Revista Brasileira de Ortopedia (English Edition)最新文献_第9页

Comparative accuracy assessment of the Gustilo and Tscherne classification systems as predictors of infection in open fractures Gustilo和Tscherne分类系统作为开放性骨折感染预测指标的比较准确性评估

Revista Brasileira de Ortopedia (English Edition) Pub Date : 2018-05-01 DOI: 10.1016/j.rboe.2018.03.005

Rafael Valadares Oliveira , Luciano Passos Cruz , Marcos Almeida Matos

{"title":"Comparative accuracy assessment of the Gustilo and Tscherne classification systems as predictors of infection in open fractures","authors":"Rafael Valadares Oliveira , Luciano Passos Cruz , Marcos Almeida Matos","doi":"10.1016/j.rboe.2018.03.005","DOIUrl":"10.1016/j.rboe.2018.03.005","url":null,"abstract":"<div><h3>Objective</h3><p>The aim of this study is to analyze the accuracy of the two classification systems for open fractures most commonly used in current medical practice, Gustilo and Tscherne, as predictors of infection.</p></div><div><h3>Methods</h3><p>A retrospective observational study was performed, including 121 patients suffering from open fracture of the appendicular skeleton treated at an emergency hospital. The fractures were classified according to Gustilo and Tscherne systems during the initial treatment, and ratings were subsequently confirmed or rectified during hospitalization. Sensitivity, specificity, positive and negative predictive values, and accuracy were calculated according to each classification adopted.</p></div><div><h3>Results</h3><p>The results of this study demonstrated that both classifications of Gustilo and Tscherne are associated with the clinical outcome of infection in open fractures. The Gustilo classification achieved sensitivity of 76.7%, specificity of 53.8%, and accuracy of 59.5%. Tscherne's classification had a sensitivity of 56.7%, specificity 82.4%, and accuracy of 76.1%.</p></div><div><h3>Conclusion</h3><p>The Tscherne system showed better accuracy, including specificity as a predictor of infection in open fractures, when compared with the Gustilo system.</p></div>","PeriodicalId":101095,"journal":{"name":"Revista Brasileira de Ortopedia (English Edition)","volume":"53 3","pages":"Pages 314-318"},"PeriodicalIF":0.0,"publicationDate":"2018-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rboe.2018.03.005","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36214393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 4

Double femoral osteotomy fixed with a Puddu plate and a retrograde intramedullary nail to treat biapical deformity of the femur 用Puddu钢板和逆行髓内钉固定双股截骨治疗股骨双尖畸形

Revista Brasileira de Ortopedia (English Edition) Pub Date : 2018-05-01 DOI: 10.1016/j.rboe.2018.03.016

Patrícia Moreno Grangeiro , Márcia Uchoa de Rezende , Camilo Partezani Helito , Alessandro Monterroso Felix , Guilherme Pereira Ocampos , Roberto Guarniero

{"title":"Double femoral osteotomy fixed with a Puddu plate and a retrograde intramedullary nail to treat biapical deformity of the femur","authors":"Patrícia Moreno Grangeiro , Márcia Uchoa de Rezende , Camilo Partezani Helito , Alessandro Monterroso Felix , Guilherme Pereira Ocampos , Roberto Guarniero","doi":"10.1016/j.rboe.2018.03.016","DOIUrl":"10.1016/j.rboe.2018.03.016","url":null,"abstract":"<div><p>Biapical femoral deformities are challenging to treat. In order to correct concomitant metaphyseal and diaphyseal deformities of the femur, the authors propose a double femoral controlled osteotomy with combined internal fixation, consisting of a Puddu plate and an intramedullary nail. The method was described in two patients. Results were analyzed using a visual analog scale (VAS), the Lysholm score, and SF-36. No complications were found. Complete consolidation of the osteotomies and radiographic alignment correction were achieved. Results were obtained with a minimum follow-up of 66 months. Both patients had improved for pain (VAS from 60 to 40 and from 50 to 20 at reassessment), function (Lysholm score from 78 to 93 and from 55 to 73) and quality of life (SF-36, both mental – from 40.7 to 57.1 in case one and from 24.7 to 59.7 in case two – and physical – from 27.7 to 45.6 and from 28.2 to 46.8). The authors have found that this technique is a reliable, accurate, and reproducible solution for biapical deformities of the femur.</p></div>","PeriodicalId":101095,"journal":{"name":"Revista Brasileira de Ortopedia (English Edition)","volume":"53 3","pages":"Pages 378-383"},"PeriodicalIF":0.0,"publicationDate":"2018-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rboe.2018.03.016","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36213337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Posterior four-part fracture-dislocations of the proximal humerus: clinical and functional evaluation of osteosynthesis treatment 肱骨近端后路四段骨折脱位:植骨治疗的临床和功能评价

