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CC BY-NC-ND 4.0 · Rev Bras Ortop (Sao Paulo) 2021; 56(05): 579-587
DOI: 10.1055/s-0041-1732332
Artigo de Atualização
Asami

Função do fixador externo circular de Ilizarov no tratamento de fraturas tibiais com síndrome compartimental iminente/incompleta[*]

Artikel in mehreren Sprachen: português | English
Kaushik Bhowmick 
1   Departmento de Ortopedia, Christian Medical College and Hospital, Vellore, Tamilnadu, Índia
,
Chandrasekaran Gunasekaran 
1   Departmento de Ortopedia, Christian Medical College and Hospital, Vellore, Tamilnadu, Índia
,
Jacob J. Kandoth 
1   Departmento de Ortopedia, Christian Medical College and Hospital, Vellore, Tamilnadu, Índia
,
Boopalan Ramasamy 
1   Departmento de Ortopedia, Christian Medical College and Hospital, Vellore, Tamilnadu, Índia
,
Thilak S. Jepegnanam 
1   Departmento de Ortopedia, Christian Medical College and Hospital, Vellore, Tamilnadu, Índia
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Resumo

Objetivo O tratamento das fraturas da tíbia complicadas por síndrome compartimental afeta o tratamento e o resultado funcional dos pacientes devido às complicações associadas à fasciotomia. O objetivo deste estudo é diferenciar a síndrome compartimental iminente/incompleta (SCI) da síndrome compartimental aguda (SCA) estabelecida nas fraturas tibiais, para avaliar o resultado da fixação do aparelho de Ilizarov nos pacientes fraturados e com SCI, que não foram submetidos à fasciotomia.

Métodos Após o estabelecimento dos critérios de inclusão e exclusão, 19 pacientes foram incluídos no estudo de janeiro de 2007 a dezembro de 2017. Todos eram do sexo masculino, com média de idade de 42,3 ± 11,38 anos. Todos esses pacientes foram tratados com a fixação do aparelho de Ilizarov, de acordo com o protocolo médico e cirúrgico estabelecido neste estudo.

Resultados O acompanhamento médio dos nossos 19 pacientes foi de 47 ± 41,5 meses. O tempo médio de aplicação do fixador circular foi de 3,7 ± 1,7 dias. No total, 3 (16,7%) desses pacientes não apresentaram consolidação. Não houve complicações nas partes moles ou neurovasculares no pós-operatório imediato. A consolidação ocorreu finalmente em todos os pacientes, sem prejuízo da mobilidade e sem sequela de síndrome compartimental.

Conclusão O fixador circular de Ilizarov pode ser utilizado no tratamento dos pacientes com fraturas tibiais com SCI, e evita a fasciotomia, com suas várias complicações de infecção e não consolidação. O resultado é um número menor de procedimentos cirúrgicos e uma reabilitação mais rápida. Os cirurgiões devem diferenciar cuidadosamente a SCA e a SCI, pois, nesses pacientes, os resultados clínicos e funcionais variam significativamente. Fasciotomias desnecessárias devem ser evitadas.

Palavras-chave

técnica de Ilizarov - fraturas da tíbia - síndromes compartimentais

* Trabalho desenvolvido no Departamento de Ortopedia, Christian Medical College and Hospital, Vellore, Índia




Publikationsverlauf

Eingereicht: 02. Dezember 2020

Angenommen: 19. Februar 2021

Artikel online veröffentlicht:
28. Oktober 2021

© 2021. Sociedade Brasileira de Ortopedia e Traumatologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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