Complicaciones de la ostectomía proximal del peroné en pacientes con genu varo doloroso
Abstract
Introducción: En el proceder quirúrgico del tratamiento del genu varo doloroso, la osteotomía del peroné es un paso común que acompaña a la osteotomía valguizante de la tibia, con un porcentaje de complicaciones conocidas. Los autores del presente trabajo comenzaron a aplicar un nuevo enfoque en el tratamiento de esta afección, con la ostectomía del peroné, donde también se presentan complicaciones.Objetivo: Identificar las complicaciones en pacientes operados mediante ostectomía del peroné.
Métodos: Fueron evaluados 116 pacientes portadores de cambios degenerativos del compartimento interno de la rodilla; operados mediante ostectomía del peroné, durante el período de abril del 2016 a abril del 2018. Las complicaciones fueron recogidas desde el momento de la intervención quirúrgica, su evolución y tratamiento, a través del seguimiento por consulta externa.
Resultados: En los pacientes obesos se observó el mayor número de complicaciones (9), de ellas 4 referentes a neuropraxia de la rama profunda del nervio peroneo o fibular, 2 con hematomas de la herida y una con infección. Hubo 2 pacientes con linfangitis. Hubo 11 pacientes con 14 complicaciones (9,4 % de los intervenidos).
Conclusiones: Las complicaciones más importantes fueron neuropraxia de las ramas superficial y profunda del nervio peroneo, el hematoma e infección de la herida.
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References
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10. Zou G, Lan W, Zeng Y, Xie J, Chen S, Qiu Y. Early clinical effect of proximal fibular osteotomy on knee osteoarthritis. Biomedical Research. 2017;28(21):9291-4. Access: 08/04/2018. Available from: http://www.alliedacademies.org/articles/early-clinical-effect-of-proximal-fibular-osteotomy-on-knee-osteoarthritis-9248.html
11. Kai L, Zhi H, Cheng W, Fei M, Shuai Z, Lei H, et al. Combination of Proximal Fibulectomy with Arthroscopic Partial Meniscectomy for Medial Compartment Osteoarthritis Accompanied by Medial Meniscal Tear. J Clin Diag Res. Jan 2018;12(1):1-3. Access: 08/04/2018. Available from: https://www.researchgate.net/publication/322750964_Combination_of_Proximal_Fibulectomy_with_Arthroscopic_Partial_Meniscectomy_for_
Medial_Compartment_Osteoarthritis_Accompanied_by_Medial_Meniscal_Tear
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13. National Institutes of Health (NIH). The practical guide: identification, evaluative and treatment of overweight and obesity in adults. Bathesda: National Institutes of Health; 2000. Access: 23/05/2018. Available from: https://www.nhlbi.nih.gov/files/docs/guidelines/prctgd_c.pdf
14. Marciniak C. Fibular (Peroneal) Neuropathy Electrodiagnostic Features and Clinical Correlates. Phys Med Rehabil Clin N Am. 2013;24:121. Access: 23/02/2018. Available from: http://dx.doi.org/10.1016/j.pmr.2012.08.016
15. Ogbemudia O, Umebese P, Bafor A, Igbinovia E, Ogbemudia P. The Level of Fibula Osteotomy and Incidence of Peroneal Nerve Palsy in Proximal Tibial Osteotomy. J Surg Tech Case Report. Jan-Jun 2010;2(1):17-9. Access: 23/05/2018. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3214483/
2. Pancorbo Sandoval EA, Ceballos Mesa A Dr. Cs, Hernández Valera D, Quesada Pérez JA, Delgado Quiñones A, Sánchez Villanueva F. Ostectomía del peroné en el genu varo doloroso de rodilla. Resultados preliminares al año de operado. Rev Méd Electrón. ene-feb 2018;40(1):99-109. Acceso: 15/04/2018. Disponible en: http://www.revmedicaelectronica.sld.cu/index.php/rme/article/view/2487/3702
3. Mattei L, Lea S, Nicolaci G, Ferrero G, Marmotti A, Castoldi F. Closing wedge tibial osteotomy: is it an actual procedure nowadays? Ann Joint. 2017 June;2(30):1-11. Access: 23/05/2018. Available from: http://dx.doi.org/10.21037/aoj.2017.06.04
4. Tunggal JAW, Higgins GA, Waddell JP. Complications of closing wedge high tibial osteotomy. International Orthopaedics (SICOT). 2010;34:255-61. Access: 05/06/2018. Available from: https://www.researchgate.net/profile/Gordon_Higgins/publication/26312464_Complications_of_closing_wedge_high_tibial_osteotomy/links/55d78b
