Fracturas del platillo tibial con hundimiento articular. Comparación entre reconstrucción con injertos óseos y sustitutos sintéticos: Revisión bibliográfica sistematizada

Renzo Fernández; Juan Del Castillo

doi:10.29193/RMU.39.1.9

Authors

Renzo Fernández Universidad de la República, Facultad de Medicina, Clínica de Traumatología y Ortopedia, Residente. Doctor en Medicina
Juan Del Castillo Universidad de la República, Facultad de Medicina, Clínica de Traumatología y Ortopedia, Asistente. Doctor en Medicina

DOI:

https://doi.org/10.29193/RMU.39.1.9

Keywords:

TIBIAL PLATEAU FRACTURES, SINKING, BONE GRAFTS, BONE SUBSTITUTES

Abstract

Objective: to find out whether there are clinical, radiological and functional differences when using different types of bone grafts or synthetic substitutes, as well as surgical times and consolidation to treat depressed tibial-plateau fractures in patients older than 18 years old.
Method: a systematized search was conducted in medical literature, PubMed, Lilacs, Scielo, Cochrane and Timbó portal databases using the following terms: “tibial plateau fracture”, “bone grafting”, “bone substitutes”. The study included comparative studies in human patients older than 18 years old with depressed tibial-plateau fractures who were treated with bone grafts or synthetic materials. Publications in Spanish, English and Portuguese, between January, 1980 and December, 2021 were included in the search, what resulted in 10 articles found.
Results: there were 10 kinds of bone grafts and bone substitutes found. Samples added up to 524 patients. Average age was 49 years old. Average follow up was 12 months. Studies were divided into 3 groups: comparison between autologous bone grafts and allogenic bone grafts, comparison between autologous grafts and synthetic substitutes and studies comparing synthetic substitutes with one another. Allogenic grafts and synthetic grafts proved at least equivalent in terms of clinical, functional and imaging studies results, improving intraoperative times and reducing complications in donor site when compared to autologous grafts.
Conclusions: autologous grafts continue to be the gold standard despite possible complications associated to the donor site, and allogenic grafts and synthetic substitutes constitute a valid option to treat these lesions.

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