1. ¿Están evolucionando las fracturas intertrocantéreas?

Bryan David Solari Chillcce; Marta Arroyo Huidobro

Bryan David Solari Chillcce Geriatría. Hospital Clínic de Barcelona
Marta Arroyo Huidobro Geriatría. Hospital Clínic de Barcelona

Palabras clave: Fractura de cadera, Fracturas intertrocantéreas, Fijación de fracturas

Abstract

El mayor uso de dispositivos intramedulares para la fijación de fracturas intertrocantereas puede reflejar un cambio en el tipo de fractura y dispositivo usado. Se comparó transversal y retrospectivamente un total de 400 pacientes, 100 adultos mayores en intervalos de 3 años del 2004 al 2013. Las fracturas se clasificaron radiológicamente en tipo Evans y según la clasificación de la AO/OTA(Orthopaedic Trauma Association) Classification for trochanteric fractures. La media de edad de los pacientes fue 80.5 años. Se halló principalmente un aumento de las fracturas intertrocantéreas con tendencia a la fijación precoz, menor estancia hospitalaria y mayor uso de clavos intramedulares en el tratamiento. Por tanto, el aumento de fracturas inestables ha provocado el mayor uso de implantes intramedulares.

The increased use of intramedullary devices for fixation of intertrochanteric fractures may reflect a change in the type of fracture and device used. A total of 400 patients, 100 older adults, were compared cross-sectionally and retrospectively at 3-year intervals from 2004 to 2013. Fractures were radiologically classified into Evans type and AO/OTA (Orthopedic Trauma Association) Classification for trochanteric fractures. The average age of the patients was 80.5 years. Mainly an increase in intertrochanteric fractures was found with a tendency towards early fixation, shorter hospital stay and greater use of intramedullary nails in the treatment. Therefore, the increase in unstable fractures has led to a major use of intramedullary implants

Citas

Gullberg B, Johnell O, Kanis JA. World-wide projections for hip fracture. Osteoporos Int 1997;7(5):407–413

Fox KM, Magaziner J, Hebel JR, Kenzora JE, Kashner TM. Intertrochanteric versus femoral neck hip fractures: differential characteristics, treatment, and sequelae. J Gerontol A Biol Sci Med Sci 1999;54(12):M635–M640

Socci AR, Casemyr NE, Leslie MP, Baumgaertner MR. Implant options for the treatment of intertrochanteric fractures of the hip: rationale, evidence, and recommendations. Bone Joint J 2017;99(1):128–133

Adams CI, Robinson CM, Court-Brown CM, McQueen MM. Prospective randomized controlled trial of an intramedullary nail versus dynamic screw and plate for intertrochanteric fractures of the femur. J Orthop Trauma 2001;15(6):394–400

Napoli N, Schwartz AV, Palermo L, et al. Risk factors for subtrochanteric and diaphyseal fractures: the study of osteoporotic fractures. J Clin Endocrinol Metab 2013;98(2):659–667

Farhang M, Mukka S, Bergstrom U, Svensson O, Sayer-Noor AS. The trend of radiological severity of hip fractures over a 30 years period: a cohort study. BMC Musculoskelet Disord 2019;20(1):358

Reindl R, Harvey EJ, Berry GK, Rahme E. Canadian Orthopaedic Trauma Society (COTS). Intramedullary versus extramedullary fixation for unstable intertrochanteric fractures: a prospective randomized controlled trial. J Bone Joint Surg Am 2015;97(23):1905–1912