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TERAPIA ULTRASONICA Y CONSOLIDACION DE LAS FRACTURAS

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Desde la perspectiva de la sociedad, el tratamiento incruento de las fracturas tibiales de baja energía asociado con ultrasonido de baja intensidad, podría ser económicamente beneficioso.
busse9.jpg Autor:
Busse, jason w
Columnista Experto de SIIC

Institución:
Department of Clinical Epidemiology and Biostatistics McMaster Health Sciences Centre Ontario, Canada

Artículos publicados por Busse, jason w
Coautores
Mohit Bhandari, MD, MSc, FRCSC*  Abhaya V. Kulkarni, MD, PhD, FRCSC** 
Department of Clinical Epidemiology and Biostatistics and Division of Surgery, McMaster University, Hamilton, Canada*
Division of Population Health Sciences, Hospital for Sick Children, Toronto, Canada**
Recepción del artículo
13 de Septiembre, 2004 		Aprobación
27 de Septiembre, 2004
Primera edición
8 de Abril, 2005 		Segunda edición, ampliada y corregida
7 de Junio, 2021

TERAPIA ULTRASONICA Y CONSOLIDACION DE LAS FRACTURAS

Resumen
La relevancia que tiene un tratamiento con pulsos de ultrasonido de baja intensidad para la consolidación de las fracturas es controvertida. Esta revisión resume la investigación de los autores acerca de la terapia ultrasónica en el manejo de las fracturas. Nuestra encuesta de las creencias y las conductas de los cirujanos ortopedistas y de los estudiantes avanzados de fisioterapia encontró que la terapia ultrasónica es utilizada rara vez, debido fundamentalmente a que es vista como carente de pruebas en cuanto a sus beneficios y a que no es fácilmente accesible. Existen datos sugestivos tomados de ensayos aleatorios de que el ultrasonido de baja intensidad podría reducir considerablemente el tiempo de consolidación de las fracturas, particularmente en el caso de aquellas tratadas incruentamente. Los beneficios del ultrasonido aplicado a las fracturas tratadas quirúrgicamente son aún inciertos. Nuestro análisis económico sugiere que, tanto desde la perspectiva gubernamental como desde la social, el enclavado endomedular fresado es el tratamiento de elección para las fracturas diafisiarias de la tibia, tanto cerradas como expuestas tipo I; sin embargo, existen además hechos indicativos de que desde la perspectiva de la sociedad, el tratamiento de las fracturas de la tibia de baja intensidad con reducción incruenta e inmovilización con yeso, en combinación con terapia ultrasónica, podría también ser una intervención económicamente beneficiosa. Se necesitan ensayos más grandes para dilucidar al papel que la terapia ultrasónica tiene en la consolidación de las fracturas.

Palabras clave
Ultrasonido, consolidación de las fracturas, rentabilidad, enyesado, enclavado endomedular


Artículo completo
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THERAPEUTIC ULTRASOUND AND FRACTURE HEALING

Abstract
The impact of low intensity, pulsed ultrasound on fracture healing is controversial. This review summarizes the authors’ research on therapeutic ultrasound in fracture management. Our survey of orthopaedic surgeons and senior physiotherapy students found that use of therapeutic ultrasound is rare, due primarily to a perceived lack of evidence and lack of availability. There is evidence from randomized trials that low intensity ultrasound may significantly reduce the time to fracture healing, particularity in those fractures treated non-operatively. The benefit of ultrasound following operatively-managed fractures remains uncertain. Our economic analysis suggests that, from both governmental and societal perspectives, reamed intramedullary nailing is the treatment of choice for closed and open grade I tibial shaft fractures; however, there is evidence from a societal perspective that treatment of low energy tibial fractures with therapeutic ultrasound and casting may also be an economically-sound intervention. Larger trials are needed to resolve the role of therapeutic ultrasound in fracture healing.

Key words
Ultrasonics, fracture healing, economics, plaster cast, intramedullary nailing


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Especialidades
Principal: Ortopedia y Traumatología
Relacionadas: Medicina Interna



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Busse, Jason W.
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Agradecimientos: Agradecemos al Dr. Wolfram Bosenberg por la traducción de una comunicación publicada en Alemán.23
Bibliografía del artículo
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Clasificado en
Artículos originales>
Expertos del Mundo

Especialidad principal:
Ortopedia y Traumatología


Relacionadas:
Medicina Interna
 
 
 
 
 
 
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