Predictores de artrosis postquirúrgica a 5 años en fracturas de meseta tibial
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2016
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Escuela de Graduados
Resumen
Las fracturas de la meseta tibial ocurren debido a una combinación de carga
axial y fuerzas aplicadas en varo / valgo que conducen a depresión articular, mala
alineación y un mayor riesgo de osteoartritis postraumática, por tal motivo es
importante realizar evaluaciones seriadas de los resultados postoperatorios a largo
plazo. Objetivo: Identificar los factores predictores de artrosis postquirúrgica a 5
años en fractura de Meseta tibial. Metodología: Estudio de enfoque cuantitativo,
observacional, analítico, retrospectivo y de corte transversal. Se analizó los
pacientes con artrosis post-traumática de rodilla por fracturas de meseta tibial
durante el periodo del 16 de octubre de 2012 hasta el 16 de octubre de 2017. La
muestra estuvo integrado por 81 pacientes. Se empleó el software estadístico
SPSS versión 21 para el análisis de los datos, utilizando estadística de tipo
descriptiva e inferencial. Resultados: Se reporta una frecuencia de artrosis postquirúrgica
en 81 pacientes (16%), el grupo etario predominante fue el adultos
jóvenes (20-40 años) con el 64%, la edad promedio de presentación fue de 26,35
+- 3,582 (DE). El sexo masculino predominó con el 83%. Las fracturas de meseta
tibial cerradas (58%), por accidentes de tránsito (56%), tipo V (28%) y VI (25%)
de la clasificación de Schatzker y las fracturas tipo C de la clasificación de la AO
(85%) fueron el tipo más común de lesión encontrada en esta investigación. Existe
asociación estadísticamente significativa entre el desarrollo de artrosis postquirúrgica
con la presencia de factores de riesgo (p = 0,0001). Conclusiones:
Existe asociación estadísticamente significativa entre el desarrollo de artrosis
post-quirúrgica por fracturas de meseta tibial con la presencia de Fracturas tipo C
de la AO, sexo masculino, depresión articular > 5 mm, osteosíntesis insuficiente,
fractura expuesta, reducción post-operatoria insuficiente, lesiones de partes
blandas asociadas, obesidad, fracturas Schatzker III, V,VI y traumatismo por
armas de fuego.
Palabras clave: fractura de meseta tibial, artrosis postraumática, factores de
riesgo.
Fractures of the tibial plateau occur due to a combination of axial load and varus / valgus applied forces that lead to joint depression, malalignment and an increased risk of post-traumatic osteoarthritis, for this reason it is important to perform serial evaluations of postoperative results. long term. Objective: To identify the predictive factors of postoperative osteoarthritis at 5 years in Tibial Plateau fracture. Methodology: Study of quantitative, observational, analytical, retrospective and cross-sectional approach. We analyzed patients with posttraumatic knee arthritis due to tibial plateau fractures during the period from October 16, 2012 to October 16, 2017. The sample consisted of 81 patients. Statistical software SPSS version 21 was used to analyze the data, using descriptive and inferential statistics. Results: A frequency of post-surgical osteoarthritis was reported in 81 patients (16%), the predominant age group was young adults (20-40 years) with 64%, the average age of presentation was 26.35 + - 3,582 (DE). The male sex predominated with 83%. Fractures of tibial plateau closed (58%), by traffic accidents (56%), type V (28%) and VI (25%) of the Schatzker classification and type C fractures of the AO classification (85 %) were the most common type of injury found in this investigation. There is a statistically significant association between the development of post-surgical osteoarthritis and the presence of risk factors (p = 0.0001). Conclusions: There is a statistically significant association between the development of post-surgical osteoarthritis due to tibial plateau fractures with the presence of Type A Fractures, male sex, joint depression> 5 mm, insufficient osteosynthesis, exposed fracture, insufficient postoperative reduction , associated soft tissue injuries, obesity, Schatzker III, V, VI fractures and traumatism by firearms.
Fractures of the tibial plateau occur due to a combination of axial load and varus / valgus applied forces that lead to joint depression, malalignment and an increased risk of post-traumatic osteoarthritis, for this reason it is important to perform serial evaluations of postoperative results. long term. Objective: To identify the predictive factors of postoperative osteoarthritis at 5 years in Tibial Plateau fracture. Methodology: Study of quantitative, observational, analytical, retrospective and cross-sectional approach. We analyzed patients with posttraumatic knee arthritis due to tibial plateau fractures during the period from October 16, 2012 to October 16, 2017. The sample consisted of 81 patients. Statistical software SPSS version 21 was used to analyze the data, using descriptive and inferential statistics. Results: A frequency of post-surgical osteoarthritis was reported in 81 patients (16%), the predominant age group was young adults (20-40 years) with 64%, the average age of presentation was 26.35 + - 3,582 (DE). The male sex predominated with 83%. Fractures of tibial plateau closed (58%), by traffic accidents (56%), type V (28%) and VI (25%) of the Schatzker classification and type C fractures of the AO classification (85 %) were the most common type of injury found in this investigation. There is a statistically significant association between the development of post-surgical osteoarthritis and the presence of risk factors (p = 0.0001). Conclusions: There is a statistically significant association between the development of post-surgical osteoarthritis due to tibial plateau fractures with the presence of Type A Fractures, male sex, joint depression> 5 mm, insufficient osteosynthesis, exposed fracture, insufficient postoperative reduction , associated soft tissue injuries, obesity, Schatzker III, V, VI fractures and traumatism by firearms.
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Fractura de meseta tibial, Artrosis postraumática, Factores de riesgo, Cirugía, Hospital de Especialidades Dr. Teodoro Maldonado Carbo, Cantón Guayaquil, Ecuador