Manejo de las Fracturas de Pilón Tibial en nuestro centro

  • Javier Guerrero Mera HOSPITAL UNIVERSITARIO DE VALME
  • Maximiliano Sánchez Martos HOSPITAL UNIVERSITARIO DE VALME
  • María Jesús Calvo-Rubio García HOSPITAL UNIVERSITARIO DE VALME
Palabras clave: fracturas de pilón tibial, fijador externo, fijación interna, resultado

Resumen

ObjetivosEste estudio tiene como objetivo conocer la incidencia de complicaciones y los resultados funcionales según el método de tratamiento.Material y métodos Se realiza un estudio descriptivo retrospectivo que incluyó a 41 fracturas de pilón tibial tratadas quirúrgicamente en nuestro servicio entre marzo de 2012 y abril de 2016.ResultadosLas principales complicaciones registradas fueron trastornos de consolidación, infección y artrosis postraumática. Se registró una incidencia de complicaciones mayor con el uso de fijador externo con respecto a la reducción abierta y fijación interna.La escala funcional usada fue AOFAS con una puntuación media de 74±14 puntos. Se obtuvo peor resultado funcional en pacientes tratados con fijador externo y con presencia de retardo de consolidación radiográfica. La satisfacción media de los pacientes fue de 8,2 puntos.ConclusionesEl tratamiento es complejo siendo el factor más importante para el mismo el estado de partes blandas. En nuestra experiencia se debe optar por realizar reducción abierta y fijación interna siempre que el estado del miembro lo permita reservando el fijador externo para traumatismos con lesiones graves de partes blandas como dispositivo temporal en una estrategia de 2 tiempos.ABSTRACTGoals This study aims to know the incidence of complications and functional outcomes according to the treatment method.Material and methodsThis retrospective study included 41 distal tibial or pilon fractures surgically treated in our service between March 2012 and April 2016.A descriptive and inferential analysis was performed (p <0.05).ResultsThere was a higher incidence of complications with the use of external fixator with respect to open reduction and internal fixation (RAFI). The main complications were nonunion, infection and posttraumatic arthritis.A significant relationship was observed between posttraumatic arthritis and the use of external fixation with respect to RAFI.The mean score on the AOFAS scale was 74 ± 14 points. Statistical significance was obtained in the score difference according to the presence or absence of consolidation disorders. The difference in score between fractures treated with external fixative and those that were made RAFI had statistical significance.ConclusionsBased on our study we believe that external fixation should be reserved for trauma with severe soft-tissue injuries as a temporary device in a 2-staged strategy.

Biografía del autor/a

Javier Guerrero Mera, HOSPITAL UNIVERSITARIO DE VALME
MÉDICO RESIDENTE CIRUGÍA ORTOPÉDICA Y TRAUMATOLOGÍA
Maximiliano Sánchez Martos, HOSPITAL UNIVERSITARIO DE VALME
FEA CIRUGÍA ORTOPÉDICA Y TRAUMATOLOGÍA
María Jesús Calvo-Rubio García, HOSPITAL UNIVERSITARIO DE VALME
FEA CIRUGÍA ORTOPÉDICA Y TRAUMATOLOGÍA

Citas

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Publicado
2018-07-16
Sección
Articulos Originales