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Colegio de Medicos y Cirujanos República de Costa Rica

2010, Number 595

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Rev Med Cos Cen 2010; 67 (595)

Tratamiento de la no unión de fracturas en el Hospital Monseñor Sanabria

Blanco AL, Barboza GP

Language: Spanish
References: 25
Page: 469-477
PDF size: 656.25 Kb.


ABSTRACT

Background: Non-union is a frequent diagnosis despite an initial orthopedic treatment. This often leads to new surgical interventions, prolonged recovery periods and high hospitalization costs. The development of non-union depends on the initial treatment. For this reason we intend to identify the factors that may have lead to this problem, as well as actions that were taken for resolution.
Materials and methods: twelve patients were treated between July 2007 and October 2008 for non union at the Monseñor Sanabria Hospital in Puntarenas. We review the charts and X-rays in November 2008, pointing age, gender, involved bones, open or closed fracture, date of the fracture, initial treatment, date of diagnosis and type of non-union, deffinitive treatment and date, outcome. Data were entered into an Excel database program for analysis.
Results: twelve patients had the diagnosis of non-union. Six were tibial fractures, of which three were open, two treated with external fixation and the other with non-locking intramedullary nail; the remainders were managed with a compression plate (one) and two with cast inmobilization. Three were femur fractures (one open, managed with non-locking intramedullary nail), and the rest of them with dynamic condylar plates. The other corresponded to a fractured ulna and a tibial malleolus that were not recognized at presentation, and a fracture of the proximal fifth metatarsal treated without immobilization. All patients underwent surgery, obtaining fracture healing in an average of 5,2 months after surgery.
Conclusion: Proper application of the principles of osteosynthesis, is normally sufficient to achieve fracture healing in patients who develop non-union.


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