Artrodesis de tobillo con FMIP, asistida con artroscopía. Propuesta alternativas



Título del documento: Artrodesis de tobillo con FMIP, asistida con artroscopía. Propuesta alternativas
Revista: Acta ortopédica mexicana
Base de datos: PERIÓDICA
Número de sistema: 000354102
ISSN: 1665-4717
Autores: 1
Instituciones: 1Hospital Angeles del Pedregal, México, Distrito Federal. México
Año:
Periodo: Sep-Oct
Volumen: 25
Número: 5
Paginación: 297-302
País: México
Idioma: Español
Tipo de documento: Artículo
Enfoque: Aplicado
Resumen en español daño de otros tejidos, se preservó la longitud de la extremidad y no se invadió la articulación subastragalina; no se observó lesión vascular o nerviosa (necrosis del talus), ni embolismo por el fresado del canal. Durante el postoperatorio se tuvo un mejor manejo del paciente pues no requirió de inmovilización rígida y aunque el apoyo no fue inmediato, a las dos semanas pudo usar una bota de descarga para apoyo parcial y apoyo total a las seis semanas. Por tanto se presentaron menos complicaciones y si cuando existió fracaso se tuvo la posibilidad de otra cirugía de rescate
Resumen en inglés The ankle is a loading joint with a small contact surface and it is therefore very vulnerable to trauma, as it is an exposed region. It is a unique joint because it forms several joints. In this joint the load falls on the contact area, which is one third of the knee or the hip, and it is the most important part of our musculo-skeletal system designed for ambulation and bipedestation. In case of ankle injuries, arthrodesis is a procedure performed to relieve pain, decrease deformity and provide stability. An optimum result of this procedure may be easily achieved if the ankle is fi xed in the right position, so this technique will continue to be a treatment alternative. With «minimally invasive percutaneous fixation (MIPF)» fixation is safe, it relieves pain and stops the progression of regeneration, it is a minimally invasive method performed through a small posteromedial incision on the ventral surface of the distal tibial metaphysis, which minimizes soft tissue dissection thus eliminating wound complications. In this study we included patients with severe joint damage and pain, with a physically demanding type of work, in whom other treatments had previously failed and in whom total arthroplasty was not possible (due to questionable results). Patients with a varusvalgus > 15°, talar necrosis, bone defects requiring a graft or subtalar arthrosis were excluded. Our results are no different from the world literature concerning the incidence rate of complications by age and diagnosis as well as the healing rate. Postoperative patient management was better as no rigid immobilization was required. Even though weight bearing was not immediate, at two weeks they could use an unloading boot for partial weight bearing, and total weight bearing was possible by week six. Therefore, there were less complications and in failed cases salvage surgery was possible
Disciplinas: Medicina
Palabras clave: Cirugía,
Terapéutica y rehabilitación,
Traumatología y ortopedia,
Tobillo,
Artrodesis,
Fijación interna,
Artroscopía,
Fracturas,
Técnicas de fijación
Keyword: Medicine,
Surgery,
Therapeutics and rehabilitation,
Traumatology and orthopedics,
Fractures,
Ankle,
Arthrodesis,
Internal fixation,
Arthroscopy,
Fixation techniques
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