ABSTRACT
Introducción: La osteodistrofia renal provoca desejes progresivos en los miembros inferiores, siendo la deformidad más frecuente el genu valgo. El crecimiento guiado (hemiepifisiodesis) es útil en la corrección de deformidades angulares en la edad pediátrica. El objetivo de este trabajo es evaluar los resultados y complicaciones de esta técnica quirúrgica aplicada a fisis patológicas. Materiales y métodos: Se presentan 11 pacientes (20 rodillas) con diagnóstico de insuficiencia renal crónica y genu valgo, tratados en nuestro servicio con hemiepifisiodesis transitoria. Se colocaron placas en 8 en 3 pacientes (5 rodillas) y en 8 pacientes, grapas (15 rodillas). Se evaluó el eje mecánico radiográfico pre y post operatorio y las complicaciones relativas a cada implante. Resultados: Se logró la corrección completa en 4 pacientes, 1 caso sobrellevó deformidad rebote, y en los restantes se obtuvo mejoría sin llegar a la normalización óptima del eje mecánico. Conclusiones: La corrección obtenida se relaciona claramente con la normalidad de la función renal. Los pacientes trasplantados consiguieron normalización en el crecimiento óseo remanente. No tuvimos diferencia en los resultados ni en las complicaciones entre los dos tipos de implantes empleados.
Subject(s)
Humans , Male , Female , Child , Adolescent , Lower Extremity Deformities, Congenital/surgery , Lower Extremity Deformities, Congenital/complications , Lower Extremity Deformities, Congenital/therapy , Bone Malalignment/surgery , Bone Malalignment/congenital , Bone Malalignment/therapy , Follow-Up Studies , Chronic Kidney Disease-Mineral and Bone Disorder/therapy , ArgentinaABSTRACT
Tibia is the most commonly fractured long bone in the body, because its particular blood supply and high complications rate we always try to find out the best method to manage such fracture with minimal disturbance to its blood supply and early mobilizations. The fracture brace is one of the best methods of treatment of fractures regarding safety and early mobilization. We used the brace in closed and compound [Gustillo I and II] in adult, and shows its advantage over other methods regarding safety, mobility, and low complication rate. Nineteen patient with tibial shaft fracture was investigated during the treatment with tibial castbrace Fractures were classified according to AO/ASIF classification. Patients were treated primarily by back slab followed by plaster application from toes to above the knee Fracture brace was applied after the pain and swelling had subsided. Serial x-ray films were taken regularly in a fixed dates to observe and prevent any unacceptable misalignment cast brace was discarded after union, when it found safe to walk independently. The average time needed for application of the cast after injury was [4.8] weeks for closed fractures and [6.1] weeks for open Fractures. Union occurred in an average of [17.2] weeks for type A1 [AO/ASIF], [16.2] weeks for A2, and the longest healing time [22.2] weeks was obtained in type C. Neither a significant shortening was obtained with a range of [8.6-13.4 mm.] nor an angulations range of [1-7.5[°]] if compared with the acceptable figures. Functional bracing is another method in accomplishing the goal of early introduction of function after bone union. It does not replace other methods of treatment which have its specific indications. Functional bracing is successful in type A, and can be used in type B and C of AO/ASIF classification .The misalignments obtained are mostly within acceptable range if compared with the standard figures
Subject(s)
Humans , Adolescent , Middle Aged , Adult , Braces , Diaphyses/injuries , Bone Malalignment/therapy , Treatment OutcomeABSTRACT
Se presenta una serie de 20 pacientes con fracturas multifragmentarias en 5 casos del húmero, en 8 del fémur y en 7 de la tibia. Todos se trataron con fijadores externos tipo Ortofix. Se obtuvo consolidación primaria en 18 casos (90 por ciento) en un promedio de 13 semanas, mientras que 2 requirieron medios masivos de osteosíntesis y aplicación de injerto óseo por haber sufrido severo retardo de consolidación