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1.
An. Facultad Med. (Univ. Repúb. Urug., En línea) ; 8(2): e301, dic. 2021. ilus, tab
Article in Spanish | LILACS, BNUY, UY-BNMED | ID: biblio-1358052

ABSTRACT

Objetivo: El objetivo del presente estudio es explorar y describir resultados y experiencias en el tratamiento de las fracturas de platillo tibial Schatzker1 I-IV con asistencia artroscópica para obtener reducción como parte de la técnica de fijación interna (ARIF). Metodología: Se realizó una búsqueda sistematizada en diferentes motores de búsqueda como Pubmed y Lilacs. Se buscó con la misma metodología por 2 revisores independientes utilizando términos MESH "Tibial Fracture", "Arthroscopic". Se incluyeron artículos publicados en los últimos 5 años (2014 a Setiembre 2020), que muestren resultados clínicos de los procedimientos, en inglés o español, en humanos y mayores de 18 años. Resultados: Siguiendo los criterios de inclusión se identificaron 114 títulos, y finalmente 9 artículos fueron incluidos en nuestra revisión sistematizada. De los 9 artículos revisados 5 corresponden a series de casos con un nivel de evidencia IV, 3 corresponden a estudios comparativos retrospectivos entre técnicas de reducción abierta y fijación interna (ORIF) y ARIF con nivel de evidencia III y un estudio corresponde a un nivel de evidencia I. Un total de 217 pacientes fueron intervenidos mediante ARIF en nuestra revisión, el tiempo promedio de seguimiento fue de 24.9 meses (12-90 m), en cuanto al tipo de fractura las más frecuentes fueron las fracturas de platillo tibial Schatzker II y III, la lesión asociada más frecuente fue la lesión meniscal seguida de la rotura del ligamento cruzado anterior. En cuanto al porcentaje total de resultados obtenidos independientemente de cada score utilizado, el 98% aproximadamente obtuvo resultados buenos o excelentes. El porcentaje de complicaciones operadas con asistencia artroscópica resultó ser aproximadamente del 6.5%, siendo la complicación más frecuente la trombosis venosa profunda con 6 casos. Conclusiones: De nuestra revisión podemos concluir que la asistencia artroscópica es útil en el tratamiento de las fracturas de platillo tibial Schatzker I-IV, siendo una técnica que provee resultados funcionales satisfactorios, sin incrementar el número de complicaciones y permite tratar lesiones asociadas en el mismo acto.


Objective: The objective of this study is to explore the experience and the results of Schatzker1 I-IV tibial plateau fractures internal fixation technique (ARIF) with arthroscopic assistance Methodology: A systematic review was carried out in different search engines such as Pubmed and Lilacs. The same methodology was applied by two independent reviewers using MESH terms "Tibial Fracture", "Arthroscopic". Articles published in the last 5 years (2014 to September 2020) were included, showing clinical results of the procedures, in English or Spanish, in humans and over 18 years of age. Results: Following the inclusion criteria, 114 titles were identified, and finally 9 articles were included in our systematic review. Of the 9 articles reviewed, 5 were case series (level of evidence IV), 3 retrospective comparative studies between open reduction and internal fixation techniques (ORIF) and ARIF with level of evidence III and one study was level of evidence I. A total of 217 patients underwent ARIF surgery in our review, the average follow-up time was 24.9 months (12-90 m), in terms of the type of fracture, the most frequent were Schatzker II tibial plateau fractures and III, the most frequent associated injury was meniscal injury followed by anterior cruciate ligament tear. Regarding the total percentage of results obtained independently of each score used, approximately 98% obtained good or excellent results. The percentage of complications with arthroscopic assistance turned out to be approximately 6.5%, the most frequent complication being deep vein thrombosis with 6 cases. Conclusions: From our review we can conclude that arthroscopic assistance is useful in the treatment of Schatzker I-IV tibial plateau fractures, since it provides satisfactory functional results, without increasing the number of complications and allows treating associated injuries simultaneously.


Objetivo: o objetivo deste estudo é explorar e descrever os resultados e experiências no tratamento das fraturas do planalto tibial de Schatzker1 I-IV com auxílio artroscópico para obter redução como parte da técnica de fixação interna (ARIF). Metodologia: : Foi realizada uma busca sistemática em diferentes motores de busca, como Pubmed e Lilacs. Foi pesquisado com a mesma metodologia por 2 revisores independentes usando os termos do MESH "Tibial Fracture", "Arthroscopic". Foram incluídos artigos publicados nos últimos 5 anos (2014 a setembro de 2020), mostrando resultados clínicos dos procedimentos, em inglês ou espanhol, em humanos e maiores de 18 anos. Resultados: Seguindo os critérios de inclusão, 114 títulos foram identificados e, finalmente, 9 artigos foram incluídos em nossa revisão sistemática. Dos 9 artigos revisados, 5 correspondem a séries de casos com nível de evidência IV, 3 correspondem a estudos comparativos retrospectivos entre técnicas de redução aberta e fixação interna (ORIF) e ARIF com nível de evidência III e um estudo corresponde a nível de evidência . evidências I. Um total de 217 pacientes foram submetidos a ARIF em nossa revisão, o tempo médio de acompanhamento foi de 24,9 meses (12-90 m), em termos do tipo de fratura, as mais frequentes foram as fraturas do planalto tibial de Schatzker II e III , a lesão associada mais frequente foi a lesão meniscal seguida de ruptura do ligamento cruzado anterior. Em relação ao percentual total de resultados obtidos independentemente de cada escore utilizado, aproximadamente 98% obtiveram resultados bons ou excelentes. O percentual de complicações operadas com assistência artroscópica revelou-se em torno de 6,5%, sendo a complicação mais frequente a trombose venosa profunda com 6 casos. Conclusões: Da nossa revisão podemos concluir que a assistência artroscópica é útil no tratamento das fraturas do planalto tibial de Schatzker I-IV, sendo uma técnica que fornece resultados funcionais satisfatórios, sem aumentar o número de complicações e permite tratar lesões associadas no mesmo ato.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Arthroscopy/methods , Tibial Fractures/surgery , Arthroscopy/adverse effects , Tibial Fractures/classification
2.
Rev. medica electron ; 43(5): 1436-1444, 2021. graf
Article in Spanish | LILACS | ID: biblio-1352123

