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Acta Ortopedica Brasileira

Thais Queiroz Santolim, André Mathias Baptista, Arlete Mazzini Miranda Giovani, Juan Pablo Zumárraga, Olavo Pires DE Camargo
Objectives: The advantages of using a peripherally inserted central catheter (PICC) in hospitalized patients make this device very important for intravenous therapy. This study describes the use of PICCs at the Institute of Orthopedics and Traumatology at the Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo over the last 10 years. Methods: This retrospective study analyzed 1,057 medical records and included 1,023 medical files with complete information on the punctured vein, diagnosis, duration of catheterization, complications, and catheter tip positioning...
May 2018: Acta Ortopedica Brasileira
Frederico Carlos Jaña, Caroline Sartori Ortega, Ellen DE Oliveira Goiano
Objective: To analyze the characteristics of patients diagnosed with pediatric osteoarticular infections treated in a level III trauma center in São Paulo, Brazil. Methods: We retrospectively analyzed patients admitted between September 2012 and August 2014. The outcomes analyzed were: age, sex, diagnosis, etiologic agent, anatomic location, time to diagnosis, history of previous trauma and infection, laboratory tests, treatment, and complications. Results: Twenty patients were included, 50% with septic arthritis, 35% with osteomyelitis, and 15% with both...
May 2018: Acta Ortopedica Brasileira
Bariş Polat, Yunus Atici, Tahsin Gürpinar, Ayşe Esin Polat, Doğaç Karagüven, Ismet Teoman Benli
Objective: This study investigates ultrasonography as an effective tool for localizing and measuring the depth and size of wooden foreign bodies to perform less invasive and easier surgery without the need for any additional radiological techniques. Methods: Fifteen patients were operated to remove foreign bodies in the extremities in 2016. The side of the affected extremity, the material, size, and location of the foreign body and time of admission after injury were noted, along with CRP, WBC, and erythrocyte sedimentation rate; length of incision, surgery duration, and complications were evaluated...
May 2018: Acta Ortopedica Brasileira
Alex DE Lima Santos, Conrado Tazima Nitta, Guilherme Boni, Gustavo Tadeu Sanchez, Marcel Jun Sugawara Tamaoki, Fernando Baldy Dos Reis
Introduction: Tibia shaft fractures are among the most common in orthopedic practice, but Brazilian literature remains limited on the subject. Objective: To evaluate the characteristics of tibia shaft fractures and conduct a comparison between exposed and closed fractures of the tibia. Methods: This comparative prospective study examined all tibia shaft fractures admitted to our services over a twelve-month period. The cases were evaluated according to age, trauma mechanism, sex, associated fractures, treatment, hospital stay, and readmission rate during the six months after discharge...
May 2018: Acta Ortopedica Brasileira
Lucas Castrillon Carmo Machado, Douglas Kenji Narazaki, Willian Gemio Jacobsen Teixeira, Alexandre Fogaça Cristante, Manoel Jacobsen Teixeira, Tarcísio Eloy Pessoa DE Barros
Introduction: The extreme lateral approach has been widely used for the treatment of degenerative diseases. The objective of this study is to present a minimally invasive extreme lateral approach for the treatment of metastatic lesions in the lumbar spine without the use of the evoked potential exam (MEP). Methods: Two patients with spinal metastases and indication for surgery via the anterior approach were treated in a cancer referral center in Brazil. They were placed in right lateral decubitus, and an oblique incision was made, exposing the psoas muscle...
May 2018: Acta Ortopedica Brasileira
Wilson Carlos Sola, Tiago Augusto Colferai, Carlos Henrique Ramos, Paulo Sérgio Dos Santos, Juliano Santini Gerlack, André Francisco Gomes
Objectives: To evaluate the tomographic distance between the sternoclavicular joints and the nearest hilar structures. Methods: Computed tomography images (axial and sagittal slices) in 120 healthy individuals (60 men and 60 women) between 18 and 60 years old were prospectively analyzed. The distances from both sternoclavicular joints to the respective brachiocephalic veins, trachea, esophagus, and lung apexes were measured and related to age, sex, and body mass index...
May 2018: Acta Ortopedica Brasileira
Tiago Lazzaretti Fernandes, Livia Dau Videira, Sandra Umeda Sasaki, Renato José Mendonça Natalino, Adriano Marques DE Almeida, André Pedrinelli, Arnaldo José Hernandez
Objectives: Several cases of bilateral diffuse pigmented villonodular synovitis (PVNS) or tenosynovial giant cell tumor have been described in the literature. Nevertheless, some presentations are rare and differential diagnoses are necessary. Methods: The purpose of this study was to perform a systematic review of the literature related to PVNS and to report a rare supra-patellar bilateral and focal presentation. We performed a systematic data review in the Pubmed Clinical Queries database using MeSH and keywords related to PVNS and tenosynovial giant cell tumor...
