Early postoperative complications of thoracolumbar fractures in patients with multiple trauma according to the surgical timing / Complicaciones postoperatoriass de fracturas toracolumbares en pacientes con traumatismo múltiple según el momento de la cirugía

Introduction and objetctives: Our objective was to compare the rate of complications in thoracolumbar fractures that occurred during the early postoperative period in patients with multiple high-energy trauma according to the time of surgery. As a secondary objective, to estimate which variables were associated with surgery before 72h. Material and methods: Retrospective analysis of a series of patients with thoracolumbar fractures and multiple associated injuries in other anatomical regions due to high energy trauma. Surgically treated in an occupational trauma referral center, by the same surgical team and during the period between January 2013 and December 2019. Results: We analyzed a sample of 40 patients (39 men and 1 woman). The rate of complications was independent of surgical delay (before and after 72h) (p=0.827). There were statistically significant differences between early and later surgery groups in the variables age, systolic blood pressure, initial SOFA score and presence of neurological damage (p=0.014; p=0.029; p=0.032; p=0.012). The overall surgical delay was correlated with the SOFA score (p=0.007). Conclusion: The rate of early postoperative complications did not show significant differences between the early and late surgery groups. We observed that the patients who had been operated before 72h from trauma were younger, had more association with neurological syntoms, presented higher blood pressure values and less physiological damage. Surgical delay was positively correlated with SOFA score on arrival.(AU)

Introducción y objetivos: Nuestro objetivo es comparar la tasa de complicaciones acontecidas durante el postoperatorio temprano de fracturas toracolumbares en pacientes con traumatismos múltiples de alta energía según el momento de la cirugía. Como objetivo secundario, estimar qué variables se asociaron el desarrollo de la cirugía antes de las 72h. Materiales y métodos: Análisis retrospectivo de una serie de pacientes con fracturas toracolumbares y múltiples lesiones asociadas en otras regiones anatómicas por traumatismo de alta energía. Tratados quirúrgicamente en un centro de derivación de trauma laboral, por el mismo equipo quirúrgico y durante el período comprendido entre enero de 2013 y diciembre de 2019. Resultados: Se incluyeron 40 pacientes (39 hombres y una mujer). La tasa de complicaciones tempranas fue independiente del momento de la cirugía (antes o después de las 72h) (p=0,827). Se presentaron diferencias estadísticamente significativas entre ambos grupos en las variables edad, presión arterial sistólica, puntuación SOFA inicial y presencia de daño neurológico (p=0,014; p=0,029; p=0,032; p=0,012). La demora quirúrgica global se correlacionó con el puntuación SOFA al ingreso (p=0,007). Conclusión: La tasa de complicaciones en el postoperatorio temprano de fracturas toracolumbares no mostró diferencias significativas entre los grupos de cirugía temprana y tardía. Los pacientes operados antes de las 72h del trauma fueron más jóvenes, presentaron valores más elevados de presión arterial, menor daño fisiológico y asociaron síntomas neurológicos con mayor frecuencia. La demora quirúrgica se correlacionó positivamente con la puntuación SOFA al ingreso.(AU)

Complicaciones posoperatorias de fracturas toracolumbares en pacientes con traumatismo múltiple según el momento de la cirugía / Early postoperative complications of thoracolumbar fractures in patients with multiple trauma according to the surgical timing

Introduction and objetctives: Our objective was to compare the rate of complications in thoracolumbar fractures that occurred during the early postoperative period in patients with multiple high-energy trauma according to the time of surgery. As a secondary objective, to estimate which variables were associated with surgery before 72h. Material and methods: Retrospective analysis of a series of patients with thoracolumbar fractures and multiple associated injuries in other anatomical regions due to high energy trauma. Surgically treated in an occupational trauma referral center, by the same surgical team and during the period between January 2013 and December 2019. Results: We analyzed a sample of 40 patients (39 men and 1 woman). The rate of complications was independent of surgical delay (before and after 72h) (p=0.827). There were statistically significant differences between early and later surgery groups in the variables age, systolic blood pressure, initial SOFA score and presence of neurological damage (p=0.014; p=0.029; p=0.032; p=0.012). The overall surgical delay was correlated with the SOFA score (p=0.007). Conclusion: The rate of early postoperative complications did not show significant differences between the early and late surgery groups. We observed that the patients who had been operated before 72h from trauma were younger, had more association with neurological syntoms, presented higher blood pressure values and less physiological damage. Surgical delay was positively correlated with SOFA score on arrival.(AU)

