We performed a retrospective analysis of 12 type III open hand fractures in seven patients with segmental bone loss and associated soft tissue injuries to determine the effectiveness of immediate autologous corticocancellous bone grafting. Radical débridement and fracture fixation were performed prior to bone grafting. Results were interpreted according to clinical and radiologic time of bony healing, rate of infection, time to return to regular work duty, grip strength, rate of complications and range of motion. The final union rate was 92%, with a mean time to bony union of 18 weeks. The infection rate was 0%. The mean time to return to regular work duty, including recovery time after secondary surgeries, was 5 months and 21 days. All patients returned to their pre-injury employment. The mean total active motion of the combined metacarpophalangeal proximal interphalangeal and distal interphalangeal joints in bone-grafted digits was 178 +/- 53 degrees at final follow-up.
Los espirales de embolización (coils o microcoils) son los agentes más comúnmente usados, con un éxito técnico reportado en aproximadamente el 81-100 % de los casos. Los espirales o coils se encuentran disponibles en una amplia variedad de configuraciones y tamaños, lo que permite acomodarse a vasos de distintos calibres; además, por su buena radiopacidad, tienen la ventaja de ser liberados con precisión. Los espirales o coils son el análogo de una ligadura arterial quirúrgica, debido a que producen una oclusión mecánica por su posicionamiento en el lumen vascular, lo que disminuye el flujo sanguíneo, y sus fibras sintéticas tienen un efecto trombogénico adicional.
Caso: presentamos cuatro casos del Hospital Universitario Fundación Santa Fe de pacientes con várices gástricas tratadas satisfactoriamente con embolización transcatéter con coils, los cuales tuvieron un buen resultado técnico; además presentamos una revisión de la literatura.
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