Colgajo microquirúrgico antebraquial en cirugía reconstructiva / Antebrachial microsurgical flap in reconstructive surgery

El colgajo antebraquial anterior es una excelente área dadora para transferir tejido. A lo largo de los años el colgajo antebraquial libre ha tomado fuerza dado que proporciona la cantidad de tejido a donar, su localización y, por sobre todo, la facilidad de disección, que se necesita para cubrir diferentes defectos en todo el cuerpo. Además, debe optimizar los resultados funcionales y estéticos. El sitio receptor debe cumplir en la medida de lo posible, utilizando colgajos con características similares, restablecer la integridad estructural o la función. Material y métodos. Se han realizado desde marzo 2021 a marzo del corriente año un total de 26 colgajos antebraquial libre. Los pacientes de esta serie fueron 80% hombres y 20% mujeres con un rango de edad de 25 a 73 años. Se utilizó tanto para patologías oncológicas, traumáticas e incluso colgajo de elección en pacientes trans para la creación del falo. Se tuvo en cuenta la utilización de la mano no hábil del paciente para así disminuir los riesgos de secuelas funcionales. Este colgajo aporta buen volumen de isla de piel, su pedículo es constante y confiable. La disección del colgajo, en manos entrenadas, acorta los tiempos quirúrgicos y demostró ser útil en muchísimas zonas receptoras del cuerpo. Resultados. Se logró el aporte de tejido necesario en todas las patologías a tratar, utilizando como zonas receptoras diferentes tipos de pedículos. También se logró un buen resultado tanto estético como funcional, volviendo a dar al paciente una calidad de vida aceptable. Conclusiones. El colgajo antebraquial libre ha demostrado ser útil en diversas patologías a tratar. Buen tegumento, su disección es fácil y accesible para cirujanos reconstructivos que recién comienzan su formación así como para cirujanos ya entrenados. Consta de un pedículo confiable con buen diámetro y longitud, lo cual lo hace aún más verídico para contar como primera opción cuando se lo necesita como colgajo libre.

The anterior antebrachial flap is an excellent donor area for tissue transfer. Over the years the free antebrachial flap has gained strength since it provides the amount of tissue to donate, its location and above all the ease of dissection, which is needed to cover different defects throughout the body. It must also optimize functional and aesthetic results. The receiving site should comply as far as possible, using flaps with similar characteristics, restore structural integrity or function

Application of trifoliate flap design of radial forearm flap in reconstruction of defects after mouth floor cancer resection / 中华肿瘤杂志

Objective: To evaluate the effect of trifoliate flap design of radial forearm flap in reconstruction of defects after mouth floor cancer resection. Methods: From June 2016 to December 2019, 12 patients with defect after resection of mouth floor cancer were treated with trifoliate flap design of radial forearm flap. All of these patients were T2 stage, included 9 well-differentiated squamous cell carcinoma (SCC) and 3 moderate differentiated SCC. The defect size ranged from 8.0 cm×6.0 cm to 5.0 cm×4.5 cm after resection of tumor and neck dissection. All defects were repaired with trifoliate flap design of radial forearm flap. The flap size ranged from 8.0 cm×2.0 cm to 4.0 cm×1.5 cm, the donor site was sutured directly on Z plasty. Results: All flaps completely survived well. Both the wound and the donor site were stage Ⅰ healing. With the average follow-up of 38.6 months, the swallowing and speech function were satisfactory. Conclusions: Trifoliate flap design of radial forearm flap can effectively repair the postoperative defect of mouth floor cancer, and the donor site can be directly sutured on Z plasty. This technique can avoid forearm scar caused by skin grafting and the formation of the second donor site.

Comparison of functional recovery of distal radius fracture by suture of pronator muscle through modified Henry approach / 中国骨伤

