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Tratamiento quirúrgico de las fracturas intertrocantéricas del fémur con placa tornillo dinámico convencional comparado con tornillo dinámico helicoidal
dc.contributor.advisor | Trillos Peña, Carlos Enrique | |
dc.creator | Morales Guerrero, Óscar Javier | |
dc.creator | Gamarra Arenas, Raúl Fernando | |
dc.creator | Ávila León, Jorge | |
dc.creator | Murcia, Luis Alejandro | |
dc.creator | Robayo García, Patricia Andrea | |
dc.creator.degree | Especialista en Epidemiología (en Convenio con el CES) | |
dc.date.accessioned | 2014-04-07T14:58:46Z | |
dc.date.available | 2014-04-07T14:58:46Z | |
dc.date.created | 2014-02-27 | |
dc.date.issued | 2014 | |
dc.description | Introducción: Las fracturas intertrocantéricas han llegado a nuestros días con una mayor incidencia dado el envejecimiento de la población, con fracturas más complejas, menos estables y asociadas a osteoporosis, se estima que representan aproximadamente 1,75 millones de años de vida perdidos ajustados a discapacidad es decir 0,1% de la carga de morbilidad a nivel mundial. Existe consenso en el tratamiento quirúrgico de este tipo de fracturas, presentando una incidencia variable de fallos, principalmente cuando son inestables, entre estos el denominado “cuto ut”. La utilización de un método de fijación con placa y tornillo helicoidal (DHHS) aparentemente disminuye la incidencia de dichos fallos con respecto a otras técnicas. Metodología: Por medio de una muestra calculada en 128 de pacientes con fracturas intertrocantéricas operados con DHS y DHHS entre el 2007 y el 2012 en La Clínica San Rafael de la ciudad de Bogotá, Colombia, se realizó un análisis multivariado para determinar si existe o no diferencias significativas en los índices de fallo entre estas dos técnicas. Resultados: Los pacientes incluidos en el estudio 54 (42,1%) fueron hombres y 74 (57,8%) fueron mujeres. 75 fueron operados con DHHS y 53 con DHS; en cuanto a las comorbilidades las principales fueron Hipertensión con 40 pacientes para DHS y 30 para DHHS, para el caso de Diabetes Mellitus fueron 13 y 9 para DHS y DHHS, respectivamente; en cuanto al tipo de fractura más común la principal fue la clasificación Tronzo II con 9 pacientes para DHS y 13 para DHHS. Conclusión. Para el estudios se evidencia que para los 3 desenlaces principales evaluados, 1. El porcentaje de re intervención (p=0,282), 2. La supervivencia en el primer año (p=0,499) y 3. El desempeño funcional con la escala de Oxford (p=0,06); no hubo diferencias estadísticamente significativas entre los grupos. | spa |
dc.description.abstract | Introduction: Intertrochanteric fractures have a higher incidence nowadays, mainly due to aging population, who are suffering fractures more complex, less stable and associated with osteoporosis. It is estimated that this type of fractures represents approximately 1.75 million years of lost life adjusted to disability, equal to 0.1% of the burden disease worldwide. There is a consensus in the surgical treatment for these fractures, which come up with a variable incidence of failures, especially when they are unstable, as in the case of the ones called "cut out". The usage of the method of fixation with plate and helical screw (DHHS) apparently decreases the incidence of such failures with respect to other techniques. Methodology: Using a calculated sample size of 128 patients with intertrochanteric fractures operated with DHS and DHHS from 2007 to 2012 at San Rafael Medical Clinic (Bogota, Colombia), a multivariate analysis was performed to determine if there are or there are not significant failure rates differences between these two techniques. Results: Patients included in this study were 54 (42.1%) male and 74 (57.8%) women. 75 were operated with DHHS and 53 with DHS. Main comorbidities were: Hypertension with 40 patients for DHS and 30 for DHHS; and, Diabetes Mellitus with 13 and 9 for DHS and DHHS respectively. The most common type of fracture in Tronzo’s classification was type 2 with 9 patients for DHS and 13 for DHHS. Conclusion: For the three main outcomes evaluated: 1. Percentage of reoperation (p=0,282) , 2. Survival during the first year (p=0,499) and 3. Functional performance according to Oxford’s scale (p=0,06), study shows there were no statistically significant differences between groups. | eng |
dc.format.mimetype | application/pdf | |
dc.format.tipo | Documento | spa |
dc.identifier.doi | https://doi.org/10.48713/10336_5072 | |
dc.identifier.uri | http://repository.urosario.edu.co/handle/10336/5072 | |
dc.language.iso | spa | |
dc.publisher | Universidad del Rosario | spa |
dc.publisher.department | Facultad de medicina | spa |
dc.rights.accesRights | info:eu-repo/semantics/openAccess | |
dc.rights.acceso | Abierto (Texto completo) | spa |
dc.rights.cc | CC0 1.0 Universal | spa |
dc.rights.licencia | EL AUTOR, manifiesta que la obra objeto de la presente autorización es original y la realizó sin violar o usurpar derechos de autor de terceros, por lo tanto la obra es de exclusiva autoría y tiene la titularidad sobre la misma. PARÁGRAFO: En caso de presentarse cualquier reclamación o acción por parte de un tercero en cuanto a los derechos de autor sobre la obra en cuestión, EL AUTOR, asumirá toda la responsabilidad, y saldrá en defensa de los derechos aquí autorizados; para todos los efectos la universidad actúa como un tercero de buena fe. EL AUTOR, autoriza a LA UNIVERSIDAD DEL ROSARIO, para que en los términos establecidos en la Ley 23 de 1982, Ley 44 de 1993, Decisión andina 351 de 1993, Decreto 460 de 1995 y demás normas generales sobre la materia, utilice y use la obra objeto de la presente autorización. | spa |
dc.rights.uri | http://creativecommons.org/publicdomain/zero/1.0/ | |
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dc.source.instname | instname:Universidad del Rosario | spa |
dc.source.reponame | reponame:Repositorio Institucional EdocUR | spa |
dc.subject | fractura intertrocantéricas | spa |
dc.subject | tornillo dinámico de cadera | spa |
dc.subject | tornillo helicoidal dinámico de cadera | spa |
dc.subject | fallo | spa |
dc.subject | Cut-out | spa |
dc.subject.keyword | Intertrochanteric fractures | eng |
dc.subject.keyword | dynamic hip screw | eng |
dc.subject.keyword | dynamic helical hip crew | eng |
dc.subject.keyword | failure | eng |
dc.subject.keyword | cut -out | eng |
dc.subject.lemb | Fracturas | spa |
dc.subject.lemb | Fracturas de cadera | spa |
dc.subject.lemb | Fracturas del fémur | spa |
dc.subject.lemb | Ortopedia | spa |
dc.title | Tratamiento quirúrgico de las fracturas intertrocantéricas del fémur con placa tornillo dinámico convencional comparado con tornillo dinámico helicoidal | spa |
dc.type | bachelorThesis | eng |
dc.type.hasVersion | info:eu-repo/semantics/acceptedVersion | |
dc.type.spa | Trabajo de grado | spa |