Acta Ortopedica Brasileira最新文献_第10页

TREATMENT OF RECURRENT ANTERIOR SHOULDER DISLOCATION USING THE LATARJET TECHNIQUE. 使用拉塔杰特技术治疗复发性肩关节前脱位。

IF 0.5 4区医学

Acta Ortopedica Brasileira Pub Date : 2023-02-20 eCollection Date: 2023-01-01 DOI: 10.1590/1413-785220233101e261896

Eduardo Angeli Malavolta, Jorge Antonio Bastos DE Souza, Jorge Henrique Assunção, Mauro Emilio Conforto Gracitelli, Fernando Brandão DE Andrade E Silva, Arnaldo Amado Ferreira

{"title":"TREATMENT OF RECURRENT ANTERIOR SHOULDER DISLOCATION USING THE LATARJET TECHNIQUE.","authors":"Eduardo Angeli Malavolta, Jorge Antonio Bastos DE Souza, Jorge Henrique Assunção, Mauro Emilio Conforto Gracitelli, Fernando Brandão DE Andrade E Silva, Arnaldo Amado Ferreira","doi":"10.1590/1413-785220233101e261896","DOIUrl":"10.1590/1413-785220233101e261896","url":null,"abstract":"Objective: To describe the functional results, recurrence rate, postoperative radiographic appearance, and complications of patients undergoing the Latarjet procedure over 24 months.Methods: Retrospective case series, including adult patients with recurrent traumatic anterior glenohumeral dislocation undergoing the Latarjet procedure. We clinically evaluated patients preoperatively by the Rowe score and at six, 12, and 24 months after the procedure. The positioning, consolidation, and resorption of the graft were analyzed by plain radiography. The recurrence rates and other complications were also described.Results: We analyzed 40 patients (41 shoulders). The Rowe score median increased from 25 before surgery to 95 at 24 months after surgery (p < 0.001). We observed graft resorption in three cases (7.3%) and consolidation in 39 (95.1%). Most grafts presented adequate placement. We observed two recurrences (4.8%), one case of dislocation and one of subluxation. Seven patients (17.1%) had a positive apprehension test. The study had no cases of infection, neuropraxia, or graft breakage.Conclusion: Latarjet surgery is a safe and effective procedure in the treatment of recurrent anterior dislocation of the shoulder. This surgery enables a statistically significant improvement according to the Rowe score, with a low number of recurrences. Level of Evidence IV, Case Series.","PeriodicalId":55563,"journal":{"name":"Acta Ortopedica Brasileira","volume":"31 1","pages":"e261896"},"PeriodicalIF":0.5,"publicationDate":"2023-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9949290/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10798872","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

S. AUREUS IS ASSOCIATED WITH A GREATER NEED FOR REOPERATION IN SEPTIC ARTHRITIS OF THE KNEE. 金黄色葡萄球菌与脓毒性膝关节炎的再手术需求相关。

IF 0.7 4区医学

Acta Ortopedica Brasileira Pub Date : 2023-01-01 DOI: 10.1590/1413-785220233102e260592

Lucas Saade Fernandes, Alexandre Joji Yagi, Alfredo Dos Santos Netto, Mauro José Salles, Victor Marques DE Oliveira, Ricardo DE Paula Leite Cury

{"title":"S. AUREUS IS ASSOCIATED WITH A GREATER NEED FOR REOPERATION IN SEPTIC ARTHRITIS OF THE KNEE.","authors":"Lucas Saade Fernandes, Alexandre Joji Yagi, Alfredo Dos Santos Netto, Mauro José Salles, Victor Marques DE Oliveira, Ricardo DE Paula Leite Cury","doi":"10.1590/1413-785220233102e260592","DOIUrl":"https://doi.org/10.1590/1413-785220233102e260592","url":null,"abstract":"Objective: To determine the frequency of reoperations in the treatment of adult patients diagnosed with septic arthritis of the knee, the average number of debridements needed to control the infection, the mortality rate, and to assess factors associated with a greater need for reoperation and mortality.Methods: Retrospective cohort study evaluating 38 adult patients diagnosed with septic arthritis who underwent arthrotomy via a medial parapatellar approach for joint cleaning and debridement. Demographic, clinical, surgical, and microbiological variables of the cases were analyzed by review of medical records. Tests for equality of two proportions, chi-square, and multivariate logistic regression analysis were performed, defining a significance level at 0.05, with 95% confidence interval.Results: A total of 50% of the cases underwent reoperation, with an average number of required debridement of 2.02 and a mortality rate of 10.5%. Patients with infection caused by Staphylococcus aureus were more likely to need a reoperation compared to patients with positive cultures for other agents (OR 6.0).Conclusion: In 50% of cases, an average of 2.02 debridements were necessary and the mortality rate was 10.5%. Staphylococcus aureus infection is associated with a 6 times greater chance of additional surgeries. / Level of Evidence IV, Case Series.","PeriodicalId":55563,"journal":{"name":"Acta Ortopedica Brasileira","volume":"31 2","pages":"e260592"},"PeriodicalIF":0.7,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10158961/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9435475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

