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      TRATAMIENTO DE LA NO UNIÓN DE LAS FRACTURAS DE ESCAFOIDES CON LA TÉCNICA DE FISK-FERNÁNDEZ Translated title: TREATMENT OF NON-UNION FRACTURES OF THE SCAPHOID WITH THE FISK-FERNANDEZ TECHNIQUE

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          Abstract

          Las fracturas del escafoides, después de las fracturas del radio distal, son las lesiones traumáticas del puño más frecuentes y al no diagnosticarse oportunamente dejan secuelas, la gran mayoría incapacitantes, que obligan a tratamientos complejos de alto riesgo y de larga evolución, al tiempo que se describen complicaciones e índices de no unión, hasta en un 50% de los manejos ortopédicos. En el presente trabajo revisa la experiencia del servicio de Cirugía Mano y Miembro Superior del Hospital Militar Central de Bogotá en el tratamiento quirúrgico de la no unión del escafoides, con el uso de la técnica de estabilización descrita con la utilización de injerto óseo y tornillo de compresión de 3,0 mm o de Fisk-Fernández (10). Para ello se realizó un estudio retrospectivo, tipo serie de casos, con una revisión sistemática de las historias clínicas de 42 pacientes intervenidos, utilizando la escala de valoración funcional de la mano (DASH), tanto preoperatoria como postoperatoria. Se encontró que con la aplicación de esta técnica disminuía el dolor, mejoraba la función en el 94% de los casos y que las complicaciones asociadas y los procedimientos secundarios eran mínimos.

          Translated abstract

          Scaphoid fractures are the most common carpal injury after fractures of the distal radial bone, which when not diagnosed timely lead to late sequelae and scaphoid non-unions that result in high-risk complex treatments with a high index of complications and non-union described in 50% of conservative treatments. This is a retrospective study of a series of 42 patients with scaphoid non-union treated with the intercalary bone graft and 3.0 mm screw fixation technique (Fisk-Fernandez); we review the experience of the upper extremity and Hand surgery department at the Hospital Militar Central, using the DASH score for functional outcomes. We found that pain and function improves in 94% of the cases, and the complications and secondary procedures were minimal.

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          Most cited references 18

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          Acute fractures of the scaphoid.

           S. Rohde,  ,  Tracey Weiland (2006)
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            Anterior bone grafting and conventional lag screw fixation to treat scaphoid nonunions.

            The results of 20 established nonunions of the scaphoid treated with resection of the pseudoarthrosis, anterior cortic-cancellous iliac bone grafting, and conventional lag screw fixation with the ASIF 2.7 mm cortical screw are presented. Union rate was 95% and the average time off work was 8.9 weeks. Review of the relevant literature uniformly shows that the most common reasons for failure are improper internal fixation techniques and/or the absence of bone grafting. Successful treatment of scaphoid nonunions with screw fixation and cast-free after-treatment does not depend on the implant used but rather on careful case selection and precise surgical technique.
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              Anterior bone grafting and conventional lag screw fixation to treat scaphoid nonunions

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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                med
                Revista Med
                rev.fac.med
                Universidad Militar Nueva Granada. Facultad de Medicina (Bogotá )
                0121-5256
                July 2007
                : 15
                : 2
                : 282-289
                Affiliations
                [1 ] Hospital Militar "Carlos J. Finlay" Cuba
                [2 ] Hospital Militar "Carlos J. Finlay" Cuba
                [3 ] Hospital Militar "Carlos J. Finlay" Cuba
                [4 ] Hospital Militar "Carlos J. Finlay" Cuba
                Article
                S0121-52562007000200016
                Product
                Product Information: website
                Categories
                PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

                Public health

                scaphoid bone, injerto óseo, bone trasplantation, hueso escafoides

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