May 2018: Acta Ortopedica Brasileira
Gustavo Bersani Silva, Matheus Teotonio Vellosa, Alvaro Baik Cho, Raquel Bernardelli Iamaguchi DA Costa, Olavo Pires DE Camargo, Rames Mattar
Objective: The medial femoral condyle corticoperiosteal flap is irrigated by the descending genicular artery, and when this is absent, by the superior medial genicular artery. The descending genicular artery divides into the muscular, saphenous, and osteoarticular branches. The objective of this study was to describe the variables involved in the dissection of the medial femoral condyle flap. Methods: Thirty thighs from 20 cadavers were dissected and the following variables were recorded: age, height, weight, thigh length, presence of the descending genicular artery, whether the saphenous branch originated from the descending genicular artery, the length of the branches originating from the descending genicular artery, and the diameter of the descending genicular artery and the vena comitans...
May 2018: Acta Ortopedica Brasileira
Rafael Aluisio Fenerich Honorio Ferreira, Leonardo Barros Mascarenhas, Rodrigo Salim, Aline Miranda Ferreira, Fabrício Fogagnolo, Maurício Kfuri
Objective: This study addresses functional data, pain, and the reoperation rate in patients undergoing primary total knee arthroplasty (TKA) during which the patella was or was not replaced. Methods: Fifty-three knees were included, 18 with the patella replaced and 35 with the patella not replaced. WOMAC and SF-12 scores and knee pain were analyzed preoperatively and 3, 6, and 12 months after TKA. The reoperation rate was also evaluated. Results: Both groups presented significant improvement in WOMAC score and pain at all postoperative follow-up appointments...
May 2018: Acta Ortopedica Brasileira
Izumi Tani, Naoki Nakano, Koji Takayama, Kazunari Ishida, Ryosuke Kuroda, Tomoyuki Matsumoto
Objective: It is difficult to achieve proper alignment after total knee arthroplasty (TKA) in patients with extra-articular deformity (EAD) because of altered anatomical axis and distorted landmarks. As of this writing, only case series have been reported with regard to the usefulness of computer-assisted navigation systems for TKA with EAD. This study therefore compared outcomes in TKA with EAD, with and without navigation. Methods: Fourteen osteoarthritis patients with EAD due to previous fracture malunion or operations were assessed...
May 2018: Acta Ortopedica Brasileira
Adriano Marques DE Almeida, Marcelo Bordalo Rodrigues, Marcia Uchôa DE Rezende, André Pedrinelli, Arnaldo José Hernandez
Objective: To clinically and radiologically evaluate patients who received meniscal suture using the outside-in technique, comparing magnetic resonance imaging (MRI), arthro-magnetic resonance imaging (arthro-MRI), and arthro-computed tomography (arthro-CT) to evaluate the healing of meniscal sutures. Methods: We evaluated eight patients with an average follow-up of 15 months. The evaluation analyzed clinical parameters using the Lysholm and IKDC scores as well as MRI, arthro-MRI, and arthro-CT imaging...
May 2018: Acta Ortopedica Brasileira
Henrique Mansur, Rafael Alvarez, Anderson Freitas, Cesar Barbosa Gonçalves, Max Rogerio Freitas Ramos
Objectives: To analyze the results of biomechanical assays of the fixation of Pauwels type II femoral neck fractures in synthetic bones, using two parallel cannulated screws or three cannulated screws in an inverted pyramid formation. Methods: Ten Brazilian-made synthetic bones were divided into 2 groups. Groups A and B utilized three and two cannulated screws, respectively, after osteotomy in the middle third of the femur, perpendicular to the axis of the femoral neck, simulating a Pauwels type II femoral neck fracture...
May 2018: Acta Ortopedica Brasileira
Hugo Alberto Nakamoto, Frederico Faleiro Ramos, Reinaldo Borges Gonçalves, Dov Charles Goldenberg, Rolf Gemperli
Objective: To evaluate postoperative epidemiological and functional factors in patients operated to treat duplicate thumb. Methods: This retrospective case series evaluated 20 patients (23 thumbs) treated from January 2012 to December 2016 at our service. Epidemiological and clinical factors were studied, including Tada score. Results: Of the 34 children who were treated surgically, only 20 appeared for the functional evaluation and were included in the study...
