-names><![CDATA[Z]]></given-names>
</name>
<name>
<surname><![CDATA[Tahririan]]></surname>
<given-names><![CDATA[MA]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Effectiveness of minimally invasive plate osteosynthesis (MIPO) on comminuted tibial or femoral fractures]]></article-title>
<source><![CDATA[Arch Bone J Surg]]></source>
<year>2017</year>
<volume>5</volume>
<numero>5</numero>
<issue>5</issue>
</nlm-citation>
</ref>
<ref id="B11">
<label>11</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Marsh]]></surname>
<given-names><![CDATA[JL]]></given-names>
</name>
<name>
<surname><![CDATA[Karam]]></surname>
<given-names><![CDATA[MD]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Tibial plateau fractures]]></article-title>
<person-group person-group-type="editor">
<name>
<surname><![CDATA[Court Brown]]></surname>
<given-names><![CDATA[CM]]></given-names>
</name>
<name>
<surname><![CDATA[Heckman]]></surname>
<given-names><![CDATA[JD]]></given-names>
</name>
<name>
<surname><![CDATA[McQueen]]></surname>
<given-names><![CDATA[MM]]></given-names>
</name>
<name>
<surname><![CDATA[Ricci]]></surname>
<given-names><![CDATA[WM]]></given-names>
</name>
<name>
<surname><![CDATA[Tornetta]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
</person-group>
<source><![CDATA[Rockwood and Green&amp;apos;s Fractures in Adults]]></source>
<year>2015</year>
<edition>8 th</edition>
<page-range>2303-67</page-range><publisher-loc><![CDATA[Philadelphia ]]></publisher-loc>
<publisher-name><![CDATA[Wolters Kluwer]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B12">
<label>12</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Prat Fabregat]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Camacho Carrasco]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Treatment strategy for tibial plateau fractures an update]]></article-title>
<source><![CDATA[EFORT Open Rev]]></source>
<year>2017</year>
<volume>1</volume>
<numero>5</numero>
<issue>5</issue>
<page-range>225-32</page-range></nlm-citation>
</ref>
</ref-list>
</back>
</article>
