Efeitos da terapia de fotobiomodulação na consolidação de fraturas atípicas do fêmur em mulheres idosas

• Autor(a) principal: Oksman, Daniel
• Data de Publicação: 2020
• Tipo de documento: Tese
• Idioma: por
• Título da fonte: Biblioteca Digital de Teses e Dissertações da Uninove
• Texto Completo: http://bibliotecatede.uninove.br/handle/tede/2753
• topic: cirurgia ortopédica; Terapia de Fotobiomodulação / TFBM; laserterapia; fraturas atípicas; consolidação; dor; cicatrização; orthopedic surgery; Low Level Laser Therapy / LLLT; laser; atypical fractures; consolidation; pain; healing; CIENCIAS DA SAUDE

Atypical Femoral Fractures (AFFs) are described as caused by minimal trauma, in the subtrochanteric or diaphyseal region of the femur, often associated with prolonged use of Bisphosphonates. Orthopedic surgery for bone fixation is the most recommended, however, complications, such as the high rates of delayed or failed bone consolidation, or even failure of the synthesis with implant failure, are more frequent than in typical fractures. The present study aims at the application of Transoperative Intramedullary Bone Photobiomodulation Therapy (PBMT), using Long Sterile Fiber Optics. It is a pilot, clinical-surgical, comparative study with control cases, longitudinal, with eleven female patients, between 60 and 90 years old, diagnosed with FFAs, distributed in two groups: Group treated with intraoperative intramedullary; and Control Group, individuals submitted to surgery only. Prototype Therapy Laser Plus equipment (DMC, São Carlos / SP - Brazil) was used. The application of PBMT through sterile polymer long fiber, with emission by laser diode (continuous mode), wavelength λ of 638 ± 10 nm, power of 200 mW, energy of 3.2 J red, for 16 seconds, in 2 points of the fracture ends. The irradiance is 25.47 W / cm², with energy density or fluency of 407.64 J / cm2, in direct contact with the fracture. In this study, we did not observe differences between the groups regarding the evolution of healing, skin complications, beginning of partial and total load, use of analgesics, length of stay, time and objective criteria for bone healing (modified RUST score) and laboratory tests . Although we did not observe statistically significant differences between the groups, in relation to the RUSTm score, we noticed that there was a tendency to increase the score in the second assessment of the group treated with PBMT. However, the small sample size was insufficient to confirm any inferences in this regard. From these results, it appears that the use of PBMT in this pilot study did not have an additive effect to surgery in the treatment of AFFs. Future studies should be conducted for new assessments of the relationship between PBMT and bone repair.