22-130

Tratamiento de la fractura subcapital de cadera mediante osteosíntesis percutánea.

RODRÍGUEZ VELA, J.; HERRERA RODRÍGUEZ, A.; MARTÍNEZ VILLA, J.; CANALES CORTES, V. y LÓPEZ MARCO, J. F. HOSPITAL «MIGUEL SERVEn>. CENTRO DE TRAUMATOLOGÍA. ZARAGOZA SERVICIO DE CIRUGÍA ORTOPÉDICA Jefe: Dr. A. HERRERA
Recepción:
16/01/2009
Aceptación:
16/01/2009
Publicación:
16/01/2009


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Resumen (ES)

The consolidation in 214 subcapital fractures of the hip treated with osteosyntesis with three AO cancellous screws are reported.The patients' average age is 72'5 and the osteoporosis degree is obvious in 89% of the cases.In each fracture the Garden and Pawel's c1assification and Lamare's displacement are considered as well as the reduction (according to Garden's «acceptable reduction» criteria).The rates of complication are: infection (0'4%), loss of reduction (15'6%), non union (10'28%) and necrosis (16%). The statistic evaluation is carried out through the «ChiSquare» test.
The factor of a poor prognostic are more likely to be found in eldery women, displaced fractures with verticalline of fracture, non acceptable reductions and faulty osteosyntesis.The X rays of avascular necrosis have a much greater tendency to affect young patients with displaced fractures and reduction in valgus.The authors come to the conclusion that a deficient reduction cannot be solved with an accurate osteosyntesis.The risk of a late segmental collapse due to a avascular neurosis is unpredictable, 4'2% of our patients required a second operation.

Palabras clave (ES):

Fijación
Cuello
Fémur
Interna
Tratamiento
Fractura
Subcapital
Cadera
Osteosíntesis
Percutánea

Resumen (EN)

The consolidation in 214 subcapital fractures of the hip treated with osteosyntesis with three AO cancellous screws are reported.The patients' average age is 72'5 and the osteoporosis degree is obvious in 89% of the cases.In each fracture the Garden and Pawel's c1assification and Lamare's displacement are considered as well as the reduction (according to Garden's «acceptable reduction» criteria).The rates of complication are: infection (0'4%), loss of reduction (15'6%), non union (10'28%) and necrosis (16%). The statistic evaluation is carried out through the «ChiSquare» test.
The factor of a poor prognostic are more likely to be found in eldery women, displaced fractures with verticalline of fracture, non acceptable reductions and faulty osteosyntesis.The X rays of avascular necrosis have a much greater tendency to affect young patients with displaced fractures and reduction in valgus.The authors come to the conclusion that a deficient reduction cannot be solved with an accurate osteosyntesis.The risk of a late segmental collapse due to a avascular neurosis is unpredictable, 4'2% of our patients required a second operation.

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