ABSTRACT

RESUMEN Las fracturas expuestas de tibia han sido uno de los problemas más importantes para los sistemas de atención en salud pública. Se caracterizan por tres factores de riesgo fundamentales: daño óseo y tejidos blandos, gran posibilidad de contaminación y dificultades para el tratamiento conservador y quirúrgico, debido al daño óseo y de partes blandas asociados, que implica un alto índice de complicaciones. El tratamiento de estas fracturas es un tema ampliamente discutido en cuanto a la técnica quirúrgica a utilizar. Debido la pobre vascularización y poca cantidad de tejidos blandos que cubren la tibia, este hueso es muy vulnerable a la pseudoartrosis y a la infección. El objetivo de este trabajo fue describir la técnica quirúrgica de transportación ósea con fijador externo Ilizarov y evaluar el resultado en defectos óseos de tibia de más de 6 cm, secundario a pseudoartrosis infectada. Como resultado, el paciente evolucionó con una pseudoartrosis séptica de tibia derecha secundaria a fractura expuesta. El seguimiento fue de 18 meses, la pérdida ósea de 6 cm, la velocidad de distracción de 1 mm/día, el período de transportación de 95 días, y el tiempo con fijador de 198 días. Fue necesario realizar un nuevo proceder quirúrgico en el sitio de contacto, con vistas a reavivar los extremos óseos. La transportación ósea con fijador Ilizarov es válida para el tratamiento de la pérdida ósea en fracturas expuestas de tibia o pseudoartrosis séptica (AU).


ABSTRACT Exposed tibia fractures have been one of the most important problems for public health care systems. They are characterized by three main risk factors: bone and soft tissue damage, high possibilities of contamination and difficulties for the surgical and conservative treatment, due to the associated bone and soft tissues damage implying a high rate of complications. The treatment of these fractures is a widely discussed topic regarding the surgical technique to be used. Due to poor vascularization and little quantity of soft tissue covering tibia, this bone is highly vulnerable to pseudoarthritis and infection. The aim of this work was to describe the surgical technique of bone transport with Ilizarov external fixator and to evaluate the result in tibial bone defects of more than 6 cm, secondary to infected pseudoarthritis. As a result, the patient evolved with septic pseudoarthritis of right tibia secondary to exposed fracture. The follow up lasted 18 months; the bone loss was 6 cm; the distraction speed was 1 mm/day; the transportation period was 95 days and the time with fixator was 198 days. It was necessary to perform a new surgical procedure at the contact site to recuperate the bone ends. Bone transport with Ilizarov fixator is valid for the bone loss treatment in tibia exposed fractures or septic pseudo arthritis (AU).


Subject(s)
Male , Pseudarthrosis/epidemiology , Tibial Fractures/surgery , Pseudarthrosis/surgery , Pseudarthrosis/complications , Surgical Procedures, Operative/methods , Tibial Fractures/diagnosis , Fractures, Open/surgery , Fractures, Open/diagnosis
3.
Rev. bras. ortop ; 56(4): 533-536, July-Aug. 2021. graf
Article in English | LILACS | ID: biblio-1341172

ABSTRACT

Abstract A deviated osteochondral fracture of the anterolateral tibia associated with fibular head avulsion in a 50-year-old patient is reported. In general, avulsion fracture of the iliotibial tract is associated with injuries in the cruciate ligament, in the meniscus and in lateral knee structures, as in the case herein reported.


Resumo Uma fratura osteocondral desviada da tíbia anterolateral associada a avulsão da cabeça da fíbula em um paciente de 50 anos é relatada. A fratura avulsão do trato iliotibial em geral está associada lesões do ligamento cruzado, do menisco, e das estruturas laterais do joelho, como no caso em questão.


Subject(s)
Humans , Male , Middle Aged , Tibial Fractures , Femoral Fractures , Knee Injuries/surgery
4.
Rev. bras. ortop ; 56(4): 459-462, July-Aug. 2021. tab
Article in English | LILACS | ID: biblio-1341166

ABSTRACT

Abstract Objective To evaluate the interobserver agreement of two classifications for floating knee: Fraser and Blake & McBryde. Method Thirty-two observers, subdivided according to the degree of titration (26 resident physicians and 6 orthopedic physicians specialized in orthopedic trauma), classified 15 fractures of the ipsilateral femur and tibia. Interobserver agreement was evaluated by using the Kappa coefficient. Result When evaluating the agreement between the 9 R1, a Kappa index of 0.58 was obtained for the Fraser classification and of 0.46 for the Blake & McBryde classification. Among the 7 R2, a rate of 0.59 was obtained for the Fraser rating and 0.51 for the Blake & McBryderating. Among the 10 R3, theagreement index was higher for both classifications: 0.72 for the Fraser and 0.71 for the Blake & McBryde classification. Considering the 3 groups (R1, R2, R3) as one large group, the general Kappa index was calculated, which resulted in 0.63for the Fraser classification and 0.56 for the Blake & McBryde classification. In the group of traumaand orthopedic knee specialists, in turn, an agreement of 0.597 was obtained for the Blake and McBryde classification and of 0.843 for the Fraser classification. Conclusion Comparatively, the two classifications presented a weak to moderate degree of agreement. Fraser classification had better agreement in both groups. The agreement was higher when evaluating orthopedic trauma physicians.


Resumo Objetivo Avaliar a concordância interobservador de duas classificações para joelho flutuante: Fraser e Blake & Mcbryde. Método Trinta e dois observadores, subdivididos de acordo com o grau de titulação (26 médicos residentes e seis médicos ortopedistas especialistas em trauma ortopédico) classificaram 15 fraturas de fêmur e tíbia ipsilaterais. A concordância interobservador foi avaliada pelo coeficiente Kappa. Resultado Ao avaliar a concordância entre os 9 R1, obteve-se índice Kappa para classificação de Fraser de 0,58 e para a classificação de Blake & McBryde de 0,46. Entre os 7 R2, obteve-se índice de 0,59 para a classificação de Fraser e 0,51 para a classificação de Blake & McBryde. Entre os 10 R3, o índice de concordância foi maior para as duas classificações: 0,72 para a classificação de Fraser e 0,71 para a de Blake & McBryde. Considerando os 3 grupos (R1, R2, R3) como um só grande grupo, calculou-se o índice Kappa geral, que teve como resultado 0,63 para a classificação de Fraser e 0,56 para a classificação de Blake & McBryde. No grupo dos traumato-ortopedistas especialistas em joelho, por sua vez, obteve-se uma concordância para a classificação de Blake e McBryde de 0,597 e para a de Fraser de 0,843. Conclusão Comparativamente, as duas classificações apresentaram grau de concordância fraco a moderado. A classificação de Fraser teve melhor concordância em ambos os grupos. A concordância foi maior quando se avaliou médicos ortopedistas especialistas em trauma ortopédico.


