¿Es habitual fijar la fractura de estiloides cubital en fracturas de radiodistal? Unidad de Servicio de salud Red sur Occidente Kennedy 2018

Autor:	Barajas Pertuz, Camilo Enmanuel, Nieto Carvajal, Maria Camila
Přispěvatelé:	Escobar, Julian Alfredo, Gallo Arbelaez, Fabio Augusto
Jazyk:	Spanish; Castilian
Rok vydání:	2018
Předmět:	Fractura estiloides cubital Ulnar styloid Fractura radio distal Radio (Hueso) Varias ramas de la medicina Cirugía Distal radius fracture
Zdroj:	MacIntyre NJ, Dewan N. Epidemiology of distal radius fractures and factors predicting risk and prognosis. J Hand Ther. 2016;29(2):136–45. Rhee PC, Shin AY. Management of Complex Distal Radius Fractures : Review of Treatment Principles and Select Surgical Techniques. 2015;21(2):140–54. Kim JK, Kim DJ, Yun Y. Natural history and factors associated with ulnar-sided wrist pain in distal radial fractures treated by plate fixation. J Hand Surg Eur Vol [Internet]. 2016;1–5. Available from: http://www.ncbi.nlm.nih.gov/pubmed/26896455 Belloti JC, Moraes VY, Albers MB, Faloppa F, Gomes Dos Santos JB. Does an ulnar styloid fracture interfere with the results of a distal radius fracture? J Orthop Sci. 2010;15(2):216–22. Gong HS, Cho HE, Kim J, Kim MB, Lee YH, Baek GH. Surgical treatment of acute distal radioulnar joint instability associated with distal radius fractures. J Hand Surg Eur Vol. 2015;40(8):783–9. Lee DS, Weikert DR. Complications of Distal Radius Fixation. 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Rosario Universidad del Rosario instacron:Universidad del Rosario
Popis:	Descripción de los hallazgos radiológicos en pacientes con fractura de radio distal tratados quirúrgicamente en la unidad de servicio de salud Red Sur Occidente Kennedy durante febrero a junio de 2018. La fractura de radio distal es una fractura común en el servicio de urgencias al que se enfrentan los ortopedistas en su ejercicio profesional, este tipo de fractura se asocia de forma frecuente a la fractura de estiloides cubital. Existe una verdadera controversia respecto a las indicaciones para la fijación de la estiloides cubital ya que no existe una clara correlación entre los efectos clínicos del manejo quirúrgico vs. conservador de la fractura de estiloides cubital. En el Servicio de Salud Red Sur Occidente Kennedy en un periodo de seis meses se recolectó una muestra de 40 pacientes con fractura de radio distal e indicación de manejo quirúrgico, con una edad media de 53 años (RIQ: 26-66 años). De estos pacientes el 72,5% presentó de forma asociada fractura de estiloides cubital, y solo el 27,6% requirió fijación de la misma y el 72, 4% recibió manejo conservador. La fractura de la base de la estiloides cubital, según la clasificación de Fernández tipo II corresponde a una factor de riesgo para inestabilidad radio-cubital distal, y tiene como resultados pobres consecuencias clínicas ya que esta sirve como lugar de inserción para el fibrocartílago triangular, por lo cual la evidencia soporta la fijación de la estiloides cubital en pacientes con fractura de la misma e inestabilidad radio-cubital distal asociada (Hideyoshi), sin embargo algunos estudios también indican que la no reparación de la fractura de estiloides cubital no afecta la función del puño cuando la fractura de radio distal es fijada mediante una placa de radio distal volar bloqueada (Zenke). En Colombia no existe un estudio comparativo de resultados clínicos entre la fijación y el manejo conservador de las fracturas de estiloides cubital, se desconoce la incidencia de este tipo de fractura, su tratamiento y su asociación con la inestabilidad radio-cubital distal por lo cual decidimos realizar este estudio. Estos datos de caracterización de nuestra población, la incidencia de fracturas de estiloides cubital asociadas a fracturas de radio distal, y el registro de las mismas según la Clasificación de Fernández para Fracturas de Estiloides Cubital es una herramienta para establecer un protocolo de su tratamiento ya sea conservador o quirúrgico. Se recomienda se debe brindar tratamiento no quirúrgico a las fracturas de las estiloides cubital si la articulación radio-cubital distal y la fractura de la estiloides son estables y el movimiento de pronosupinación se encuentra conservado. Las fracturas de la estiloides cubital que se deben tratar de manera quirúrgica si hay inestabilidad de la fractura a pesar de mantener la fractura del radio adecuadamente reducido, fracturas con desplazamiento mayor a 3mm y en casos donde el control imagenológico evidencia ensanchamiento radio-cubital distal. Description of the radiological findings in patients with distal radius fracture treated surgically in the South Western Kennedy Health Service during February to June 2018. The fracture of the distal radius is a common fracture in the emergency service faced by orthopedists in their professional practice, this type of fracture is frequently associated with ulnar styloid fracture. There is a real controversy regarding the indications for the fixation of the ulnar styloid since there is no clear correlation between the clinical effects of surgical management vs. conservative ulnar styloid fracture. At the South Western Kennedy Health Service, a sample of 40 patients with a distal radius fracture and indication of surgical management was collected over a period of six months, with a mean age of 53 years (RIQ: 26-66 years). Of these patients, 72.5% had associated ulnar styloid fractures, and only 27.6% required fixation of the same and 72.4% received conservative management. The fracture of the ulnar styloid base, according to the Fernández type II classification, corresponds to a risk factor for distal radio-ulnar instability, and results in poor clinical consequences since it serves as an insertion site for the triangular fibrocartilage, therefore, the evidence supports the fixation of the ulnar styloid in patients with fracture of the same and associated distal radio-ulnar instability (Hideyoshi), however some studies also indicate that the non-repair of the ulnar styloid fracture does not affect the function of the fist when the fracture of the distal radius is fixed by distal radius blocked plate. In Colombia there is no comparative study of clinical outcomes between fixation and conservative management of ulnar styloid fractures, the incidence of this type of fracture, its treatment and its association with distal radio-ulnar instability is not known, which is why we decided perform this study. These data of characterization of our population, the incidence of ulnar styloid fractures associated with fractures of distal radius, and the registration of them according to the Fernández Classification for ulnar styloid Fractures is a tool to establish a protocol of their treatment, either conservative or surgical. It is recommended that non-surgical treatment be given to ulnar styloid fractures if the distal radio-ulnar joint and the styloid fracture are stable and the pronosupination movement is preserved. Fractures of the ulnar styloid that should be treated surgically if there is instability of the fracture despite keeping the fracture of the radius adequately reduced, fractures with displacement greater than 3mm and in cases where the imaging control demonstrates distal radio-ulnar widening.
Databáze:	OpenAIRE
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