Fracturas expuestas de miembro inferior, factores etiológicos y complicaciones en el Hospital Teodoro Maldonado Carbo, año 2015-2016
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2016
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Carrera de Medicina
Resumen
Las fracturas abiertas son un grave problema para el cirujano ortopédico y que dejan secuelas funcionales importantes dependiendo de su ubicación y la gravedad de la lesión debido a la magnitud de la fuerza aplicada al cuerpo. El propósito de esta investigación fue analizar los factores etiológicos y las complicaciones de las fracturas expuestas de miembro inferior en pacientes del Hospital IESS Teodoro Maldonado Carbo durante el periodo del 2015 al 2016. El presente estudio fue de tipo analítico, observacional de corte transversal y retrospecivo. Se analizó todos los pacientes con fracturas expuestas de extremidades inferiores atendidos en el Servicio de Traumatología y Ortopedia entre el 1 de enero del 2015 al 28 de febrero del 2016. Las fracturas de las extremidades inferiores representaron el 56,30% (3.476) del total de fracturas ingresadas entre el 1 de enero del 2015 hasta el 28 de febrero del 2016 (6.173), las fracturas de tobillo con el 44% (1.533) y las del pie con el 21% (745) fueron las principales. La población masculina adulta joven y laboralmente productiva fue las afectada, ya que el 50% correspondieron a pacientes afiliados activos (50%) y el 59% (74) correspondieron al grupo etario entre 18-40 años de edad, siendo el sexo masculino (77%) el principal. Las fracturas expuestas grado III (63%) de la clasificación de Gustilo-Anderson constituyeron el grupo predominante, de las cuales el 37% (46) fueron fracturas IIIB. El 29% (37) de los pacientes presentaron fracturas expuestas tardías que tuvieron más de 6 horas de evolución considerándose fracturas infectadas. Las las lesiones cutáneas graves de espesor total, con abrasión y perdida cutánea significativa IO4 (40%) constituyeron las lesiones más frecuentes. Puntaje MESS > 7 puntos, se encontró en 9 pacientes, 5 de los cuales terminaron en amputación. La etiología principal fueron los traumatismos directos de alta energía (62%) (57) ocasionados por accidentes de tránsito. El 58% (73) presentaron complicaciones, la más frecuente fue la infección de la herida traumática (65%). Se encontró asociación estadísticamente significativa entre el desarrollo de complicaciones con la edad (p 0,02), sexo (0,03) y factores de riesgo (0,001).
Open fractures are a serious problem for the orthopedic surgeon and leave important functional consequences depending on the location and severity of injury due to the magnitude of the force applied to the body. The purpose of this research was to analyze the etiological factors and complications of open fractures of the lower limb in patients IESS Hospital Teodoro Maldonado Carbo during the period 2015 to 2016. This study was analytic, observational cross-sectional and retrospecivo. all patients with open fractures of the lower limbs treated at the Trauma and Orthopedics between January 1, 2015 to February 28, 2016. The lower extremity fractures accounted for 56.30% (3,476) of the total analyzed of admitted between January 1, 2015 until February 28, 2016 (6,173) fractures, ankle fractures 44% (1,533) and foot with 21% (745) were the main. Young adult male population and labor production was the affected, since 50% were active affiliates patients (50%) and 59% (74) were the age group between 18-40 years of age, being male ( 77%) the principal. Exposed fractures grade III (63%) of GustiloAnderson were the predominant group, of which 37% (46) were IIIB fractures. 29% (37) of patients had open fractures that had delayed more than 6 hours of evolution considered infected fractures. The serious skin lesions total thickness, with significant skin abrasion and loss IO4 (40%) were the most common injuries. MESS score> 7 points, was found in 9 patients, 5 of which ended in amputation. The main etiology were direct high-energy trauma (62%) (57) caused by traffic accidents. 58% (73) had complications, the most frequent was traumatic wound infection (65%). statistically significant association between the development of complications with age (p 0.02), sex (0.03) and risk factors (0.001) was found.
Open fractures are a serious problem for the orthopedic surgeon and leave important functional consequences depending on the location and severity of injury due to the magnitude of the force applied to the body. The purpose of this research was to analyze the etiological factors and complications of open fractures of the lower limb in patients IESS Hospital Teodoro Maldonado Carbo during the period 2015 to 2016. This study was analytic, observational cross-sectional and retrospecivo. all patients with open fractures of the lower limbs treated at the Trauma and Orthopedics between January 1, 2015 to February 28, 2016. The lower extremity fractures accounted for 56.30% (3,476) of the total analyzed of admitted between January 1, 2015 until February 28, 2016 (6,173) fractures, ankle fractures 44% (1,533) and foot with 21% (745) were the main. Young adult male population and labor production was the affected, since 50% were active affiliates patients (50%) and 59% (74) were the age group between 18-40 years of age, being male ( 77%) the principal. Exposed fractures grade III (63%) of GustiloAnderson were the predominant group, of which 37% (46) were IIIB fractures. 29% (37) of patients had open fractures that had delayed more than 6 hours of evolution considered infected fractures. The serious skin lesions total thickness, with significant skin abrasion and loss IO4 (40%) were the most common injuries. MESS score> 7 points, was found in 9 patients, 5 of which ended in amputation. The main etiology were direct high-energy trauma (62%) (57) caused by traffic accidents. 58% (73) had complications, the most frequent was traumatic wound infection (65%). statistically significant association between the development of complications with age (p 0.02), sex (0.03) and risk factors (0.001) was found.
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Fracturas abiertas, Extremidad inferior, Epidemiología analítica, Estudios retrospectivos, Hospital de Especialidades Dr. Teodoro Maldonado Carbo, Cantón Guayaquil, Ecuador