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Órgano Oficial del Colegio Mexicano de Ortopedia y Traumatología

2003, Número 2

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Acta Ortop Mex 2003; 17 (2)


Tratamiento de las fracturas abiertas de la tibia mediante enclavado endomedular encerrojado no fresado.

Blanco-Blanco JF , Ramos-Galea R , Hernández-Martín P , Borrego Ratero D , De Pedro-Moro JA

Idioma: Español
Referencias bibliográficas: 50
Paginas: 81-84
Archivo PDF: 41.60 Kb.


RESUMEN

Presentamos los resultados clínicos y radiológicos del tratamiento inmediato de 20 casos de fracturas abiertas de la tibia, utilizando el enclavado endomedular encerrojado y sin fresado, con un seguimiento medio de 21 meses. Catorce pacientes eran varones y 6 eran mujeres, con una edad media de 43 años. La etiología más frecuente ha sido los accidentes de tráfico. De los 20 casos 6 eran Grado I, 8 casos eran Grado II, 4 eran IIIA y 2 casos eran IIIB. Todos los pacientes fueron tratados en las primeras 8 horas siguientes al accidente. En todos los casos se emplearon clavos finos (9-10 mm) de Grosse-Kempf encerrojados y sin fresado. Todos los pacientes recibieron tratamiento antibiótico con cefuroxima y tobramicina durante una semana. Todas las heridas fueron cubiertas durante la primera semana tras el accidente. Todas las fracturas consolidaron y no se produjo ningún caso de infección profunda. En tres casos se produjo un acortamiento mayor de 1 cm y en un caso se produjo una consolidación en valgo de 8o. A la vista de estos resultados, aunque la serie presentada es corta, el tratamiento inmediato de las fracturas abiertas de la tibia mediante el enclavado endomedular encerrojado y sin fresado parece un método eficaz y seguro, especialmente en los grados I, II y IIIA.


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