Revista Brasileira de Ortopedia (English Edition) Pub Date : 2018-05-01 DOI: 10.1016/j.rboe.2018.03.010

Carla Teresa Barbosa de Oliveira , Elpídio da Graça , Vânia Aparecida Fanelli

{"title":"Posterior four-part fracture-dislocations of the proximal humerus: clinical and functional evaluation of osteosynthesis treatment","authors":"Carla Teresa Barbosa de Oliveira , Elpídio da Graça , Vânia Aparecida Fanelli","doi":"10.1016/j.rboe.2018.03.010","DOIUrl":"10.1016/j.rboe.2018.03.010","url":null,"abstract":"<div><h3>Objective</h3><p>To evaluate patients diagnosed with posterior four-part fracture-dislocations of the proximal humerus, that were surgically treated with osteosynthesis, regarding their clinical and functional outcomes.</p></div><div><h3>Methods</h3><p>A prospective observational study of eight patients from the same hospital institution in the interior of São Paulo State (Brazil), through individual interviews using the UCLA, DASH, and Constant international scores. The active movements included in the scores plus the range of motion of the affected and non-affected limb were measured. The affected shoulder's radiographs were requested to verify bone conditions and the fixation of the osteosynthesis.</p></div><div><h3>Results</h3><p>The rating of eight patients by the international scores indicated that seven of the eight patients presented good clinical and functional evolution of the affected limb; this represents 87.5% of the evaluated individuals.</p></div><div><h3>Conclusion</h3><p>Surgical treatment with osteosynthesis performed during the acute period (<four weeks) leads to good results in most cases.</p></div>","PeriodicalId":101095,"journal":{"name":"Revista Brasileira de Ortopedia (English Edition)","volume":"53 3","pages":"Pages 350-356"},"PeriodicalIF":0.0,"publicationDate":"2018-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rboe.2018.03.010","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36214321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 3

Neurotrophin expression and histomorphometric evaluation in Wistar rats subjected to neural mobilization after compression of the median nerve 正中神经受压后神经活动Wistar大鼠神经营养因子表达及组织形态计量学评价

Revista Brasileira de Ortopedia (English Edition) Pub Date : 2018-05-01 DOI: 10.1016/j.rboe.2018.03.006

Marieli Araujo Rossoni Marcioli , José Luis da Conceição Silva , Lucinéia de Fátima Chasko Ribeiro , Rose Meire Costa Brancalhão , Gladson Ricardo Flor Bertolini

{"title":"Neurotrophin expression and histomorphometric evaluation in Wistar rats subjected to neural mobilization after compression of the median nerve","authors":"Marieli Araujo Rossoni Marcioli , José Luis da Conceição Silva , Lucinéia de Fátima Chasko Ribeiro , Rose Meire Costa Brancalhão , Gladson Ricardo Flor Bertolini","doi":"10.1016/j.rboe.2018.03.006","DOIUrl":"10.1016/j.rboe.2018.03.006","url":null,"abstract":"<div><h3>Objective</h3><p>To evaluate the neurotrophin mRNA expression and axon count in the median nerve of Wistar rats submitted to neural mobilization (NM) after nerve compression.</p></div><div><h3>Methods</h3><p>Eighteen animals were randomly divided into G1 (nerve compression only), G2 (NM for 1min), and G3 (NM for 3min). For NM, the animals were anesthetized and the right scapula received the mobilization, adapted as indicated for humans, on alternate days, from the third to the 13th postoperative (PO) day, totaling six days of therapy. On the 14th PO day, animals were anesthetized and euthanized. Fragments of the median nerve, distal to the compression procedure, were removed for histomorphometric analysis and expression of neurotrophins, nerve growth factor (NGF), and brain-derived neurotrophic factor (BDNF) by RT-PCR.</p></div><div><h3>Results</h3><p>Histomorphometric analysis revealed differences in the number of axons in the injured side, which was significantly lower in the injured limb nerve compared to the control limb, whereas the RT-PCR analysis showed no significant differences in the expression of NGF or BDNF.</p></div><div><h3>Conclusion</h3><p>NM treatment did not affect median nerve regeneration, which maintained normal recovery rates.</p></div>","PeriodicalId":101095,"journal":{"name":"Revista Brasileira de Ortopedia (English Edition)","volume":"53 3","pages":"Pages 276-280"},"PeriodicalIF":0.0,"publicationDate":"2018-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rboe.2018.03.006","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36214388","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 3