cf08aeb38e8a85b150/Complications-of-closing-wedge-high-tibial-osteotomy.pdf?origin=publication_detail
5. Kurosaka M, Tsumura N, Yoshiya S, Matsui N, Mizuno K. A new fibular osteotomy in association with high tibial osteotomy (a comparative study with conventional mid-third fibular osteotomy). International Orthopaedics (SICOT). 2000 Jun;24:227-30. Access: 06/06/2018. Available from: https://www.ncbi.nlm.nih.gov/pubmed/11081847
6. Duivenvoorden T, Van Diggele P, Reijman M, Bos P, Van Egmond J, et al. Adverse events and survival after closing‑ and opening‑wedge high tibial osteotomy: a comparative study of 412 patients. Knee Surg Sports Traumatol Arthrosc. Dec 2017;25:895-901. Access: 23/03/2018. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5332482/
7. Seo S, Kim O, Seo J, Kim D, Kim Y, Lee I. Complications and Short-Term Outcomes of Medial Opening Wedge High Tibial Osteotomy Using a Locking Plate for Medial Osteoarthritis of the Knee. Knee Surgery & Related Research. 2016 Dec;28(4):289-96. Access: 23/05/2018. Available from: https://doi.org/10.5792/ksrr.16.028
8. Wang TC, Bao QD, Duan WP, Zhang B, Wei XC. A short term clinical study of fibular osteotomy for knee osteoarthritis. China Journal of Orthopaedics. 2016 Sep;29(9):787-90. Access: 23/12/2017. Available from: https://www.ncbi.nlm.nih.gov/pubmed/29282945
9. Zhang YZ, Yang ZY,Li CX, Wang J, Shao DC, Hou ZY, et al. Medial compartment decompression by fibular osteotomy to treat medial compartment knee osteoarthritis: A Pilot Study. Orthopedics. 2015 Dec;38(12):1110-4. Access: 02/02/2018. Available from: https://www.ncbi.nlm.nih.gov/pubmed/26652332
10. Zou G, Lan W, Zeng Y, Xie J, Chen S, Qiu Y. Early clinical effect of proximal fibular osteotomy on knee osteoarthritis. Biomedical Research. 2017;28(21):9291-4. Access: 08/04/2018. Available from: http://www.alliedacademies.org/articles/early-clinical-effect-of-proximal-fibular-osteotomy-on-knee-osteoarthritis-9248.html
11. Kai L, Zhi H, Cheng W, Fei M, Shuai Z, Lei H, et al. Combination of Proximal Fibulectomy with Arthroscopic Partial Meniscectomy for Medial Compartment Osteoarthritis Accompanied by Medial Meniscal Tear. J Clin Diag Res. Jan 2018;12(1):1-3. Access: 08/04/2018. Available from: https://www.researchgate.net/publication/322750964_Combination_of_Proximal_Fibulectomy_with_Arthroscopic_Partial_Meniscectomy_for_
Medial_Compartment_Osteoarthritis_Accompanied_by_Medial_Meniscal_Tear
12. Cañete R, Guilhem D, Brito K. Consentimiento informado: algunas consideraciones actuales. Acta Bioethica. 2012;18(1):121-7. Acceso: 20/03/2018. Disponible en: https://scielo.conicyt.cl/pdf/abioeth/v18n1/art11.pdf
13. National Institutes of Health (NIH). The practical guide: identification, evaluative and treatment of overweight and obesity in adults. Bathesda: National Institutes of Health; 2000. Access: 23/05/2018. Available from: https://www.nhlbi.nih.gov/files/docs/guidelines/prctgd_c.pdf
14. Marciniak C. Fibular (Peroneal) Neuropathy Electrodiagnostic Features and Clinical Correlates. Phys Med Rehabil Clin N Am. 2013;24:121. Access: 23/02/2018. Available from: http://dx.doi.org/10.1016/j.pmr.2012.08.016
15. Ogbemudia O, Umebese P, Bafor A, Igbinovia E, Ogbemudia P. The Level of Fibula Osteotomy and Incidence of Peroneal Nerve Palsy in Proximal Tibial Osteotomy. J Surg Tech Case Report. Jan-Jun 2010;2(1):17-9. Access: 23/05/2018. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3214483/
Published
2018-11-09
How to Cite
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Pancorbo Sandoval EA, Hernández Valera D, Quesada Pérez JA, Delgado Quiñones A, Sánchez Villanueva F. Complicaciones de la ostectomía proximal del peroné en pacientes con genu varo doloroso. Rev Cubana Med Milit [Internet]. 2018 Nov. 9 [cited 2025 Mar. 14];47(4):451-9. Available from: https://revmedmilitar.sld.cu/index.php/mil/article/view/241
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