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CC BY-NC-ND 4.0 · Revista Chilena de Ortopedia y Traumatología 2024; 65(01): e40-e46
DOI: 10.1055/s-0044-1786541
Artículo de Revisión | Review Article

Tratamiento de la contractura en flexión de rodilla en parálisis cerebral

Artikel in mehreren Sprachen: español | English
Gino Martinez 
1   Clínica Universidad de los Andes, Las Condes, Santiago, Chile
,
Javier Segovia
2   Instituto Teletón, Santiago, Chile
,
Martín Cariola
1   Clínica Universidad de los Andes, Las Condes, Santiago, Chile
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Resumen

La extensión completa de la rodilla es esencial para la marcha. Los pacientes con parálisis cerebral infantil con frecuencia pueden tener déficit de extensión de distinta magnitud, lo que compromete la marcha e incluso la bipedestación. El tratamiento de la contractura en flexión de rodilla parte por tratar la espasticidad de los músculos comprometidos y con fisioterapia. Cuando el flexo es estructurado, el tratamiento es quirúrgico mediante distintas técnicas, dependiendo de la magnitud de la contractura y de la edad del paciente. Las técnicas sobre partes blandas incluyen alargamientos funcionales de isquiotibiales y transferencias musculares. Cuando la contractura es capsular, es preferible realizar cirugía ósea, la cual extiende el fémur proximal, ya sea en forma progresiva, mediante fisiodesis anterior en pacientes pediátricos, o en forma aguda, mediante osteotomía extensora del fémur distal. Con frecuencia existe una patela alta, la cual hay que corregir en el mismo acto quirúrgico para mantener la eficiencia del aparato extensor.

Palabras clave

parálisis cerebral - rodilla - contractura - marcha - diplejía - isquiotibiales - patela alta


Publikationsverlauf

Eingereicht: 14. November 2023

Angenommen: 01. April 2024

Artikel online veröffentlicht:
03. Mai 2024

© 2024. Sociedad Chilena de Ortopedia y 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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