Manejo artroscópico de las lesiones ligamentarias escafolunares, algoritmo de diagnóstico y tratamiento
Fecha
2016
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Escuela de Graduados
Resumen
Las lesiones ligamentarias escafolunares son daños anatómicos que se producen en el ligamento interóseo escafolunar, con prevalencia en todos los traumatismos de la muñeca. Son los responsables del patrón más frecuente de inestabilidad carpiana y generalmente son subestimadas por lo que el conocimiento de la biomecánica, epidemiología, métodos diagnósticos, tratamientos disponibles de las lesiones agudas y/o crónicas y su relación con los cambios degenerativos de la muñeca es muy importante. La artroscopia es una técnica invasiva que ha permitido la valoración de casi todas las articulaciones y a nivel de la muñeca ha sido la herramienta que ha abierto el conocimiento de la compleja anatomía de la muñeca, su funcionamiento y la identificación de sus problemas. Actualmente no sólo es un método diagnóstico sino que también es propuesto como una alternativa de tratamiento de las lesiones ligamentarias de la muñeca. El objetivo del presente estudio de casos es determinar la eficacia y seguridad de la artroscopia en el manejo de las lesiones ligamentarias escafolunares y construir un algoritmo de diagnóstico y tratamiento. Se realizó un análisis cualitativo de la información de pacientes con este tipo de lesiones, el conocimiento médico sobre el tema y la literatura existente en los últimos cuatro años para encontrar la mejor evidencia disponible. Los resultados mostraron que la artroscopia es el estándar de oro en el diagnóstico de las lesiones ligamentarias escafolunares pero a su vez se encontró muy poca evidencia sobre la efectividad en cuanto a su uso como tratamiento
The scapholunate ligament injuries are anatomical damage that occur in the scapholunate interosseous ligament, with prevalence in all wrist injuries. They are responsible for the most common pattern of carpal instability and are generally underestimated so the knowledge of biomechanics, epidemiology, available diagnostic methods, treatment of acute and/ or chronic injuries and their relationship with degenerative changes in the wrist is very important. Arthroscopy is an invasive technique that has allowed the assessment of almost all the joints and the wrist has been the tool that has opened the understanding of the complex anatomy of the wrist, operation and identification of their problems. Currently it is not only a diagnosis method but also is proposed as an alternative treatment of ligament injuries of the wrist. The objective of this case study is to determine the efficacy and safety of arthroscopy in the management of scapholunate ligament injuries and build a diagnosis and treatment algorithm. A qualitative analysis of information from patients with these injuries, medical knowledge on the subject and the literature in the last four years was conducted to find the best available evidence. The outcomes showed that arthroscopy is the gold standard in the diagnosis of scapholunate ligament injuries but in turn found very little evidence on the effectiveness in terms of its use as a treatment.
The scapholunate ligament injuries are anatomical damage that occur in the scapholunate interosseous ligament, with prevalence in all wrist injuries. They are responsible for the most common pattern of carpal instability and are generally underestimated so the knowledge of biomechanics, epidemiology, available diagnostic methods, treatment of acute and/ or chronic injuries and their relationship with degenerative changes in the wrist is very important. Arthroscopy is an invasive technique that has allowed the assessment of almost all the joints and the wrist has been the tool that has opened the understanding of the complex anatomy of the wrist, operation and identification of their problems. Currently it is not only a diagnosis method but also is proposed as an alternative treatment of ligament injuries of the wrist. The objective of this case study is to determine the efficacy and safety of arthroscopy in the management of scapholunate ligament injuries and build a diagnosis and treatment algorithm. A qualitative analysis of information from patients with these injuries, medical knowledge on the subject and the literature in the last four years was conducted to find the best available evidence. The outcomes showed that arthroscopy is the gold standard in the diagnosis of scapholunate ligament injuries but in turn found very little evidence on the effectiveness in terms of its use as a treatment.
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Ligamento escafolunar, Heridas y traumatismos, Artroscopía de muñeca, Algoritmos, Hospital Alcívar, Cantón Guayaquil