Subject(s)
Tibial Fractures/classification , Validation Study
5.
Rev. cuba. ortop. traumatol ; 35(1): e353, 2021. ilus
Article in Spanish | LILACS, CUMED | ID: biblio-1289554

ABSTRACT

Introducción: Las fracturas diafisarias de la tibia tienen una alta incidencia por año, incluidas las del tercio distal. Son las más frecuentes de los huesos largos y se observan sobre todo en adultos jóvenes. Se producen, generalmente, por traumatismos de alta energía como accidentes del tránsito y caídas de alturas. Objetivo: Presentar los resultados del tratamiento realizado a un paciente con fractura extrarticular del tercio distal de la tibia, mediante una técnica de osteosíntesis percutánea mínimamente invasiva. Presentación del caso: Paciente de 45 años, masculino, de piel blanca que sufrió accidente del tránsito, y fue atendido en el servicio de Ortopedia y Traumatología del Hospital General Docente Dr. Antonio Luaces Iraola, con trauma en pierna izquierda. Presentó dolor, inflamación e imposibilidad para caminar. A la exploración física se constató dolor, deformidad, crepitación, movilidad anormal, aumento de volumen e impotencia funcional absoluta. Se realizó radiografía, se corroboró diagnóstico y se decidió tratamiento quirúrgico con técnica mínima invasiva percutánea. Se siguieron los principios de la osteosíntesis biológica y se utilizó placa de segunda generación del sistema AO. Conclusiones: El tiempo quirúrgico fue de 45 minutos, la estadía hospitalaria fue de 48 horas. Se comenzó apoyo parcial a las ocho semanas, y total a las 15 semanas. Se logró la consolidación total de la fractura a las 16 semanas de operado, evaluado de excelente a través de la American Orthopaedic Foot and Ankle Society (AOFAS) score(AU)


Introduction: Diaphyseal fractures of the tibia have high incidence per year, including those of the distal third. They are the most common of the long bones and are seen mostly in young adults. They are generally caused by high-energy trauma such as traffic accidents and falls from heights. Objective: To present the results of the treatment on a patient with extra-articular fracture of the distal third of the tibia, using minimally invasive percutaneous osteosynthesis technique. Case report: A white 45-year-old male patient was injured in a traffic accident, and he was treated in the Orthopedics and Traumatology service at Dr. Antonio Luaces Iraola General Teaching Hospital, because of a trauma to his left leg. He had pain, swelling and inability to walk. Physical examination revealed pain, deformity, crepitus, abnormal mobility, increased volume, and absolute functional impotence. X-rays were performed. The diagnosis was confirmed, and surgical treatment was decided with a minimally invasive percutaneous technique. The principles of biological osteosynthesis were followed and a second generation plate of AO system was used. Conclusions: The surgical time was 45 minutes. The hospital stay was 48 hours. Partial support of the leg was started at eight weeks, and full support at 15 weeks. Full fracture healing was achieved 16 weeks after surgery, the procedure was evaluated as excellent according to the American Orthopedic Foot and Ankle Society (AOFAS) score(AU)


Subject(s)
Humans , Male , Middle Aged , Tibial Fractures/diagnostic imaging
6.
Rev. cuba. ortop. traumatol ; 35(1): e306, 2021. tab
Article in Spanish | LILACS, CUMED | ID: biblio-1289544

ABSTRACT

Introducción: Las fracturas diafisiarias de la tibia son las que con mayor frecuencia encuentran los cirujanos ortopédicos en su práctica habitual. La fractura expuesta de tibia es una urgencia quirúrgica que requiere desbridamiento, lavado, reducción y estabilización de los fragmentos óseos lo antes posible, e inicio de la administración de antibióticos profilácticos. Objetivo: Caracterizar los pacientes con fractura expuesta de tibia grado II y IIIA, tratados mediante estabilización con clavo acerrojado intramedular, identificando mecanismo de producción, número de intervenciones quirúrgicas por paciente, así como las principales complicaciones encontradas. Método: Estudio observacional, descriptivo, ambispectivo y de corte transversal en pacientes con fractura abierta de tibia, tratados quirúrgicamente con clavo acerrojado intramedular. Resultados: La edad de los pacientes osciló entre 21 y 69 años. Predominó el sexo masculino (65,4 porciento), la mayor causa traumática fueron los accidentes en la vía pública (37 pacientes); predominaron las fracturas del tercio medio abiertas grado IIIA con estadía hospitalaria menor de 10 días, y complicaciones en la tercera parte de los pacientes. Conclusiones: Se observó mayor incidencia en pacientes masculinos en edades comprendidas entre 18 y 29 años por accidentes del tránsito. La localización habitual fue el tercio medio y más de la mitad fueron clasificadas como grado IIIA de la tipología de Gustilo y Anderson(AU)


Introduction: Diaphyseal fractures of the tibia are those most frequently treated by orthopedic surgeons in their common practice. The exposed fracture of the tibia is a surgical emergency that requires debridement, lavage, reduction and stabilization of the bone fragments as soon as possible, and initiation of the administration of prophylactic antibiotics. Objective: To characterize patients with grade II and IIIA exposed tibial fracture, treated by stabilization with an intramedullary nail, identifying production mechanism, number of surgical interventions per patient, as well as the main complications found. Method: An observational, descriptive, ambispective and cross-sectional study in patients with an open fracture of the tibia treated surgically with an intramedullary locking nail. Results: The age of the patients ranged between 21 and 69 years. Male sex predominated (65.4 percent), the major traumatic cause was accidents on public roads (37 patients); Grade IIIA open middle third fractures predominated with hospital stays of less than 10 days, and complications in a third of the patients. Conclusions: High incidence was observed in male patients between the ages of 18 and 29 due to traffic accidents. The usual location was the middle third and more than half were classified as grade IIIA of Gustilo and Anderson typology(AU)


Subject(s)
Humans , Male , Female , Adult , Aged , Tibial Fractures/surgery , Tibial Fractures/diagnosis , Tibial Fractures/therapy , Tibial Fractures/diagnostic imaging
7.
Rev. venez. cir. ortop. traumatol ; 53(1): 27-34, jun. 2021. tab
Article in Spanish | LILACS, LIVECS | ID: biblio-1252908

