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Traumatología y Ortopedia
HGA IGSS

 Hueso sesamoideo más grande
 Cartílago más grueso (5mm)
 1 % de todas las fracturas
Fx Patela


Rx


Clasificación



 Conservador
 Separación menor de 3 mm
 Incongruencia articular menor de 2 mm
 Cilindro de yeso por 4-6 semanas
Tratamiento

 Banda de Tensión
 Tornillos Interfragmentarios
 Implantes biodegradables
 Hemipatelectomía
 Patelectomía
Tx Qx




Banda de Tensión












 Ejercicios isométricos para Cuadriceps
 Apoyo desde el primer día
 Extracción del Implante
 Mínimo 1 año
Post Op

Tornillos

Cerclaje

Hemipatelectomía


Patelectomía Total


 Indications
 Small distal fragment

 Advantages (compared to plate fixation)
 Less dissection necessary
 Less expensive

 Disadvantages
 Soft tissue irritation
 Risk of backing out of the K-wires
 Wire breakage with poor twisting technique


















 Aftercare
 A bulky compression dressing and a lower leg backslab,
or a splint, are applied, and the limb is kept elevated in
order to avoid swelling and to decrease pain.
 In anatomically reconstructed, stable malleolar fractures,
early active exercises and light partial weight bearing are
encouraged after day one. In osteoporotic bone weight
bearing should be postponed.
 X-ray evaluation is made after 1 week and then monthly
until full healing has occurred. Progressive weight
bearing is recommended as tolerated.

 Indication
 Intraarticular, simple transverse fracture of the olecranon

 Contraindication
 Oblique or multifragmentary fracture of the olecranon

 Advantages
 Dynamic fracture compression
 Easy technique
 Inexpensive implant

 Disadvantages
 Risk of joint penetration with K-wires
 Risk of backing-up of K-wires
 Skin irritation
 Risk of fragmentation in osteoporotic bone

















AO 2007
Campbell 11ª ed

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