Introducción y objetivos: Nuestro objetivo es comparar la tasa de complicaciones acontecidas durante el postoperatorio temprano de fracturas toracolumbares en pacientes con traumatismos múltiples de alta energía según el momento de la cirugía. Como objetivo secundario, estimar qué variables se asociaron el desarrollo de la cirugía antes de las 72h. Materiales y métodos: Análisis retrospectivo de una serie de pacientes con fracturas toracolumbares y múltiples lesiones asociadas en otras regiones anatómicas por traumatismo de alta energía. Tratados quirúrgicamente en un centro de derivación de trauma laboral, por el mismo equipo quirúrgico y durante el período comprendido entre enero de 2013 y diciembre de 2019. Resultados: Se incluyeron 40 pacientes (39 hombres y una mujer). La tasa de complicaciones tempranas fue independiente del momento de la cirugía (antes o después de las 72h) (p=0,827). Se presentaron diferencias estadísticamente significativas entre ambos grupos en las variables edad, presión arterial sistólica, puntuación SOFA inicial y presencia de daño neurológico (p=0,014; p=0,029; p=0,032; p=0,012). La demora quirúrgica global se correlacionó con el puntuación SOFA al ingreso (p=0,007). Conclusión: La tasa de complicaciones en el postoperatorio temprano de fracturas toracolumbares no mostró diferencias significativas entre los grupos de cirugía temprana y tardía. Los pacientes operados antes de las 72h del trauma fueron más jóvenes, presentaron valores más elevados de presión arterial, menor daño fisiológico y asociaron síntomas neurológicos con mayor frecuencia. La demora quirúrgica se correlacionó positivamente con la puntuación SOFA al ingreso.(AU)

Early postoperative complications of thoracolumbar fractures in patients with multiple trauma according to the surgical timing. / Complicaciones posoperatorias de fracturas toracolumbares en pacientes con traumatismo múltiple según el momento de la cirugía.

INTRODUCTION AND OBJECTIVES: Our objective was to compare the rate of complications in thoracolumbar fractures that occurred during the early postoperative period in patients with multiple high-energy trauma according to the time of surgery. As a secondary objective, to estimate which variables were associated with surgery before 72 h. MATERIAL AND METHODS: Retrospective analysis of a series of patients with thoracolumbar fractures and multiple associated injuries in other anatomical regions due to high energy trauma. Surgically treated in an occupational trauma referral center, by the same surgical team and during the period between January 2013 and December 2019. RESULTS: We analyzed a sample of 40 patients (39 men and 1 woman). The rate of complications was independent of surgical delay (before and after 72 h) (p = 0.827). There were statistically significant differences between early and later surgery groups in the variables age, systolic blood pressure, initial SOFA score and presence of neurological damage (p = 0.014; p = 0.029; p = 0.032; p = 0.012). The overall surgical delay was correlated with the SOFA score (p = 0.007). CONCLUSION: The rate of early postoperative complications did not show significant differences between the early and late surgery groups. We observed that the patients who had been operated before 72 h from trauma were younger, had more association with neurological syntoms, presented higher blood pressure values and less physiological damage. Surgical delay was positively correlated with SOFA score on arrival.

Early postoperative complications of thoracolumbar fractures in patients with multiple trauma according to the surgical timing.

INTRODUCTION AND OBJETCTIVES: Our objective was to compare the rate of complications in thoracolumbar fractures that occurred during the early postoperative period in patients with multiple high-energy trauma according to the time of surgery. As a secondary objective, to estimate which variables were associated with surgery before 72h. MATERIAL AND METHODS: Retrospective analysis of a series of patients with thoracolumbar fractures and multiple associated injuries in other anatomical regions due to high energy trauma. Surgically treated in an occupational trauma referral center, by the same surgical team and during the period between January 2013 and December 2019. RESULTS: We analyzed a sample of 40 patients (39 men and 1 woman). The rate of complications was independent of surgical delay (before and after 72h) (p=0.827). There were statistically significant differences between early and later surgery groups in the variables age, systolic blood pressure, initial SOFA score and presence of neurological damage (p=0.014; p=0.029; p=0.032; p=0.012). The overall surgical delay was correlated with the SOFA score (p=0.007). CONCLUSION: The rate of early postoperative complications did not show significant differences between the early and late surgery groups. We observed that the patients who had been operated before 72h from trauma were younger, had more association with neurological syntoms, presented higher blood pressure values and less physiological damage. Surgical delay was positively correlated with SOFA score on arrival.

