Pseudoartrosis como complicación en pacientes diagnosticados con fractura de tibia, Hospital Alcívar de Guayaquil, enero 2019 a diciembre 2023.

Abstract

Introduction: The objective of this research is to describe the clinical characteristics of Pseudarthrosis as a complication of Osteosynthesis of tibia fractures. For this study, a quantitative, retrospective and cross-sectional model was used. Materials and methods: The study population was obtained at the Alcívar Hospital in Guayaquil and consisted of 85 patients with tibia fracture, of which 27 presented pseudoarthrosis. Data collection was done from the medical records obtained from the Statistics Department of said hospital. Results: Regarding the age distribution between 24 and 36 years, 10 cases were found (37.04%), between 37 and 49 years, 12 cases were recorded (44.44), between 50 and 62 years, 3 cases were found (11.11%), between 63 and 75 years there were 0 cases (0%) and between 76 and 88 years there were 2 cases (7.41%). Regarding orthopedic material, 2 patients (10%) used intramedullary nails in diaphyseal fractures, 18 patients (90%) used osteosynthesis plates in diaphyseal fractures, and no patients (0%) used intramedullary nails plus diaphyseal plates. In epiphyseal fractures, intramedullary nails were used in 2 patients (28.57%), osteosynthesis plates in 4 patients (57.14%), and intramedullary nails plus epiphyseal plates in 1 patient (14.29%). Regarding the effectiveness of orthopedic material, pseudoarthrosis occurred during the osteosynthesis process with intramedullary nails in 4 cases (14.81%), with osteosynthesis plates in 22 cases (81.48%), and with intramedullary nails plus osteosynthesis plates in 1 case (3.70%). Regarding risk factors, we found 7 diabetics (25.93%), 8 cases of hypertension (29.63%), 1 case of arthritis (3.70%), 5 cases of obesity (18.52%), 1 case of lymphoma (3.70%), and 5 cases without other conditions (18.52%). In the mean surgical time in subjects who developed pseudoarthrosis, we found 27 cases with an average of 190 minutes and without pseudoarthrosis 58 cases with an average of 157 minutes. Conclusions: The age group that developed more pseudoarthrosis was between 37 and 49 years. Regarding orthopedic material in diaphyseal fractures, there was a greater number of pseudoarthrosis in those who used osteosynthesis plates. Regarding orthopedic material in epiphysis fractures, there was a greater number of pseudoarthrosis in those who used osteosynthesis plates. Of the comorbidities, those most frequently associated with pseudoarthrosis were diabetes and arterial hypertension. Regarding the mean surgical time, those who developed pseudoarthrosis were those whose surgery was longer. Recommendations: People with tibial fractures should be treated quickly and effectively, based on a detailed clinical history, which includes work activity, habits and comorbidities, because this results in a lower development of pseudoarthrosis.