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Revista Brasileira de Ortopedia

Carlos Roberto Schwartsmann, João Pedro Farina Brunelli, Gabriel Severo da Silva, Silvio Coelho
Slipped capital femoral epiphysis is a very frequently seen condition in orthopedics centers worldwide. Even in successfully treated cases, complications related either with the pathology per se or with the chosen synthesis method are not rare. This report presents a case of bilateral slipped capital femoral epiphysis treated with pinning, in which one of the limbs developed a very rare condition: the formation of a femoral pseudoaneurysm that ruptured.
January 2018: Revista Brasileira de Ortopedia
Carlos Roberto Schwartsmann, Carlos Alberto de Souza Macedo, Carlos Roberto Galia, Ricardo Horta Miranda, Leandro de Freitas Spinelli, Marco Tonding Ferreira
This article aims to report four cases of unstable pelvic fractures in pregnant women treated by open reduction and internal fixation. Cases report: The study included four cases of pregnant women with unstable pelvic fractures; their outcomes were analyzed and discussed. Data were obtained from two University Hospitals. The mean age of women was 23 years; most (3/4) were primiparous, with a mean pregnancy age of 23 weeks. Two women had Malgaigne-type fractures and the other two had symphyseal disjunction associated with acetabular fractures...
January 2018: Revista Brasileira de Ortopedia
Alberto Naoki Miyazaki, Luciana Andrade Silva, Guilherme do Val Sella, Caio Santos Checchia, Marcos Cazer Simionato, Sergio Luiz Checchia
The authors describe a surgical biological reconstruction of the humeral head with frozen autogenous allograft technique for the treatment of young patients with focal osteonecrosis of the humeral head. This represents a possible alternative, maybe even definitive for some patients, when compared to hemiarthroplasty or total shoulder arthroplasty. The technique consists of the fixation of a frozen autogenous allograft with previously-molded articular cartilage from the humeral head, after cleansing the osteonecrotic focus...
January 2018: Revista Brasileira de Ortopedia
André Luiz Natálio Dias, Fernando Flores de Araújo, Alexandre Fogaça Cristante, Raphael Martus Marcon, Tarcísio Eloy Pessoa de Barros Filho, Olavo Biraghi Letaif
Objective: The primary objective of this study was to analyze the characteristics and outcomes of cases admitted to hospital with cauda equina syndrome (CES) at the Institute of Orthopedics and Traumatology (IOT) from 2005 to 2015. Secondly, this article is a continuation of the epidemiological work of the same base published in 2013, and will be important for other comparative studies to a greater understanding of the disease and its epidemiology. Methods: This was a retrospective study of the medical records of admissions due to CES at IOT in the period 2005-2015 with diagnosis of CES and neuropathic bladder...
January 2018: Revista Brasileira de Ortopedia
Lucas Lopes da Fonseca, Icaro Gusmão Nunes, Rodrigo Reis Nogueira, Gustavo Eduardo Vieira Martins, Antônio Cesar Mesencio, Sílvia Iovine Kobata
Objective: This study evaluated the reproducibility of the three main classifications of ankle fractures most commonly used in emergency clinical practice: Lauge-Hansen, Danis-Weber, and AO-OTA. The secondary objective was to assess whether the level of professional experience influenced the interobserver agreement for the classification of this pathology. Methods: The study included 83 digitized preoperative radiographic images of ankle fractures, in anteroposterior and lateral views, of different adults that had occurred between January and December 2013...
January 2018: Revista Brasileira de Ortopedia
Carlos Eduardo Benvindo Rosal da Fonseca Neto, Marcos Murilo Santana Lima, Bruno Tavares Rabello, Leonardo da Silva Sena, Luiz Carlos Zacaron Júnior, Maurício Tarrago Viana
Objective: This study is aimed at evaluating the fixation of trabecular metal wedges in patients who underwent revision of total hip arthroplasty with large acetabular bone defects. Methods: The radiographs of 19 patients (21 hips), who underwent revision of total hip arthroplasty using trabecular metal wedges from September 2010 to December 2014 were evaluated. This study included only cases of Paprosky 3A and 3B. Preoperative and postoperative images were analyzed...
January 2018: Revista Brasileira de Ortopedia
Vincenzo Giordano, Alexandre Leme Godoy Dos Santos, William Dias Belangero, Robinson Esteves Santos Pires, Pedro José Labronici, Hilton Augusto Koch
Objective: To determine the ideal working area for a simple transverse fracture line treated with a bridge plate. Methods: A 2-D finite element analysis of a hypothetical femur was performed for the quantitative evaluation of a large-fragment titanium alloy locking plate based on the precept of relative stability in a case of a simple transverse diaphyseal fracture. Two simulations (one case of strain and another case of stress distribution) were analyzed in three unique situations according to the von Mises stress theory...
