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PubMed Central
Article . 2021
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Revista Brasileira de Ortopedia
Article . 2021
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Minimally Invasive Osteosynthesis of Transtrochanteric Fractures with Dynamic Hip Screw (DHS).

Authors: Guimarães, José André Melo Barreto; Machado, Marcos Cezar Feitosa de Paula; Galvão, Pauliana Valéria Machado; Lima, Jéssika Cristina de; Gomes, Lucas dos Santos; Guimarães, Pedro Ferreira Barreto;

Minimally Invasive Osteosynthesis of Transtrochanteric Fractures with Dynamic Hip Screw (DHS).

Abstract

Resumo O método aqui apresentado consiste em técnica cirúrgica minimamente invasiva para osteossíntese de fraturas transtrocantéricas com Dynamic Hip Screw (DHS) 135º. Esta técnica é indicada no tratamento de fraturas 31-A1 e 31-A2 (Classificação Arbeitsgemeinschaft für Osteosynthesefragen - AO) que cumpram os pré-requisitos exigidos para o uso do DHS. A cirurgia é realizada, preferencialmente, antes de 48 horas após o acometimento da fratura. Com a utilização do mesmo instrumental da técnica cirúrgica tradicional e auxílio do arco-C, realiza-se redução incruenta da fratura e implantação do DHS por incisão cirúrgica com 2 cm, através de dissecção dos tecidos subjacentes, com mínimo sangramento e agressão às partes moles. No pós-operatório imediato, o paciente é estimulado ao ortostatismo e à deambulação com carga total, o que antecipa a alta hospitalar e favorece a reabilitação funcional precoce. O retorno ambulatorial é agendado com 2, 6, 12 e 24 semanas de pós-operatório, com avaliação radiográfica, a fim de avaliar a consolidação da fratura.

Abstract The method presented here consists of a minimally invasive surgical technique for osteosynthesis of transtrochanteric fractures with Dynamic Hip Screw (DHS) 135º. It is indicated in the treatment of 31-A1 and 31-A2 fractures (Arbeitsgemeinschaft für Osteosynthesefragen Classification - AO) that meet the prerequisites required for using DHS. The surgery is performed, preferably, before 48 hours after the fracture. With the use of the same instruments as the traditional surgical technique and the aid of the C-arm, a closed reduction of the fracture and implantation of the DHS is performed by a 2-cm surgical incision, through dissection of the underlying tissues, with minimal bleeding and damage to the soft parts. In the immediate postoperative period, the patient is encouraged to orthostatism and walk with full load, which anticipates hospital discharge and favors early functional rehabilitation. Outpatient return is scheduled at 2, 6, 12 and 24 weeks postoperatively, with radiographic evaluation to assess fracture healing.

Keywords

fraturas do quadril, Orthopedic surgery, hip fractures, femoral fractures, R, Medicine, fraturas do fêmur, procedimentos cirúrgicos minimamente invasivos, RD701-811, minimally invasive surgical procedures

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
6
Top 10%
Average
Top 10%
Green
gold