Resultados radiológicos y funcionales en fracturas de platillo tibial de alta energía / Radiological and functional results in high-energy tibial plate fractures

Resumen: Introducción: Las fracturas de platillo tibial por mecanismos de alta energía son lesiones graves que ocurren sobre una articulación de carga. Son difíciles de abordar, ya que además de afectar la estructura ósea de la pierna suelen tener lesiones de partes blandas asociadas. Objetivo: Evaluar los resultados radiológicos y funcionales de las fracturas de platillo tibial de alta energía con un mínimo seguimiento de un año. Material y métodos: Estudio retrospectivo, observacional y multicéntrico. Análisis de los resultados radiológicos y funcionales en el tratamiento de fracturas de platillo tibial de alta energía tratadas mediante reducción abierta y fijación interna (RAFI) entre 2014 y 2019. Resultados: 54 fracturas tratadas mediante RAFI. Seguimiento un año, 98.1% de consolidación en 13 semanas de promedio, 83.4% sin alteraciones del eje en plano coronal, 74% sin ensanchamiento articular postoperatorio. Escalas funcionales: Lysholm 82.1 puntos promedio y Oxford Knee Score (OKS) 39.5 puntos promedio. Conclusión: El rango de movilidad articular se redujo luego de una fractura de platillos tibiales de alta energía, pero con buenos resultados funcionales. Cuanto menor deseje y menor ensanchamiento radiográfico postoperatorio, se obtienen mejores resultados.

Abstract: Introduction: The tibial plateau fractures due to high-energy mechanisms are serious injuries that occur on a load bearing joint. These are difficult to approach because, also affect the bone structure of the leg, they usually have associated soft tissue injuries. Objective: To evaluate the radiological and functional results of high-energy tibial plateau fractures with a minimum follow-up of one year. Material and methods: Retrospective, observational and multicenter study. Analysis of radiological and functional outcomes in the treatment of high-energy tibial plateau fractures, treated by open reduction and internal fixation (ORIF) between 2014 and 2019. Results: 54 fractures treated by ORIF. Follow-up one year. 98.1% consolidation in 13 weeks on average. 83.4% without alterations of the axis in the coronal plane. 74% without postoperative joint widening. Functional scores: Lysholm 82.1 average points and Oxford Knee Score (OKS) 39.5 average points. Conclusion: The joint range of motion was reduced after a high-energy tibial plateau fracture, but with good functional results. The less off axis and less post-operative radiographic widening, the better results are obtained.

[Radiological and functional results in high-energy tibial plate fractures]. / Resultados radiológicos y funcionales en fracturas de platillo tibial de alta energía.

INTRODUCTION: The tibial plateau fractures due to high-energy mechanisms are serious injuries that occur on a load bearing joint. These are difficult to approach because, also affect the bone structure of the leg, they usually have associated soft tissue injuries. OBJECTIVE: To evaluate the radiological and functional results of high-energy tibial plateau fractures with a minimum follow-up of one year. MATERIAL AND METHODS: Retrospective, observational and multicenter study. Analysis of radiological and functional outcomes in the treatment of high-energy tibial plateau fractures, treated by open reduction and internal fixation (ORIF) between 2014 and 2019. RESULTS: 54 fractures treated by ORIF. Follow-up one year. 98.1% consolidation in 13 weeks on average. 83.4% without alterations of the axis in the coronal plane. 74% without postoperative joint widening. Functional scores: Lysholm 82.1 average points and Oxford Knee Score (OKS) 39.5 average points. CONCLUSION: The joint range of motion was reduced after a high-energy tibial plateau fracture, but with good functional results. The less off axis and less post-operative radiographic widening, the better results are obtained.

INTRODUCCIÓN: Las fracturas de platillo tibial por mecanismos de alta energía son lesiones graves que ocurren sobre una articulación de carga. Son difíciles de abordar, ya que además de afectar la estructura ósea de la pierna suelen tener lesiones de partes blandas asociadas. OBJETIVO: Evaluar los resultados radiológicos y funcionales de las fracturas de platillo tibial de alta energía con un mínimo seguimiento de un año. MATERIAL Y MÉTODOS: Estudio retrospectivo, observacional y multicéntrico. Análisis de los resultados radiológicos y funcionales en el tratamiento de fracturas de platillo tibial de alta energía tratadas mediante reducción abierta y fijación interna (RAFI) entre 2014 y 2019. RESULTADOS: 54 fracturas tratadas mediante RAFI. Seguimiento un año, 98.1% de consolidación en 13 semanas de promedio, 83.4% sin alteraciones del eje en plano coronal, 74% sin ensanchamiento articular postoperatorio. Escalas funcionales: Lysholm 82.1 puntos promedio y Oxford Knee Score (OKS) 39.5 puntos promedio. CONCLUSIÓN: El rango de movilidad articular se redujo luego de una fractura de platillos tibiales de alta energía, pero con buenos resultados funcionales. Cuanto menor deseje y menor ensanchamiento radiográfico postoperatorio, se obtienen mejores resultados.