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Órgano Oficial del Colegio Mexicano de Ortopedia y Traumatología

2010, Número 5

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Acta Ortop Mex 2010; 24 (5)


Resultados funcionales de reconstrucción nerviosa en miembro torácico. Estudio multicéntrico

Herrera-Tenorio JG, Chávez-Galván CR, Sesma-Villalpando RA, Farías-Castañeda RE, Núñez-Fernández AI

Idioma: Español
Referencias bibliográficas: 38
Paginas: 291-297
Archivo PDF: 382.81 Kb.


RESUMEN

Objetivo: Evaluar los resultados funcionales en reconstrucción nerviosa con injertos interfasciculares de nervio autólogo en el miembro torácico. Material y métodos: De Enero de 1999 a Diciembre de 2006. Lesiones nerviosas completas de radial, mediano y cubital. Mínimo 12 meses de seguimiento. Variables: edad, longitud del defecto nervioso, localización, intervalo entre lesión y tratamiento, mecanismo, lesiones y tratamientos agregados. Procedimientos realizados por los autores. Suturas 9 y 10-0. Medición funcional con escala Medical Research Council System (MRCS). Chi cuadrada a variables y resultados funcionales. Resultados: 43 pacientes, 48 nervios, edad promedio 26.7 años; 29 hombres y 14 mujeres. Diecinueve en cubital (39.5%), 18 en mediano (37.5%), 11 en radial (23%). Cinco pacientes con lesión mediana y cubital. Veintitrés lesiones en muñeca (53.4%), 7 en antebrazo (16.2%) y 12 (27.9%) en el brazo. Intervalo de tiempo entre la lesión y el tratamiento en promedio 42.09 días. Promedio del defecto nervioso 4.4 cm. Seguimiento promedio 17.5 meses. Cuarenta y dos pacientes con lesiones asociadas y 37 con tratamiento agregado. Función motora: Buenos en 15 (31.2%), regulares en 21 (43.8%), pobres en 10 (20.8%) y malos en 2 (4.2%). Función sensitiva: Buenos en 36 (75%), regulares en 4 (8.3%), pobres en 6 (12.5%) y malos en 2 (4.2%). Discusión: Resultados similares a los reportados en literatura. Conclusiones: Buenos resultados en brechas menores o iguales a 5 cm, casos sin lesión arterial y en retardo del tratamiento no mayor a 40 días. (P ‹ 0.05). Edad, nervio y sitio de lesión no fueron factores influyentes.


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