Clavos endomedulares vs. placas para el tratamiento de las fracturas de la tibia distal: comparación clínica y radiológica
DOI:
https://doi.org/10.1016/S0120-8845(13)70011-7Palabras clave:
fracturas de la tibia, fijación intramedular de las fracturas, placas óseas, fijación interna de las fracturas, nivel de evidencia: IVResumen
Introducción: El manejo quirúrgico de las fracturas distales de la tibia es controvertido; los resultados de los estudios no muestran superioridad de una técnica sobre la otra. Los objetivos de esta investigación fueron comparar los resultados clínicos, radiológicos y funcionales de los pacientes manejados con clavos endomedulares y placas.
Materiales y métodos: Se realizó un estudio cuasi experimental en 25 pacientes con fracturas de la tibia distal ocurridas entre abril de 2009 y marzo de 2011. Se documentó la presencia de consolidación clínica y radiológica de las fracturas, y se aplicó la escala funcional IOWA. Además, se tuvo en cuenta la duración de las cirugías, la estancia hospitalaria y el tiempo entre el ingreso y la cirugía definitiva.
Resultados: Todas las fracturas consolidaron al final del seguimiento. La consolidación clínica y radiológica no mostró diferencias entre los 2 grupos de tratamiento. Los resultados funcionales fueron excelentes en ambos grupos. Aunque no fueron estadísticamente significativos, la duración de las cirugías, la estancia hospitalaria y el tiempo transcurrido entre el ingreso hospitalario y la fijación definitiva fueron menores en los pacientes tratados con clavos endomedulares.
Discusión: La consolidación clínica y radiológica y los resultados funcionales fueron similares en los 2 grupos. No se puede concluir la superioridad de un método sobre otro, pero se sugiere que la elección se haga con base en la experiencia y preferencia del cirujano.
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