ABSTRACT

Las técnicas quirúrgicas mínimamente invasivas ayudan a que el proceso natural de la consolidación ósea ocurra proporcionando estabilidad biomecánica suficiente para obtener los mejores resultados. El objetivo de este trabajo es mostrar los resultados clínicos y radiológicos del tratamiento de las fracturas diafisiarias de tibia con osteosíntesis mínimamente invasiva con placa por cara lateral. Se realizó un estudio clínico observacional, prospectivo, longitudinal y no concurrente. Se incluyeron pacientes mayores de 18 años, de ambos sexos, con diagnósticos de fracturas diafisiarias de tibia 42A, 42B ó 42C, abiertas o cerradas. Se estableció tiempo de seguimiento mínimo de 6 meses. Se incluyeron 23 pacientes, 82,60% de sexo masculino. Promedio de edad de 21±5,63(16­49) años. La fractura más frecuente fue la 42B2 en 26,00% de los casos, y 34,80% fracturas fueron abiertas. A las 12 semanas, 65,10% habían alcanzado consolidación Montoya III; y para la semana 16, 91,30% de los pacientes. De acuerdo a la escala ASAMI, se alcanzaron resultados excelentes en 100,00% pacientes para la semana 16. No se presentaron complicaciones como infección, aflojamiento séptico o aséptico del implante, ni fatiga del mismo. El uso de la técnica MIPO para tratamiento de fracturas diafisiarias de la tibia, por cara lateral es una técnica efectiva y segura, con alta tasas de consolidación, mínimas complicaciones y buenos resultados finales(AU)


Minimally invasive surgical techniques help the natural bone healing process to occur, by providing enough biomechanical stability to obtain the best results. The objective is to show the clinical and radiological results of the treatment of diaphyseal tibial fractures with minimally invasive osteosynthesis with lateral plating. An observational, prospective, longitudinal and non-concurrent clinical study was made. Patients older than 18 years, both sexes, with diagnoses of open or closed tibial shaft fractures 42A, 42B or 42C, were included. A minimum follow-up time of 6 months was established. 23 patients were included, 82,60% male. Average age of 21 years. The most frequent fracture was 42B2 in 26,00% cases, and 34,80% were open fractures. At 12 weeks, 65,10% had reached Montoya III consolidation criterias; and for week 16, 91,30% of the patients. According to the ASAMI scale, excellent results were achieved in 100,00% patients. There were no complications such as infection, septic or aseptic loosening of the implant, or fatigue of the implant. The use of the MIPO technique for the treatment of diaphyseal fractures of the tibia on the lateral aspect is an effective and safe technique, with high rates of union, minimal complications and good final results(AU)


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Orthopedic Fixation Devices , Tibial Fractures , Fracture Fixation, Internal , Growth Plate , Traumatology , Orthopedic Procedures
8.
Rev. bras. ortop ; 56(3): 399-402, May-June 2021. graf
Article in English | LILACS | ID: biblio-1288665

ABSTRACT

Abstract Tillaux fractures are fractures of the lateral margin of the distal tibia, usually reported in children between 12 and 14 years old. As intraarticular fractures, they require anatomic reduction and fixation to avoid posttraumatic complications. Since the injury mechanism is external rotation of the foot on the leg, these injuries are commonly associated with other fractures or ligamentous lesions. Currently, arthroscopy is being increasingly used to assist and improve surgical treatment of ankle fractures. The authors describe a 12-month follow-up of a rare case of a missed Tillaux fracture associated with syndesmosis injury in a 76-year-old polytrauma patient, successfully treated by arthroscopically-assisted reduction and internal fixation.


Resumo As fraturas de Tillaux são fraturas da margem lateral da tíbia distal, geralmente relatadas em crianças entre 12 e 14 anos. Como fraturas intra-articulares, requerem redução e fixação anatômica para evitar complicações pós-traumáticas. Como o mecanismo de lesão é a rotação externa do pé na perna, essas lesões são comumente associadas a outras fraturas ou lesões ligamentares. Atualmente, a artroscopia está sendo cada vez mais utilizada para auxiliar e melhorar o tratamento cirúrgico das fraturas do tornozelo. Os autores descrevem um acompanhamento de 12 meses de um caso raro de uma fratura não percebida de Tillaux associada a lesão por sindesmose em um paciente de politrauma com 76 anos de idade, tratado com sucesso por redução e fixação interna assistida por artroscopia.


Subject(s)
Humans , Male , Aged , Tibial Fractures , Multiple Trauma , Ankle Injuries , Minimally Invasive Surgical Procedures , Intra-Articular Fractures , Arthroplasty, Replacement, Ankle , Ankle Fractures
9.
Arq. bras. med. vet. zootec. (Online) ; 73(3): 589-597, May-June 2021. tab, ilus
Article in English | LILACS, VETINDEX | ID: biblio-1278368

ABSTRACT

This study aimed to evaluate the effectiveness of bridge plating of simple tibial fractures in dogs by minimally invasive plate osteosynthesis (MIPO). Medical and radiographic records of twenty-nine dogs with simple tibial fractures that underwent bridge fixation by MIPO were retrospectively evaluated. The clinical outcome was classified considering the presence of lameness at the end of the treatment. The tibial mechanical joint angles were measured and compared with the values described in the literature. Additionally, fragment apposition and implant disposition were evaluated. Based on the modified Radiographic Union Scale for Tibial fractures, the moment of clinical union was determined. Clinically, at the end of treatment, only one patient presented lameness at a trot. While there was no significant difference between the bone alignment in the frontal plane values and the values described in the literature (P>0.05), the caudal proximal tibial angle was significantly higher (P=0.001). The median fragment apposition was considered acceptable. The average bridge plate ratio, plate working length, and plate screw density were 0.8, 0.57, and 0.48, respectively. The median time to clinical union was 30 days. Bridge plating in simple tibial fractures resulted in fast healing and low complication rates.(AU)


