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1.
Artrosc. (B. Aires) ; 29(1): 28-32, 2022.
Article in Spanish | LILACS, BINACIS | ID: biblio-1369637

ABSTRACT

Presentamos el caso clínico de un paciente de cuarenta y un años que ingresa por guardia con dolor agudo de rodilla luego de un traumatismo deportivo (practicando fútbol). Se diagnosticó luxación de la articulación tibioperonea proximal. El tratamiento elegido fue quirúrgico mediante fijación dinámica de la articulación tibioperonea proximal con buena evolución y retorno a la actividad deportiva. Realizamos una búsqueda bibliográfica sobre las últimas publicaciones de dicha patología y sus tratamientos. La luxación de esta articulación proximal es una patología infrecuente y requiere de su sospecha para realizar el diagnóstico inicial. La fijación interna dinámica es una opción de tratamiento válida. Nivel de Evidencia: IV


We present the clinical case of a forty-one-year-old patient who was admitted with acute knee pain after a sports injury (playing football). A diagnosis of dislocation of the proximal tibiofibular joint was made. Surgical treatment was performed by means of dynamic fixation of the superior tibiofibular joint with good evolution and return to sports activity. We carry out a search on the latest publications presented on this pathology and its treatments. The dislocation of the proximal tibiofibular joint is an infrequent pathology and requires its suspicion to make the initial diagnosis. Dynamic internal fixation is a valid treatment option. Level of Evidence: IV


Subject(s)
Adult , Athletic Injuries , Tibia/injuries , Knee Dislocation , Return to Sport , Knee Injuries
2.
Rev. bras. ortop ; 56(6): 813-818, Nov.-Dec. 2021. graf
Article in English | LILACS | ID: biblio-1357147

ABSTRACT

Abstract Recurrent stress fractures rarely affect the same athlete. We present the case of a female triathlete who suffered multiple stress fractures in both tibias, the right fibula, and the left femoral neck. Conservative treatment was instituted in all episodes, with rest, reduced training load, and physical therapy rehabilitation. The relative energy deficiency in sport syndrome, along with an eating disorder, training overload, and osteopenia, was identified as a risk factor. Although rare, multiple stress fractures can occur in female triathletes. These patients must be screened for risk factors associated with biomechanics, nutrition, and training to develop an effective prevention and treatment program.


Resumo Fraturas por estresse recorrentes num mesmo atleta são raras. Apresentamos o caso de uma triatleta que sofreu múltiplas fraturas por estresse na tíbia bilateral, na fíbula direita e no colo femoral esquerdo. O tratamento conservador foi instituído em todos os episódios, com repouso, redução da carga de treino e reabilitação fisioterápica. Foi identificada como fator de risco a síndrome da deficiência energética relativa no esporte, com distúrbio alimentar, sobrecarga de treino e osteopenia. Mesmo que seja raro, múltiplas fraturas por estresse podem ocorrer em mulheres triatletas, nas quais é importante avaliar os fatores de risco associados à biomecânica, nutrição e ao treinamento para arquitetar um programa de prevenção e tratamento efetivos.


Subject(s)
Humans , Female , Adult , Tibia/injuries , Fractures, Stress , Risk Factors , Physical Therapy Modalities , Lower Extremity , Female Athlete Triad Syndrome , Athletes
3.
Rev. bras. cir. plást ; 33(4): 501-510, out.-dez. 2018. ilus, tab
Article in English, Portuguese | LILACS | ID: biblio-980146

