Cerclajes o tornillos tipo poller como ayuda a la reducción y estabilización del enclavado retrógrado en fracturas del fémur distal. Técnica y comparación sobre una breve serie de casos.

Abstract

Retrograde nailing is widely accepted in the management of fractures of the distal femur. The mechanical characteristics of the nail and the distal femur make it difficult to achieve proper alignment, so there are several methods to improve reduction and stability. In this retrospective, single-center study, the use of cerclages or poller screws defined two groups of patients, with one-year follow-up. We included 33 patients, predominating elderly women. Cerclages were used in 22 and poller screws in 11. Cerclages predominated in spiroid fractures (16/22) and yielded better sagittal alignments (malalignment 0.6º vs. 2.6º for poller; p<0.01). We found no differences in bone healing times, bleeding or complications. Cerclages and poller are useful in combination with femoral retrograde nails. Cerclages are especially helpful in spiroid fractures, which are frequent in fragile population.