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We report a 94-year-old patient with a fractured radius that was being managed conservatively. At 2 months, an abscess was observed overlying the fracture site. An MRI scan was done and samples obtained for microbiological and pathological analyses. The patient was diagnosed with tuberculous osteomyelitis. Surgical debridement of the fracture site was performed, and the bone defect was filled with bone cement impregnated with gentamicin and rifampicin. Anti-tuberculosis therapy was administered for 9 months and the patient made an uneventful recovery. Early diagnosis and correct medical treatment depend on sound evidence of tuberculous osteomyelitis. Surgical debridement is essential if abscesses are present in the bone. Level of Evidence: Level V (Therapeutic).

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BACKGROUND: Proximal humerus fractures are one of the main osteoporotic fractures. Choosing between conservative or surgical treatment is a controversial topic in the literature, as is the functional impact. The main aim of our study was to analyse whether patient comorbidities should influence the final therapeutic decision for these fractures. MATERIAL AND METHODS: We collected data from 638 patients with proximal humerus fractures. The main variable collected was exitus. We also collected the following data: age, gender, type of fracture, laterality, type of treatment, production mechanism, comorbidities and the Charlson comorbidity index (CCI) for each patient. The therapeutic indication used the criteria established by the Upper Limb Unit in our centre. We performed chi-square tests, Fischer's exact tests and Student's t-tests to compare the variables. We used the Kaplan-Meier method to analyse both the overall and disease-specific survival rates. We employed the Cox regression model to analyse factors associated with mortality. RESULTS: Patients with a CCI greater than 5 showed greater mortality (HR = 3.83; p < 0.001) than those with a CCI lower than 5. Within the patients who underwent surgery, those with a CCI higher than 5 had an increased mortality rate (HR = 22.6; p < 0.001) compared with those with a CCI lower than 5. Within the patients who received conservative treatment, those with a CCI over 5 showed greater mortality (HR = 3.64; p < 0.001) than those with a CCI under 5. CONCLUSIONS: Patients with proximal humerus fractures and associated comorbidities (CCI > 5) presented higher mortality than healthier patients. This mortality risk was greater in patients with comorbidities if surgical treatment was indicated rather than conservative treatment. Patient's comorbidities should be a fundamental parameter when planning the therapeutic strategy. LEVEL OF EVIDENCE: Level 3.

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Objetivo: Determinar qué efectos produce un programa de ejercicio terapéutico sobre la capacidad física funcional en personas con discapacidad intelectual. Material y métodos: Se realizó un estudio cuasi-experimental con una muestra final de 24 adultos con discapacidad intelectual, de un rango de edad comprendido entre 24 y 60 años, distribuidos de forma aleatoria en un grupo experimental (11 hombres y 6 mujeres) y un grupo control (6 hombres y una mujer). Se evaluó la condición física funcional antes de realizar un programa de ejercicio terapéutico de 10 semanas de duración, inmediatamente después del programa y 6 meses después de finalizar el mismo. Resultados: Al realizar una comparación de los grupos con respecto a los registros obtenidos dentro del período preintervención y postintervención, observamos que el grupo de ejercicio terapéutico obtuvo mejores puntuaciones (p < 0,01) que el grupo control en las variables de resistencia aeróbica, fuerza de piernas, fuerza de brazos, agilidad y coordinación. Comparando los períodos preintervención y 6 meses después de finalizar el programa, el grupo de ejercicio terapéutico siguió mostrando mejores puntuaciones (p < 0,05) en fuerza de piernas, fuerza de brazos y resistencia aeróbica con respecto al grupo control. Conclusiones: La aplicación de un programa de ejercicio terapéutico de 10 semanas de duración mejora las puntuaciones en las variables de la condición física funcional medidas a través del Senior Fitness Test en adultos con discapacidad intelectual. El efecto del programa de intervención presenta una duración menor a los 6 meses, período a partir del cual los registros retornan a valores iniciales

Objective: To determine the effect of a therapeutic exercise program on functional physical capacity in persons with intellectual disabilities. Material and methods: A quasi-experimental study was conducted with a final sample of 24 adults with intellectual disabilities, aged between 24 and 60 years old, which was randomized into an experimental group (11 men and 6 women) and a control group (6 men and 1 woman). Functional fitness was assessed before a therapeutic exercise program, 10 weeks immediately after the program, and 6 months after the end of it. Results: On comparing the results obtained in the pre-intervention and post-intervention period from the two groups, it was observed that the group that the therapeutic exercises had better scores (P < 0.01) than the control group on the variables: aerobic endurance, leg strength, arm strength, agility, and coordination. On comparing the results obtained in the pre-intervention period with those at 6 months after completion of the program, the group that performed exercise therapy continued to show better scores (P < 0.05) in leg strength, arm strength and aerobic endurance, compared to the control group. Conclusions: The application of a ten-week therapeutic exercise program, improved scores on the variables of functional fitness, measured by the Senior Fitness Test, in adults with intellectual disabilities. The effect of the intervention program has a duration of less than 6 months, a period after which the scores returned to baseline

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