ABSTRACT

Introdução: Muitos retalhos são descritos para reparar as perdas de substância nos terços médio e distal da perna. A principal vantagem do retalho de músculo hemisóleo medial é a preservação da inervação da metade do músculo sóleo no sítio doador, mantendo a força de flexão plantar. Além disso, este retalho tem um arco de rotação maior quando comparado ao retalho de músculo sóleo convencional. Novos conceitos vasculares e técnicos, descritos recentemente, aumentaram a viabilidade deste retalho. O objetivo deste estudo é relatar a utilização do retalho de hemisóleo medial enfatizando as vantagens, reafirmando as indicações e analisando as complicações. Métodos: Em dez anos, um total de nove retalhos de hemisóleo medial foram confeccionados para a reparação de feridas traumáticas com exposição da tíbia em oito pacientes. Os critérios de indicação e técnica cirúrgica são descritos detalhadamente. Resultados: A cicatrização completa da perda de substância foi alcançada em todos os pacientes. Observou-se baixo índice de complicações no leito doador e em um paciente houve necrose parcial da extremidade do retalho. O tempo médio de realização do procedimento foi de duas horas. Conclusões: Retalhos de hemisóleo medial são muito úteis na reparação destas perdas de substância e permitem a cobertura com tecido de espessura intermediária, rica vascularização, baixo índice de morbidade na área doadora, preservação da função motora plantar, reabilitação mais rápida no pós-operatório, técnica cirúrgica acessível e menor tempo operatório.


Introduction: The use of many flaps has been described to repair substance loss in the medial and distal thirds of the lower leg. The main advantage of the muscle medial hemisoleus flap is preserving one half of the innervated medial soleus muscle in situ and keeping the foot's plantar flexion power. Moreover, the flap has a longer arc of rotation. As recently described, new vascular concepts and techniques have increased flap viability. This study aimed to examine the use and advantages of the medial hemisoleus flap with emphasis on an indication and complication analysis. Methods: Over a 10-year period, nine medial hemisoleus flaps were executed to repair traumatic wounds with tibial exposure in eight patients. We describe the indications and surgical techniques in detail. Results: Complete wound healing was achieved in all patients. There was a low donor-site complications rate. One patient suffered from partial necrosis of the extremity flap. The mean operative time was 2 h. Conclusions: The medial hemisoleus flap is useful for repairing substance loss and provides coverage with intermediary thickened tissue, high vascularity, minimal donor-site morbidity, foot plantar flexion power preservation, faster rehabilitation, accessible surgical techniques, and a shorter operative time.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Postoperative Complications , Surgical Flaps/surgery , Tibia/surgery , Tibia/injuries , Reconstructive Surgical Procedures/adverse effects , Reconstructive Surgical Procedures/methods , Musculoskeletal System
4.
Rev. bras. ortop ; 53(4): 510-513, July-Aug. 2018. graf
Article in English | LILACS | ID: biblio-959162

ABSTRACT

ABSTRACT 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. The patient showed excellent results and returned to sports after 12 months of follow-up.


RESUMO A fratura-avulsão da tuberosidade anterior da tíbia é uma lesão incomum que ocorre no jovem atleta, resultado de uma contração excêntrica do mecanismo extensor do joelho com o membro inferior fixo ao solo. Lesões concomitantes ao tendão patelar são muito raras, com poucos casos relatados na literatura. Os autores apresentam o caso de um atleta de basquete de 15 anos que sofreu uma fratura-avulsão da tuberosidade anterior da tíbia associada à ruptura completa distal do tendão patelar durante movimento de arremesso no treino esportivo. O paciente foi tratado com redução aberta da fratura e reparo do tendão patelar com miniâncoras e parafuso poste com reforço tendinoso com enxerto autólogo de semitendíneo. O paciente apresentou ótimos resultados e retornou ao esporte após 12 meses de acompanhamento.