OBJECTIVE@#To investigate the effect of suture of pronator muscle on forearm function after modified Henry approach for distal radius fractures.@*METHODS@#from January 2018 to December 2020, 220 patients with distal radius fractures were treated with open reduction and locking plate internal fixation through the modified Henry approach. They were divided into two groups according to different suture methods. There were 112 cases in the intraoperative suture group, including 35 males and 77 females;The age ranged from 37 to 65(48.5±7.4) years;AO classification of fracture, 46 cases of type B and 66 cases of type C;After fracture reduction and locking plate fixation, the pronator muscle was opened and sutured. There were 108 cases in the non suture group, 32 males and 76 females;The age ranged from 34 to 67(47.6±7.8) years;There were 41 cases of fracture type B and 67 cases of fracture type C;After fracture reduction and locking plate fixation, the open pronator muscle was not sutured, and it was laid on the surface of the plate in situ. The range of wrist motion (pronation, supination, palmar inclination and dorsiflexion), the score of disability of arm shoulder and hand dash and visual analog scale(VAS) were compared between the two groups at 6 weeks and 6 months after operation.@*RESULTS@#All 220 patients were followed up for 6 to 18 (8.5±1.3) months. There was no significant difference in the range of motion and DASH score of forearm and wrist between the two groups 6 weeks after operation (P>0.05);There was significant difference in VAS score between suture group (2.6±1.2) and non suture group (5.8±2.3)(P<0.05). Six months after operation, there was no significant difference in the range of motion, DASH score and VAS score of forearm and wrist between the two groups(P>0.05).@*CONCLUSION@#The modified Henry approach has no obvious advantages in the range of wrist movement and upper limb function, but the intraoperative suture of pronator can reduce the early postoperative pain. It is suggested that the pronator should be sutured during the operation.

Three-dimensional analysis of the gap space under forearm casts / 中华创伤杂志(英文版)

PURPOSE@#Secondary displacement represents a frequent complication of conservative treatment of fractures, particularly of the distal radius. The gap space between skin and cast may lead to a certain degree movements and this increased mobility might favor redisplacement. The aim of this study was to develop a new 3D method, to measure the gap space in all 3 geometrical planes, and to validate this new technique in a clinical setting of distal radius fractures.@*METHODS@#This study applies 3D imaging to measure the space between plaster and skin as a potential factor of secondary displacement and therefore the failure of conservative treatment. We developed and validated a new methodology to analyze and compare different forearm casts made of plaster of Paris and fiberglass. An unpaired t-test was performed to document differences between the investigated parameters between plaster of Paris and fiberglass casts. The significance level was set at p < 0.05.@*RESULTS@#In a series of 15 cases, we found the width of the gap space to average 4 mm, being slightly inferior on the radial side. Comparing the two different casting materials, plaster of Paris and fiberglass, we found a significantly larger variance of space under casts made of the first material (p=0.39). A roughness analysis showed also a markedly significantly higher irregularity of the undersurface of plaster of Paris as compared with fiberglass.@*CONCLUSION@#This study allows for a better understanding of the nature of the "gap space" between cast and skin and will contribute to develop and improve new immobilization techniques and materials.

Nail disorders associated with cast immobilization of the forearm and wrist: report of two cases and review of the literature

Abstract Cast immobilization is used in the management of various injuries of joints and/or limbs. A variety of nail disorders have been reported in association with cast immobilization of the forearm and wrist among a limited number of patients so far. The mechanism was not clearly identified in some of these cases. Here, the authors report two patients with nail disorders appeared after the removal of immobilization cast of forearm and wrist and review the literature.

Nervio interóseo posterior: origen, localización y trayecto nervioso: una revisión / Posterior interosseous nerve: origin, location and nerve path: a review

RESUMEN: El nervio interóseo posterior (NIP) ha sido utilizado como sinónimo ocontinuación inmediata del ramo profundo del nervio radial (RPNR) al emerger en el compartimiento posterior del antebrazo. Su origen tampoco es claro, describiéndose como nervio interóseo posterior a su trayecto proximal, intermedio o distal al músculo supinador. El objetivo de esta revisión es detallar la visión de diversos autores respecto al origen y trayecto del NIP, proponiendo una correcta terminología para estas estructuras. Se realizó una revisión bibliográfica de varios textos y de algunos artículos utilizados para la enseñanza de la anatomía humana, publicados entre los años 1800 y la actualidad. En la búsqueda, se determinaron criterios de inclusión que consideraban, anatomía humana, escritos en español, francés o inglés y que aludieran al NIP. Tras la exploración inicial se localizaron 18 libros, procedentes de Francia, Rusia, España, Argentina, Estados Unidos, Canadá, Reino Unido, Alemania, India y México. Una descripción del NIP más precisa, en cuanto al origen, trayecto y función, es aquella postulada por la vertiente francesa, correspondiendo a un origen terminal del ramo profundo del nervio radial, luego de emitir sus ramos musculares. Este delgado nervio transcurre adosado a la membrana interósea para luego avanzar por el cuarto compartimiento extensor, distribuyéndose en las articulaciones dorsales del carpo a quienes inerva sensitiva y propioceptivamente.

