Tratamiento de pseudoartrosis postquirúrgica en la base del segundo metatarsiano mediante autoinjerto de calcáneo: caso clínico

• Sergio Miralles Ruíz ^[1] ; Víctor Mateos Selma ^[1] ; Javier Pascual Huerta ^[2]
  1. [1] Clínica Podológica Sergio Miralles. Castellón de la Plana, España
  2. [2] Clínica del Pie Elcano. Barakaldo. Vizcaya, España
• Localización: Revista española de podología, ISSN 0210-1238, Vol. 34, Nº. 1, 2023, págs. 39-46
• Idioma: español
• DOI: 10.20986/revesppod.2023.1656/2022
• Títulos paralelos:
  • Treatment of postsurgical pseudoarthrosis in the base of the second metatarsal with calcaneus autograft: a case report
• Enlaces
  • Texto completo
• Resumen
  • español

    Los procesos de no-unión postquirúrgicos en pie y tobillo no son infrecuentes debido a la gran cantidad de procedimientos quirúrgicos mediante osteotomías o artrodesis que se realizan anualmente. Ocasionalmente, estos procedimientos no tienen una estabilización óptima del foco de fractura y pueden acabar degenerando en un proceso de no-unión. Presentamos el caso de una paciente a la que se le realizaron osteotomías en la base de los metatarsianos menores por cirugía mínimamente invasiva para el tratamiento de metatarsalgia, que derivó en el desarrollo de pseudoartrosis dolorosa en la base del segundo metatarsiano y de no-unión en el 4.º metatarsiano. Se realizó tratamiento quirúrgico consistente en la utilización de autoinjerto corticoesponjoso de calcáneo y estabilización con placa de bloqueo dorsal para 2.º metatarsiano y estabilización con placa dorsal de bloqueo para el 4.º metatarsiano. La radiología mostró integración del injerto a las 8 semanas y los resultados clínicos fueron muy satisfactorios tras 5 años de seguimiento. El autoinjerto de calcáneo con estabilización rígida por medio de placa de bloqueo dorsal puede ser un tratamiento efectivo para el tratamiento de la no unión y pseudoartrosis en la base de los metatarsianos.

  • English

    Postsurgical nonunions of the foot and ankle are not uncommon because of the large number of procedures by means of osteotomies and arthrodesis that are performed annually. We present a clinical case of a patient who developed a painful nonunion in the base of the second metatarsal after a minimally invasive surgical procedure for metatarsalgia within a base osteotomy that developed a painful pseudoartrhosis of the 2nd metatarsal and also a nonunion of the 4th metatarsal. The patient was treated with the use of an autograft of corticocancellous bone from ipsilateral calcaneus that was fixated with a dorsal locking plate for the 3rd metatarsal and also with stabilization by means of a dorsal locking plate of the 4th metatarsal. Radiology showed good integration of the graft at 8 weeks and clinical results were excellent after 5 years of followup. Autograft from calcaneus fixed with a locking dorsal plate can be an effective treatment of nonunions in the base of the metatarsals.

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