traumatología

BACKGROUND: Medial epicondyle fractures represent up to 20% of elbow fractures in children and adolescents. There is a growing body of literature to support surgical fixation for displaced fractures. However, controversy regarding imaging modality for displacement measurement and surgical indications remain controversial. The purpose of this survey was to gauge Latin American surgeons' practices and preferences for the evaluation and treatment of medial epicondyle fractures. METHODS: A web-based survey containing 19 questions was distributed to active members of SLAOTI (Sociedad Latinoamericana de Ortopedia y Traumatología Infantil) in November 2018...

INTRODUCTION: The acromioclavicular joint, important part of the shoulder complex is formed by clavicular lateral end and acromial medial border, with high index of injury in different grades, associated to physical activity and work accidents, most commonly in active young adults. OBJECTIVE: To analyze functional outcomes in patients with acromioclavicular dislocation with use of tight rope in one year. Material and methods: Descriptive, prospective, longitudinal, unicentric study, from March 2015 and July 2016 in post-operated patients with diagnosis of acromioclavicular dislocation grade III in Hospital de Traumatología y Ortopedia de Puebla...

BACKGROUND: Medial epicondyle fractures represent up to 20% of elbow fractures in children and adolescents. There is a growing body of literature to support surgical fixation for displaced fractures. However, controversy regarding imaging modality for displacement measurement and surgical indications remain controversial. The purpose of this survey was to gauge Latin American surgeons' practices and preferences for the evaluation and treatment of medial epicondyle fractures. METHODS: A web-based survey containing 19 questions was distributed to active members of SLAOTI (Sociedad Latinoamericana de Ortopedia y Traumatología Infantil) in November 2018...

Objective  To define the major epidemiological features of upper limb penetrating injuries, as well as to identify the causes and the frequency of these lesions at the Instituto de Ortopedia e Traumatologia, a hand surgery center in the city of São Paulo, state of São Paulo, Brazil. Methods  The present study was based on a sample of consecutive patients from our orthopedics and traumatology institute from May 2014 to May 2016. Data were collected by telephone, and a prestructured questionnaire regarding data and features of the lesions was applied...

BACKGROUND: Shared decision-making (SDM) is widely accepted as an essential feature of patient-centered care. However, to our knowledge, there has been no empirical research on the factors that influence orthopaedic surgeons' use of SDM in Guatemala. METHODS: Questions about physician attributes and SDM were included in a 2016 electronic survey distributed to the 221 members of the Asociación Guatemalteca de Ortopedia y Traumatología (AGOT). RESULTS: A total of 114 (52%) of the AGOT-registered orthopaedic surgery residents and orthopaedic surgeons who were sent surveys returned them, and 79 of these surveys contained complete responses to study variables of interest...

BACKGROUND: Quality of life has become a key outcome in assessing the effectiveness of treatments and interventions in health. METHODS: Accordingly, this research study aimed to measure quality of life using the EQ-5D-3L instrument for patients from the Jamil Haddad National Institute of Traumatology and Orthopedics (Instituto Nacional de Traumatologia e Ortopedia Jamil Haddad - INTO) with femoral fractures, hospitalized between 11/2015 and 10/2016. RESULTS: A total of 165 orthopedic trauma patients with femoral fractures, aged 18 years or older, who were hospitalized and operated upon in the INTO were assessed...

Cervical spine injury is rare in children. It is seen primarily in those who sustain significant, severe blunt trauma, occurring in 1 to 2 percent of such cases. The interpretation of cervical spine radiographs and the clinical examination in children may be difficult.The objective of this case clinic is to report on a physiological radiographic finding of the cervical spine in childhood that trends to be misjudged as pathologic: C2-C3 pseudosubluxation. We presented a boy, aged 5 years, who came to our Traumatic pediatric emergency center for cervical pain after falling from a height...

OBJECTIVE: To assess the opinion of Brazilian orthopedists surgeons on the diagnosis and treatment of femoroacetabular impingement (FAI). METHODS: A questionnaire was sent to several orthopedic societies around the world, including the Sociedade Brasileira de Ortopedia e Traumatologia (SBOT). This questionnaire was sent electronically and included questions on many topics related to FAI. RESULTS: 253 Brazilian orthopedists responded the questionnaire...

OBJECTIVE: To analyze the characteristics of patients with Lisfranc injuries and their associated fractures . METHODS: This is a retrospective analysis on 42 patients with Lisfranc injuries hospitalized at Instituto de Ortopedia e Traumatologia do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, between 2006 and 2010. Parameters on patient profile, risk factors, fracture characteristics, data on treatment and acute complications were analyzed ...