SUMMARY: The posterior interosseous nerve (PIN) has been used as a synonym or immediate continuation of the deep branch of the radial nerve as it emerges in the posterior compartment of the forearm. Its origin is not clear either, being described as a posterior interosseous nerve to its proximal, intermediate or distal path to the supinator muscle. The objective of this review is to detail the vision of various authors regarding the origin and path of the PIN, proposing a correct terminology for these structures. A bibliographic review of several texts and some articles used for the teaching of human anatomy, published between the 1800s and the present day, was carried out. In the search, inclusion criteria were determined that considered human anatomy, written in Spanish, French or English and that alluded to the PIN. After the initial exploration, 18 books were located, coming from France, Russia, Spain, Argentina, the United States, Canada, the United Kingdom, Germany, India and Mexico. A more precise description of the PIN, in terms of origin, path and function, is that postulated by the French literature, corresponding to a terminal origin of the deep branch of the radial nerve, after emitting its muscular branches. This thin nerve runs attached to the interosseous membrane to then advance through the fourth extensor compartment, distributing itself in the dorsal carpal joints to which it innervates sensitively and proprioceptively.

Importancia del sitio de terminación de la vena cefálica del antebrazo / Importance of the cephalic antebrachial vein termination site

RESUMEN: Las venas superficiales de la fosa cubital se han estudiado con varios fines, venopunciones, cateterismos, fístulas, entre otros. Se han descrito varios patrones venosos en esta región en diferentes poblaciones. En uno de estos la vena cefálica termina en la vena basílica a nivel del antebrazo generando posibles riesgos de lesiones durante la canalización. En el presente estudio se evaluaron 200 miembros superiores de 100 personas colombianas, 50 mujeres y 50 hombres, 70 de ellas nacidas en la ciudad de Bucaramanga y 30 en la ciudad de Villavicencio. Se registró el número de venas cefálicas y su sitio de terminación, en el brazo o antebrazo. El patrón venoso que predominó en ambos miembros superiores fue el tipo I. El patrón IV en el cual la vena cefálica termina en la vena basílica se presentó en 12 casos (6 %) en el miembro superior derecho y en 17 casos (8,5 %) en el miembro superior izquierdo. Se encontró dos venas cefálicas entre el 13 % y 13,5 % dependiendo del lado y tres venas cefálicas entre el 1 % y 2 %. Conocer esta particularidad de los patrones venosos podría disminuir el riesgo de complicaciones durante la venopunción.

SUMMARY: The superficial veins of the ulnar fossa have been studied for various purposes, venipuncture, catheterization, fistulae, among others. Various venous patterns have been described in this region in different populations. In one of these, the cephalic vein ends in the basilic vein at the level of the forearm, generating possible risks of injury during cannulation. In the present study, 200 upper limbs of 100 Colombians, 50 women and 50 men, were evaluated, 70 of them born in the city of Bucaramanga and 30 in the city of Villavicencio. The number of cephalic veins and their termination site, on the arm or forearm, were recorded. The venous pattern that predominated in both upper limbs was type I. Pattern IV in which the cephalic vein ends in the basilic vein occurred in 12 cases (6 %) in the right upper limb and in 17 cases (8.5 %) in the left upper limb. Two cephalic veins were found between 13 % and 13.5 % depending on the side and three cephalic veins between 1 % and 2 %. Knowing this particularity of venous patterns could reduce the risk of complications during venipuncture.

Anastomosis Patterns between the Median and Ulnar Nerves in the Upper Limbs

There are four types of anastomoses between themedian and ulnar nerves in the upper limbs. It consists of crossings of axons that produce changes in the innervation of the upper limbs, mainly in the intrinsic muscles of the hand. The forearm has two anatomical changes ­ Martin-Gruber: branch originating close to the median nerve joining distally to the ulnar nerve; and Marinacci: branch originating close to the ulnar nerve and distally joining the median nerve. The hand also has two types of anastomoses, which are more common, and sometimes considered a normal anatomical pattern ­ Berrettini: Connection between the common digital nerves of the ulnar and median nerves; and Riche-Cannieu: anastomosis between the recurrent branch of the median nerve and the deep branch of the ulnar nerve. Due to these connection patterns, musculoskeletal disorders and neuropathies can be misinterpreted, and nerve injuries during surgery may occur, without the knowledge of these anastomoses. Therefore, knowledge of them is essential for the clinical practice. The purpose of the present review is to provide important information about each type of anastomosis of the median and ulnar nerves in the forearm and hand.

