2013, Number 1
Ortho-tips 2013; 9 (1)
Prevención, tratamiento y pronóstico de las fracturas por alta energía en la muñeca de pacientes jóvenes
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ABSTRACTWrist fractures are among the most common evaluated and treated in the emergency department. We now know that fractures in the young adult population may be more problematic and difficult to treat, because it is in this age group that high energy fractures are more often present. While in most cases of fractures in the elderly, they are a result of a fall, in young patients are usually secondary to a motor vehicle accident or sport injury and, in some cases, wounds caused by firearm projectile and represent a group of fractures with different morphological features and greater complexity. In the prevention of these fractures, there are many risk factors, including age, sex, race, lifestyle, practice of extreme sports, residence and medical condition that may or may not be modified to a greater or lesser degree, but we might assert that there are no more relevant prevention strategies than the use of proper protective equipment, or failing that, to avoid events that potentially produce the injury. Most distal radius fractures can be evaluated with high quality radiographic projections. Special projections in addition to the conventional lateral and PA are often essential, particularly in high-energy fractures. They often note articular extensions or undetected shifts not seen in the standard frontal and lateral projections. 3D computed tomography may be of greater value in the accurate definition of anatomical disruption, particularly in intra-articular fractures with multiple components. The treatment goals have always been to restore the anatomy of the radius taking into account the length, tilt angle and articular surface. In the outcome of high energy wrist fractures there are determining factors such as fracture-related factors, surgeon, implant and patient-related factors. While ensuring an anatomical and stable reconstruction, there are many paths that can lead to successful treatment of these fractures.