MODIFIED MUBARAK TECHNIQUE FOR FLEXIBLE FLATFOOT CORRECTION IN CHILDREN AND ADOLESCENTS. 改良穆巴拉克技术在儿童和青少年柔韧性扁平足矫正中的应用。

IF 0.7 4区医学

Acta Ortopedica Brasileira Pub Date : 2023-01-01 DOI: 10.1590/1413-785220233104e265045

Bruno Air Machado DA Silva, Nilzio Antônio DA Silva, Jonatas Barbosa Vasconcelos

{"title":"MODIFIED MUBARAK TECHNIQUE FOR FLEXIBLE FLATFOOT CORRECTION IN CHILDREN AND ADOLESCENTS.","authors":"Bruno Air Machado DA Silva, Nilzio Antônio DA Silva, Jonatas Barbosa Vasconcelos","doi":"10.1590/1413-785220233104e265045","DOIUrl":"https://doi.org/10.1590/1413-785220233104e265045","url":null,"abstract":"Objective: To describe the technique, analyze possible radiographic correction and evaluate the clinical result of medial and plantar calcaneal displacement osteotomy associated with opening wedge cuboid osteotomy for flexible flatfoot correction.Methods: 23 patients (30 feet) diagnosed with flexible flat foot treated with plantar and medial calcaneal displacement osteotomy associated with opening wedge cuboid osteotomy were evaluated retrospectively. In the lateral radiographs calcaneal pitch and Meary's angle were the radiographic parameters evaluated; while the talonavicular coverage angle was evaluated in the anteroposterior radiographs. To assess the clinical outcome of the surgical procedure, the American Orthopedic Foot and Ankle Society Score (AOFAS) for the ankle and hindfoot was adopted.Results: The mean values of the evaluated angles and AOFAS score for ankle and hindfoot significantly improved when comparing pre- and postoperative values.Conclusion: Plantar and medial calcaneal displacement osteotomy associated with an opening wedge cuboid osteotomy is able to improve radiological and clinical parameters of child patients with flexible flatfoot. Level of Evidence III, Retrospective Comparative Study.","PeriodicalId":55563,"journal":{"name":"Acta Ortopedica Brasileira","volume":"31 4","pages":"e265045"},"PeriodicalIF":0.7,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10399999/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10324907","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

METAL ION RELEASE ACCORDING TO LEG LENGTH DISCREPANCY IN CERAMIC-ON-METAL HIP ARTHROPLASTY. 金属陶瓷髋关节置换术中腿部长度差异对金属离子释放的影响。

IF 0.7 4区医学

Acta Ortopedica Brasileira Pub Date : 2023-01-01 DOI: 10.1590/1413-785220233102e265272

