Evaluación de las características clínicas y funcionales en los pacientes con lesiones de flexores en zona II, que se intervinieron mediante reconstrucción de la polea A4 utilizando una bandeleta lateral de flexor digitorum superficialis en el Hospital Militar Central en el año 2012 y 2013
Assessment of the clinical and functional in patients with injuries flexor zone II, by reconstruction of using a lateral sling of flexor digitorum superficialis for A4 pulley in Hospital Militar Central since 2012 to 2013
Citación
Fecha
2014-01-222013-10-24
Autor
Cabrera Chicangana, Fernando Andrés
Título obtenido
Especialista en Cirugía Plástica, Reconstructiva y Estética
Publicador
Universidad Militar Nueva Granada
Palabras claves
; biomecanica; cirugia de las articulaciones; tendones
Metadatos
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Resumen
La función del sistema fibroóseo de poleas es mantener a los tendones flexores cerca de las falanges subyacentes para evitar la deformidad en cuerda de arco (bowstringing) durante la flexión de los dedos y para maximizar el arco de flexión, lo cual es indispensable para realizar la función de agarre de manera adecuada.1,2,3
En nuestro medio, las lesiones tendinosas representan un lesión común, no solo secundarias a violencia sino también a accidentes domésticos y del tipo laboral. Asimismo, la intrincada y compleja anatomía del sistema de poleas, hace que su reconstrucción sea un reto para el Cirujano de Mano, ya que si no se realiza una reparación lo más cercano al estado basal, el paciente quedará con una limitación funcional para la prehensión, tendrá deformidades por contractura articular e inclusive presentará dolor neuropático.
Fibro-osseous system function is to keep the pulley flexor tendons close to the underlying phalanges to prevent deformity bowstring (bowstringing) during flexion of the fingers and for maximizing the range of flexion, which is essential for the gripping function.
In our environment, tendon injuries are a common injury, not only violence but also secondary to domestic accidents and occupational type. Also, the intricate and complex pulley system anatomy makes its reconstruction is a challenge for the hand surgeon, because if a repair is not performed as close to baseline, the patient left with a functional limitation prehension , will have joint contracture deformities and even present neuropathic pain.
Complex injuries of the hand and especially the flexor tendon injuries , are included within the most common and disabling in our environment hand be an extension of ourselves to the outside world , this is affected in large numbers of situations traumatic pathology or infectious type which leads to loss of employment potential and a decrease in the quality of life of our patients. The flexor tendon injuries are included in their most frequent and important upper limb pathology .. Repair with autografts or synthetic materials is done with a transverse vector reconstruction , however to avoid morbidity tendons using other areas can use a shock absorbing superficialis flexor , and a vector without detachment distal oblique , which facilitates the surgical technique and reduces the use of sutures that can generate greater foreign body reaction and adhesions . There are no studies comparing the oblique reconstruction technique without detachment of the superficial flexor tendon reconstruction technique.