Objetivou-se avaliar a efetividade da estabilização em ponte de fraturas tibiais simples em cães utilizando-se a técnica de osteossíntese minimamente invasiva com placa (MIPO). Registros médicos e radiográficos de 29 cães com fraturas simples de tíbia, fixadas em ponte por meio da MIPO, foram retrospectivamente avaliados. O resultado clínico foi classificado com base na deambulação ao final do tratamento. Os ângulos articulares mecânicos da tíbia foram aferidos e comparados aos valores descritos na literatura. Adicionalmente, foram avaliadas a aposição dos fragmentos e a disposição dos implantes. Por meio da escala modificada de união radiográfica para fraturas de tíbia, determinou-se o momento de união clínica. Clinicamente, ao final do tratamento, apenas um animal apresentou claudicação ao trote. Não houve diferença significativa entre o alinhamento ósseo no plano frontal quando comparado com dados da literatura (P>0,05), enquanto, no plano sagital, o ângulo mecânico caudal proximal da tíbia foi significativamente maior (P=0,001). A mediana para aposição dos fragmentos foi considerada aceitável. As médias para relação placa em ponte, comprimento de trabalho da placa e densidade de parafusos da placa foram, respectivamente, 0,8; 0,57 e 0,48. A mediana para união clínica foi de 30 dias. A estabilização em ponte de fraturas tibiais simples resultou em rápida consolidação óssea, com baixas taxas de complicação.(AU)


Subject(s)
Animals , Dogs , Tibial Fractures/veterinary , Fracture Healing , Fracture Fixation, Internal/veterinary , Radiography/veterinary
10.
Rev. medica electron ; 43(2): 3103-3119, mar.-abr. 2021. tab
Article in Spanish | LILACS, CUMED | ID: biblio-1251929

ABSTRACT

RESUMEN Introducción: las fracturas de pilón tibial son un desafío para el cirujano y actualmente existe controversia en cuanto a su tratamiento. Objetivo: evaluar los resultados del tratamiento aplicado. Materiales y métodos: se realizó un estudio observacional, descriptivo, longitudinal, con el universo de estudio de todos los pacientes que fueron atendidos y tratados con fractura de pilón tibial desde el 1 de enero de 2015 al 31 de diciembre de 2016. Se seleccionó una muestra de 27 pacientes. Resultados: hubo un predominio del sexo masculino (78 %), y del grupo de edades de 40 a 49 años para ambos sexos (37 %). Prevalecieron las fracturas producidas por accidentes de tránsito, con 59 %. Las fracturas cerradas fueron las más representadas, con 78 %. El 67 % de los pacientes no presentaron lesiones asociadas y predominaron las fracturas tipo II en el 55 % del total. Se aplicó tratamiento quirúrgico a un 74 % y se logró la consolidación en un 78 % de los casos antes de las 16 semanas. Antes de las 20 semanas se le indicó el apoyo al 78 % de los casos. Se complicaron 13 pacientes, para un 48 % del total. A pesar de ello, como resultado final, fueron evaluados de excelente y bien el 63 % de los pacientes. Conclusiones: la fractura de pilón tibial constituye una lesión de muy difícil manejo para el cirujano traumatólogo de hoy (AU).


ABSTRACT Introduction: tibial pylon fractures are a challenge for the surgeon surgery and currently there is a controversy regarding their treatment. Objective: to assess the outcomes of the applied treatment. Materials and methods: an observational, descriptive, longitudinal study was carried out with the study universe of all the patients who were attended and treated with tibial pylon fracture from January 1st, 2015 to December 31st, 2016. A sample composed by 27 patients was chosen. Results: male sex (78 %) and both-sexes 40-49 age group (37 %) predominated. There was a predominance of fractures caused by traffic accidents with 59 %, being closed fractures the most represented ones, with 78 %. 67 % of the patients did not present associated injuries, being type II fractures predominant in 55 % of the total. 74 % of the cases underwent surgery, achieving consolidation in 78 % of the cases before 16 weeks. Before 20 weeks, 78 % of the cases were indicated to set on their foot, and 13 patients had complications, representing 48 % of the total. In spite of this, 63 % of the patients were evaluated as excellent and well as final outcome. Conclusions: the tibial pylon fracture is an injury of very difficult handling for the today's orthopedic surgeon (AU).


Subject(s)
Humans , Male , Female , Patients , Tibial Fractures/therapy , Therapeutics/methods , Tibial Fractures/surgery , Orthopedic Surgeons/standards , Fracture Fixation, Internal/methods
11.
Rev. chil. ortop. traumatol ; 62(1): 11-18, mar. 2021. ilus, tab
Article in Spanish | LILACS | ID: biblio-1342590

ABSTRACT

OBJETIVO: Realizar la evaluación clínica, imagenológica y funcional de pacientes con fracturas avulsivas tibiales del ligamento cruzado posterior (FTALCPs) fijadas con tornillos canulados con técnica abierta. MÉTODOS: Los pacientes con FTALCP operados entre 2010 y 2017 fueron revisados retrospectivamente. Criterios de inclusión: fracturas agudas, desplazadas, test de cajón posterior grado III, lesiones combinadas de rodilla, seguimiento > 12 meses. Se excluyeron pacientes > 65 años, con FTALCPs bilaterales, lesiones del ligamento cruzado posterior (LCP) intrasustancia, test de cajón posterior grados I-II, fracturas expuestas, lesiones neurovasculares, y seguimientos < 12 meses. Objetivo primario: medir la estabilidad clínica mediante test de cajón posterior y radiografía de estrés arrodillada comparativa. Objetivos secundarios: nvaluar la consolidación en radiografías, complicaciones y funcionalidad con las escalas de Lysholm y Tegner. Resultados Se incluyeron 20 pacientes, con edad media de 41 años (rango: 32 a 61 años). El seguimiento promedio fue de 33,9 meses (rango: 12 a 82 meses). La estabilidad clínica mejoró en 93% (cajón posterior postoperatorio grados 0 y I) de los pacientes. La radiografía de estrés arrodillada mostró una diferencia promedio de 2,6 mm (rango: 0,1 mm a 6,8 mm) de traslación posterior al comparar con el lado sano. Todas las fracturas consolidaron. Siete pacientes presentaron complicaciones. El puntaje promedio de la escala de Lysholm al final del seguimiento fue de 85,17. El promedio preoperatorio del puntaje en la escala de Tegner no varió significativamente en comparación con el postoperatorio. CONCLUSIONES: La fijación de fracturas avulsivas tibiales del LCP con tornillos canulados con técnica abierta es efectiva en restaurar la estabilidad posterior y lograr la consolidación ósea. La funcionalidad clínica a mediano plazo es buena, a pesar del alto número de complicaciones y lesiones concomitantes. NIVEL DE EVIDENCIA: tipo IV.


