Resultados funcionales y radiológicos de fracturas de Pilón tibial tratadas con fijador híbrido y fijación interna. Hospítal Alcívar 2008 - 2012
Fecha
2014
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Escuela de Graduados
Resumen
El presente estudio se realizó para determinar los resultados funcionales y
radiológicos en el tratamiento de fracturas de Pilón Tibial tratadas con Fijación
Interna mediante placa y métodos externos con el uso de Tutor Externo Hibrido en el
Hospital Alcivar de la ciudad de Guayaquil durante el período 2008 al 2012, se trata
de un estudio descriptivo, retrospectivo no experimental; donde se estudiaron 30
pacientes que fueron tratados con los métodos antes descritos obteniendo los
siguientes resultados: 30 pacientes: 73.3% hombres, 26.7% mujeres; se utilizo
fijación interna con el uso de placa en 43.3 % , y fijacion externa con tutor hibrido en
56.6 % . En cuanto a los resultados radiologicos se los valoró mediante la escala de
Burwell y Charnley, arrojando una reducción anátomica 77.7 %, regular 23.3 % con
el uso de tutor externo híbrido, con el uso de fijación interna : 61.5 % anátomico, 23
% regular. 15.3 % mala. La valoración anatomo - funcional se la realizo mediante la
escala de Olerud C, Molander, como resultado en lo que respecta a la fijación externa
se obtuvieron resultados: pobre 5.88%, regular 5.88%, bueno 58.8%, excelente 29.4% ;
con el uso de fijación interna pobre 15.38 %, regular 61.53 %, bueno 23.07%. Se
presentó complicaciones en el 23 %, con el uso de fijación interna: 3 pacientes con
infección superficial, 2 pacientes con pseudoartrosis y 1 paciente presento dehiscencia
de sutura. Con el uso de tutor externo no se presentaron caso de infección ni superficial,
ni profunda pero si de pseudoartrosis en 2 casos. En conclusión creemos que el mejor
método de reducción en fracturas complejas de pilon tibial es el uso de tutor externo
hibrido permite disminuir el riesgo de infección a este nivel anatómico, evitaría el
retiro de material de osteosíntesis y cambio a otro sistema de fijación.
The present study was performed to determine the functional and radiological results in the treatment of tibial Pilon fractures treated with internal fixation using plate and external methods using Hybrid External Tutor Alcivar Hospital in Guayaquil during the period 2008 to 2012, it is a descriptive, retrospective non-experimental study; 30 patients: where 30 patients were treated with the methods described above with the following results were studied 73.3% male, 26.7% female; internal fixation was used with the use of plate in 43.3%, and external fixation with hybrid tutor 56.6%. Regarding the radiological results were those assessed by the scale of Burwell and Charnley, yielding an anatomic 77.7% reduction, average 23.3% with the use of hybrid external fixator, with the use of internal fixation: 61.5% anatomic .23%. 15.3% bad. The anatomopathological assessment - functional is the performed by Olerud C, Molander, resulting in regard to external fixation results were obtained: poor 5.88%, 5.88% Regular, good 58.8% Excellent 29.4%; with the use of internal fixation poor 15.38%, average 61.53% 23.07% good. Complications in 23% occurred with the use of internal fixation: 3 patients with superficial infection, 2 patients with nonunion and 1 patient presented suture dehiscence. With the use of external fixator were ignored or superficial infection occurred, nor deep but if nonunion in 2 cases. In conclusion we believe that the best method of reducing complex tibial pilon fractures is the use of hybrid external fixator can reduce the risk of infection to the anatomical level, prevent the removal of osteosynthesis material change to another system and fixing.
The present study was performed to determine the functional and radiological results in the treatment of tibial Pilon fractures treated with internal fixation using plate and external methods using Hybrid External Tutor Alcivar Hospital in Guayaquil during the period 2008 to 2012, it is a descriptive, retrospective non-experimental study; 30 patients: where 30 patients were treated with the methods described above with the following results were studied 73.3% male, 26.7% female; internal fixation was used with the use of plate in 43.3%, and external fixation with hybrid tutor 56.6%. Regarding the radiological results were those assessed by the scale of Burwell and Charnley, yielding an anatomic 77.7% reduction, average 23.3% with the use of hybrid external fixator, with the use of internal fixation: 61.5% anatomic .23%. 15.3% bad. The anatomopathological assessment - functional is the performed by Olerud C, Molander, resulting in regard to external fixation results were obtained: poor 5.88%, 5.88% Regular, good 58.8% Excellent 29.4%; with the use of internal fixation poor 15.38%, average 61.53% 23.07% good. Complications in 23% occurred with the use of internal fixation: 3 patients with superficial infection, 2 patients with nonunion and 1 patient presented suture dehiscence. With the use of external fixator were ignored or superficial infection occurred, nor deep but if nonunion in 2 cases. In conclusion we believe that the best method of reducing complex tibial pilon fractures is the use of hybrid external fixator can reduce the risk of infection to the anatomical level, prevent the removal of osteosynthesis material change to another system and fixing.
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Palabras clave
Fracturas de la tibia, Fijación híbrida, Fijación interna de fracturas, Epidemiología descriptiva, Estudios retrospectivos, Hospital Alcívar, Cantón Guayaquil, Ecuador, Resultados funcionales