January 2018: Revista Brasileira de Ortopedia
Carlos Roberto Schwartsmann, Henrique Marquardt Lammerhirt, Leandro de Freitas Spinelli, Ary da Silva Ungaretti Neto
Objective: The purpose of this study is to evaluate the performance of dynamic hip screw for the treatment of dislocated femoral neck fractures in young patients, focusing on osteonecrosis. Methods: A series of 53 patients with less than 55 years of age were retrospectively evaluated. All patients had dislocated femoral neck fractures (Garden III or IV) and were treated with DHS. Ficat's staging system was used to evaluate avascular necrosis. Results: There were 38 (71...
January 2018: Revista Brasileira de Ortopedia
Edie Benedito Caetano, Luiz Angelo Vieira, Tyago Araújo Almeida, Luis Andres Montero Gonzales, José Eduardo de Bona, Thais Mayor Simonatto
Objective: The aim of this study was to analyze the anatomic variations of the bicipital aponeurosis (BA) (lacertus fibrosus) and its implications for the compression of the median nerve, which is positioned medially to the brachial artery, passing under the bicipital aponeurosis. Methods: Sixty upper limbs of 30 cadavers were dissected, 26 of which were male and four, female; of the total, 15 had been previously preserved in formalin and glycerine and 15 were dissected fresh in the Laboratory of Anatomy...
January 2018: Revista Brasileira de Ortopedia
Diogo Lino Moura, Augusto Reis E Reis, João Ferreira, Manuel Capelão, José Braz Cardoso
Objective: This study aims to describe the surgical approach to such injuries and to present the clinical and functional outcomes obtained in a cohort of patients. Methods: This is an observational retrospective study that included 153 patients with acute acromioclavicular joint dislocation, operated between 1999 and 2015. Clinical evaluation included the following outcomes: Constant functional scale, development of complications, time to return to previous work/sport activities, and satisfaction index...
January 2018: Revista Brasileira de Ortopedia
Alberto de Castro Pochini, Marcus de Souza Barbosa Rodrigues, Larissa Yamashita, Paulo Santoro Belangero, Carlos Vicente Andreoli, Benno Ejnisman
Objective: To assess the tendon reconstruction technique for total rupture of the pectoralis major muscle using an adjustable cortical button. Methods: Prospective study of 27 male patients with a mean age of 29.9 (SD = 5.3 years) and follow-up of 2.3 years. The procedure consisted of autologous grafts taken from the semitendinosus and gracilis tendons and an adjustable cortical button. Patients were evaluated functionally by the Bak criteria. Results: The surgical treatment of pectoralis major muscle tendon reconstruction was performed in the early stages (three weeks) in six patients (22...
January 2018: Revista Brasileira de Ortopedia
Evandro Pereira Palacio, Gilberto José Cação Pereira, Paulo Roberto de Almeida Silvares, Gabriel Guimarães Di Stasi, Caio de Andrade Staut, Trajano Sardenberg
Objective: Synthetic adhesives are used by various medical specialties, especially in surgery; however, studies reporting their use in orthopedic practice are scarce. The aim of this study was to compare the results in using ethyl-2-cyanoacrylate or butyl-2-cyanoacrylate in the treatment of fractures in rats. Methods: This was an experimental prospective controlled study in 90 rats, with humerus, femur, and tibia fractures, treated with ethyl-2-cyanoacrylate (SB group; n = 45) or butyl-2-cyanoacrylate (HA group; n = 45)...
January 2018: Revista Brasileira de Ortopedia
Fernanda Gimenez de Souza, Beatriz Luci Fernandes, Carmen Lucia Kuniyoshi Rebelatto, Alessandra Melo de Aguiar, Letícia Fracaro, Paulo Roberto Slud Brofman
Objective: To evaluate the ability of the eluate from fibrin-rich plasma (FRP) membrane to induce proliferation and differentiation of isolated human adipose-derived stem cells (ASCs) into chondrocytes. Method: FRP membranes were obtained by centrifugation of peripheral blood from two healthy donors, cut, and maintained in culture plate wells for 48 h to prepare the fibrin eluate. The SCATh were isolated from adipose tissue by collagenase digestion solution, and expanded in vitro...
January 2018: Revista Brasileira de Ortopedia
Martins Back Netto, Ana Beatriz Sanches Barranco, Karen Waleska Kniphoff de Oliveira, Fabrícia Petronilho
Objective: Comparative analysis of the quality of life and functionality of patients undergoing lumbar spine arthrodesis due to degenerative lumbar spine disease. The authors sought to correlate the influence of anxious and depressive symptoms before and after surgery. Methods: A prospective cohort study was performed, with 32 patients submitted to arthrodesis due to degenerative lumbar spine disease and the visual analogue pain scale pain questionnaire, the Oswestry Disability Index questionnaire, the Medical Outcomes Survey Short Form questionnaire - 36 items (SF-36), and the Hospital Anxiety and Depression Scale, applied in the preoperative period and four months after the procedure...