Young-Ho Roh, Taehan Kang, Chaemoon Lim, Kwang Woo Nam

{"title":"METAL ION RELEASE ACCORDING TO LEG LENGTH DISCREPANCY IN CERAMIC-ON-METAL HIP ARTHROPLASTY.","authors":"Young-Ho Roh, Taehan Kang, Chaemoon Lim, Kwang Woo Nam","doi":"10.1590/1413-785220233102e265272","DOIUrl":"https://doi.org/10.1590/1413-785220233102e265272","url":null,"abstract":"Objective: The ceramic-on-metal (CoM) bearing has the theoretical advantages over ceramic-on-ceramic (CoC) and metal-on-metal bearings. This study aimed to analyze factors affecting the metal ion release of CoM bearings and compare clinical performance with CoC bearings.Methods: The 147 patients were divided into 96 patients in group 1 (CoM group) and 51 patients in group 2 (CoC group). Additionally, within group1, 48 patients and 30 patients were sub-categorized into group 1-A with leg length discrepancy (LLD) less than 1cm and group 1-B greater than 1 cm. The level of serum metal ions, functional scores and plain radiographs were obtained for the analysis.Results: The level of cobalt (Co) 2-years after surgery and chromium (Cr) 1-year after surgery showed significantly higher in the group1 than the group2. LLD indicated statistically significant positive correlation between serum metal ion levels among CoM bearing THAs. In comparison of the average metal ions level changes, group 1-B showed higher level of metal ion than group 1-A.Conclusion: In patients underwent THA with CoM bearings, large LLD have a higher risk of complications associated to metal ions. Therefore, it is critical to reduce the LLD to 1 cm or less in using CoM bearing. Level of Evidence III; Case Control Study.","PeriodicalId":55563,"journal":{"name":"Acta Ortopedica Brasileira","volume":"31 spe2","pages":"e265272"},"PeriodicalIF":0.7,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10263412/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10028235","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

PATELLAR FRACTURE IN ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION: IN VITRO ANALYSIS. 前交叉韧带重建髌骨骨折:体外分析。

IF 0.7 4区医学

Acta Ortopedica Brasileira Pub Date : 2023-01-01 DOI: 10.1590/1413-785220233102e259557

Marcelo DE Almeida Ferrer, Mariana DE Oliveira Lobo, Laís Maria Pinto Almeida, Anderson Freitas, Sílvio Leite DE Macedo Neto, Leonardo Morais Paiva, Leonardo Rigobello Battaglion

{"title":"PATELLAR FRACTURE IN ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION: IN VITRO ANALYSIS.","authors":"Marcelo DE Almeida Ferrer, Mariana DE Oliveira Lobo, Laís Maria Pinto Almeida, Anderson Freitas, Sílvio Leite DE Macedo Neto, Leonardo Morais Paiva, Leonardo Rigobello Battaglion","doi":"10.1590/1413-785220233102e259557","DOIUrl":"https://doi.org/10.1590/1413-785220233102e259557","url":null,"abstract":"Objective: To determine, by biomechanical analysis, safe patellar cut limits in anterior cruciate ligament (ACL) reconstruction that minimize fracture risks.Methods: From three-dimensional reconstruction, triangular cuts were made in the patella, with a depth of 6.5 mm and variable width and length (10 to 20 mm and 8 to 12 mm, respectively, both with an interval of 1 mm). The combinations of cuts constituted 55 models for tests, with five variations in width and 11 variations in length, tested with the finite element method (FEM).Results: The mean of the localized principal maximum (traction force) values was 4.36 Pa (SD 0.87 ± 0.76) and the localized principal minimum (compression force) was -4.33 Pa (SD 1.05 ± 1.11). Comparing width and length to the tension force of the values of the main maximum, we found statistical significance from 11 mm for width and 13 mm for length.Conclusion: In ACL reconstruction, the removal of the patellar bone fragment is safe for fragments smaller than 11 mm in width and 13 mm in length, which corresponds to 24% of the width and 28% of the length of the patella used. Level of Evidence II, Comparative Prospective Study.","PeriodicalId":55563,"journal":{"name":"Acta Ortopedica Brasileira","volume":"31 2","pages":"e259557"},"PeriodicalIF":0.7,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10158969/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9782980","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

EPIDEMIOLOGICAL PROFILE AND EVOLUTION IN MUSCULOSKELETAL TUMORS AT THE LEVEL OF THE ELBOW. 肘部水平肌肉骨骼肿瘤的流行病学概况和演变。

IF 0.7 4区医学

Acta Ortopedica Brasileira Pub Date : 2023-01-01 DOI: 10.1590/1413-785220233101e261309