Clinical comparative study of free posterior tibial artery perforator flap and radial forearm free flap for head and neck reconstruction / 中华耳鼻咽喉头颈外科杂志

Objective: To compare the clinical application results of the FPTF (free posterior tibial artery perforator flap) and RFFF (radial forearm free flap) for reconstruction of head and neck defects. Methods: A retrospective analysis of 27 cases treated with FPTF (19 males and 8 females, aged 14-69 years) and 24 cases with RFFF (11 males and 13 females, aged 22-69 years) for head and neck defect reconstruction at Beijing Tongren Hospital of Capital Medical University from January 2015 to December 2020 was conducted. Flap size, vascular pedicle length, matching degree of recipient area blood vessels, preparation time, total operation time, hospital stay, recipient area complications, donor area complications and scale-based patient satisfaction were compared between two groups of patients with FTPF and RFFF. SPSS 26.0 statistical software was used for statistical analysis. Results: There was no statistically significant difference between the two groups of patients in tumor T staging (P=0.38), primary sites (P=0.05) and mean flap areas ((53.67±29.84) cm2 vs. (41.13±11.08) cm2, t=-1.472, P=0.14). However the mean vascular pedicle length of FPTF was more than that of RFFF ((11.15±2.48)cm vs. (8.50±1.69)cm, t=-4.071, P<0.01). The donor sites of 4 patients in FPTF group could be sutured directly, while all the 24 patients in RFFF group received skin grafts from the donor sites. There was no statistically significant difference in the recipient area arteries between two groups of flaps (P=0.10), with more commonly using of the facial artery (RFFF: FPTF=21∶27), but there was significant difference in the recipient area veins (P<0.01), with more commonly using of the external jugular vein in RFFF (14/24) than FPTF (4/32) and the posterior facial vein in FPTF (27/32) than RFFF (9/24). There were 10 recipient complications and 3 donor complications in RFFF group; no recipient complication and 3 donor complications occurred in FPTF group. With patient's subjective evaluation of the donor site at 12 months after surgery, FPTF was better than RFFF (χ²=22.241, P<0.01). Conclusions: FPTF is an alternative to RFFF in head and neck reconstruction and has unique advantages in aesthetics and clinical application.

Comparison of three kinds of free flaps used in patients with oral and oropharyngeal tumors / 中华耳鼻咽喉头颈外科杂志

Objective: To compare the recovery and quality of life of patients with oral and oropharyngeal tumors treated with three kinds of free soft tissue flaps. Methods: The clinical data of 103 patients, including 66 males and 37 females, aged 26-74 years, who underwent primary repair of defects after resection of oral and oropharyngeal tumors in Sichuan Tumor Hospital from July 2014 to August 2020 were analyzed. Anterolateral thigh flap (ALTF) was used in 43 patients, radial forearm free flap (RFFF) in 45 patients, and lateral arm free flap (LAFF) in 15 patients. Postoperative qualities of life of patients were evaluated by the university of Washington quality of life questionnaire and oral health impact scale (HIP-14 Chinese edition). SPSS 23.0 software was used for statistical analysis. Results: The T staging of RFFF or LAFF group was significantly lower than that of ALTF group (P<0.05). There was no significant difference in mean flap areas between ALTF group ((55.87±27.38) cm2) and LAFF group ((49.93±19.44) cm2), while RFFF group had smaller mean flap area ((33.18±6.05) cm2) than ALTF group (t=5.311, P<0.001) and LAFF group (t=3.284, P=0.005). In terms of oral functions including swallowing, mastication, taste and spitmouth, there were no significant differences between LAFF group and RFFF group (P>0.05), but both groups had better oral functions than ALTF group (P<0.05). There was no significant difference in appearance scores between LAFF group (75(75, 75)) and ALTF group (75(75,75) vs.75(75,75),Z=-1.532, P=0.126), and both groups had higher scores than RFFF group (50(50, 75),Z values were -3.447 and -3.005 respectively, P<0.05). RFFF group had higher speech score (100(67, 100)) than LAFF group (67(50, 76),Z=-2.480, P<0.05) and ALTF group (67(33, 67),Z=-5.414, P<0.05). ALTF group had lower mean score of quality of life than RFFF group [72(56,77) vs.79(69, 89),Z=-3.070, P<0.05), but there was no statistical difference in the mean scores of qualities of life between ALTF group and LAFF group (Z=1.754, P=0.079). According to the evaluation of oral health impact scale (HIP-14 Chinese version) 1 year after surgery, individual item scores and the average score of all items in ALTF group were lower than those in RFFF and LAFF groups (P<0.05), with no significant difference between RFFF group and LAFF group (P>0.05). Conclusions: RFFF has unique advantages for small tissue defects, while ALTF is suitable for large tissue defects, such as buccal penetrating defect, whole tongue and near whole tongue defect, and LAFF is a compromise choice between ALTF and RFFF. ALTF is inferior to RFFF and LAFF in oral functional reconstruction, including swallowing, chewing, taste and spittle. ALTF and LAFF are superior to RFFF in postoperative appearance.