BACKGROUND: Four-corner fusion has been shown to be a reliable option of treatment of wrist arthritis, but there is no consensus about which implant and surgical procedure should be used in the arthrodesis. The present study aimed to describe a surgical technique using 2 crossed screws as implants, inserted in a retrograde manner, and to demonstrate preliminary results of the use of the technique. METHODS: A retrospective study was conducted using medical records and imaging tests (radiographs and computed tomography) of all 15 patients who underwent a standardized 4-corner fusion technique, between December 2011 and July 2015, in the Department of Hand Surgery of Instituto Nacional de Traumatologia e Ortopedia (INTO), Rio de Janeiro, Brazil...

Adolescent idiopathic scoliosis is a 3D spinal deformity in frontal, sagittal and axial planes, with high relevance in the pediatric population especially in adolescents and females between 10 years of age and the end of growth spurt and skeletal maturity. The radiographic manifestation is a curve greater than 10° measured by Cobb method associated with vertebral rotation. "Idiopathic" diagnosis has to be done after neuroanatomical anomalies of the posterior cerebral fosa and spinal canal have been ruled out...

BACKGROUND: Functional and radiographic evaluation at midshaft clavicle fractures is better with surgical than conservative management. The aim of this paper is to describe the functional and radiological evaluation of patients with midshaft clavicle fracture surgery at the Hospital de Traumatología y Ortopedia of the Instituto Mexicano del Seguro Social. METHODS: Descriptive studies, conducted during the period June 2014 to June 2015, patients undergoing surgical treatment for midshaft clavicle fracture were included...

Scapholunate advance collapse (SLAC) and Scaphoid nonunion advance collapse (SNAC), are the two most common patterns of postraumatic wrist arthritis. SLAC wrist develops after attenuation, either traumatically or atraumatically, of the scapholunate ligament. Atraumatic causes of SLAC wrist include calcium pyrophosphate dehydrate deposition disease, reumathoid arthritis, neuropathic diseases, and b2-microglobulin asociated amyloid deposition diseases. On the other hand, SNAC wrist develops following a scahpoid fracture that has progressed to a nonunion...

This article has two parts. The first discusses the relationship between industry and health interests based on three different but non-mutually exclusive "logics": (a) independent; (b) divergent; and (c) convergent. The second part describes the experience at the Brazilian National Institute of Traumatology and Orthopedics (INTO) with a technology management model. The accumulated expertise in orthopedics at INTO can favor Brazil's domestic medical equipment industry without jeopardizing the country's social health needs...

OBJECTIVE: To obtain epidemiological data from the tumors of the patella diagnosed and treated at the Instituto de Ortopedia e Traumatologia do Hospital das Clínicas da Universidade de São Paulo (IOT-HC-FMUSP) between 1998 and 2015. METHODS: Series of cases with retrospective evaluation of patients diagnosed with tumors located in the patella. The data was obtained from the records and patients' charts at the Department of Pathology of IOT-HC-FMUSP. RESULTS: A total of 2220 medical records from patients with anatomopathological reports were included in the study...

Treatment of orthopedic infections usually requires prolonged antimicrobial therapy, ranging from 14 days up to 6 months. Nowadays, rising levels of antimicrobial resistance demands parenteral therapy for many patients. Outpatient parenteral antimicrobial therapy (OPAT) is a modality that allows treatment out of hospital in these situations. In Brazil, where a public universal healthcare system allows full coverage for all citizens, implantation and dissemination of OPAT programs would be beneficial for patients and for the system, because it would allow a better allocation of health resources...

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OBJECTIVE: To present a series of 50 consecutive patients with non-metastatic extremity osteosarcoma, and attempt to correlate expression of the vascular endothelial growth factor (VEGF) protein in biopsy tissue to their prognosis regarding overall survival, disease-free survival and local recurrence. METHODS: Fifty cases of non-metastatic osteosarcoma of the extremities treated between 1986 and 2006 at Instituto de Ortopedia e Traumatologia da Universidade de São Paulo, São Paulo, Brasil, were evaluated regarding expression of the VEGF protein...

The practice of physical activities in children and adolescents requires that the pediatrician carry out a physical examination and extend certification that enables them to participate. When listening to doctors and sports institutions concerns, our Committee decided to update the topic. The relevant point that we have considered is to change the term “Certificate” for “Record”,which implies shared responsibility among doctors, parents, institutions and teachers when taking into consideration the child that practices physical activity; the best time to request an electrocardiogram, and to emphasize attention on the locomotive apparatus when doing a physical examination...

OBJECTIVES: To evaluate the epidemiology of ankle fractures surgically treated at the Instituto de Ortopedia e Traumatologia do Hospital das Clínicas da Universidade de São Paulo. METHODS: Medical records of patients admitted with foot and ankle fractures between 2006 and 2011 were revised. Seventy three ankle fractures that underwent surgical treatment were identified. The parameters analyzed included age, gender, injured side, AO and Gustilo & Anderson classification, associated injuries, exposure, need to urgent treatment, time to definitive treatment and early post-operative complications...