Resultado funcional de las fracturas triplanares de tibia distal
2014
espanolObjetivos: Evaluar la funcionalidad, dolor y calidad de vida de los pacientes despues de sufrir una fractura triplanar de tibia distal. Material y metodo: Se realizo un analisis retrospectivo de fracturas triplanares documentadas en los ultimos tres anos en nuestro hospital. Se utilizaron dos escalas para evaluar los resultados funcionales de las fracturas triplanares (protocolo de Weber modificado y la escala FAOS). Se llevo a cabo una revision retrospectiva de las historias clinicas y radiografias para determinar sexo, edad, metodo de tratamiento, mecanismo de lesion y complicaciones. La evaluacion radiografica incluia la medicion del gap y escalon articular en imagenes pre y postquirurgicas Resultados: Evaluamos 8 pacientes (5 hombres, 3 mujeres), edad media al diagnostico de 13 anos. Se trataron de forma ortopedica 5 casos mediante reduccion cerrada e inmovilizacion con yeso e intervencion quirurgicamente 3 casos. Con un tiempo minimo de seguimiento de 2 anos, segun el protocolo de Weber modificado obtuvimos resultados excelentes en 5 casos, buenos en 1 caso, razonable en 1 caso y pobre en 1 caso. En la escala FAOS, la media de cada subescala fue: dolor de 89.2, sintomas de 94.4, actividades de la vida diaria de 98.1, deporte de 95.6 y calidad de vida de 92,1. Conclusiones: El resultado funcional de las fracturas triplanares es bueno a excelente a corto plazo. Es necesario aumentar el tamano muestral y realizar un seguimiento mayor en el tiempo para determinar la evolucion de dichas fracturas. EnglishBackground: The purpose of our study was to evaluate the functional outcome, the pain and the health-related quality of life after a triplane fracture. Methods: We performed a retrospective review of the patients with a triplane fracture treated at our institution during the last three years. We used 2 validated outcome measures, the Foot and Ankle outcomes Score (FAOS) and the modified Weber protocol, to assess functional results. A retrospective chart and radiographic review was performed to identify the sex, the age, the treatment method, the mechanism of injury and the complications. The radiographic evaluation included the measurements of the articular gap and step-off on preoperative and postoperative images. Results: We evaluated 8 patients (5 boys, 3 girls), with a mean age of 13 years. Five patients were treated with closed reduction and cast inmobilization, whereas the three remaining patients were surgically treated. The mean follow-up was 2 years. We obtained 5 excellent results, 1 good, 1 fair and 1 poor according to the modified Weber protocol. The mean values of each FAOS subscales were: 89,2 for symptoms, 94,4 for pain, 98,1 for activities of daily living, 95,6 for sports and recreation, and 92,1 for quality of life. Conclusions: Functional results of triplane fractures are good to excellent at short term follow-up. It is necessary to increase both the sample size and the follow-up to determine the evolution of these fractures.
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