Anatomical Study of the Motor Branches of the Radial Nerve in the Forearm / Estudo anatômico dos ramos motores do nervo radial no antebraço

Abstract Objective To analyze the anatomical variations of the motor branches of the radial nerve in the elbow region. The origin, course, length, branches, motor points and relationships with neighboring structures were evaluated. Materials and Methods Thirty limbs from15 adult cadavers were dissected and prepared by intra-arterial injection of a 10% glycerin and formaldehyde solution. Results The first branch of the radial nerve in the forearm went to the brachioradialis muscle (BR), originating proximally to the division of the radial nerve into superficial branch of the radial nerve (SBRN) and posterior interosseous nerve (PIN) in all limbs. The branches to the extensor carpi radialis longus muscle (ECRL) detached from the proximal radial nerve to its division into 26 limbs, in 2, at the dividing points, in other 2, from the PIN. In six limbs, the branches to the BR and ECRL muscles originated from a common trunk. We identified the origin of the branch to the extensor carpi radialis brevis muscle (ECRB) in the PIN in 14 limbs, in the SBRN in 12, and in the radial nerve in only 4. The branch to the supinator muscle originated from the PIN in all limbs. Conclusion Knowledge of the anatomy of the motor branches of the radial nerve is important when performing surgical procedures in the region (such as the approach of the proximal third and the head of the radius, release of compressive syndromes of the posterior interosseous nerve and radial tunnel, and distal nerve transfers) in order to understand the order of recovery of muscle function after a nerve injury.

Resumo Objetivo Analisar as variações anatômicas dos ramos motores do nervo radial na região do cotovelo. Foram avaliadas a origem, curso, comprimento, ramificações, pontos motores e relações com estruturas vizinhas. Materiais e Métodos Foram dissecados 30 membros de 15 cadáveres adultos, preparados por injeção intra-arterial de uma solução de glicerina e formol a 10%. Resultados O primeiro ramo do nervo radial no antebraço foi para o músculo braquiorradial (BR), que se origina proximalmente à divisão do nervo radial em ramo superficial do nervo radial (RSNR) e nervo interósseo posterior (NIP) em todos os membros. Os ramos para o músculo extensor radial longo do carpo (ERLC) se desprenderam do nervo radial proximalmente à sua divisão em 26 membros, em 2, nos pontos de divisão, em outros 2, do NIP. Em seis, os ramos para os músculos BR e ERLC originavam-se de um tronco comum. Identificamos a origem do ramo para o músculo extensor radial curto do carpo (ERCC) no NIP em 14 membros, no RSNR em 12, e no nervo radial em apenas 4. O ramo para o músculo supinador originou-se do NIP em todos os membros. Conclusão O conhecimento da anatomia dos ramos motores do nervo radial é importante quando se realizam procedimentos cirúrgicos na região, como a abordagem do terço proximal e da cabeça do rádio, a liberação das síndromes compressivas do nervo interósseo posterior e do túnel radial, as transferências nervosas distais, e para entender a ordem de recuperação da função muscular após uma lesão nervosa.