Erratum to “Polypropylene prosthesis for the treatment of fingertip injuries. Description of surgical technique and results” 聚丙烯假体治疗指尖损伤的勘误。手术技术及结果说明”

Revista Brasileira de Ortopedia (English Edition) Pub Date : 2018-05-01 DOI: 10.1016/j.rboe.2018.04.001

Leandro Azevedo de Figueiredo, Rafael de Souza Ribeiro, Antonio Leão Bandeira de Melo, André Luiz Lima, Bernardo Barcellos Terra, Fernando Carvalho Ventin

引用次数: 0

Trans-olecranon fossa four-cortex purchase lateral pinning in displaced supracondylar fracture of the humerus – a prospective analysis in 48 children 经鹰嘴窝四皮质购买外侧钉钉治疗肱骨髁上移位骨折-一项48例儿童的前瞻性分析

Revista Brasileira de Ortopedia (English Edition) Pub Date : 2018-05-01 DOI: 10.1016/j.rboe.2017.03.014

Saravanan Kasirajan , Rajesh Govindasamy , Bhava Ramalingam Jawaharlal Sathish , Jimmy Joseph Meleppuram

{"title":"Trans-olecranon fossa four-cortex purchase lateral pinning in displaced supracondylar fracture of the humerus – a prospective analysis in 48 children","authors":"Saravanan Kasirajan , Rajesh Govindasamy , Bhava Ramalingam Jawaharlal Sathish , Jimmy Joseph Meleppuram","doi":"10.1016/j.rboe.2017.03.014","DOIUrl":"10.1016/j.rboe.2017.03.014","url":null,"abstract":"<div><h3>Objective</h3><p>The current study aims at a functional analysis of trans-olecranon lateral pinning for displaced supracondylar fracture of the humerus (SCFH) in children.</p></div><div><h3>Methods</h3><p>A prospective study of 48 children (30 males, 18 females; mean age: 7.4 years) with displaced SCFH was treated at this institution with modified technique from March 2011 to September 2014. Cases were selected on the basis of inclusion criteria. The functional outcome was assessed clinically by modified Flynn's criteria along with achievement of full range of motion.</p></div><div><h3>Results</h3><p>All 48 children with a mean follow up of 20 months (range: 6–26 months) were assessed. All fractures united well. With modified Flynn's criteria, results were excellent in 40 children (83.3%), good in six children (12.5%), and fair in two children (4.2%). There were no poor results. Preoperative nerve palsies seen in four children recovered at ten weeks. Full range of motion was achieved on an average of 20 days after K-wire removal and no new post-operative nerve palsies were noted.</p></div><div><h3>Conclusion</h3><p>The modified trans-olecranon fossa four-cortex purchase (TOF-FCP) technique was promising in all cases of unstable SCFH without the complications of loss of reduction or iatrogenic ulnar nerve injury. This technique is simple, safe, and reproducible, with good clinical results in this type of fracture.</p></div>","PeriodicalId":101095,"journal":{"name":"Revista Brasileira de Ortopedia (English Edition)","volume":"53 3","pages":"Pages 342-349"},"PeriodicalIF":0.0,"publicationDate":"2018-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rboe.2017.03.014","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36214319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 7

Periacetabular hip osteotomy for residual dysplasia treatment: preliminary results 髋臼周围髋关节截骨术治疗残余发育不良:初步结果

Revista Brasileira de Ortopedia (English Edition) Pub Date : 2018-05-01 DOI: 10.1016/j.rboe.2018.03.012

Vinicius de Brito Rodrigues , Josiano Valério , Francisco Zaniolo , Mark Deeke , Marco Pedroni , Ademir Schuroff

引用次数: 1

488 hand surgeries with local anesthesia with epinephrine, without a tourniquet, without sedation, and without an anesthesiologist 488例手部手术采用肾上腺素局部麻醉，不使用止血带，不使用镇定剂，也没有麻醉师

Revista Brasileira de Ortopedia (English Edition) Pub Date : 2018-05-01 DOI: 10.1016/j.rboe.2018.03.011

Trajano Sardenberg , Samuel Ribak , Ricardo Colenci , Rafael Barcellos de Campos , Denis Varanda , Andrea Christina Cortopassi

