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Fracturas de alta energía en cuello y diáfisis femoral ipsilaterales: revisión sistemática de alcance 2019-2020

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dc.contributor.advisorBlanco Vargas, Edgar Alejandro
dc.contributor.advisorBuitrago Medina, Daniel Alejandro
dc.creatorBurgos Espinosa, Eduardo José,
dc.creatorGuzmán Potes, Jorge Enrique
dc.creator.degreeEspecialista en Ortopedia y Traumatología FSFBspa
dc.creator.degreetypeFull timespa
dc.date.accessioned2020-08-04T16:44:51Z
dc.date.available2020-08-04T16:44:51Z
dc.date.created2020-07-27
dc.descriptionLas fracturas de cuello femoral y diafisiarias de forma aislada difieren epidemiológicamente en incidencia, mecanismo traumático y grupo etáreo. Su presentación conjunta refleja traumatismos únicos o múltiples de alta energía con trazo de fractura vertical o basicervical en el fémur proximal, factor que favorece un diagnóstico tardío y a su vez posibles complicaciones como necrosis avascular capital femoral. Su presentación ipsilateral fue descrita inicialmente en 1953 (1), con diferentes publicaciones posteriores que incluyen opciones de tratamiento no unificadas. Esta representa un reto para el ortopedista por la proximidad de las lesiones y la frecuencia del subdiagnóstico de la fractura proximal al centrar la atención en el trazo diafisiario. La incidencia de esta asociación reportada en la literatura varía entre 5-16% dato relacionado directamente con las herramientas diagnósticas que incluyen la radiología simple, con una sensibilidad entre 50-60%, la tomografía computada con sensibilidad mayor para el diagnóstico y finalmente la resonancia magnética como estándar de oro para evaluar fracturas ocultas (2-9). Se han descrito en la literatura diferentes métodos terapéuticos para estas lesiones los cuales no han evidenciado inferioridad entre sí al evaluar resultados. No se ha unificado un método específico para abordar estos pacientes. Dado el amplio rango de incidencia, el pobre consenso sobre el método diagnóstico y tratamiento, se realiza una revisión sistemática de alcance de la literatura que incluye series de casos, casos y controles, ensayos clínicos, revisiones sistemáticas y metanálisis de pacientes con fracturas ipsilaterales de cuello y diáfisis femoral para determinar incidencia, métodos diagnóstico y terapéuticos empleados.spa
dc.description.abstractIsolated femoral neck or shaft fractures are epidemiologically different in certain aspects. Ipsilateral neck and femoral shaft fracturas are due to unique and high energy trauma having vertical o basicervical fractures for the proximal femor, which makes diagnosis harder to catch and possibly delayed which can result in complications such as avascular necrosis of the femoral head. The first case with ipsilateral fractures of femoral neck and shaft was described in 1953 (1), and continued to be described in further publications with various diagnostic and treatment options which are not standarized. This specific diagnosis represents a particular challenge for the orthopeadic surgeon accounting for the associated injurioes o complications, and the frequency of subdiagnosis. Incidence of the association of both fractures, is described in literatura between 5-16%, which is directly related to the different diagnostic methods used, includin simple radiology, with a sensitivity between 50-60%, CT scan with agreater sensitivity, and MRI as a gold standard to evaluate occult fractures (2-9). There are also several methods for definitive fixation that have not shown inferiority among them at the moment of evaluating outcomes. There is no global standard for the management of these fractures. Having such a wide range of incidence values, the poor consensus regarding diagnostic and fixation method, a scoping review of literatura has been done which includes cases series, cases and controls, clincal trials, and meta analysis of patients with ipsilateral fractures of femoral neck and shaft after high energy trauma to determine incidence, diagnostic and fixation methods used.spa
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dc.identifier.doihttps://doi.org/10.48713/10336_25837
dc.identifier.urihttps://repository.urosario.edu.co/handle/10336/25837
dc.language.isospaspa
dc.publisherUniversidad del Rosariospa
dc.publisher.departmentFacultad de Medicinaspa
dc.publisher.programEspecialización en Ortopedia y Traumatología FSFBspa
dc.rightsAtribución-SinDerivadas 2.5 Colombiaspa
dc.rights.accesRightsinfo:eu-repo/semantics/openAccess
dc.rights.accesoAbierto (Texto Completo)spa
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dc.source.instnameinstname:Universidad del Rosariospa
dc.source.reponamereponame:Repositorio Institucional EdocURspa
dc.subjectFémurspa
dc.subjectFractura ipsilateralspa
dc.subjectAlta energíaspa
dc.subjectCuello femoralspa
dc.subjectDiáfisis femoralspa
dc.subject.ddcVarias ramas de la medicina, Cirugíaspa
dc.subject.ddcFarmacología & terapéuticaspa
dc.subject.keywordFemoral shaftspa
dc.subject.keywordFemoral neckspa
dc.subject.keywordIpsilateral femur fracturesspa
dc.subject.keywordHigh energy traumaspa
dc.titleFracturas de alta energía en cuello y diáfisis femoral ipsilaterales: revisión sistemática de alcance 2019-2020spa
dc.title.TranslatedTitleHigh-energy fractures of the neck and ipsilateral femoral shaft: systematic review 2019-2020eng
dc.typemasterThesiseng
dc.type.documentRevisión de la literaturaspa
dc.type.hasVersioninfo:eu-repo/semantics/acceptedVersion
dc.type.spaTrabajo de gradospa
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