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      Empleo del clavo intramedular de Küntscher en pacientes con fracturas diafisarias de tibia Translated title: Use of Küntscher intramedullary nail in patients with tibial diaphyseal fractures

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          Abstract

          Se realizó un estudio descriptivo, longitudinal y retrospectivo de 123 pacientes con fractura diafisaria de tibia, quienes fueron intervenidos mediante la técnica quirúrgica de fijación con clavo intramedular de Küntscher sin fresado del canal, desde agosto del 2012 hasta diciembre del 2013, en el Hospital Especial de Tumbi, de Kibaha, Tanzania, con vistas a evaluar los resultados de dicho procedimiento. En la serie predominaron el sexo masculino (74,0 %), el grupo etario de 26-35 años (37,4 %), los accidentes de tránsito como causa principal de las lesiones (74,0 %) y la reducción de la fractura de forma abierta (90,2 %); asimismo, 29,4 % de los pacientes presentó complicaciones y 80,5 % mostró buenos resultados en la evaluación final. Finalmente, se pudo concluir que el uso del clavo intramedular de Küntscher sin fresado del canal, es una técnica quirúrgica viable para solucionar las fracturas diafisarias de tibia

          Translated abstract

          A descriptive, longitudinal and retrospective study of 123 patients with tibial diaphyseal fracture who were surgically treated by means of the surgical technique of fixation with Küntscher intramedullary nail without reaming of channels was carried out from August, 2012 to December, 2013, in Tumbi Special Hospital, Kibaha, Tanzania, with the aim of evaluating the results of this procedure. The male sex (74.0%), the age group 26-35 years (37.4%), the traffic accidents as main cause of the lesions (74.0%) and the reduction of the fracture in an open way (90.2%) prevailed in the series; also, 29.4% of the patients presented complications and 80.5% showed good results in the final evaluation. Finally, it could be concluded that the use of Küntscher intramedullary nail without reaming channels, is a viable surgical technique to solve the tibial diaphyseal fractures

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          Most cited references20

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          Treatment of open fractures of the tibial shaft with the use of interlocking nailing without reaming.

          Fifty open fractures of the tibial shaft that were treated with débridement and interlocking nailing without reaming were followed for an average of twelve months. Most of the fractures were the result of high-energy trauma, and 68 per cent of the fracture wounds were grade III. Forty-eight (96 per cent) of the fifty fractures united at an average of seven months; there were no malunions. There were four infections (8 per cent), all at the sites of grade-III fractures. Locking screws broke in five tibiae (10 per cent), but the breakage did not result in a loss of reduction. Three nails broke, two at the sites of ununited fractures and one at the site of a healed fracture. These results are comparable with, or better than, those obtained with other forms of fixation, including immobilization with a cast, unlocked intramedullary nailing, and external fixation.
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            Reamed or unreamed nailing for closed tibial fractures. A prospective study in Tscherne C1 fractures.

            We performed a prospective, randomised study on 50 patients with Tscherne C1 tibial diaphyseal fractures comparing treatment with reamed and unreamed intramedullary nails. Our results show that reamed nailing is associated with a significantly lower time to union and a reduced requirement for a further operation. Unreamed nailing should not be used in the treatment of the common Tscherne C1 tibial fracture.
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              Infection after intramedullary nailing of the tibia. Incidence and protocol for management.

              There is concern about the incidence and serious nature of infection after intramedullary nailing of the tibia, especially for open injuries. We have reviewed 459 patients with tibial fractures treated by primary reamed nailing. The incidence of infection was 1.8% in closed and Gustilo type I open fractures, 3.8% in type II, and 9.5% in type III fractures (5.5% in type IIIa, 12.5% in type IIIb). These incidences appear to be acceptable in comparison with other published results. We describe the different modes of presentation of infection in these cases, and suggest a protocol for its management, which has been generally successful in our series.
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                Author and article information

                Journal
                san
                MEDISAN
                MEDISAN
                Centro Provincial de Información de Ciencias Médicas (Santiago de Cuba, , Cuba )
                1029-3019
                December 2015
                : 19
                : 12
                : 1477-1484
                Affiliations
                [01] Santiago de Cuba orgnameHospital Provincial Docente Clinicoquirúrgico Saturnino Lora Torres Cuba
                Article
                S1029-30192015001200006 S1029-3019(15)01901206
                ae77264a-bbf2-463b-b4d5-5a0e1cec14ee

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

                History
                : 11 October 2015
                : 05 November 2015
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 20, Pages: 8
                Product

                SciELO Cuba

                Categories
                ARTÍCULOS ORIGINALES

                clavo intramedular de Küntscher,Tanzania,scher intramedullary nail,tibial diaphyseal fractures,fractura diafisaria de tibia

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