Vinicius DE Abreu Mazzolin, Julia Rocha Kalluf, Fiama Kuroda Ogata, Nathalia Sundin Palmeira DE Oliveira, Jairo Greco Garcia, Marcelo DE Toledo Petrilli, Marcos Korukian, Dan Carai Maia Viola

{"title":"EPIDEMIOLOGICAL PROFILE AND EVOLUTION IN MUSCULOSKELETAL TUMORS AT THE LEVEL OF THE ELBOW.","authors":"Vinicius DE Abreu Mazzolin, Julia Rocha Kalluf, Fiama Kuroda Ogata, Nathalia Sundin Palmeira DE Oliveira, Jairo Greco Garcia, Marcelo DE Toledo Petrilli, Marcos Korukian, Dan Carai Maia Viola","doi":"10.1590/1413-785220233101e261309","DOIUrl":"https://doi.org/10.1590/1413-785220233101e261309","url":null,"abstract":"Objective: To present the epidemiological profile of bone and soft tissue tumors that affect the elbow region treated at an oncology referral center in Brazil.Methods: Retrospective observational case series study to evaluate the results of elbow cancer undergoing clinical and/or surgical treatment with the first visit from 1990 to 2020. The dependent variables were benign bone tumor, malignant bone tumor, benign soft tissue tumor, malignant soft tissue tumor. Independent variables were sex, age; presence of symptoms (pain/increase in local volume/fracture); diagnosis; treatment and recurrence.Results: In total, 37 patients were included, 51.35% of whom were female, with a mean age at diagnosis of 33.5 years. Soft tissue neoplasms correspond to 51% of cases against 49% of bone tumors. Among the symptoms, the general prevalence of pain was 56.75%, the general increase in local volume occurred in 54.04% of the patients and the presence of fractures in 13.43%. Surgical treatment occurred in 75.67% of cases and recurrence in 16.21% of cases.Conclusion: The tumors that affect the elbow in our series correspond mostly to benign tumors, involving bone or soft tissues, with a higher occurrence in young adult patients. Level of Evidence IV, Case Series.","PeriodicalId":55563,"journal":{"name":"Acta Ortopedica Brasileira","volume":"31 1","pages":"e261309"},"PeriodicalIF":0.7,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9949311/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9785439","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

FIXATION METHODS IN LATARJET: BIOMECHANICAL COMPARISON OF SCREW TYPES AND PLATE FIXATION. 斜椎弓根内固定方法:螺钉与钢板固定的生物力学比较。

IF 0.7 4区医学

Acta Ortopedica Brasileira Pub Date : 2023-01-01 DOI: 10.1590/1413-785220233102e260966

Ufuk Arzu, Mehmet Ersin, Mehmet Chodza, Koray Şahin, Önder Kiliçoğlu, Ali Erşen

{"title":"FIXATION METHODS IN LATARJET: BIOMECHANICAL COMPARISON OF SCREW TYPES AND PLATE FIXATION.","authors":"Ufuk Arzu, Mehmet Ersin, Mehmet Chodza, Koray Şahin, Önder Kiliçoğlu, Ali Erşen","doi":"10.1590/1413-785220233102e260966","DOIUrl":"https://doi.org/10.1590/1413-785220233102e260966","url":null,"abstract":"Objective: Latarjet procedure is often preferred in recurrent shoulder dislocations accompanied by glenoid bone loss. It is observed that the superiority of bone graft fixation methods is still controversial. The aim of this study is to biomechanically compare the bone graft fixation methods in the Latarjet procedure.Methods: 15 third-generation scapula bone models were divided into 3 groups. Graft was fixated in the first group with fully-threaded cortical screws of 3.5mm diameter, in the second group two 16 mm partially-threaded cannulated screws of 4.5mm diameter, and in the third group via a mini plate and screw. The hemispherical humeral head was placed on the tip of the cyclic charge device, and thus, the charge applied to the coracoid graft was homogeneous.Results: No statistically significant difference was found between paired comparisons (p>0.05). The forces in 5 mm displacement in total vary between 502-857N. Total stiffness measurements ranged between 105 and 625; the mean value was 258.13±53.54 with no statistically significant difference by groups (p = 0.958).Conclusion: This biomechanical study showed that there is no difference between three coracoid fixation options in terms of fixation strength. Unlike previous assumptions, plate fixation is not biomechanically superior to screw fixation. Surgeons should consider their personal preferences and experience in choosing fixation methods.","PeriodicalId":55563,"journal":{"name":"Acta Ortopedica Brasileira","volume":"31 spe2","pages":"e260966"},"PeriodicalIF":0.7,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10263413/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10011005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 2

