RESUMEN
Fibrin adhesive proved to be useful in the reattachment of chondral and osteochondral fragments. Its use is based on sound biological principles. It offers a number of advantages over internal fixation; it causes no further damage to the cartilage, even small chondral fragments can be reattached and a second operation for the removal of metalwork is unnecessary. Its bonding strength provides only contact stability, so that immobilization in plaster for 3 weeks is always necessary. In the last 5 years we have used fibrin adhesive in 28 patients for the fixation of 39 chondral or osteochondral fragments. Of these, 26 cases were followed up for periods of 6 months to 5 years. Twelve patients were examined arthroscopically; 9 of them showed complete healing of the fragments, and only 3 slight localized degenerative changes. In 15 cases we were able to see radiological healing. All except two showed union of the fragments and restoration of the joint surface. In view of our results fibrin adhesive can be recommended for the operative management of cartilage injuries.
Asunto(s)
Aprotinina , Cartílago Articular/lesiones , Factor XIII , Fibrinógeno , Trombina , Adhesivos Tisulares , Adolescente , Adulto , Animales , Moldes Quirúrgicos , Niño , Combinación de Medicamentos , Femenino , Adhesivo de Tejido de Fibrina , Fijación de Fractura , Humanos , Traumatismos de la Rodilla/cirugía , Masculino , Persona de Mediana Edad , Complicaciones Posoperatorias , Conejos , Cicatrización de HeridasAsunto(s)
Traumatismos de la Rodilla/cirugía , Lesiones de Menisco Tibial , Anciano , Clavos Ortopédicos , Fijación Interna de Fracturas , Humanos , Inestabilidad de la Articulación/etiología , Inestabilidad de la Articulación/cirugía , Traumatismos de la Rodilla/complicaciones , Meniscos Tibiales/cirugía , Persona de Mediana EdadAsunto(s)
Fracturas del Fémur/cirugía , Fracturas Abiertas/clasificación , Fracturas del Húmero/cirugía , Fracturas de la Tibia/cirugía , Accidentes , Adulto , Anciano , Placas Óseas , Femenino , Fracturas del Fémur/diagnóstico por imagen , Fijación Interna de Fracturas/métodos , Fracturas Abiertas/diagnóstico por imagen , Fracturas Abiertas/cirugía , Humanos , Fracturas del Húmero/diagnóstico por imagen , Masculino , Persona de Mediana Edad , Radiografía , Terminología como Asunto , Fracturas de la Tibia/diagnóstico por imagenRESUMEN
The term 'deux étages fracture' is used in different meanings. Therefore, an exact definition seems necessary. 38 own cases of this kind treated in the last 5 years are analysed. Special problems of diagnosis and treatment of this type of fracture are dealt with. Because of the risky complications primary definitive treatment is emphasized especially in cases of compound fractures and in cases with severe simultaneous lesions.