May 2018: Acta Ortopedica Brasileira
Vinícius Ynoe DE Moraes, Priscila Frantz Ruff, Carlos Henrique Fernandes, João Baptista Gomes Dos Santos, João Carlos Belloti, Flávio Faloppa
Objective: To assess the applicability of randomized clinical trials and whether certain factors (surgeon experience/journal impact factor) influence their applicability. Methods: In this survey study we used the Pubmed/Medline database to select 32 consecutive randomized clinical trials published between 2013 and 2015, involving hand surgery (high/low impact). These studies were independently assessed by 20 hand surgeons (with more or less than 10 years of practice) who answered 4 questions regarding their applicability...
May 2018: Acta Ortopedica Brasileira
Paulo Lobo, Eugênio Dos Santos, José Humberto DE Souza Borges, Luana Junqueira Resende Volpe Dias, Ronny DE Souza Machado, Anderson Freitas
Objective: To conduct a systematic review of literature about the use of contralateral patellar tendon autograft in anterior cruciate ligament reconstructions and present the results. Methods: The LILACS, MEDLINE, Cochrane, PubMed, Scielo and Google Scholar databases were searched without date restrictions for the keywords "anterior cruciate ligament reconstruction" combined with "contralateral" in the article title. After the studies were identified, two independent evaluators collected the qualitative characteristics of the studies and classified them according to clinical outcomes of these grafts as positive, neutral, or negative...
March 2018: Acta Ortopedica Brasileira
Alexandre Leme Godoy-Santos, Cesar DE Cesar
Spatial understanding of osteoarticular deformities of the foot and ankle is vital to correct diagnosis and therapeutic decision making. Poor reproducibility in conventional standing radiography in three orthogonal views has driven the development of weight-bearing computed tomography (WBCT) technology over the last decade. We analyzed the available literature on WBCT imaging in patients with foot and ankle disorders by performing a literature review of relevant clinical studies in multiple databases including PubMed, MedLine, and Scopus from January 1999 to October 2017...
March 2018: Acta Ortopedica Brasileira
Bruno Azevedo Veronesi, Marcelo Bordalo Rodrigues, Marina Tommasini Carrara DE Sambuy, Rodrigo Sousa Macedo, Álvaro Baik Cho, Marcelo Rosa DE Rezende
Objective: To compare magnetic resonance imaging and intraoperative findings in patients diagnosed with traumatic injury to the brachial plexus. Methods: Patients with a diagnosis of traumatic injury to the brachial plexus admitted to the hand and microsurgery outpatient consult of the Hospital das Clínicas at the University of São Paulo were selected during December 2016. A total of three adult patients with up to six months of injury who underwent surgical treatment were included in the study...
March 2018: Acta Ortopedica Brasileira
Gustavo Bersani Silva, Bruno Azevedo Veronesi, Luciano Ruiz Torres, Raquel Bernardelli Imaguchi, Alvaro Baik Cho, Hugo Alberto Nakamoto
Objective: To analyze 10 consecutive cases of microsurgical arteriovenous loops created to reconstruct complex injuries from March 2011 to May 2012. Methods: This observational cohort-type study conducted by the Hand and Microsurgery Group at the HC-FMUSP included patients who were candidates for microsurgical reconstruction as a last alternative to amputation of the limb with proven absence of adequate recipient vessels for primary microsurgical anastomosis, in a prospective and consecutive manner...
March 2018: Acta Ortopedica Brasileira
Marco Aurélio Cotegipe Negrelli, Rafael Garcia DE Oliveira, Ivan Dias DA Rocha, Alexandre Fogaça Cristante, Raphael Martus Marcon, Tarcísio Eloy Pessoa DE Barros
Objective: To collect data from patients with cervical fracture who were treated surgically in a tertiary health service, in order to better understand the current scenario of this kind of injury in our population. Methods: This retrospective survey examined consecutive cases of patients with cervical spine trauma who received surgical treatment during 2013 and 2014. The data were subjected to descriptive statistical analysis. Results: Fifty-two patients were treated with surgery during 2013 and 2014...
March 2018: Acta Ortopedica Brasileira
Michael Minsu Shu, Andre Langes Canhos, Guilherme Pereira Ocampos, Perola Grimberg Plapler, Olavo Pires Camargo, Marcia Uchoa DE Rezende
Objective: To evaluate the profile of patients with osteoporotic fractures treated at a tertiary orthopedic hospital. Methods: Using questionnaires, 70 patients with osteoporotic fractures (OF) were compared with 50 outpatients with multiple osteoarthritis (OA) followed through an outpatient clinic. Results: The OF group was older (p <0.001), less heavy (p=0.003), had lower BMI (p=0.006), was more likely to be white (p=0.011), was less likely to be married (p=0...
March 2018: Acta Ortopedica Brasileira
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