METACARPAL FRACTURES TREATMENT: COMPARASION BETWEEN KIRSCHNER WIRE AND INTRAMEDULLARY SCREW. 掌骨骨折的治疗:克氏针与髓内螺钉的比较。

IF 0.7 4区医学

Acta Ortopedica Brasileira Pub Date : 2023-01-01 DOI: 10.1590/1413-785220233103e266948

Bruno Cesar Silva de Jesus, Clóvis Rodrigo Guimarães Braz Pereira da Silva, Rodrigo Domiciano Cardoso, Vitor Augusto Queiroz Mauad, Rafael Saleme Alves, Fernando Nogueira Zambone Pinto

{"title":"METACARPAL FRACTURES TREATMENT: COMPARASION BETWEEN KIRSCHNER WIRE AND INTRAMEDULLARY SCREW.","authors":"Bruno Cesar Silva de Jesus, Clóvis Rodrigo Guimarães Braz Pereira da Silva, Rodrigo Domiciano Cardoso, Vitor Augusto Queiroz Mauad, Rafael Saleme Alves, Fernando Nogueira Zambone Pinto","doi":"10.1590/1413-785220233103e266948","DOIUrl":"https://doi.org/10.1590/1413-785220233103e266948","url":null,"abstract":"ABSTRACT Introduction: Metacarpal fractures are common and can be treated surgically using Kirschner wires (K-wires) or intramedullary fixation with compression screws (IMCS). Objectives: Analyze the postsurgical results from treating the metacarpal extra-articular fractures through the retrograde Kirschner wire technique, and compare it with the intramedullary compression screw fixation. Methods: Retrospective and quantitative studies were to analyze patients’ medical records, and a postsurgical evaluation questionnaire was given to the patients, who were divided into K-wire and IMCS. Results: The period of immobilization with a splint took six weeks for the K-wire group and four weeks for the IMCS group. The average time for consolidation took, respectively, fifty-seven days and forty-seven days. The first group could restart their activities twenty-two days after the other, and the average force value of the treated hand, when compared with its contralateral, was 93.9% and 95.4%, respectively. Between the operated hand and its contralateral, there was a difference of 16° in the total measures of the metacarpophalangeal and interphalangeal joint's range of movement among the K-wire group and 5° among the IMCS group. Conclusion: The patients who participated in this study showed excellent results after surgery, and both treatments were proven to be safe and reliable. Evidence level III; Retrospective comparative study .","PeriodicalId":55563,"journal":{"name":"Acta Ortopedica Brasileira","volume":"31 spe3","pages":"e266948"},"PeriodicalIF":0.7,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10502975/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10300452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

WEDGE FRAGMENT VARIATIONS OF TIBIAL SHAFT FRACTURES WITH INTRAMEDULLARY NAILING. 髓内钉治疗胫骨干骨折的楔形碎片变异。

IF 0.7 4区医学

Acta Ortopedica Brasileira Pub Date : 2023-01-01 DOI: 10.1590/1413-785220233103e268124

Mario Sergio Boff, Pedro Henrique de Oliveira Paolucci, Gabriel Machado de Oliveira, Leonardo Zanesco, Fernando Brandao Andrade-Silva, Marcos de Camargo Leonhardt, Paulo Roberto Dos Reis, Jorge Dos Santos Silva, Kodi Edson Kojima

