Tenosinovitis y roturas de flexores en fracturas de radio distal tratadas con placa palmar
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Introducción: En el manejo de la fractura de radio distal el abordaje palmar resulta más beneficioso que el abordaje dorsal, aunque el uso de la placa de radio palmar puede provocar neuropatÃa, adherencias y lesiones tendinosas, especialmente del tendón flexor pollicis longus.
Objetivo: Evaluar los sÃntomas de tenosinovitis y rupturas tendinosas en pacientes con antecedente de reducción abierta y fijación interna con placa palmar en fractura del extremo distal del radio.
Métodos: Se incluyeron 54 pacientes con fractura del extremo distal del radio, que utilizaron reducción abierta y fijación interna con placa palmar. Se evaluaron la tenosinovitis, desde el punto de vista clÃnico, y las imágenes diagnósticas.
Resultados: Requirieron cirugÃa 11 pacientes porque presentaron signos y sÃntomas de tenosinovitis del tendón flexor pollicis longus, dos de ellos tuvieron rotura completa del tendón con otras lesiones asociadas y se trataron con transferencia tendinosas. Según la clasificación de Soong, 10 casos resultaron tipo 1 y uno tipo 2.
Conclusiones: La tenosinovitis y las roturas de flexores constituyen una complicación en fracturas de radio distal con reducción y fijación con placas. Se sugiere tener en cuenta la clasificación de Soong para el pronóstico, ya que permite determinar el riesgo de tenosinovitis y la rotura de los tendones, especialmente el flexor pollicis longus.
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Referencias
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