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Revista Brasileira de Ortopedia

André Lourenço Pereira, Ângelo Ribeiro Vaz de Faria, Túlio Vinícius de Oliveira Campos, Marco Antônio Percope de Andrade, Guilherme Moreira de Abreu E Silva
Avulsion of the tibial tubercle is an uncommon injury that occurs in the young athlete, resulting from an eccentric contraction of the extensor mechanism with the leg fixed to the ground. Concomitant injuries to the patellar tendon are very rare, with few cases reported in the literature. The authors present a case of a 15-year-old basketball player who suffered an avulsion of the tibial tubercle associated with complete distal rupture of the patellar tendon while training. It was treated with open reduction of the tibial fragment and reconstruction of the patellar tendon with mini-anchors and cannulated screws, as well as hamstring autograft tendon reinforcement...
July 2018: Revista Brasileira de Ortopedia
Rodrigo Pires E Albuquerque, Pedro Guilme Teixeira de Sousa Filho, Fabrício Bolpato Loures, Hugo Cobra, João Maurício Barretto, Naasson Cavanellas
The occurrence of permanent patellar dislocation associated with severe osteoarthritis is considered rare and difficult to treat. Literature: The literature is quite controversial on the subject. The objective of the study is to report two rare cases of severe osteoarthritis with permanent dislocation of the patella that underwent total knee arthroplasty, in addition to a review of the literature on the subject and related surgical technique. Total knee arthroplasty with using the medial parapatellar approach associated with lateral release was a good surgical option in patients with permanent patellar dislocation associated with advanced osteoarthritis...
July 2018: Revista Brasileira de Ortopedia
Guilherme Conforto Gracitelli, Fernando Cury Rezende, Ana Luiza Cabrera Martimbianco, Carlos Eduardo da Silveira Franciozi, Marcus Vinicius Malheiros Luzo
The authors report a rare case of osteochondritis dissecans of the trochlea. The treatment of these lesions, in which the osteochondral fragment is not viable, is difficult and often limited in Brazil. A clinical case is presented with functional and radiological outcomes after treatment with microfracture technique, bone graft, and collagen membrane coverage.
July 2018: Revista Brasileira de Ortopedia
Nivaldo Cardozo Filho, Gyoguevara Patriota, Rodrigo Falcão, Roberto Maia, Gildásio Daltro, Daniel Alencar
Fournier's gangrene is a rare, high-mortality infection that affects the subcutaneous tissue with rapidly progressive necrosis. The objective is to report a case of Fournier's gangrene involving the region of the shoulder girdle after closed fracture of the clavicle, and to discuss this unusual evolution. The patient underwent a series of surgical procedures and was followed up on an outpatient basis for 12 months, at which point she was discharged. Fournier's gangrene is an aggressive lesion and requires early diagnosis (clinical-laboratory correlation) with the appropriate adequate surgical approach and clinical stabilization...
July 2018: Revista Brasileira de Ortopedia
Kiran Makwana, Mayank Vijayvargiya, Nitesh Agarwal, Ketan Desai, Vivek Shetty
Musculoskeletal injuries such as dislocation of the shoulder and hip joints and fractures of the femoral neck are known complications of seizures. Bilateral central subluxation of the hip joint with associated bilateral quadrilateral plate fracture is a rare entity and is prone to delayed diagnosis, even more so in patients who experience post-seizure disorientation. The authors report the case of a 74-year-old male patient with bilateral central subluxation of the hip joint with associated bilateral quadrilateral plate fracture due to seizure activity...
July 2018: Revista Brasileira de Ortopedia
Sahu Ramji Lal
Objective: The aim of this study was to evaluate the functional outcome of surgically treated acetabular fractures. Methods: A prospective longitudinal study was undertaken in this hospital during the period from December 2010 to December 2014. A total number of 46 patients with the diagnosis of acetabular fracture were included in the study. The main cause of the acetabular injury was a road traffic accident. All the patients were treated surgically with plates and screws...
July 2018: Revista Brasileira de Ortopedia
Anmol Sharma, Anisha Sethi, Shardaindu Sharma
Objective: To evaluate and compare the clinical and radiological outcomes of patients with stable intertrochanteric fractures treated with proximal femoral nail vs. dynamic hip screw. Methods: Sixty patients with stable intertrochanteric fractures, aged over 18 years, were randomly divided into the proximal femoral nail and dynamic hip screw groups. Dynamic hip screw with a three-hole side-plate and an anti-rotation screw were used, as well as a modified ultra-short proximal femoral nail for the smaller Asian population...
