Indicaciones y resultados de la cementación de la lámina en el enclavado del fémur proximal
Resumen
Objetivo del trabajo Analizar los resultados de la cementación de la lámina espiral del clavo PFNA en diferentes indicaciones. Material y métodos Se realizó la técnica de cementación con PMMA (polimetilmetacrilato) de lámina espiral tras enclavado convencional con PFNA en doce pacientes con una edad media de 75 años. Se analizaron las indicaciones de dicha técnica, las complicaciones y el resultado tras un seguimiento medio de 11,1 meses. Resultados Las indicaciones fueron tres casos de pseudoartrosis, dos fallos del implante tipo cut-out, dos tipo pull-out, una fractura periimplante, un error técnico en el enclavado primario y tres metástasis en cuello femoral. En dos casos se apreció salida de PMMA intraarticular, sin impacto clínico asociado. El cemento se distribuyó en el mismo número de casos en la punta, en el cuello y en ambos (33%). Hubo un caso de movilización de material durante el seguimiento, en un paciente con metástasis en cuello femoral que sufrió fallo tipo cut-out. Todas las fracturas consolidaron en 18,67 semanas. Conclusiones La cementación de la lámina espiral en el enclavado cefalomedular en fracturas pertrocantéreas es una opción de rescate en casos de fallo del material, fracturas periimplante o pseudoartrosis, con buenos resultados y escasas complicaciones.Citas
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