Manejo quirúrgico de las fracturas de las falanges y los metatarsianos: una revisión actualizada

• Autores: Alberto González Sayago, Ramón Cancelo Barea, Pedro Hernández Cortés
• Localización: Revista de la Sociedad Andaluza de Traumatología y Ortopedia, ISSN-e 1578-9756, Vol. 37, Nº. 1, 2020, págs. 8-18
• Idioma: español
• Títulos paralelos:
  • Surgical management of phalangeal and metacarpal fractures: an updated review
• Enlaces
  • Texto completo
• Resumen
  • español

    Las fracturas de falanges y metacarpianos son de las más frecuentes. Las posibilidades quirúrgicas son muy variadas, como también los distintos tipos de fracturas. La dificultad de poder comparar distintos tipos de fractura entre sí hace complejo el análisis del mejor tipo de tratamiento quirúrgico.

    Objetivo: Realizar una revisión actualizada de los distintos manejos quirúrgicos para el tratamiento de las fracturas de falanges y metacarpianos en la mano para decidir el mejor tratamiento para cada tipo de fractura.

    Materiales y métodos: Se ha realizado una búsqueda no sistemática en PubMed, Scopus y Embase para localizar artículos sobre manejo quirúrgico de fracturas de falanges y metacarpianos, estudiando todos las zonas y tipos de fractura, así como sus posibilidades quirúrgicas.

    Resultados: De un total de 56 artículos publicados en los últimos 10 años, se seleccionaron 30 artículos, tras aplicar los criterios de selección y exclusión. Lamayoría fueron revisiones bibliográficas; el resto, estudios retrospectivos y prospectivos, series de casos y 2 ensayos clínicos controlados aleatorizados. Conclusiones: Las posibilidades quirúrgicas para cada zona y tipo de fractura en falanges y metacarpianos son tremendamente variables, actualmente no existe evidencia suficiente que permita establecer el mejor tratamiento para cada fractura. Hacen falta ensayos clínicos de alta calidad.

  • English

    Fractures of phalanges and metacarpals are the most frequent. The surgical possibilities are very different, as there are a plenty of types of fractures. It is difficult to compare different types of fractures with each other, what makes the analysis of the best surgical treatment complex.

    Objectives. To perform an updated review of the different surgical procedures for the treatment of phalangeal and metacarpal fractures in the hand to elucidate the best treatment for each type of fracture.

    Methods. A non-systematic search has been carried out in PubMed, Scopus and Embase to locate articles on the surgical management of phalangeal and metacarpal fractures, studying all areas and types of fractures, as well as their surgical possibilities.

    Results. From a total of 56 articles published in the last 10 years, 30 articles were selected, after applying the selection and exclusion criteria. Most of the were bibliographic reviews. The rest were retrospective and prospective studies, case series and 2 randomized controlled clinical trials.

    Conclusions. The surgical possibilities for each area and type of fracture in phalanges and metacarpals are very variable, but there is currently insufficient evidence to establish the best treatment for each fracture. High quality clinical trials are needed.

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