Estudo prospectivo e randomizado de pacientes com fraturas expostas da diáfise do fêmur submetidos a osteossíntese com placa e haste intramedular bloqueada a foco aberto

• Autor(a) principal: Ferracini, Antonio Marcos
• Data de Publicação: 2008
• Outros Autores: Faloppa, Flávio [UNIFESP], Daltro, Gildasio de Cerqueira, Crisóstomo Júnior, Dalton de Castro, Reis, Fernando Baldy dos [UNIFESP], Belloti, Joao Carlos [UNIFESP]
• Tipo de documento: Artigo
• Idioma: por
• Título da fonte: Repositório Institucional da UNIFESP
• dARK ID: ark:/48912/00130000199hh
• Texto Completo: http://dx.doi.org/10.1590/S1413-78522008000200008; http://repositorio.unifesp.br/handle/11600/4123
• topic: Fracture fixation intramedullary; Femoral fractures; Bone plates; Diaphyses; Fractures open; Fixação intramedular de fraturas; Fraturas do fêmur; Placas ósseas; Diáfises; Fraturas expostas

We assessed the complications and treatment outcomes in a prospective and randomized study of two osteosynthesis techniques in open femoral shaft fractures. Between January 2002 and April 2004, 40 patients with open fractures of the femoral shaft were assessed, with 20 being treated with open reamed intramedullary locked nail and 20 with plate. Twenty-six (65%) fractures were classified as Gustilo type -I open fractures; ten (25%) as type II and four (10%), as type IIIA. There were 21 blunt injuries and 19 gunshot injuries. Three patients were excluded from the final assessment. Complications were observed in 12 (32.4%) patients, 4 in the plate group and 8 in the nail group. Reamed intramedullary locked nail resulted in two deep infections (10%), two superficial infections (10%), and one nonunion (5%). With plate techniques, we had one deep infection associated to nonunion (5,8%) and one superficial infection (5.8%). Good and excellent outcomes were found in 28 fractures (75.7%), fair (7.5%) in three cases, and poor (15%) in six, according to Thorensen s criteria. In this study, the stabilization with plate results in lower complications rate when compared to the open intramedullary nail, although with no statistical significance.