OBJECTIVE: To report mid-term clinical, radiographic, and functional outcomes following open reduction and fixation of posterior cruciate ligament tibial avulsion fractures (PCLTAFs) with cannulated screws. METHODS: This is a retrospective analysis of patients with PCLTAF operated on from August 2010 to April 2017. Patients with acute fractures, with more than 2 mm of displacement and grade III on the posterior drawer test, combined or not to knee injuries, were included. Patients older than 65 years of age, with bilateral avulsion fractures, intrasubstance posterior cruciate ligament (PCL) lesions, stable grade-I to -II on the posterior drawer test, concomitant neurovascular injuries, mid-substance tears, open fractures, and less than 12 months of follow-up were excluded. Primary outcomes: the clinical stability was assessed using the posterior drawer test and a single comparative knee stress radiograph. Secondary outcomes: radiographic consolidation, complications, Lysholm score, and Tegner activity score. RESULTS: In total, 20 patients with a mean age of 41 years (range: 32 to 61 years) were included. The mean follow-up was of 33.9 months (range: 12 to 82 months). Clinical stability (grade 0 or I on the posterior drawer test) was observed in 93% of the patients. The mean difference in contralateral posterior displacement was of 2.6 mm (range: 0.1 mm to 6.8 mm) on a single comparative knee stress radiograph. All fractures presented radiological consolidation. Seven patients developed complications. The mean Lysholm score at the last follow-up visit was of 85.17. The postoperative Tegner activity scores did no vary significantly compared to the preinjury scores. CONCLUSIONS: Cannulated screw fixation of a displaced PCLTAF through a posterior approach restores clinical and radiographic stability and has excellent union rates. The mid-term functional outcomes are good despite the high rates of combined knee lesions and postoperative complications. LEVEL OF EVIDENCE: IV.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Tibial Fractures/surgery , Tibial Fractures/diagnostic imaging , Bone Screws , Posterior Cruciate Ligament/surgery , Posterior Cruciate Ligament/diagnostic imaging , Fracture Fixation/methods , Tibial Fractures/physiopathology , Retrospective Studies , Follow-Up Studies , Posterior Cruciate Ligament/physiopathology , Treatment Outcome , Fractures, Avulsion , Fracture Fixation/instrumentation
12.
Rev. chil. ortop. traumatol ; 62(1): 39-45, mar. 2021. ilus
Article in Spanish | LILACS | ID: biblio-1342670

ABSTRACT

Los fragmentos posterolaterales (FPLs) en fracturas de platillo tibial son frecuentes, pero difíciles de reducir y estabilizar. Actualmente existe controversia sobre cómo deben ser abordados; si bien un abordaje anterolateral es más seguro, este puede ser insuficiente para lograr una correcta reducción. Los abordajes posterolaterales y posteriores ofrecen una visión directa y permiten una fijación con ventaja biomecánica; sin embargo, son más demandantes y exponen al paciente a una mayor morbilidad. A continuación, se presenta una nota técnica sobre la reducción y fijación de FPLs con una placa rim por medio de un abordaje anterolateral extendido a través del espacio paraligamento colateral lateral.


Posterolateral fragments (PLFs) are commonly seen in tibial plateau fractures, but their reduction and fixation are challenging. There is no consensus about the ideal approach to fix this particular fragment. Even though an anterolateral approach is a safe option, it may impair a correct reduction. The posterolateral and posterior approaches offer direct visualization of the fragment, and enable a fixation with a biomechanical advantage; however, they are more demanding and expose the patient to a higher risk if morbidity. The following technical note describes the reduction and fixation of PLFs with a rim plate through an extended anterolateral approach using the paralateral collateral ligament space.


Subject(s)
Humans , Male , Aged , Tibial Fractures/surgery , Bone Plates , Fracture Fixation, Internal/methods , Tibial Fractures/rehabilitation , Collateral Ligaments , Fracture Fixation, Internal/instrumentation
13.
Article in Spanish | LILACS, BINACIS | ID: biblio-1353893

ABSTRACT

La fractura del poste tibial luego de un reemplazo total de rodilla es una complicación poco frecuente e incapacitante. Presentamos a dos pacientes con fractura del poste tibial no traumática, que acudieron con dolor más inestabilidad en recurvatum, de forma repentina, después de reemplazos articulares con buen funcionamiento previo. El primer paciente se presentó a los 12 años del reemplazo total de rodilla primario y el segundo, a los 14 meses. Ambos tenían el mismo modelo de prótesis estabilizada a pos-terior. Los dos pacientes fueron sometidos a una revisión con prótesis abisagrada rotatoria (Endo-Model NR®, Waldemar Link, EEUU), sin recidiva de la deformidad. Nivel de Evidencia: IV


Tibial post fracture after posterior stabilized total knee replacement (TKR) is a uncommon and disabling complication. We report two cases of non-traumatic tibial post fracture, which presented with sudden pain and recurvatum instability in joint replacements with good previous function. For the first case, the presentation time was 12 years from the primary TKR, and for the second it was 14 months. Both presented the same model of a posterior stabilized prosthesis. In both cases, a revision TKR was performed witha rotating hinge prosthesis (Endo-Model NR®, Waldemar Link), without recurrence of the deformity. Level of Evidence: IV


Subject(s)
Middle Aged , Aged , Tibial Fractures , Arthroplasty, Replacement, Knee/adverse effects
14.
Article in Spanish | LILACS, BINACIS | ID: biblio-1353912

ABSTRACT

Las técnicas quirúrgicas que más se utilizan en la actualidad para fracturas de platillo tibial no contemplan correctamente la conminución ósea multiplanar ni la presencia de fragmentos óseos posteriores. Nos hemos enfrentado con esta problemática al tratar a un paciente con fractura de platillo tibial tipo Schatzker VI, en la cual se suplementó la osteosíntesis habitualmente utilizada con una placa horizontal circunferencial posterior. Se logró la consolidación ósea y los resultados funcionales a corto plazo fueron buenos. Del análisis de la bibliografía citada, se concluye en que se han desarrollado varias técnicas de contención posterior de los platillos tibiales, y la osteosíntesis circunferencial es una técnica por considerar. Nivel de Evidencia: IV


Surgical techniques commonly used today for tibial plateau fractures do not properly contemplate multiplanar bone comminution nor the presence of posterior bone fragments. We have faced this problem when treating a patient with a Schatzker VI type fracture, in which the commonly used osteosynthesis was supplemented with a posterior horizontal circumferential plate. Bone consolidation and good results were achieved in the short term in the case we present. From the analysis of the cited literature, we concluded that several techniques for containing posterior tibial plateau bone comminution have been developed. Among them, circumferential osteosynthesis is a technique to take into account. Level of Evidence: IV


