Perfil epidemiológico dos pacientes com fratura de úmero proximal tratados no Hospital São Paulo, Brasil / Epidemiological profile of patients with proximal humerus fracture treated at Hospital São Paulo, Brazil

Objetivo: Analisar os aspectos epidemiológicos das fraturas de úmeroproximal e descrever o perfil dos pacientes com este tipo de fraturainternados e tratados em nosso serviço no período de 2008 a 2013.Métodos: Foram analisados retrospectivamente os prontuários dospacientes com diagnóstico de fratura de úmero proximal tratados cirurgicamente.Foram levadas em consideração idade, gênero, mecanismode lesão, tempo de internação, tratamento realizado e doençasassociadas. Resultados: Dos pacientes estudados, 52 eram do sexofeminino, sendo a sexta década a mais acometida. Quanto ao mecanismode trauma, a queda da própria altura foi o principal fator causalentre as mulheres (88,46%) e entre os homens foi o acidente de motocicleta(31,42%). Fixação com placa bloqueada foi o tratamento realizadocom maior frequência. Conclusão: A maioria dos pacientes foi do sexofeminino, na quinta década de vida, sendo a queda da própria alturao mecanismo de lesão mais comum. O tratamento mais realizado foia fixação com placa bloqueada e os pacientes permaneceram cercade 7 dias internados. Nível de Evidência II, Estudo Retrospectivo.

Objective: To analyze the epidemiological aspects of proximalhumerus fractures and describe the profile of patients with proximalhumerus fractures hospitalized and treated at HospitalSão Paulo, between 2008 and 2013. Methods: Hospital recordswere retrospectively analyzed for surgically treated patientsdiagnosed with proximal humerus fracture. Age, gender, injurymechanism, length of hospital stay, performed treatment andassociated diseases were considered. Results: From all patientsstudied, 52 were female at their sixth decade of life. Asfor the injury mechanism, fall from height was the main causefor women (88.46%) and for man it was motorcycle accidents(31.42%). Fixation with locked plate was the most frequentlyused treatment. Conclusion: Most patients were female in theirfifth decade of life, injured mainly by fall from height. Fixationwith locked plate was the most frequently used treatment andthe patients were admitted for 7 days, on average. Level ofEvidence II, Retrospective Study.

Refractures of the Upper Extremity in Children

Purpose: To investigate the etiologic factors related to refractures of the upper extremity in children. Patients and Methods: Eighteen refractures were divided into three groups according to the location of the initial fractures. They were analyzed in terms of the type of refractures, fracture patterns, and the existence of an underlying deformity. Results: Of nine supracondylar fractures of the humerus, two involved refractures at the supracondylar region, and the other seven involved the lateral condyle. Underlying cubitus varus was present in six cases. Of three lateral condylar fractures of the humerus, one had a refracture at the supracondylar region, and two cases involved the lateral condyle. One had an underlying cubitus varus. All but one case in the humeral fractures group were late refractures, and were treated with surgery. Of six repeat forearm fractures, five were early type and occurred at the original site within nine weeks, four at the diaphysis of both bones of the forearm, and one at the diaphysis of the ulna. All cases in the forearm fractures group, save one, had volar angulation before the refracture, and were treated conservatively. Conclusion: In the humerus, the underlying cubitus varus was the most important predisposing factor for refractures and lateral condyle fractures were common. In the forearm, volar angulation of the diaphysis was related to refractures, and complete and circular consolidation of the primary fracture of the forearm was thought to be important in prevention.

New observations on carrying angle.

Based on experiments on fresh cadaveric and accidentally amputated 8 upper limbs of children, study of ulnae for presence and absence of non articular strip on the trochlear notch, measurements of carrying angle, length of forearm bones, pronation-supination, height and weight in 2250 infants, children and adults of various age groups and clinical observations on 800 cases of injuries around elbow many new facts have been observed about the development of the carrying angle and its significance in the etiopathogenesis of various types of fractures seen around the elbow. The carrying angle develops in response to pronation of the forearm and is dependent on length of the forearm bones. Lesser the length of forearm bones greater is the carrying angle. So the carrying angle is more in shorter persons as compared to taller persons. It is abduction at the shoulder and not the carrying angle which keeps the swinging upper limbs away from the side of the pelvis during walking. Carrying angle is not a secondary sex character. The type of fracture a child sustains after fall on outstretched hand is also determined by the value of the carrying angle. A new type of fracture hitherto undescribed in the literature, T-Y fracture of the distal humeral epiphysis is also reported.

Deslizamientos epifisiarios traumáticos: revisión epidemiológica en un periodo de cuatro años / Traumatic epiphyseal separations: a epidermiologic review through a four-year period

Los deslizamientos epifisiarios traumáticos constituyen un problema muy común que debe tratarse correctamente y con oportunidad, o de lo contrario conducen ya sea a acortamiento o a deformidad de las extremidades. Se presenta una serie de 48 pacientes con 53 deslizamientos epifisiarios traumáticos en las extremidades. Todos recibieron tratamiento mediante manipulación cerrada en el Hospital Infantil de Morelia, en la etapa aguda, entre agosto de 1988 y julio de 1992. En ninguno se utilizó fijación interna. Los resultados de la reducción cerrada tanto clínica como radiológicamente han sido excelentes en el 90 por ciento de los casos. Ninguno desarrolló deformidad ni acortamiento.

Study of shoulder injuries in athletes

227 male players sharing in different types of sports were examined as regards the shoulder girdle region, the types of injuries and duration of sport participation. It was found that the incidence of shoulder injuries in all players examined was [22.47%] and shoulder affection was common among weight lifters and wrestlers. It was also found that the commonest injuries encountered frequently among players were, respectively, rotator cuff lesion [19.60%], impingement syndrome [15.68%], anterior subluxation of the glenohumeral joint [13.7%], then anterior dislocation, bicipital tendinitis and pectorolis major lesion all had the some percentage [9.80%]