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2021, Número 1

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Revista Cubana de Ortopedia y Traumatología 2021; 35 (1)


Fracturas trocántereas inestables. ¿Fijación extramedular o intramedular?

Tabares NHI, Diaz QJM, Tabares SH, Morales SR

Idioma: Español
Referencias bibliográficas: 28
Paginas: 1-14
Archivo PDF: 510.60 Kb.


RESUMEN

Introducción: Las fracturas trocantéreas inestables presentan dificultad para lograr la osteosíntesis estable, el apoyo precoz y la rápida reintegración social. Se tratan mediante osteosíntesis extra o intramedular. La osteosíntesis extramedular mediante placa atornillada estática o dinámica. Los implantes intramedulares poseen clavos o tornillos deslizantes.
Objetivo: Revisar la literatura publicada entre 2015 y 2020 que comparen los diferentes métodos de fijación quirúrgica de las fracturas trocantéreas inestables.
Estrategia de búsqueda: En PubMed de publicaciones entre los años 2010-2020 en ingles con los términos: “fracturas trocantéreas inestables”, “tratamiento de las fracturas extracapsulares de fémur proximal”, “osteosíntesis en fracturas trocantéreas femorales inestables”.
Conclusiones: Las fracturas trocantéreas inestables poseen tendencia al desplazamiento en varo con medialización de la diáfisis. El clavo-placa estático muestra elevados índices de fallo, superiores al del clavo-placa deslizante (DHS), pero la placa estabilizadora trocantérea (TSP) parece ser el mejor implante para osteosíntesis extramedular muy semejante a lo reportado con los implantes intramedulares.


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