ABSTRACT
Abstract Objective The Latarjet procedure is a well-accepted treatment of shoulder instability. This technique is associated with a unique set of complications with overall rates of up to 30%. The purpose of the present study was to investigate the incidence and risk factors associated with complications after open Latarjet procedure. Methods We retrospectively reviewed 102 patients submitted to open Latarjet procedure. Complications were divided into three types: clinical; graft-related; and screw-related. All of the patients were submitted to radiography and computed tomography (CT). The risk factors analyzed were gender, age, previous surgery, epilepsy, experience of the surgeon. Results A total of 102 consecutive patients (108 cases) underwent the Latarjet procedure. The mean age was 33.7 years old (18 to 61 years old), with 88 males and 14 females. The overall complication rate was 21.2%, being 12% clinical-related, 7.4% graft-related, and 2.7% screw-related. The most frequent were anterior apprehension (eight cases) and lateral overhang of the graft in six patients. Computed tomography scan at a minimum of 6 months was performed in 79 cases (73%), and graft union occurred in 75 patients (94.9%). There were no cases of instability in the remaining four cases of nonunion. Ten patients (9.2%) required revision surgery. The risk factors associated with complications were epilepsy (p = 0.0325), experience of the surgeon (p = 0.0499) and patients ≥ 40 years old at the time of the surgery (p = 0.0151). There was no correlation with gender and previous surgery. Conclusion The complication rate following the Latarjet procedure was 21.2%, with 9% requiring revision surgery. Epilepsy, age ≥ 40 years old and experience of the surgeon were risk factors.
Resumo Objetivo A cirurgia de Latarjet é bem estabelecida para o tratamento da instabilidade anterior do ombro. Apresenta complicações específicas com taxas de até 30%. Nosso objetivo é avaliar a incidência e os fatores de risco associados às complicações após a cirurgia de Latarjet. Métodos Analisamos retrospectivamente 102 pacientes submetidos ao procedimento. Dividimos as complicações em três tipos: clínicas, relacionadas ao enxerto e relacionadas aos implantes. Todos os pacientes foram submetidos a radiografias e tomografia computadorizada (TC). Os fatores de risco analisados foram gênero, idade, cirurgia prévia, epilepsia e experiência do cirurgião. Resultados Um total de 102 pacientes consecutivos (108 casos) foram avaliados. A média de idade foi 33,7 anos (18 a 61 anos), com 88 homens e 14 mulheres. A taxa de complicações foi de 21,2%, sendo 12% clínicas, 7,4% relacionadas ao enxerto e 2,7% relacionadas ao implante. As mais frequentes foram apreensão anterior (oito casos) e posicionamento lateral do enxerto, em seis casos. A TC foi realizada com o mínimo de 6 meses em 79 casos (73%), evidenciando a consolidação do enxerto em 75 pacientes (94.9%). Nenhum caso de não união apresentou instabilidade. Dez pacientes (9.2%) precisaram de cirurgia de revisão. Os fatores de risco relacionados às complicações foram epilepsia (p = 0.0325), experiência do cirurgião (p = 0.0499) e pacientes ≥ 40 anos (p = 0.0151). Não houve correlação com gênero e cirurgia prévia. Conclusão A taxa de complicações após a cirurgia de Latarjet foi de 21,2%, com 9% necessitando de revisão cirúrgica. Epilepsia, idade ≥ 40 anos e experiência do cirurgião foram fatores de risco.
Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Shoulder Dislocation , Tomography, X-Ray Computed , Risk Factors , Joint Instability/complicationsABSTRACT
In small-scale human settlements, the acquisition of animal protein is strictly related to subsistence activities, and yours dietary habits are determined by the availability and the selectivity permitted by the diversity of these resources. This study analyzed the consumption of animal protein sources in seven traditional riverine communities of the Tapajos National Forest, located in Eastern Brazilian Amazonia, considering fish, game meat and domestic animals. The analysis of animal protein consumption was based on the assumptions of the diet breadth model and the Optimal Foraging Theory. We compared diet breadths between communities and between rainy and dry seasons. The study focused on seven traditional riverside communities, six of them distributed along the right bank of the Tapajos River and one on the right bank of the Cupari River. Data collection was performed in four fields trips, two in the rainy season (May and July) and two in the dry season (September and November) in 2010. Data were collected through semi-structured interviews where the informant mentioned the source of animal protein consumed in the last three meals and which would be consumed at the next meal, if possible. We carried out a total of 470 interviews, where we documented 1 512 meals, and in only 12% of the meals there was no consumption of any animal protein source. The fish was consumed in 60.4% of the meals, being the most important source of animal protein consumed, differing significantly from other protein sources (χ²=23.79, df=5, p<0.001). A total of 11 species of wild animals and 46 species of fish were consumed. The choice in the consumption of game meat consisted on Tayassu pecari, Hydrochoerus hidrochaeris and Cuniculus paca, while the preference for fish consumption included Plagioscion spp., Astronotus spp., Cichla spp. and Leporinus spp.. The Simpson index did not vary significantly between the rainy and dry season (N=6, t=1.25, p=0.267) or between communities (N=6, t=5, p=0.42), although São Francisco das Chagas have significantly higher consumption of game meat (χ²=370.41, df=25, p<0.001). Fishing is an activity of paramount importance to these communities, and factors that lead to decreased availability of fish may lead to subsequent increase in hunting pressure. For the conservation of preserve of both wildlife natural resources and practices of subsistence of riverine communities of the Tapajós National Forest, it is necessary to ensure the maintenance of fish stocks and the protection of the Tapajós River areas large enough to maintain viable populations of wild animals and more tolerant to hunting and habitat loss.
En pequeños asentamientos rurales, la adquisición de proteína animal está estrechamente relacionada con actividades de subsistencia, y su hábitos alimentares son determinados por la disponibilidad y diversidad de estos recursos. Este estudio examinó el consumo de pescado, caza y animales domésticos en siete comunidades tradicionales ribereñas de la Floresta Nacional do Tapajós, ubicadas en la Amazonia oriental Brasileña. La análisis se basa en los supuestos de modelos de la amplitud de la dieta y la teoría de forrajeo óptimo, se comparó la amplitud de dieta en siete comunidades ribereñas en periodo seco y lluvioso. La recolección de datos se realizó en cuatro viajes, dos en la temporada de lluvias y dos en la estación seca en el 2010, mediante entrevistas semi-estructuradas. El pescado fue consumido en el 60.4% de las comidas, siendo la fuente de proteína animal más consumida. Un total de 11 especies de animales silvestres y 46 especies de pescado fueron documentadas y la preferencia en el consumo cayó sobre T. pecari, C. paca y Hydrochoerus hidrochaeris y la preferencia por el consumo de pescado cayó sobre Plagioscion spp. Astronotus spp., Cichla spp. y Leporinus spp.