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CC BY-NC-ND 4.0 · Rev Bras Ortop (Sao Paulo)
DOI: 10.1055/s-0044-1779320
Artigo Original | Original Article

Fraturas periprotéticas do fêmur no peroperatório das artroplastias totais primárias do quadril[*]

Article in several languages: português | English
Conrado Auer Trentini 
1   Ortopedia e Traumatologia, Hospital Universitário Regional dos Campos Gerais, Ponta Grossa, PR, Brasil
2   Ortopedia e Traumatologia, Hospital Universitário Cajuru, Curitiba, PR, Brasil
,
Marcela de Andrade Balsano 
1   Ortopedia e Traumatologia, Hospital Universitário Regional dos Campos Gerais, Ponta Grossa, PR, Brasil
,
Mark Deeke 
2   Ortopedia e Traumatologia, Hospital Universitário Cajuru, Curitiba, PR, Brasil
,
Francisco José Zaniolo 
2   Ortopedia e Traumatologia, Hospital Universitário Cajuru, Curitiba, PR, Brasil
› Author Affiliations Suporte Financeiro Não houve suporte financeiro de fontes públicas, comerciais, ou sem fins lucrativos.
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Resumo

Objetivo Determinar a incidência de fraturas periprotéticas do fêmur no peroperatório em artroplastias primárias do quadril e correlacioná-las com os fatores de risco inerentes aos pacientes, implantes e ao diagnóstico de coxoartrose e/ou fratura do colo do fêmur.

Métodos Estudo transversal, com análise retrospectiva de prontuários e exames de imagem de arquivos dos pacientes operados entre 2014 e 2019. As variáveis analisadas seguiram o proposto pela literatura mundial, sendo elas: idade, sexo, índice de Dorr, indicação cirúrgica, classificação de Vancouver, local, tipo de fixação (cimentada ou não cimentada), modelo do implante utilizado, diagnóstico intraoperatório e tratamento instituído. Todas as cirurgias utilizaram a mesma via de acesso póstero-lateral e foram realizadas pelo mesmo grupo de cirurgiões.

Resultados Dentro da amostra de 2.217 artroplastias (2.154 pacientes) foram identificadas 12 fraturas (0,56%) em 12 pacientes. A amostra foi composta por 8 pacientes do gênero feminino e 4 do gênero masculino, com média de idade de 62,53 anos. Em todos os casos diagnosticados foram adicionadas cerclagens de proteção ao nível do pequeno trocanter e ou do grande trocanter e em 3 casos houve mudança de hastes femorais não cimentadas para cimentadas e apenas 1 evoluiu com necessidade de revisão.

Conclusão A análise dos dados permite afirmar que o risco de fratura periprotética intraoperatória é maior em mulheres e com o uso de hastes não cimentadas. A ocorrência destas neste estudo teve taxa inferior a 1%.

Palavras-chave

artroplastia - complicações intraoperatórias - fraturas do quadril - fraturas periprotéticas

* Trabalho desenvolvido no Hospital Universitário Cajuru, Curitiba, PR, Brasil.




Publication History

Received: 24 October 2022

Accepted: 10 August 2023

Article published online:
31 January 2024

© 2024. Sociedade Brasileira de Ortopedia e Traumatologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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