Discondrosteosis de Léri-Weill. Presentación de una familia afectada / Léri-Weill dyschondrosteosis. Presentation of an affected family

RESUMEN Fundamentación: La discondrosteosis de Léri-Weill, displasia ósea de origen genético que afecta la región mesomélica con acortamiento de las extremidades, provoca talla baja con extremidades cortas con deformidad de Madelung; esta enfermedad muestra un patrón de herencia autosómico dominante con alta penetrancia. Objetivo: Describir las deformidades de esta discondrosteosis de baja frecuencia con expresividad variable, que se presentó de la misma forma en todos los afectados de esta familia. Presentación de caso: Se reportó una familia con enfermos en tres generaciones con deformidad de Madelung de ambas muñecas y baja estatura de origen mesomélico, que se mantiene seguimiento en consultas de Genética Clínica y Ortopedia. Conclusiones: El examen físico y radiológico imprescindibles para llegar al diagnóstico clínico. El método clínico y la valoración multidisciplinaria resultaron de gran valor para definir esta enfermedad y poder brindar un adecuado asesoramiento genético a esta familia.

ABSTRACT Background: Léri-Weill dyschondrosteosis, bone dysplasia of genetic origin that affects the mesomelic region with shortening of the extremities, causes short stature with short extremities with Madelung deformity.This disease shows an autosomal dominant inheritance pattern with high penetrance. Objective: To describe the deformities of this low frequency dyschondrosteosis with variable expressivity which was presented in the same way in all those affected in this family. Case presentation: A family with sick members was reported in three generations with Madelung deformity of both wrists and short stature of mesomelic origin which is followed up in consultations of Clinical Genetics and Orthopedics. Conclusion: The essential physical and radiological examination to reach the clinical diagnosis. The clinical method and the multidisciplinary assessment were of great value to define this disease and to be able to provide adequate genetic counseling to this family.

The evaluation of RS1805086 and RS1805065 polymorphisms in Mstn gene and anthropometric properties of national and amateur arm wrestlers / Evaluación de los polimorfismos RS1805086 y RS1805065 en el gen Mstn y las propiedades antropométricas de los luchadores de brazo nacionales y amateurs

The aim of this study is to investigate rs1805086 and rs1805065 polymorphisms of MSTN gene of national and amateur Turkish arm wrestlers and people leading a sedentary lifestyle, and the anthropometric properties such as hand, wrist, and forearm circumferences of national and amateur Turkish arm wrestlers are aimed to be explored. In this study, a total of 79 volunteers who were 24 national (7 females, 17 males) Turkish arm wrestlers, 21 amateur (7 females, 14 males) Turkish arm wrestlers and 34 sedentary people (12 females, 22 males) participated. To analyse the data, Statistical Package for the Social Sciences, SPSS 22 (SPSS Inc., Chicago, IL, USA) was used. As a result of the study, when data on rs1805086 and rs1805065 polymorphisms of MSTN gene were examined respectively, it was found out that MSTN 153KK genotype was 100.0% dominant in both national (n=24) and amateur (n=21) arm wrestlers, and it was 94.12 % dominant in sedentary people. KR genotype was observed in 5.88 % of the sedentary people. The data from the other rs1805065 polymorphism of MSTN gene showed that all participants (n = 45, 100.0 %) were carriers of normal homozygous genotype. Furthermore, for both female group and male group, there found to be statistically significant difference in terms of anthropometric properties. It can be concluded that though there was no significant difference between national and amateur Turkish arm wrestlers in terms of their MSTN gene characteristics; in terms of anthropometric properties, significant differences were discovered. It was found out that on these athletes, not MSTN gene polymorphisms but anthropometric properties were effective.

