Comparação do tratamento cirúrgico e conservador para fratura de terço médio da clavícula em adultos
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Tipo
TCC
Data de publicação
2023-11-27
Periódico
Citações (Scopus)
Autores
Barros, Caio Eduardo Faidiga de
Rocha, Leonardo Siana
Rocha, Leonardo Siana
Orientador
Zini, Cassio
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Introdução: A fratura de clavícula é uma das fraturas ósseas mais comuns, sendo que a região mais acometida é o terço médio do órgão. No passado, fraturas de terço médio da clavícula eram tratados quase sempre de forma conservadora, porém o tratamento cirúrgico tem se popularizado. Todavia, qual a melhor modalidade de tratamento é um tema controverso. Portanto, mais estudos são necessários para determinar a melhor forma de tratamento. Objetivo: Comparar a presença da consolidação e de complicações entre o tratamento cirúrgico e o conservador para a fratura de terço médio da clavícula. Métodos: O estudo foi retrospectivo, observacional, transversal e individuado, realizado a partir de análise de 88 prontuários de pacientes do Hospital Universitário Evangélico Mackenzie (HUEM). Foram coletados, dos prontuários, dados sobre o tempo de consolidação das fraturas, bem como de complicações do tratamento. Em seguida, foram feitos testes estatísticos para comparar o tratamento conservador com o cirúrgico. Resultados: O retardo de consolidação esteve presente em 5 dos 45 pacientes do grupo de tratamento conservador, enquanto nenhum dos 43 pacientes tratados cirurgicamente apresentou a complicação, diferença estatisticamente significativa. Não foram achadas diferenças estatisticamente significativas na ocorrência de pseudartrose, defeito estético, desalinhamento, dor residual e perda funcional. Conclusão: Não foram encontradas diferenças relevantes entre o resultado do tratamento cirúrgico e conservador, exceto na ocorrência de retardo de consolidação, na qual o tratamento cirúrgico ficou em vantagem.
Introduction: One of the most commonly fractured bones is the clavicle, from which the midshaft is the most frequent fracture site. Historically, midshaft clavicle fractures were almost always treated conservatively, however, recently, surgery has been getting more popular. That said, which of the two yields better results is controversial. Thus, more studies are necessary to determine the best form of treatment. Objective: To compare surgical and conservative treatment for midshaft clavicle fractures in terms of the occurrence of consolidation and complications following treatment. Methods: This study was retrospective, observational and cross-sectional, conducted by analyzing 88 medical records of patients from Hospital Universitário Evangélico Mackenzie (HUEM). Information on fracture consolidation time and treatment complications were collected from these medical records. Subsequently, statistical tests were performed to compare conservative treatment with surgical treatment. Results: Delayed union was present in 5 out of 45 patients treated conservatively and none from the 43 patients treated surgically, which was a statistically significant finding. However, no relevant discrepancies were found in nonunion, poor cosmetic appearance, misalignment, poor functional outcome and residual pain rates. Conclusion: No relevant differences were found between surgical and conservative treatment results other than a lower delayed union rate in the surgically treated group.
Introduction: One of the most commonly fractured bones is the clavicle, from which the midshaft is the most frequent fracture site. Historically, midshaft clavicle fractures were almost always treated conservatively, however, recently, surgery has been getting more popular. That said, which of the two yields better results is controversial. Thus, more studies are necessary to determine the best form of treatment. Objective: To compare surgical and conservative treatment for midshaft clavicle fractures in terms of the occurrence of consolidation and complications following treatment. Methods: This study was retrospective, observational and cross-sectional, conducted by analyzing 88 medical records of patients from Hospital Universitário Evangélico Mackenzie (HUEM). Information on fracture consolidation time and treatment complications were collected from these medical records. Subsequently, statistical tests were performed to compare conservative treatment with surgical treatment. Results: Delayed union was present in 5 out of 45 patients treated conservatively and none from the 43 patients treated surgically, which was a statistically significant finding. However, no relevant discrepancies were found in nonunion, poor cosmetic appearance, misalignment, poor functional outcome and residual pain rates. Conclusion: No relevant differences were found between surgical and conservative treatment results other than a lower delayed union rate in the surgically treated group.
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Palavras-chave
fraturas , clavícula , fixação interna de fraturas , tratamento conservador , fractures , clavicle , internal fixation , conservative treatment