Artículos recomendados por Dr. Juan David Castro, Residente III UPB

Agradecemos la colaboración del Dr. Castro. Solo se publican los resumenes por cuestiones de derechos de autor.

Coronal plane partial articular fractures of the distal humerus: current concepts in management. Ruchelsman DE, Tejwani NC, Kwon YW, Egol KA.
J Am Acad Orthop Surg. 2008 Dec;16(12):716-28.

Abstract:

Partial articular fractures of the distal humerus commonly involve the capitellum and may extend medially to involve the trochlea. As the complex nature of capitellar fractures has become better appreciated, treatment options have evolved from closed reduction and immobilization and fragment excision to a preference for open reduction and internal fixation. The latter is now recommended to achieve stable anatomic reduction, restore articular congruity, and initiate early motion. More complex fracture patterns require extensile surgical exposures. The fractures are characterized by metaphyseal comminution of the lateral column and have associated ipsilateral radial head fracture. With advanced instrumentation, elbow arthroscopy may be used in the management of these articular fractures. Though limited to level IV evidence, clinical series reporting outcomes following open reduction and internal fixation of fractures of the capitellum, with or without associated injuries, have demonstrated good to excellent functional results in most patients when the injury is limited to the radiocapitellar compartment. Clinically significant osteonecrosis and heterotopic ossification are rare, but mild to moderate posttraumatic osteoarthrosis may be anticipated at midterm follow-up.

Operative treatment of scapular fractures: a systematic review.

Lantry JM, Roberts CS, Giannoudis PV.
Injury. 2008 Mar;39(3):271-83. Epub 2007 Oct 4. Review.

Abstract:

We systematically reviewed the published evidence regarding the operative treatment of scapular fractures. Publications were identified using MEDLINE databases and were included if they reported operative indications, surgical approach and implants, postoperative complications, and functional outcomes. Seventeen investigations encompassing 243 cases met our eligibility criteria. All were retrospective case series (evidence-based medicine level IV). The most common injuries treated with surgery were glenoid fossa fractures and scapular neck fractures. Approximately 25% of the cases had a concomitant injury to the clavicle or acromioclavicular ligaments. Internal fixation was most often achieved with a plate and screws through a posterior approach. The complication rate was low with infection, shoulder stiffness, and implant failure the most commonly reported problems. Good to excellent functional results were obtained in approximately 85% of the cases an average of 49.9 months postoperatively.

Scapula fractures.

Lapner PC, Uhthoff HK, Papp S.
Orthop Clin North Am. 2008 Oct;39(4):459-74, vi. Review.

Abstract:

Fractures of the scapula are rare and the diagnosis and treatment may be unfamiliar to some surgeons. This article outlines a diagnostic work-up and treatment approach for the various types of scapular fractures. The approach helps guide decision making on operative versus nonoperative treatment based on what is known regarding prognosis and outcomes of management. Operative technique and fixation strategies are discussed for the common fracture patterns along with guidelines for postsurgical shoulder rehabilitation.