{"title":"WEDGE FRAGMENT VARIATIONS OF TIBIAL SHAFT FRACTURES WITH INTRAMEDULLARY NAILING.","authors":"Mario Sergio Boff, Pedro Henrique de Oliveira Paolucci, Gabriel Machado de Oliveira, Leonardo Zanesco, Fernando Brandao Andrade-Silva, Marcos de Camargo Leonhardt, Paulo Roberto Dos Reis, Jorge Dos Santos Silva, Kodi Edson Kojima","doi":"10.1590/1413-785220233103e268124","DOIUrl":"https://doi.org/10.1590/1413-785220233103e268124","url":null,"abstract":"ABSTRACT Introduction: Tibial shaft fracture is the most common long-bone fracture, and the standard treatment is intramedullary (IM) nail fixation. Regardless of the development of this technique pseudoarthrosis remains prevalent. Objectives: Evaluate the correlation between wedge fragment size and displacement, displacement of the main fragments of the 42B2 type, and pseudoarthrosis incidence. Methods: We retrospectively assessed all patients with 42B2 type fracture treated with IM nailing between January, 2015 and December, 2019. Six radiographic parameters were defined for preoperative radiographs in the anteroposterior (AP) and lateral views. Another six parameters were defined for postoperative radiographs at three, six, and 12 months. The Radiographic Union Score for Tibial Fractures score was used to assess bone healing. Results: Of 355 patients with tibial shaft fractures, 51 were included in the study. There were 41 (82.0%) male patients, with a mean age of 36.7 years, 37 (72.5%) had open fractures, and 28 (54.9%) had associated injuries. After statistical analysis, the factors that correlated significantly with nonunion were wedge height > 18 mm, preoperative translational displacement of the fracture in the AP view > 18 mm, and final distance of the wedge in relation to its original anatomical position after IM nailing > 5 mm. Conclusion: Risk factors for nonunion related to the wedge and42B2 fracture are wedge height > 18 mm, initial translation in the AP view of the fracture > 18 mm, and distance > 5 mm of the wedge from its anatomical position after IM nailing. Evidence level III; Retrospective comparative study .","PeriodicalId":55563,"journal":{"name":"Acta Ortopedica Brasileira","volume":"31 spe3","pages":"e268124"},"PeriodicalIF":0.7,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10502966/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10308469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

DISTAL NEUROTIZATION OF THE ANTERIOR INTEROSSEOUS NERVE TO RECOVER HAND GRASPING. 前骨间神经远端神经化恢复手部抓握。

IF 0.7 4区医学

Acta Ortopedica Brasileira Pub Date : 2023-01-01 DOI: 10.1590/1413-785220233101e257852

Álvaro Baik Cho, Carlos Henrique Vieira Ferreira, Renan Martins Fontana, Gary Alan Ângulo Montano, Leandro Yoshinobu Kiyohara, Luiz Sorrenti

{"title":"DISTAL NEUROTIZATION OF THE ANTERIOR INTEROSSEOUS NERVE TO RECOVER HAND GRASPING.","authors":"Álvaro Baik Cho, Carlos Henrique Vieira Ferreira, Renan Martins Fontana, Gary Alan Ângulo Montano, Leandro Yoshinobu Kiyohara, Luiz Sorrenti","doi":"10.1590/1413-785220233101e257852","DOIUrl":"https://doi.org/10.1590/1413-785220233101e257852","url":null,"abstract":"Lower trunk lesions are uncommon, representing about 3 to 5% of brachial plexus lesions in adults. One of the functions lost by patients who suffer this type of injury is the flexion of the fingers, with important harming of palmar grip. This series of cases proposes the transfer of a branch of the radial nerve to the anterior interosseous nerve (AIN), presenting a new alternative for the treatment of these lesions with highly satisfactory results.Objective: To demonstrate our strategy, technique, and results in the reinnervation of the AIN in lesions isolated from the lower trunk of the brachial plexus in four cases of high lesion of the median nerve.Method: Prospective cohort study in which four patients underwent neurotizations. The treatment was directed to the recovery of the fingers' flexors of the hand and the grip.Results: All patients presented reinnervation of the flexor pollicis longus (FPL) and deep flexors of the 2nd, 3rd, and 4th fingers. The deep flexor of the 5th finger also showed reinnervation but with reduced strength (M3/4) comparing to the others (M4+).Conclusion: Despite the limited number of cases in this and other studies, the results are uniformly good, allowing to consider this treatment predictable. Level of Evidence IV, Case Series.","PeriodicalId":55563,"journal":{"name":"Acta Ortopedica Brasileira","volume":"31 1","pages":"e257852"},"PeriodicalIF":0.7,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9949207/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10789158","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0