Injerto óseo vascularizado pediculado del radio distal para tratar la seudoartrosis recalcitrante del cúbito. [Vascularized bone graft of the distal radius for recalcitrant ulnar pseudoarthrosis.]

• Autores: Ezequiel Ernesto Zaidenberg, Ezequiel Martínez, Martín Pastrana, Fernando Juarez Cesca, Federico Olazarri, Carlos Rodolfo Zaidenberg
• Localización: Revista de la Asociación Argentina de Ortopedia y Traumatología, ISSN 1852-7434, Vol. 83, Nº. 1, 2018, págs. 31-37
• Idioma: español
• Títulos paralelos:
  • Vascularized bone graft of the distal radius for recalcitrant ulnar pseudoarthrosis.
• Enlaces
  • Texto completo (pdf)
• Resumen
  • español

    IntroducciónEl objetivo de este trabajo es presentar los resultados clínicos y radiológicos de una serie de pacientes tratados con el injerto óseo vascularizado (IOV) pediculado del radio distal para pseudoartrosis recalcitrantes de cubito diafisario o proximal. Materiales y MétodosSe realizo un estudio retrospectivo donde se incluyeron pacientes con pseudoartrosis de cubito diafisario o proximal con defectos menores a 6 centímetros, con al menos tres cirugías previas y con un seguimiento mínimo de 2 años tratados con IOV pediculado del radio distal. Se registró en número de cirugías previas. Se evaluó el rango de movimiento de codo y de muñeca, la fuerza de puño comparativa, la Escala Visual analógica (EVA) para dolor, el cuestionario QuickDASH y el Score de Mayo para codo. ResultadosSiete pacientes fueron incluidos. La edad media fue de 42 años (rango 26-64). El número promedio de cirugías anteriores fue 4 (3-7). El seguimiento medio fue de 21 meses (rango 24-36). Todas las pseudoartrosis consolidaron. El score de Mayo fue  bueno en 4 pacientes, excelente en 2 pacientes y moderado en un paciente. El QuickDASH posoperatorio promedio fue de 13 (0-29). El arco de flexo-extensión de la muñeca fue del 81% del contralateral. El rango de movilidad de codo fue > 100° en 5 pacientes y entre 50° - 100° en  2 pacientes.  ConclusiónEl injerto óseo vascularizado pediculado del radio distal es una alternativa efectiva para el tratamiento de la pseudoartrosis de cubito. AbstractIntroduction: The purpose of this study was to analyze the clinical and radiological outcomes of a series of patients treated with pedicled distal radius vascularized bone graft for recalcitrant ulnar nonunions.Methods: A retrospective study was performed. The inclusion criteria were patients with diaphyseal or proximal ulnar nonunions with bone defects <6 cm, at least three previous surgeries and a minimum follow-up of 2 years, treated with pedicled vascularized bone graft of distal radius. The number of previous surgeries was recorded. Elbow and wrist range of motion, comparative grip strength, and pain using the Visual Analogue Scale, QuickDASH questionnaire and Mayo Clinic score for elbow were evaluated. Results: Seven patients were included. The mean age was 42 years (range 26-64). The average number of previous surgeries was 4 (range 3-7). The mean follow-up was 31 months (range 24-43). All pseudoarthrosis consolidated. The Mayo Clinic score was good in 4 patients, excellent in 2 patients and moderate in one patient. The mean postoperative QuickDASH score was 13 (range 0-29). Flexion-extension arch of the wrist was 81% of the contralateral. The elbow range of motion was >100° in 5 patients and 50°- 100° in 2 patients.Conclusion: The pedicled vascularized bone graft of the distal radius is an effective alternative for the treatment of recalcitrant ulnar nonunions. 

  • English

    IntroductionThe purpose of this study was to analyze the clinical and radiological outcomes of a series of patients treated with the pedicled distal radius vascularized bone graft (VBG) for recalcitrant ulnar nonunions.MethodsA retrospective study was perfomed. The inclusion criteria were patients with diaphyseal or proximal ulnar nonunions with bone defects smaller than 6 centimeters, at least three previous surgeries and a minimum follow-up of 2 years treated with pedicled VBG of the distal radius. The number of previous surgeries was recorded. The elbow and wrist range of motion, the comparative grip strength, the Visual Analogue Scale (VAS) for pain, the QuickDASH questionnaire and the Mayo Score for elbow were evaluated. ResultsSeven patients were included. The mean age was 42 years (range 26-64). The average number of previous surgeries was 4 (3-7). The mean follow-up was 21 months (range 24-36). All pseudoarthrosis consolidated. The Mayo score was good in 4 patients, excellent in 2 patients and moderate in one patient. The mean postoperative QuickDASH was 13 (0-29). The flexion-extension arch of the wrist was 81% of the contralateral. The elbow range of motion was > 100° in 5 patients and 50°- 100° in 2 patients.ConclusionThe pedicled vascularized bone graft of the distal radius is an effective alternative for the treatment of recalcitrant ulnar nonunions.