July 2018: Revista Brasileira de Ortopedia
Chilan Bou Ghosson Leite, Rodrigo Sousa Macedo, Guilherme Honda Saito, Marcos Hideyo Sakaki, Kodi Edson Kojima, Túlio Diniz Fernandes
Objective: To analyze the epidemiology and characteristics of patients with calcaneus fractures. Methods: This is a retrospective revision of patients with calcaneus fractures hospitalized in the Institute of Orthopedics and Traumatology of this institution between 2006 and 2010. Data such as age, gender, laterality, trauma mechanism, type of fracture, associated injuries, compound fractures, and time from injury to surgery were analyzed. Results: The analysis of 52 patients showed that men were more commonly affected than women, at a ratio of 5...
July 2018: Revista Brasileira de Ortopedia
Leandro Duil Kim, Fabiana Toledo Bueno, Eduardo Sadao Yonamine, José Donato de Próspero, Geanete Pozzan
Objectives: To determine the role of immunohistochemistry in identifying the primary site of tumors, and in establishing which bones are most frequently involved, their relationship with the primary tumor site, and the rate of pathologic bone fracture as the first symptom of a malignant tumor. Methods: A retrospective analysis of all medical records on bone metastases the cases treated between January 2006 and December 2011 at the Department of Orthopedics and Traumatology was performed...
July 2018: Revista Brasileira de Ortopedia
José Antonio Galbiatti, Fabrício Luz Cardoso, James Augusto Soares Ferro, Rafael Cassiolato Garcia Godoy, Sérgio de Oliveira Bruno Belluci, Evandro Pereira Palacio
Objective: This study aims at analyzing retrospectively the clinical-functional and radiographic results of surgical treatment of the terrible elbow triad, with at least 12 months of postoperative follow-up evaluating elbow function. Methods: A group of patients for retrospective analysis from 2004 to 2015 was defined, in which 12 patients were studied. They underwent surgery due to fracture of the radial head, coronoid fracture, and elbow dislocation; they were evaluated by the Disabilities of the Arm, Shoulder and Hand (DASH) score, the degree of patient satisfaction, the degree of trauma energy, radiographic images, range of motion, and complications...
July 2018: Revista Brasileira de Ortopedia
Ricardo Barreto Monteiro Dos Santos, Cleber Maciel de Morais Prazeres, Ricardo Mertens Fittipaldi, João Monteiro Neto, Tiago Cerqueira Lima Nogueira, Saulo Monteiro Dos Santos
Objective: To evaluate the labral height and pullout resistance after the repair of Bankart lesions in the glenohumeral joint of swine models, using double-loaded anchors with two suture configurations: simple and Mason-Allen. Methods: Ten swine shoulders were used, in which Bankart lesions were created. For each specimen, the lesion was sutured randomly with Mason-Allen sutures or simple sutures. The labral height was measured before the lesion was created and after the labral repair...
July 2018: Revista Brasileira de Ortopedia
Luís Filipe Senna, Max Rogério Freitas Ramos, Ricardo Folador Bergamaschi
Objective: Evaluate and compare the results of single-row (SR) vs. double-row (DR) arthroscopic rotator cuff repair. Methods: From December 2009 to May 2013, 115 arthroscopic rotator cuff repairs were performed using suture anchors. After applying the exclusion criteria, there were 75 patients (79 shoulders) to be evaluated, retrospectively, of whom 53 (56 shoulders) attended re-evaluation. The patients were divided into two groups: SR with 29 shoulders, and DR) with 27 shoulders...
July 2018: Revista Brasileira de Ortopedia
Eduardo Angeli Malavolta, Jorge Henrique Assunção, Mauro Emilio Conforto Gracitelli, Pedro Antonio Araújo Simões, Danilo Kenji Shido, Arnaldo Amado Ferreira Neto
Objective: To evaluate the correlation between the UCLA and Constant-Murley scores in the surgical treatment of rotator cuff tears and proximal humeral fractures (PHF). Methods: Retrospective study evaluating patients submitted to arthroscopic rotator cuff repair and surgical treatment of PHF with 2-year follow-up. Patients were evaluated by the UCLA and Constant-Murley scores in the preoperative period for the rotator cuff repairs, and 3, 6, 12 and 24 months after surgery for both diagnoses...
