Defectos óseos diafisarios postraumáticos en la extremidad superior de niños. [Post-traumatic diaphyseal bone defects in the upper extremity of children].

Luciano Gentile, Santiago Luis Iglesias, Esteban Lobos Centeno, Fernando Vanoli, Christian Antonio Allende

Resumen


Introducción

El objetivo de este trabajo es evaluar los resultados obtenidos en niños con defectos óseo segmentarios diafisarios crónicos en húmero o huesos del antebrazo.

Material y Métodos

Evaluamos retrospectivamente nueve niños, tratados entre 2005 y 2015, que presentaban fracturas en huesos largos de la extremidad superior que se infectaron y resultaron en defectos óseos segmentarios; todas con 6 o mas meses de evolución desde el trauma inicial. Siete fueron de sexo masculino y dos de sexo femenino. La edad de los pacientes promedió 9.9 años. Cuatro defectos óseos se localizaban en el húmero, tres en el cúbito y dos en el radio. Todos los pacientes habían tenido intervenciones quirúrgicas previas, promediando 3.7; originando defectos óseos que promediaron 4.5 centímetros. El tiempo entre el trauma inicial y la cirugía definitiva promedió 21.8 meses.

Resultados

El seguimiento promedió 2.2 años. En todos los casos se obtuvo consolidación. En un caso se utilizó espaciador de cemento; en otro injerto libre de peroné. Dos pacientes con lesión en húmero presentaron acortamiento significativo. Todos los niños retomaron sus actividades deportivas y recreacionales sin limitaciones.

Discusión

 Los defectos óseos postraumáticos son raros en niños. Presentamos nueve niños con defectos óseos diafisarios segmentarios localizados en húmero, cúbito o radio; en ocho casos se utilizó autoinjerto óseo y una placa puenteando el defecto, obteniendo consolidación, estabilidad y ausencia de dolor en todos los casos.


Abstract

Introduction: The aim of this study was to evaluate the results achieved in children with chronic segmental bone defects at the humerus or forearm.

Methods: Nine children, treated between 2005 and 2015, presenting long bone upper extremity fractures that got infected resulting in segmentary bone defects were retrospectively evaluated; all lesions had 6 or more months from trauma. Seven patients were male and two female, with an average age of 9.9 years. Four defects were located at the humerus, three at the ulna, and two at the radius. All patients had had previous surgical interventions (average 3.7), originating bony defects that averaged 4.5 cm. Time from initial trauma to definitive surgery averaged 21.8 months.

Results: Follow-up averaged 2.2 years. Union was achieved in all patients. A cement spacer was used in one case, in another case a free fibular bone graft was used. Two patients with humeral defects had significant shortening. All patients returned to their recreational and sports activities without limitations.

Conclusions: The combination of different types of bone autograft, various plaques placed bypassing the lesion and the induced membrane technique allowed us to obtain consolidation and return to normal activity in the nine children with segmental bone defects in humerus, ulna or radius.


Palabras clave


Defectos óseos; postraumáticos; Extremidad superior; Niños.Bone defects; posttraumatic; upper extremity; children.

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Referencias


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DOI: http://dx.doi.org/10.15417/691

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Registro de la Propiedad Intelectual Nº 5353562 (en línea).

ISSN 1852-7434 (en línea).

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