El objetivo de este estudio fue investigar los polimorfismos rs1805086 y rs1805065 del gen MSTN de luchadores de brazos turcos, nacionales y aficionados, y personas que llevan un estilo de vida sedentario, y las propiedades antropométricas además de las circunferencias de manos, muñecas y antebrazos de los luchadores de brazos turcos nacionales y aficionados. En este estudio, participaron un total de 79 voluntarios: 24 luchadores de brazos turcos nacionales (7 mujeres, 17 hombres), 21 luchadores de brazos turcos aficionados (7 mujeres, 14 hombres) y 34 personas sedentarias (12 mujeres, 22 hombres). Para analizar los datos, se utilizó el Paquete Estadístico para las Ciencias Sociales, SPSS 22 (SPSS Inc., Chicago, IL, EE. UU.). Como resultado del estudio, cuando se examinaron los datos sobre los polimorfismos rs1805086 y rs1805065 del gen MSTN respectivamente, se descubrió que el genotipo MSTN 153KK era 100,0 % dominante en luchadores de brazos nacionales (n = 24) y aficionados (n = 21) , y era 94,12 % dominante en personas sedentarias. El genotipo KR se observó en el 5,88 % de las personas sedentarias. Los datos del otro polimorfismo rs1805065 del gen MSTN mostraron que todos los participantes (n = 45; 100,0 %) eran portadores del genotipo homocigoto normal. Además, tanto para el grupo femenino como para el masculino, se encontró una diferencia estadísticamente significativa en términos de propiedades antropométricas. Se puede concluir que, aunque no hubo una diferencia significativa entre los luchadores de brazos turcos nacionales y aficionados en términos de sus características genéticas MSTN; en términos de propiedades antropométricas, se descubrieron diferencias significativas. Se descubrió que, en estos atletas, no fueron los polimorfismos del gen MSTN sino las propiedades antropométricas las efectivas.

Severe Osteoarthritis of the Elbow after a Non- Displaced Radial Head Fracture: Case Report / Osteoartrite global do cotovelo após uma fratura não deslocada da cabeça radial: Relato de caso

Abstract Fractures of the radial head account for over 50% of all fractures of the forearm. Broberg and Morrey (modification of the Mason classification) classify them in four types. Type 1 fractures are non-displaced or minimally displaced, considered stable and without mechanical joint blockage. In this type of fracture, a non-operative management with a short period of immobilization leads to a good clinical result without adverse outcomes. Clinically relevant associated lesions are not common. Because of this, arthritis of the radiocapitellar and ulnohumeral joint after the non-displaced radial head fracture is uncommon. This case report presents a young patient diagnosed with isolated non-displaced radial head fracture, that evolved 8 months later, to global arthritis of the elbow.

Resumo As fraturas da cabeça radial representam mais de 50% de todas as fraturas do antebraço. Broberg e Morrey (modificação da classificação de Mason) as classificam em quatro tipos. As fraturas do tipo 1 são aquelas não deslocadas ou minimamente deslocadas, consideradas estáveis e sem bloqueio mecânico das articulações. Nesse tipo de fratura, um manejo não operatório com um curto período de imobilização permite bom resultado clínico sem desfechos adversos. Lesões associadas clinicamente relevantes não são comuns. Por esse motivo, a artrite da articulação radiocapitelar e ulnoumeral após a fratura da cabeça do rádio não deslocada é incomum. Este relato de caso apresenta um paciente jovem com diagnóstico de fratura isolada da cabeça radial não deslocada que evoluiu, 8 meses depois, para artrite global do cotovelo.

Efeito do treino com restrição de fluxo sanguíneo versus treino resistido de alta intensidade sobre a força de indivíduos sedentários: um ensaio clínico controlado e randomizado / Blood flow restriction training versus high-intensity resistance training in sedentary individuals: a randomized controlled trial

Objetivos: comparar os efeitos do treino com restrição de flux o sanguíneo com o treino resistido de alta intensidade no ganho de força e hipertrofia. Material e métodos: n este ensaio clínico randomizado e controlado, 24 homens sedentários foram randomizados em do is grupo s: treino com restrição de fluxo sanguíneo ou treino resistido de alta intensidade. Ambos os grupos realizaram 10 sessões de exercício de preensão manual até com 3 séries de exercícios até a falha, sendo que o grupo com treino de restrição de fluxo sanguíneo realizou com 30% da carga máxima obtida no teste de 1 repetição máxima, enquanto que o grupo de alta intensidade realizou com 80% da carga. T odo s o s voluntários foram avaliados e reavaliados a dinamometriade preensão manual e a perimetria de antebraço. Os dados foram tabulados e analisados no statistical package for the social sciences, utilizando o teste t-student, e o não paramétrico u de mann whitney, adotando a significância de 5% (α = 0,05). Resultados: para o desfecho força, identificou-se que tanto o grupo que treino com restrição do fluxo, quanto o grupo que treinou com alta intensidade tiveram aumentos significativos (p= 0,005 e 0,026, respectivamente). Já em relação ao aumento da circunferência, notou-se que somente o treino de restrição do flux o se mostrou estatisticamente quando comparado o aumento entre os grupos (p= 0,00 1). Conclusão: foi possível concluir que o treinamento com restrição do fluxo sanguíneo mostrou eficaz tanto para o ganho de força, quanto para o aumento de circunferência, apresentando vantagens quando comparado ao grupo de treinamento resistido com alta intensidade...(AU)

