Resultados funcionales y complicaciones post reducción cerrada y fijación con tornillo en la epifisiolistesis de la cabeza femoral, Hospital Alcívar 2002 - 2014
Fecha
2015
Autores
Título de la revista
ISSN de la revista
Título del volumen
Editor
Universidad de Guayaquil. Facultad de Ciencias Médicas. Escuela de Graduados
Resumen
La epifisiolistesis de la cabeza femoral, a pesar de ser la patología más frecuente de la cadera del adolescente, aún crea temor en el ortopedista a realizar o no maniobras de reducción por las secuelas o complicaciones que puedan presentar. Es una lesión característica de un grupo particular de pacientes, generalmente con aumento de la masa corporal, con crecimiento rápido, con alteraciones de tipo endocrinos y sin antecedentes traumáticos o al estar presentes son de baja energía. Su manejo requiere identificar una serie de elementos y condiciones: como el tiempo de evolución; aguda, crónica o reagudizada, la estabilidad; estable o inestable y el porcentaje de desplazamiento: leve, moderado, grave. El tratamiento tiene el objetivo de estabilizar la cadera evitando el desplazamiento de la metáfisis sobre la epífisis, que generalmente se lo realiza con un clavo o tornillo roscado a través del cuello femoral previa reducción o fijándolo in situ, a fin de mejorar la biomecánica de la cadera y disminuyendo las secuelas. Mediante un estudio analítico, longitudinal, casos sin control, se demostró, que existen en la institución protocolos definidos para realizar maniobras de reducción y fijación quirúrgica en este tipo de lesión, con buenos resultados y mínimas complicaciones que se evidenciaron con la escala funcional de Harris y los estudios radiológicos. Este trabajo se realizó en base a la información obtenida de los expedientes de los pacientes manejados en el servicio de Traumatología y Ortopedia del Hospital Alcívar en el período comprendido desde el 2002 al 2014
The epifisiolistesis of the femoral head, despite being the most frequent pathology hip teenager, still creates fear in the orthopedist to do or no reduction maneuvers by the effects or complications that may arise. It is a characteristic lesion of a particular group of patients, usually with increased body mass, with rapid growth, endocrine disorders such without trauma history or to be present are low energy. Its management requires identifying a number of elements and conditions: as the time of evolution; acute, chronic or acute exacerbation, stability; stable or unstable and the percentage of displacement: mild, moderate and severe. The treatment aims to stabilize the hip preventing movement of the metaphysis of the epiphysis, which usually is performed with a nail or screw threaded through the femoral neck after in situ reduction or fixing, to improve the biomechanics hip and reducing sequelae. Through analytical, longitudinal, case studies without control, it was shown, that exist in the protocols institution defined for maneuvers reduction and surgical fixation on this type of injury, with good results and minimal complications that became apparent with the functional scale of Harris and radiologic studies. This work was based on information obtained from the records of patients treated at the Trauma and Orthopedics Hospital Alcivar in the period from 2002 to 2014.
The epifisiolistesis of the femoral head, despite being the most frequent pathology hip teenager, still creates fear in the orthopedist to do or no reduction maneuvers by the effects or complications that may arise. It is a characteristic lesion of a particular group of patients, usually with increased body mass, with rapid growth, endocrine disorders such without trauma history or to be present are low energy. Its management requires identifying a number of elements and conditions: as the time of evolution; acute, chronic or acute exacerbation, stability; stable or unstable and the percentage of displacement: mild, moderate and severe. The treatment aims to stabilize the hip preventing movement of the metaphysis of the epiphysis, which usually is performed with a nail or screw threaded through the femoral neck after in situ reduction or fixing, to improve the biomechanics hip and reducing sequelae. Through analytical, longitudinal, case studies without control, it was shown, that exist in the protocols institution defined for maneuvers reduction and surgical fixation on this type of injury, with good results and minimal complications that became apparent with the functional scale of Harris and radiologic studies. This work was based on information obtained from the records of patients treated at the Trauma and Orthopedics Hospital Alcivar in the period from 2002 to 2014.
Descripción
PDF
Palabras clave
Cabeza de fémur, Epífisis desprendida de cabeza femoral, Fijación de fracturas, Tornillos ortopédicos, Hospital Alcivar, Cantón Guayaquil, Ecuador, Resultados funcionales, Complicaciones