Fracturas de tobillo Comparación entre la cirugía abierta y el método mínimamente invasivo

• Autores: Juan Manuel Yañez Arauz, Ignacio Ricardo Arzac Ulla, Gustavo Fiorentini, Juan Martín Yañez Arauz
• Localización: Revista de la Asociación Argentina de Ortopedia y Traumatología, ISSN 1852-7434, Vol. 81, Nº. 1, 2016, págs. 27-34
• Idioma: español
• DOI: 10.15417/506
• Títulos paralelos:
  • Ankle fractures. Comparison between open surgery and a minimally invasive method
• Enlaces
  • Texto completo (pdf)
• Resumen
  • español

    IntroducciónLas fracturas de tobillo son lesiones traumáticas frecuentes. El tratamiento, en general, es quirúrgico. La cirugía puede ser abierta o percutánea. El objetivo de este estudio es comparar el método mínimamente invasivo y el de la cirugía convencional abierta en el tratamiento de las fracturas de tobillo AO B.Materiales y MétodosEstudio prospectivo comparativo de 75 casos de fracturas AO B operados con MIPO y 58 casos operados por vía convencional. Se agruparon según a la clasificación AO. Se evaluaron las características durante el período intraoperatorio y la hospitalización, los resultados funcionales, según los puntajes de la AOFAS y de Weber, y los resultados radiológicos  El seguimiento promedio de ambos grupos fue de 20.4 meses.ResultadosSe mencionan los resultados comparativos del tiempo quirúrgico, la estadía hospitalaria, el tiempo de fluoroscopia, la carga del peso. El puntaje de la AOFAS a los 3 meses: grupo A: 96,5 y grupo B: 99. Reducción radiológica: 97,4% con MIPO y 98,3% de los casos convencionales. Retorno a la actividad laboral: grupo A, 3.6 meses promedio, grupo B: 2.5 meses promedio. Retorno a la actividad deportiva: grupo A: media 4.8 meses; grupo B: media 3.7 meses.ConclusionesDe este estudio, se desprende que la MIPO para tratar las fracturas transindesmales es una buena opción, la evolución y la recuperación son más rápidas que con la técnica abierta, y el índice de complicaciones es bajo. 

  • English

    Introduction. Ankle fractures are common traumatic injuries. Treatment is usually surgical. Surgery may be open or percutaneous. The aim of this study is to compare the minimally invasive method, and conventional open reduction internal fixation (RAFI) surgery in the treatment of ankle fractures AO B.Material and methods. This study prospective included  75 pacients with ankle fracture AO classification type B operated with MIPO technique and 58 pacients operated by RAFI. They were grouped according to the AO classification. Intraoperative characteristics and hospitalization, functional outcomes according to AOFAS and Weber score and radiological results were evaluated. The follow-up was 20.4 months for both groups.Results. Comparative results of surgical time, hospital stay, fluoroscopy time, weight load. AOFAS at 3 months: Group A: 96.5 points, and group B: 99 points. Anatomical reduction: 97.4% using MIPO technique and 98.3% using RAFI technique. Return to work activity: Group A, 3.6 average months Group B: average 2.5 months. Return to sport: in Group A: mean 4.8 months; Group B: mean 3.7 monthsConclusions. It is clear from this study that the MIPO technique for the treatment of fractures syndesmotic is a good choice, presenting evolution and faster recovery than open surgery, and low complication rate.

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