Subject(s)
Aged , Tibial Fractures , Fracture Fixation, Internal , Knee Injuries
15.
Article in Spanish | LILACS, BINACIS | ID: biblio-1353931

ABSTRACT

Introducción: La afección articular que lleva a la necesidad de una artrodesis tibio-calcánea puede estar acompañada de una segunda lesión en el mismo segmento óseo, y los clavos de diseño para artrodesis no tienen la longitud adecuada para cubrir ambas lesiones. No hallamos opciones terapéuticas para este tipo de lesiones en la bibliografía. Objetivo: Presentar una serie de casos en los que se utilizó un único clavo de tibia (de colocación anterógrada) de forma retrógrada, con el doble objetivo de efectuar una artrodesis tibio-talo-calcánea, sumada al tratamiento de una lesión asociada en un mismo tiempo quirúrgico. Materiales y métodos: Se evaluó, en forma retrospectiva, desde septiembre de 2009 hasta junio de 2019, a un grupo de 12 pacientes que requirió una artrodesis tibio-talo-calcánea sumada a la necesidad de resolver simultáneamente un defecto secundario local. La edad promedio fue de 43.7 años, y el seguimiento global fue de 43.9 meses. Resultados: Todos los pacientes lograron una artrodesis tibio-calcánea constatada en radiografías de frente y de perfil, y el 83,3% recuperó el stock óseo de manera completa. Conclusión: Ante la ausencia en el mercado de osteosíntesis para resolver las patologías asociadas en un mismo paciente, proponemos el uso del clavo endomedular largo de tibia colocado de manera retrógrada como una opción de tratamiento, porque se ha demostrado que es eficaz para lograr la artrodesis tibio-calcánea. Además, se lo pudo utilizar como guía en el alargamiento y el transporte óseo, y como estabilización para tratar lesiones simultáneas. Nivel de Evidencia: IV


background: The joint condition that leads to the need for a tibiocalcaneal arthrodesis may be accompanied by a second injury in the same bone segment, and design nails for arthrodesis are not of adequate length to cover both injuries. We have not found therapeutic options for this type of injury in the literature. Objective: To present a series of cases where a single tibia nail (antegrade placement) was used retrogradely, with the dual objective of performing a tibiotalocalcaneal arthrodesis added to the treatment of an associated injury in the same surgical stage. materials and methods: We retrospectively evaluated a group of 12 patients who required a tibiotalocalcaneal arthrodesis as well as to simultaneously resolve a local secondary defect from September 2009 to June 2019. The average age was 43.7 (27-61) years, and the global follow-up was 43. 9 months. Results: All patients achieved a tibiocalcaneal arthrodesis confirmed in antero-posterior and lateral radiographs, and 83.3% of the patients recovered their bone stock completely. Conclusion: Faced with the lack of osteosynthesis in the market to resolve associated pathologies in the same patient, we propose the use of a long tibial intramedullary nail placed in a retrograde manner as a treatment option since it has proven to be efficient in achieving tibiocalcaneal arthrodesis. In addition, it could be used as a rail for bone lengthening and transport, and as stabilization to treat simultaneous injuries. Level of Evidence: IV


Subject(s)
Adult , Middle Aged , Arthrodesis , Tibial Fractures , Bone Lengthening , Treatment Outcome , Fracture Fixation, Intramedullary , Ankle Joint
16.
Article in Spanish | LILACS, BINACIS | ID: biblio-1358325

ABSTRACT

La fractura por avulsión de la tuberosidad tibial es una patología poco común. Es una lesión característica de la infancia, con afección directa a la fisis, que amerita un diagnóstico oportuno y un tratamiento óptimo a fin de evitar complicaciones en el crecimiento, la mayoría de ellas graves. Para este tipo de lesión la reducción abierta y fijación interna es el tratamiento de elección; sin embargo, el procedimiento quirúrgico es un riesgo agregado al daño de la lesión per se. Suelen tener una evolución satisfactoria con un adecuado tratamiento y rehabilitación. Tomando en cuenta la baja incidencia de esta patología, en el siguiente artículo reportamos el caso de un paciente de 14 años con avulsión de tuberosidad tibial bilateal tipo II de Watson-Jones y tipo III de Watson-Jones, el abordaje diagnóstico-terapéutico y el éxito obtenido a seis meses de seguimiento; asimismo, realizamos una revisión de la literatura


Subject(s)
Adolescent , Tibial Fractures , Knee Injuries
17.
Artrosc. (B. Aires) ; 28(2): 165-170, 2021.
Article in Spanish | LILACS, BINACIS | ID: biblio-1282682

ABSTRACT

Introducción: Las fracturas de la espina tibial son entidades con una baja incidencia, pero frecuentemente asociadas a lesiones concomitantes. La RM es el estudio considerado patrón de oro para estudiarlas y descartarlas.Presentación del caso: se presenta un caso de fractura de espina tibial desplazada y lesión en asa de balde concomitante. El tratamiento artroscópico de la lesión consistió en la fijación de la fractura de espina tibial con dos pines biodegradables y sutura meniscal interna con tres sistemas todo-adentro Meniscal Cinch® y dos puntos verticales fuera-dentro con FiberWire 2.0®. Conclusión: el paciente tuvo una excelente evolución clínica, sin presentar complicaciones inherentes a la lesión inicial ni al tratamiento implementado, con un retorno a sus actividades deportivas al mismo nivel previo a la lesión.Tipo de estudio: Reporte de caso.


Introduction: Tibial eminence fractures are uncommon injuries but are frequently associated to concomitant injuries. MRI is considered the Gold Standard; it allows a detailed evaluation of any soft tissue involvement with the injury. Case presentation: an unusual presentation case is reported: a displaced tibial spine fracture and a bucket handle medial meniscus injury. Arthroscopic reduction and fixation were performed, using two bioabsorbable pins for the tibial spine fixation; and three all-inside and two vertical outside-in sutures were needed for the medial meniscus repair. Conclusion: the patient presented excellent clinical outcomes, without presenting inherent complications due to primary injury nor realized treatment, achieving sport activity levels prior to injury. Type of study: Case report


Subject(s)
Adolescent , Arthroscopy/methods , Tibial Fractures/surgery , Menisci, Tibial/surgery , Knee Injuries , Treatment Outcome
18.
Artrosc. (B. Aires) ; 28(2): 175-180, 2021.
Article in Spanish | LILACS, BINACIS | ID: biblio-1282685

