RESUMEN
Objetivo. Estudio retrospectivo de 98 fracturas diafisarias de antebrazo en adultos tratadas mediante osteosíntesis percutánea intramedular con agujas de Kirchner. Materiales y método. Se revisan 64 pacientes que presentaban 98 fracturas de antebrazo con un seguimiento clínico-radiológico, evaluando la presencia de seudoartrosis o retardo de la consolidación y valorando los resultados funcionales mediante la Escala de Anderson y el Disability of the Arm, Shoulder and Hand. Resultados. La consolidación clínica y radiológica se consiguió con una media de 12 semanas, obteniendo un 77% de excelentes y buenos resultados con los criterios de Anderson. Se registraron 4 casos de seudoartrosis y 6 casos de retardo de consolidación. Conclusión. La osteosíntesis percutánea presenta una serie de ventajas con respecto a otras técnicas como son una baja incidencia de complicaciones, ausencia de infecciones, refracturas y lesiones yatrogénicas vasculonerviosas. Se consigue una menor estancia hospitalaria y un acortamiento del tiempo quirúrgico, con unos resultados similares al tratamiento con placas y clavos endomedulares en cuanto a consolidación y resultados funcionales, como comprobamos al consultar la bibliografía publicada (AU)
Objective. This is a retrospective study of 98 diaphyseal forearm fractures in adults, treated by a percutaneous technique with intramedullar Kirchner wires. Materials and method. We reviewed 64 patients with 98 forearm fractures with a radiographic follow-up, assessing the presence of pseudarthrosis or delayed bone union and evaluating functional outcomes with the Anderson and the Disability of the Arm, Shoulder and Hand scale. Results. Clinical and radiological bone union was achieved in an average of 12 weeks. We obtained 77% of excellent and good results following Anderson's scale. There were 4 cases of pseudarthrosis and 6 cases of delayed bone union. Conclusion. This surgical technique provides several advantages, such as a low incidence of complications and a total absence of infections, refractures and iatrogenic neurovascular injuries. It allows a lower hospital stay and a shortening of the surgery time compared with other techniques such as plates and intramedullary nails, that have similar results, in terms of bone union and functional outcomes, as we have verified from the published literature (AU)
Asunto(s)
Humanos , Diáfisis/lesiones , Traumatismos del Antebrazo/cirugía , Fijación Interna de Fracturas/métodos , Fracturas Óseas/cirugía , Estudios Retrospectivos , Resultado del Tratamiento , Recuperación de la Función/fisiologíaRESUMEN
OBJECTIVE: This is a retrospective study of 98 diaphyseal forearm fractures in adults, treated by a percutaneous technique with intramedullar Kirchner wires. MATERIALS AND METHOD: We reviewed 64 patients with 98 forearm fractures with a radiographic follow-up, assessing the presence of pseudarthrosis or delayed bone union and evaluating functional outcomes with the Anderson and the Disability of the Arm, Shoulder and Hand scale. RESULTS: Clinical and radiological bone union was achieved in an average of 12 weeks. We obtained 77% of excellent and good results following Anderson's scale. There were 4 cases of pseudarthrosis and 6 cases of delayed bone union. CONCLUSION: This surgical technique provides several advantages, such as a low incidence of complications and a total absence of infections, refractures and iatrogenic neurovascular injuries. It allows a lower hospital stay and a shortening of the surgery time compared with other techniques such as plates and intramedullary nails, that have similar results, in terms of bone union and functional outcomes, as we have verified from the published literature.
Asunto(s)
Fijación Intramedular de Fracturas/métodos , Fracturas del Radio/cirugía , Fracturas del Cúbito/cirugía , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Hilos Ortopédicos , Diáfisis/diagnóstico por imagen , Diáfisis/lesiones , Diáfisis/cirugía , Femenino , Estudios de Seguimiento , Fijación Intramedular de Fracturas/instrumentación , Humanos , Masculino , Persona de Mediana Edad , Radiografía , Fracturas del Radio/diagnóstico por imagen , Estudios Retrospectivos , Resultado del Tratamiento , Fracturas del Cúbito/diagnóstico por imagen , Adulto JovenRESUMEN
Se presenta un caso de fractura-luxación central acetabular con migración intrapélvica de la cabeza femoral que se encontraba fracturada a nivel basicervical. Esta asociación es poco frecuente afortunadamente. Existen pocos casos descritos en la literatura; suelen acompañarse de fracturas complejas de pelvis. El tratamiento consistió en la extracción de la cabeza femoral, la reconstrucción de la pared acetabular y la colocación de una prótesis total de cadera. La reconstrucción acetabular se realizó aprovechando los restos de la cabeza femoral. El resultado final tras 4 años de seguimiento se considera excelente
This is a case of a central acetabular fracture-dislocation with intrapelvic migration of the femoral head, which was fractured at the basicervical level. This is an infrequent combination of which very few cases are described in the literature. The ones that exist are often accompanied by complex pelvic fractures. In our case, treatment involved the extraction of the femoral head, the reconstruction of the acetabular wall and the implantation of a total hip prosthesis. For the acetabular reconstruction, fragments of the fractured femoral head were used. The final result after 4 years' follow-up is deemed excellent