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Fracturas epicondiles mediales tratadas con diversas técnicas de fijación: una serie de casos
Santosh D Ghoti1, Akshay D Punekar2, Jaideep Das1
1Department of Orthopaedics, Grant Government Medical College and Sir JJ Group of Hospitals, Mumbai, Maharashtra, India.
Journal of orthopaedic case reports
|February 11, 2026
Resumen
La fijación quirúrgica de las fracturas epicondiles mediales en pacientes pediátricos conduce a altas tasas de unión y excelentes resultados funcionales. Varios métodos de fijación, incluyendo K-cables y tornillos, son efectivos para las fracturas desplazadas o inestables.
Área de la Ciencia:
- La cirugía ortopédica es una cirugía ortopédica.
- La ortopedia pediátrica es una especialidad pediátrica.
- Traumatología en Traumatología.
Sus antecedentes:
- Las fracturas medianas del epicóndilo son comunes en los niños, a menudo vinculadas a dislocaciones del codo.
- Se debate el manejo de las fracturas desplazadas, con un tratamiento no quirúrgico que corre el riesgo de no ser sindicado.
- La fijación quirúrgica muestra tasas de unión significativamente mayores en comparación con los métodos no quirúrgicos.
Objetivo del estudio:
- Para presentar los resultados de cinco pacientes pediátricos con fracturas medianas del epicóndilo tratados con diversas técnicas de fijación quirúrgica.
- Para resaltar las consideraciones de gestión y los resultados funcionales asociados con los diferentes métodos de fijación.
Principales métodos:
- La reducción abierta y la fijación interna se realizaron en cinco pacientes (de 15 a 70 años) con fracturas agudas del epicóndilo medial.
- Los métodos de fijación incluyen alambres K, tornillos canulados, placas antideslizantes o combinaciones de los mismos.
- La inmovilización postoperatoria varió de 2 a 4 semanas, seguida de fisioterapia.
Principales resultados:
- Todas las fracturas lograron la unión en aproximadamente 12 semanas, con una excelente recuperación funcional y rango de movimiento.
- Las puntuaciones de Mayo Elbow y QuickDASH indicaron una discapacidad mínima y excelentes resultados funcionales.
- No se observaron no uniones, infecciones profundas, inestabilidad crónica o paradas de crecimiento.
Conclusiones:
- Varias estrategias de fijación quirúrgica pueden tratar eficazmente las fracturas medianas del epicóndilo, adaptadas al tamaño del fragmento y al patrón de lesión.
- La fijación rígida permite una movilización temprana y una unión confiable, mientras que los cables K son adecuados para fragmentos más pequeños.
- La fijación quirúrgica juiciosa promueve la unión, restaura la estabilidad y permite el retorno temprano a la actividad en fracturas desplazadas o inestables.
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