FRACTURAS DIAFISARIAS DE HÚMERO Y PARÁLISIS RADIAL
Resumen
La parálisis radial es una complicación tan frecuente como temida en las fracturas diafisarias del húmero. Se produce con una incidencia similar tanto en las fracturas del tercio medio como en las del tercio distal. Tanto la denominada parálisis radial primaria, descrita en el momento del traumatismo, como la secundaria, producida tras un gesto quirúrgico o tratamiento conservador, son motivo de controversia entre los distintos autores a la hora de afrontarla.La literatura sólo deja claro que las parálisis primarias que se producen tras traumatismos de alta energía y en las fracturas abiertas, son candidatas a la cirugía de revisión temprana del nervio por debajo de las dos semanas, debido a las altas tasas de laceraciones de éste. La decisión a seguir ante las parálisis radiales secundarias es aún más controvertida, aunque se aconseja la revisión nerviosa en las parálisis postmanipulación.Entre las distintas técnicas quirúrgicas que se usan a día de hoy para la estabilización de estas fracturas, la técnica MIPO, es con diferencia la que menos daña al nervio radial en comparación con la cirugía abierta y el enclavado intramedular.Citas
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