Objectives: to compare the effects of blood flow restriction trainin g wit h h igh in tensity resistance training on strength gain and hypertrophy. Material and methods: in this randomized controlled trial, 24 sedentary men were randomized into two groups: restricted blood flow training or high inten sity resistance training. Both groups performed 10 handgrip exercise sessions up to 3 sets of exercises un t il failure, and the group with blood flow restriction training performed with 3 0 % o f t he m ax imum lo ad obtained in the 1-repetition maximum test, while the high intensity group performed with 80% of the load. All volunteers were assessed and reassessed by handgrip dynamometry and forearm perimetry. Data were tabulated and analyzed in the statistical package for the social sciences, using the t-studen t test an d t he non-parametric mann whitney u test, adopting the significance of 5% (α = 0.05). Results: for the stren gth outcome, it was found that both the flow restriction training group and the high intensity train in g gro up had significant increases (p = 0.005 and 0.026, respectively). Regarding the increase in circumference, it was noted that only the flow restriction training was statistically when compared to the increase bet ween the groups (p = 0.001). Conclusion: it was concluded that training with blood flow restriction was effective for both strength gain and circumference increase, presenting advantages when compared to the high intensity resistance training group...(AU)

Reinsertion of Distal Brachial Biceps Tendon Rupture through Single Incision Using Anchors / Reinserção da ruptura distal do bíceps braquial mediante incisão única com uso de âncoras

Abstract Objective To evaluate 15 patients with ruptured distal biceps tendon submitted to reinsertion via a single, anterior and transverse approach using two anchors. They were submitted to a rehabilitation protocol and, within six months, to an evaluation of the range of motion and strength intensity during flexion and supination of the operated elbow. Methods The data were collected prospectively, and were analyzed through the Mann-Whitney test and the mixed-model test to evaluate the force between the operated and non-operated elbows. Results A total of 80% of the patients were men, 60% were injured on the dominant side, 46% were manual workers, and 73% led sedentary lifestyles. The use of anabolic steroids was reported by two patients. After the treatment, the patients recovered supination strength by 98% and flexion by 94%. According to the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire, 73% of the patients presented the score expected of a normal population. Conclusion The single, anterior and transverse approach associated with tendon repair using anchors was esthetically satisfactory, with good strength recovery during flexion and supination, and no occurrence of heterotopic ossification.

Resumo Objetivo Avaliar 15 pacientes com ruptura do tendão distal do bíceps submetidos a reinserção por meio de via única, anterior e transversa no antebraço com o uso de duas âncoras. Os pacientes foram submetidos a um protocolo de reabilitação e, ao término de seis meses, efetuou-se avaliação do arco de movimento do cotovelo operado e da intensidade de força durante a flexão e a supinação. Métodos Os dados foram coletados de maneira prospectiva, e foram analisados pelo teste de Mann-Whitney e pelo teste de modelos mistos para avaliar a força entre os cotovelos operado e não operado. Resultados Um total de 80% dos pacientes eram homens, 60% sofreram lesão do lado dominante, 46% eram trabalhadores braçais, e 73% não praticavam atividades físicas regularmente. O uso de anabolizante foi relatado por dois pacientes. Após o tratamento, os pacientes recuperaram 98% da força de supinação, e 94% da de flexão. De acordo com questionário de Disfunções do Braço, Ombro e Mão (Disabilities of the Arm, Shoulder and Hand, DASH), 73% dos pacientes encontram-se dentro do esperado para uma população normal. Conclusão A via única, anterior e transversa associada ao reparo do tendão com o uso de âncoras apresentou-se esteticamente satisfatória, com boa recuperação da força durante a flexão e a supinação, não ocorrendo casos de ossificação heterotópica ou complicações graves.