Abstract

TABOADELA, Fernando J.; MANTELLA GOROSITO, Daniela; BORRE, Florencia  and  NARVAEZ, Fabián. Epidemiología y manejo de las fracturas de fémur por arma de fuego. Nuestra experiencia. Rev. Asoc. Argent. Ortop. Traumatol. [online]. 2023, vol.88, n.3, pp.275-285. ISSN 1852-7434.  http://dx.doi.org/https://doi.org/10.15417/issn.1852-7434.2023.88.3.1691.

Introduction: Gunshot injuries affect the civilian population with increasing frequency. 57% of the patients present bone compromise, with femur fractures being the most common. The lack of a standardized protocol for its treatment prompted the development of this study. Materials and Methods: A retrospective, descriptive study was conducted. Patients with femur fractures caused by firearms between 2019 and 2021 were included. The anatomical region, classification, treatment, and complications were analyzed. Results: Of a total of 35 patients, 25 (71.43%) had complete fractures and 10 (28.57%) had incomplete fractures. The distal femur was the most affected area (48.57%), according to the location. Reduction and osteosynthesis were used to treat 26 patients, with 9 being treated noninvasively. Conclusions: We used a simple classification system to categorize fractures as complete or incomplete. All complete ones were deemed unstable regardless of location, and all incomplete ones were deemed stable, with the exception of those in the proximal third, for which prophylactic fixation is advised. Incomplete shaft fractures can be treated noninvasively, but complete shaft fractures require reduction and osteosynthesis. For zone I and II fractures, the intramedullary nail is the preferred treatment. In zone III, an individualized analysis is required for each pattern. We believe that the initial management and the correct selection of the implant according to the affected area are decisive factors in achieving satisfactory outcomes.

Keywords : Firearm; femur fracture; epidemiology; classification.

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