ABSTRACT

Introducción: Las fracturas por avulsión del ligamento cruzado anterior (LCA) en adultos son inusuales y en general se deben a traumatismos de alta energía. Nuestro objetivo fue evaluar clínica y funcionalmente una serie de pacientes adultos con avulsión de espina tibial. Materiales y métodos: analizamos doce pacientes operados por avulsión de espina tibial entre diciembre de 2009 y diciembre de 2019 tratados con reducción y fijación artroscópica mediante suturas pull-out o tornillos canulados. Evaluamos el rango de movilidad articular (RMA) y la estabilidad postoperatoria con pruebas de Lachman, pivot shift y KT-1000, así como el retorno al deporte y resultados funcionales con las escalas de Lysholm e IKDC. Examinamos consolidación radiográfica y complicaciones postquirúrgicas. Resultados: ocho pacientes fueron incluidos. Cuatro tratados con tornillos canulados (grupo 1) y cuatro con suturas pull-out (grupo 2) con edad promedio de veintinueve años y seguimiento promedio de setenta y ocho y cuarenta y dos meses (grupos 1 y 2, respectivamente). Todos recuperaron el RMA, presentaron Lachman y pivot shift negativos y KT-1000 <3 mm. Tres de cinco pacientes retomaron deportes de pívot. Todos los pacientes presentaron consolidación radiográfica. No se registraron complicaciones postoperatorias.Conclusión: ambas técnicas quirúrgicas fueron efectivas para restablecer la estabilidad articular, lograr buenos resultados funcionales a corto y mediano plazo y alcanzar la consolidación radiográfica en los primeros tres meses postoperatorios


Introduction: Avulsion fractures of the anterior cruciate ligament (ACL) are rare in adults and generally due to high-energy trauma. The objective of this paper was to evaluate clinically and functionally a series of adult patients with anterior tibial eminence fractures treated with reduction and arthroscopic fixation using "pull-out" sutures or cannulated screws.Materials and methods: twelve patients operated on anterior tibial eminence fractures between December of 2009 and December of 2019 were analyzed in whom arthroscopic treatment was performed with "pull-out" sutures or cannulated screws. We evaluated the joint range of motion (ROM) and postoperative stability with Lachman, Pivot-Shift, and KT-1000 tests. Return to sport and functional results were evaluated with the Lysholm and IKDC scales. We analyzed radiographic consolidation and postsurgical complications. Results: eight patients were included. Four of them were treated with cannulated screws (group 1) and four with pull-out sutures (group 2) with a mean age of twenty-nine years and a mean follow-up of seventy-eight and forty-two months (groups 1 and 2, respectively). All of them recovered the ROM, presented negative Lachman and Pivot-Shift, and KT-1000 <3 mm at last follow-up. Three out of five patients returned to pivoting sports. The Lysholm average was 98.75 (group 1) and 91.25 (group 2). The IKDC average was 85.25 (group 1) and 74.67 (group 2). All patients presented radiographic consolidation. No postoperative complications were recorded.Conclusion: both surgical techniques were effective in restoring joint stability, achieving good functional results in the short and medium-term, and achieving radiographic consolidation in the first three postoperative months


Subject(s)
Adult , Arthroscopy/methods , Tibial Fractures/surgery , Knee Injuries , Follow-Up Studies , Treatment Outcome
19.
Rev. Asoc. Med. Bahía Blanca ; 31(1): 19-23, 2021.
Article in Spanish | LILACS, BINACIS, UNISALUD | ID: biblio-1293382

ABSTRACT

Introducción: El tratamiento de las fracturas tibiales con clavos endomedulares a través del abordaje suprapatelar, ha demostrado una serie de ventajas. El siguiente artículo presenta un caso de fractura medio-diafisaria de tibia, tratado en el Hospital Naval Puerto Belgrano. Objetivo: Presentar un paciente de 25 años con fractura tibial medio-diafisaria, tratado con enclavado endomedular acerrojado mediante técnica de colocación suprapatelar. Conclusiones: El abordaje suprapatelar en semi-extensión, se ofrece como una opción válida para el tratamiento de este tipo de fracturas.


Introduction: The treatment of tibial fractures with endomedullary nails through the suprapatellar approach has demonstrated a series of advantages. The following article presents a case of a mid-diaphyseal tibial fracture treated at the Naval Hospital in Puerto Belgrano. Objective: To present a 25-year-old patient with a mid-diaphyseal tibial fracture, treated with interlocking endomedullary nailing using a suprapatellar placement technique. Conclusions: The suprapatellar approach in semi-extension is a valid option for the treatment of this type of fracture.


Subject(s)
Tibial Fractures , Bone Nails , Case Reports
20.
Article in Chinese | WPRIM | ID: wpr-921943

ABSTRACT

OBJECTIVE@#To investigate the short-term effect of suprapatellar interlocking intramedullary nail in the treatment of tibial fractures.@*METHODS@#Eighty patients with tibial fractures treated from January 2016 to June 2018 were treated with interlocking intramedullary nail, who were divided into observation group (suprapatellar approach) and control group (patellar ligament approach) according to different surgical approaches. There were 40 cases in the observation group, including 28 males and 12 females, aged 28 to 67 years with a mean of (46.70±10.34) years. There were 40 cases in the control group, including 30 males and 10 females, aged 31 to 69 years with a mean of(49.38±10.74) years. The operation time, incision length, intraoperative C-arm X-ray fluoroscopy times, intraoperative blood loss, fracture healing time, postoperative active straight leg raise (SLR) time, hospital stay, visual analogue scale (VAS), knee pain rate and postoperative Hospital for Special Surgery (HSS) score were recorded and compared between two groups.@*RESULTS@#All the patients were followed up, and the duration ranged from 19 to 38 months, with an average of(24.60±4.52) months. In the observation group, the operation time was(53.83± 7.01) min;the incision length was (3.98±0.83) cm;the number of intraoperative C-arm X-ray fluoroscopy was (18.90±1.75) times;the fracture healing time was (10.03±0.89) weeks;the postoperative active SLR time was (1.19±0.25) days;and the hospital stay was(6.73±1.06) days. The above indexes were better than those in the control group (@*CONCLUSION@#The treatment of tibial fractures with suprapatellar interlocking intramedullary nail has the advantages of less trauma and better recovery of knee function. It can obtain more satisfactory clinical results and can be further widely used.


Subject(s)
Bone Nails , Female , Follow-Up Studies , Fracture Fixation, Intramedullary , Fracture Healing , Humans , Male , Tibial Fractures/surgery , Treatment Outcome
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