Resultados anátomo-funcionales postratamiento de fracturas de meseta tibial en pacientes con traumatismos de alta energía
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2018
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Escuela de Graduados
Resumen
Las fracturas de la meseta tibial se presentan en un amplio espectro de severidad y patrón de la lesión, cada una de las cuales requiere un enfoque y una estrategia diferentes para lograr buenos resultados clínicos. Lograr esos resultados comienza con una evaluación exhaustiva y un período de planificación preoperatoria, lo que lleva a elegir el enfoque quirúrgico y la estrategia de fijación más apropiados.
Objetivo: Correlacionar los resultados anatomo-funcionales postratamiento de las fracturas de meseta tibial en pacientes con traumatismos de alta energía del hospital Regional IESS “Teodoro Maldonado Carbo” durante el periodo de estudio 2015-2017.
Metodología: El estudio es tipo observacional, analítico, retrospectivo y de corte longitudinal, que incluyó a 205 pacientes con fracturas de meseta tibial de la consulta externa de Traumatología y Ortopedia del hospital Regional IESS “Teodoro Maldonado Carbo” captados durante el periodo de 16 de octubre del 2015 hasta el 16 de octubre del 2017. La gestión de datos se realizó en hojas de cálculo de Microsoft Excel 2010, donde se realizó el procesamiento de datos y para el análisis estadístico se empleó el programa SPSS versión 21.
Resultados: De manera general, al realizar la evaluación funcional se observó que el tratamiento quirúrgico ofrece resultados funcionales buenos en el 57,60% (118) y excelentes (32,20%) determinados mediante la escala KOOS. Al comparar las dos técnicas quirúrgicas, se observó que los resultados funcionales posoperatorios fueron superiores con la técnica MIPO (91,2% resultados excelentes) que con la técnica RAFI (20,5% resultados excelentes). Existe correlación entre el grado consolidación y los resultados funcionales (p = 0,001). Existe asociación estadísticamente significativa entre los resultados posoperatorios excelentes y la técnica RAFI/MIPO con una p significativa de 0.001 y de 0,01, lo cual indica que ambas técnicas son procedimientos quirúrgicos que proporcionan resultados funcionales excelente de la rodilla después de una cirugía por fractura de meseta tibial.
Palabras clave: fractura de meseta tibial, complicaciones, resultados funcionales.
Fractures of the tibial plateau are presented in a broad spectrum of severity and pattern of the lesion, each of which requires a different approach and strategy to achieve good clinical results. Achieving these results begins with a thorough evaluation and a preoperative planning period, which leads to choosing the most appropriate surgical approach and fixation strategy. Objective: To correlate the post-treatment anatomo-functional results of tibial plateau fractures in patients with high-energy trauma at the IESS “Teodoro Maldonado Carbo” Regional hospital during the 2015-2017 study period. Methodology: The study is observational, analytical, retrospective and longitudinal, which included 205 patients with tibial plateau fractures from the outpatient clinic of Traumatology and Orthopedics of the IESS “Teodoro Maldonado Carbo” Regional hospital, received since the 16th of October 2015 until October 16, 2017. Data management was carried out in Microsoft Excel 2010 spreadsheets, where the data was processed and for the statistical analysis the SPSS program version 21 was used. Results: In general, when performing the functional evaluation it was observed that the surgical treatment offers good functional results in 57.60% (118) and excellent (32.20%) determined by the KOOS scale. When comparing the two surgical techniques, it was observed that postoperative functional results were higher with the MIPO technique (91.2% excellent results) than with the RAFI technique (20.5% excellent results). There is a correlation between the degree of consolidation and functional results (p = 0.001). There is a statistically significant association between excellent postoperative results and the RAFI / MIPO technique with a significant p of 0.001 and 0.01, which indicates that both techniques are surgical procedures that provide excellent functional results of the knee after a fracture surgery. of tibial plateau. Key words: fracture of tibial plateau, complications, functional results.
Fractures of the tibial plateau are presented in a broad spectrum of severity and pattern of the lesion, each of which requires a different approach and strategy to achieve good clinical results. Achieving these results begins with a thorough evaluation and a preoperative planning period, which leads to choosing the most appropriate surgical approach and fixation strategy. Objective: To correlate the post-treatment anatomo-functional results of tibial plateau fractures in patients with high-energy trauma at the IESS “Teodoro Maldonado Carbo” Regional hospital during the 2015-2017 study period. Methodology: The study is observational, analytical, retrospective and longitudinal, which included 205 patients with tibial plateau fractures from the outpatient clinic of Traumatology and Orthopedics of the IESS “Teodoro Maldonado Carbo” Regional hospital, received since the 16th of October 2015 until October 16, 2017. Data management was carried out in Microsoft Excel 2010 spreadsheets, where the data was processed and for the statistical analysis the SPSS program version 21 was used. Results: In general, when performing the functional evaluation it was observed that the surgical treatment offers good functional results in 57.60% (118) and excellent (32.20%) determined by the KOOS scale. When comparing the two surgical techniques, it was observed that postoperative functional results were higher with the MIPO technique (91.2% excellent results) than with the RAFI technique (20.5% excellent results). There is a correlation between the degree of consolidation and functional results (p = 0.001). There is a statistically significant association between excellent postoperative results and the RAFI / MIPO technique with a significant p of 0.001 and 0.01, which indicates that both techniques are surgical procedures that provide excellent functional results of the knee after a fracture surgery. of tibial plateau. Key words: fracture of tibial plateau, complications, functional results.
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FRACTURA DE MESETA TIBIAL, COMPLICACIONES, RESULTADOS FUNCIONALES, POSOPERATORIO, HOSPITAL DE ESPECIALIDADES DR. TEODORO MALDONADO CARBO, CANTON GUAYAQUIL, ECUADOR