January 2018: Revista Brasileira de Ortopedia
Jairo Greco Garcia, Adriano Martinez, Reynaldo Jesus Garcia Filho, Marcelo Toledo Petrilli, Dan Carai Viola
Objective: Describe the epidemiological profile of patients with primary or secondary neoplastic lesions in the pelvis who required a surgical procedure such as hemipelvectomy. Methods: This study retrospectively evaluated 69 patients located in the database of a São Paulo educational institution, subject to surgical hemipelvectomy treatment between January 1990 and December 2013. All patients had previous diagnosis of bone tumor (primary or metastatic) in the pelvis (ilium, ischium, pubis, and/or sacrum)...
January 2018: Revista Brasileira de Ortopedia
Sergio Figueiredo, Luis Sa Castelo, Ana Daniela Pereira, Luis Machado, Joao Andre Silva, Antonio Sa
Objective: Magnetic resonance imaging (MRI) is paramount in the assessment of knee pathology, particularly when planning for a surgical procedure. This study compared the diagnostic accuracy in MRI reading of pathological knees by radiologists and orthopaedic surgeons. Materials and methods: Cross-sectional study comprising 80 randomly selected patients previously submitted to arthroscopic surgery after clinical examination and MRI. A diagnosis by MRI interpretation was requested from the two teams, one of radiologists and another of orthopaedic surgeons...
January 2018: Revista Brasileira de Ortopedia
Jose Luiz Colleoni, Fernando Noel Ribeiro, Paulo Augusto Castro Mos, João Paulo Reis, Henrique Rosa de Oliveira, Beatriz Kawata Miura
Objectives: To compare the efficacy and safety of aspirin and rivaroxaban in preventing venous thromboembolism (VTE) after total knee arthroplasty (TKA). Methods: Thirty-two patients with osteoarthritis of the knee and knee arthroplasty indication were selected. The operated patients were randomized into two groups (A and B). Group A received 300 mg of acetylsalicylic acid (aspirin) and Group B received 10 mg of rivaroxaban daily for 14 days. Follow-up was performed weekly for four weeks and evaluated the presence of signs and symptoms of DVT, the healing of the surgical wound, and possible local complications such as hematoma, and superficial or deep infection that required surgical approach...
January 2018: Revista Brasileira de Ortopedia
Daniel Tôrres Jácome, Fernando Henrique Uchôa de Alencar, Marcos Vinícius Vieira de Lemos, Rudolf Nunes Kobig, João Francisco Recalde Rocha
Objectives: This study is aimed at comparing the functional outcome of axillary nerve neurotization by a triceps motor branch through the axillary approach and posterior arm approach. Methods: The study included 27 patients with post-traumatic brachial plexus injury treated with axillary nerve neurotization by a triceps motor branch for functional recovery of shoulder abduction and external rotation. The patients were retrospectively evaluated and two groups were identified, one with 13 patients undergoing axillary nerve neurotization by an axillary approach and the second with 14 patients using the posterior arm approach...
January 2018: Revista Brasileira de Ortopedia
Henrique Gonçalves Mansur, Edmo Rodrigues de Oliveira, Cesar Barbosa Gonçalves
Objective: To evaluate the risk factors and analyze the characteristics of patients and lesions in Dupuytren's disease. Methods: Retrospective analysis of patients diagnosed with Dupuytren's disease in a hand surgery clinic in 2013. The authors evaluated parameters associated with the patient profiles and risk factors, the form and severity of involvement, and characteristics of the lesions. Results: 58 patients were evaluated, totaling 79 hands, with bilateral involvement in 46% of cases...
January 2018: Revista Brasileira de Ortopedia
Vinícius Alexandre de Souza Almeida, Carlos Henrique Fernandes, João Baptista Gomes Dos Santos, Francisco Alberto Schwarz-Fernandes, Flavio Faloppa, Walter Manna Albertoni
Objective: To measure the reliability of Albertoni's classification for mallet finger. Methods: Agreement study. Forty-three radiographs of patients with mallet finger were assessed by 19 responders (12 hand surgeons and seven residents). Injuries were classified by Albertoni's classification. For agreement comparison, lesions were grouped as: (A) tendon avulsion; (B) avulsion fracture; (C) fracture of the dorsal lip; and (D) physis injury-and subgroups (each group divided into two subgroups)...
January 2018: Revista Brasileira de Ortopedia
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