July 2018: Revista Brasileira de Ortopedia
Marcio de Castro Ferreira, Julio Cesar Pinto Oliveira, Flavio Ferreira Zidan, Carlos Eduardo da Silveira Franciozi, Marcus Vinicius Malheiros Luzo, Rene Jorge Abdalla
Objective: To analyze the number of hospital permits for total knee arthroplasty (TKA) and total hip arthroplasty (THA) in Brazil between 2008 and 2015, and correlate them with regional, national, and international demographic and epidemiological aspects. Methods: Data on demographics, economic level, and TKA and THA were obtained from the website of the Ministry of Health/DATASUS, Brazilian Institute of Geography and Statistics, and the National Health Agency to assess the assistance provided by the Public Health Care System in arthroplasties for elderly Brazilian population without private health care...
July 2018: Revista Brasileira de Ortopedia
Eduardo Frois Temponi, João Newton Penido Oliveira, Luiz Fernando Machado Soares, Lúcio Honório de Carvalho Júnior
Objective: Violation of the posterior femoral cortex commonly referred to as posterior wall blowout, can be a devastating intraoperative complication in anterior cruciate ligament reconstruction (ACLR) and can lead to loss of graft fixation or early graft failure. This study describes and analyzes whether the femoral tunnel view test can ensure the integrity of the femoral tunnel during ACLR. Methods: Intraoperative femoral tunnel integrity using the 360° arthroscopic view test was performed in 584 ACLR patients between 2014 and 2016...
July 2018: Revista Brasileira de Ortopedia
Julio Cesar Gali, Danilo Bordini Camargo, Felipe Azevedo Mendes de Oliveira, Rafael Henrique Naves Pereira, Phelipe Augusto Cintra da Silva
Objective: To evaluate the morphology of the anterior cruciate ligament (ACL) femoral insertion in order to describe its anatomical features and insertion site location, with the aim of verifying if the ACL femoral insertion has individual characteristics and to provide information for appropriate femoral tunnel placement on anatomic ACL reconstruction. Methods: Sixteen knees obtained from amputations were studied. The ACL femoral bundles and insertion shape were observed macroscopically, and the ligaments insertion length and thickness were measured with a digital caliper...
July 2018: Revista Brasileira de Ortopedia
Lauro Augusto Veloso Costa, Marcos Barbieri Mestriner, Thiago Alvim do Amaral, Bárbara Dos Santos Barbosa, Camila Cohen Kaleka, Ricardo de Paula Leite Cury
Objectives: To describe the microscopic anatomy of the posterior cruciate ligament femoral insertion in order to identify and establish differences between the direct and indirect insertions of this ligament. Methods: Ten cadaveric knees were used for this study. The posterior cruciate ligament femoral insertion was observed microscopically. Hematoxylin and eosin staining was performed to observe the morphology of the posterior cruciate ligament insertion. Alcian blue staining was performed to determine the location of the cartilage matrix and better assist in the observation and differentiation between direct and indirect insertions...
July 2018: Revista Brasileira de Ortopedia
Bruno Adelmo Ferreira Mendes Franco, David Sadigursky, Gildásio de Cerqueira Daltro
Objectives: To determine the prevalence of high patella in adult patients with knee pain, and to correlate patellar height with symptoms of patellar instability, episode of patellofemoral dislocation and anterior pain in the knee; and also verify the concordance correlation between the Insall-Salvati and Caton-Deschamps indices. Method: Cross-sectional study analyzing the medical records of patients with knee pain, using lateral view knee radiographs with 30° degrees of flexion and computed tomography...
July 2018: Revista Brasileira de Ortopedia
Diego da Costa Astur, João Victor Novaretti, Andre Cicone Liggieri, César Janovsky, Alexandre Pedro Nicolini, Moises Cohen
Objective: Perform the preoperative measurement of the hamstring tendons using ultrasound imaging, validating and correlating the measured value with that found during surgical reconstruction of the ligament. Methods: A cross-sectional study was carried out with 24 patients who underwent ultrasonographic measurement of the semitendinosus and gracilis muscle tendons and were subsequently submitted to surgical reconstruction of the ACL, with ipsilateral semitendinosus and gracilis tendon grafting...
July 2018: Revista Brasileira de Ortopedia
Luciano Rodrigo Peres, Matheus Silva Teixeira, Caetano Scalizi Júnior, Wolf Akl Filho
Objective: To evaluate the inclination and the length of the femoral tunnel in patients submitted to anterior cruciate ligament reconstruction (ACL) surgery by transtibial and anatomical techniques. Methods: This is an analytical observational study in patients with ACL injury that underwent arthroscopic reconstruction through transtibial and anatomical surgical techniques. In the immediate postoperative period, computed tomography (CT) and anteroposterior (AP) view digital radiographs (X-rays) were performed to evaluate the inclination and length of the femoral tunnel...
July 2018: Revista Brasileira de Ortopedia
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