Jun 20

Síndrome compartimental glúteo tras artroplastia de cadera.


Síndrome compartimental glúteo tras artroplastia de cadera.

El síndrome compartimental tras artroplastia de cadera es una entidad rara. Implica el aumento de presión en alguno de los tres compartimentos de la cadera: esta presión puede llegar a destruir el músculo del compartimento y el tratamiento es urgente y quirúrgico (fasciotomía para descompresión).

Dos cirujanos de Parc Taulí, Sabadell, ha publicado en el volumen de agosto de 2013 de la Revista Española de Cirugía Ortopédica y Traumatología un report de dos casos y tanto la exposición de los casos como la discusión es muy interesante.

Explican que existen pocas referencias en la literatura, y que las causas potenciales son:

– Traumatismo (fracturas femorales y tratamiento con enclavado endomedular, fracturas pélvicas y contusión de partes blandas).

– Lesión vascular: lesiones espontáneas o traumáticas de la arteria glútea superior o la arteria circunfleja femoral medial.

– Inmovilización prolongada: en pacientes con alteración de consciencia

– Abuso de drogas vía intramuscular

– Rabdomiolisis inducida por ejercicio.

Incluso se han descrito síndromes compartimentales glúteos contralaterales debidos principalmente a obesidad y tiempo prolongado de cirugía, así como mal posicionamento del soporte glúteo posterior.

En los dos casos que los autores publican, refieren que no existía ninguno de estos antecedentes, pero lo que explican es que en los dos casos se observaron hematomas de 2,8L y 2,7 L.

Es importante tener en mente este diagnóstico en el diagnóstico diferencial dedolor intenso inexplicable tras la implantación de una prótesis de cadera.BIBLIOGRAFÍA
 Villalba J, Solernou X. Gluteal compartment syndrome after total hip replacement. A presentation of two cases. Rev Esp Cir Ortop Traumatol. 2013 July – August;57(4):296-299.

About the author

 Soy un médico que utiliza el bisturí para arreglar caderas y el 2.0. para divulgar y reflexionar 🙂 Jenaro Fernández-Valencia

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