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Estudio biomecánico, clínico y económico del sistema de osteosíntesis de fracturas de rótula mediante tornillos canulados y obenque modificado

Fecha de lectura: 2024-02-12 Centro: | ID: 10486/713636

Autor/a: Sáez Martínez, David

Director/a: López-Oliva Muñoz, Felipe ; Calvo Crespo, Emilio

Resumen

Tesis Doctoral inédita leída en la Universidad Autónoma de Madrid, Facultad de Medicina, Departamento de Cirugía. Fecha de Lectura: 12-02-2024 (General); Patella fractures account for 1% of skeletal injuries. Given the crucial role this bone plays in knee function, effective treatment of these fractures is key to avoid sequelae. The most accepted surgical treatment today (use of Kirschner wire and cerclage wire) offers good results, but it is not exempt from complications, such as intolerance to this material, so a significant percentage of patients require a second surgery to remove it. The objective of this work is to compare the behavior of a surgical alternative that consists of the use of screws and cerclage cable, at three levels: biomechanical in a study carried out in 3-D printed patella models, clinical in a consecutive series of patients surgically treated at Fundación Jimenez Diaz Hospital in Madrid and economic comparing the costs of both assemblies. In the biomechanical study, the specimens were subjected to tensile and distraction tests. The results obtained in both tests show that samples using cannulated screws and cable provide stiffer unions with higher resistances than kirschner wires and cerclage wire. In the clinical study, the group of patients operated with screws and cable was compared with a retrospective group in which the kischners wires and cerclage wire system was used. The clinical results of the screw group were good in terms of pain, strength and knee function, presenting a lower percentage of complications than the control group. At an economic level, the screws and cable suppose, in each patient, a direct extra cost per implant of more than 248 euros, being debatable if this extra cost is compensated by the advantages described above. For all these reasons, we consider the surgical alternative with screws and cable to be considered for the treatment of patella fractures (Summary)

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