{"title":"488 hand surgeries with local anesthesia with epinephrine, without a tourniquet, without sedation, and without an anesthesiologist","authors":"Trajano Sardenberg , Samuel Ribak , Ricardo Colenci , Rafael Barcellos de Campos , Denis Varanda , Andrea Christina Cortopassi","doi":"10.1016/j.rboe.2018.03.011","DOIUrl":"10.1016/j.rboe.2018.03.011","url":null,"abstract":"<div><h3>Objectives</h3><p>Evaluate the incidence of digital infarction and tissue necrosis using local anesthesia with 1% lidocaine and 1:100,000 epinephrine in wrist, hand, and fingers surgeries, without a tourniquet, without sedation, and without an anesthesiologist.</p></div><div><h3>Methods</h3><p>Patients with wrist, hand, and fingers disorders prospectively underwent surgery under local anesthesia with 1% lidocaine and 1:100,000 epinephrine. The primary outcomes evaluated were the presence of digital infarction and tissue loss due to necrosis. As secondary outcomes, the need for the use of sedatives, tourniquet, anesthesiologist assistance, or surgery suspension were evaluated.</p></div><div><h3>Results</h3><p>Fifty-three wrists, 307 hands, and 128 fingers were anesthetized with lidocaine and epinephrine without any complications related to epinephrine. There was no patient that presented with any of the primary or secondary outcomes.</p></div><div><h3>Conclusions</h3><p>Wrist, hand, and fingers surgeries can be safely performed with local anesthesia with 1% lidocaine and 1:100,000 epinephrine, without sedation, without a tourniquet, and without an anesthesiologist.</p></div>","PeriodicalId":101095,"journal":{"name":"Revista Brasileira de Ortopedia (English Edition)","volume":"53 3","pages":"Pages 281-286"},"PeriodicalIF":0.0,"publicationDate":"2018-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rboe.2018.03.011","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36214469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 7

A study on the prevalence of the anconeus epitrochlearis muscle by magnetic resonance imaging 核磁共振成像对上耳蜗肌闭锁患病率的研究

Revista Brasileira de Ortopedia (English Edition) Pub Date : 2018-05-01 DOI: 10.1016/j.rboe.2018.03.015

Sergio Ricardo Rios Nascimento , Cristiane Regina Ruiz

引用次数: 9

Intra-articular viscosupplementation of hyaluronic acids in an experimental osteoarthritis model 透明质酸在实验性骨关节炎模型中的关节内粘补充

Revista Brasileira de Ortopedia (English Edition) Pub Date : 2018-05-01 DOI: 10.1016/j.rboe.2018.03.009

Marcello Zaia Oliveira, Mauro Batista Albano, Guilherme Augusto Stirma, Mario Massatomo Namba, Leandro Vidigal, Luiz Antonio Munhoz da Cunha

{"title":"Intra-articular viscosupplementation of hyaluronic acids in an experimental osteoarthritis model","authors":"Marcello Zaia Oliveira, Mauro Batista Albano, Guilherme Augusto Stirma, Mario Massatomo Namba, Leandro Vidigal, Luiz Antonio Munhoz da Cunha","doi":"10.1016/j.rboe.2018.03.009","DOIUrl":"10.1016/j.rboe.2018.03.009","url":null,"abstract":"<div><h3>Objective</h3><p>To analyze, from the immunohistochemical perspective, the effects of hyaluronic acid of different molecular weights in an experimental model of osteoarthritis in rabbits.</p></div><div><h3>Methods</h3><p>Forty-four male California rabbits were randomly assigned to three different groups (PR, S, and P) and submitted to the resection of the anterior cruciate ligament of the right knee. Three weeks after the surgical procedure, three intra-articular weekly injections were carried out with low-molecular-weight native hyaluronic acid (Hyalgan®) to PR group, high molecular weight branched chain hyaluronic acid (Synvisc®) to group S, and saline solution 0.9% to group P. All animals were sacrificed 12 weeks after the surgical procedure, and the tibial plateaus of the infiltrated knees were then dissected. Histological sections of cartilage from the tibial plateau support areas were stained with immunohistochemical markers in order to investigate the amount of metalloproteases (MMPs 3 and 13) and their inhibitors (TIMPs 1 and 3). The staining intensity was quantified on a Zeiss Imager.Z2 Metasystems microscope and analyzed by Metafer4 Msearch software.</p></div><div><h3>Results</h3><p>The chondroprotective effect of the hyaluronic acids used in the study was demonstrated when compared to the control group. However, the comparison between them presented no significant statistical difference regarding chondroprotection.</p></div><div><h3>Conclusion</h3><p>The injection of saline solution demonstrated signs of OA development, while adding native hyaluronic acid of low molecular weight (Hyalgan®) and hyaluronic acid of high molecular weight (Synvisc®) protected the articular cartilage in this model of OA.</p></div>","PeriodicalId":101095,"journal":{"name":"Revista Brasileira de Ortopedia (English Edition)","volume":"53 3","pages":"Pages 293-299"},"PeriodicalIF":0.0,"publicationDate":"2018-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rboe.2018.03.009","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36214389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 5