Subject(s)
Humans , Male , Adolescent , Rupture , Tibia/injuries , Patellar Ligament , Fractures, Avulsion
5.
J. appl. oral sci ; 26: e20170470, 2018. graf
Article in English | LILACS, BBO | ID: biblio-954503

ABSTRACT

Abstract The hypothesis of this study was that the peri-implant bone healing of the group of pinealectomized rats would differ from the control group. The samples were subjected to immunohistochemical, microtomographic (total porosity and connectivity density), and fluorochrome (mineralized surface) analyses. Objectives The goal of this study was to investigate the cellular changes and bone remodeling dynamics along the bone/implant interface in pinealectomized rats. Material and Methods The total of 18 adult male rats (Rattus norvegicus albinus, Wistar) was divided into three groups (n=6): control (CO), pinealectomized without melatonin (PNX) and pinealectomized with melatonin (PNXm). All animals were submitted to the first surgery (pinealectomy), except the CO group. Thirty days after the pinealectomy without melatonin, the second surgery was conducted, in which all animals received an implant in each tibia (36 titanium implants with surface treatment were installed - Implalife® São Paulo, SP, Brazil). By gavage, the rats of the PNX group received the vehicle solution, and the procedure. Results Immunohistochemical analysis for runt-related transcription factor 2 (RUNX2), alkaline phosphatase (ALP), osteopontin (OP) and osteocalcin (OC) showed that the bone repair process in the PNXm group was similar to that of the CO group, whereas the PNX group showed a delay. The microtomographic parameters of total porosity [Po(tot)] and bone surface (BS) showed no statistically significant differences, whereas for the connective density (Conn.Dn) a statistical difference was found between the CO and PNXm groups. Fluorochrome analysis of the active mineralized surface showed statistically significant difference between the CO and PNX and between the CO and PNXm groups. Conclusion The absence of the pineal gland impaired the bone repair process during osseointegration, however the daily melatonin replacement was able to restore this response.


Subject(s)
Animals , Male , Pineal Gland/surgery , Osseointegration/drug effects , Bone Density Conservation Agents/pharmacology , Bone-Implant Interface , Melatonin/pharmacology , Tibia/drug effects , Tibia/injuries , Tibia/pathology , Titanium , Immunohistochemistry , Osteocalcin/analysis , Reproducibility of Results , Treatment Outcome , Rats, Wistar , Implants, Experimental , Dental Implantation, Endosseous , Alkaline Phosphatase/analysis , Core Binding Factor Alpha 1 Subunit/analysis , Osteopontin/analysis , X-Ray Microtomography , Fluorescent Dyes
6.
Acta cir. bras ; 32(9): 767-780, Sept. 2017. tab, graf
Article in English | LILACS | ID: biblio-886243

ABSTRACT

Abstract Purpose: To assess the efficacy of allogeneic mesenchymal stem cells and xenogenic platelet rich plasma in the treatment of bone failure of osteoporotic rabbits secondary to estrogenic deprivation and iatrogenic hypercortisolism. Methods: Eight female rabbits underwent ovarian resection and corticoid therapy to induce clinical status of osteoporosis. Four failures were produced in the tibiae, with each failure being treated with hemostatic sponge, allogenic mesenchymal stem cells, xenogenic platelet-rich plasma and the association between both. The animals were divided into two groups, evaluated radiographically and histopathologically at 30 and 60 days post treatment. Results: A radiographically confirmed consolidation of bone failures treated with allogeneic mesenchymal stem cells, associated with the histopathological image of mature and immature bone tissue, without evidence of osteopenia, was compared with the other groups, in which radiolucent failures with osteopenia and fibrosis were still present, denoting the satisfactory effect of the first treatment in detriment to the others. Conclusion: The treatment of bone failures of rabbits with secondary osteoporosis with allogeneic mesenchymal stem cells induced greater bone consolidation with mature and immature bone tissue production (p<0.01), when compared to the other treatments.


Subject(s)
Animals , Female , Rats , Osteoporosis/complications , Tibia/pathology , Bone Regeneration/physiology , Mesenchymal Stem Cell Transplantation , Platelet-Rich Plasma , Tibia/injuries , Time Factors , Transplantation, Heterologous
7.
Rev. chil. infectol ; 33(6): 696-699, dic. 2016. ilus
Article in Spanish | LILACS | ID: biblio-844424

ABSTRACT

A case of a girl with chronic posttraumatic osteomyelitis of the right tibia with microbiological isolation of Bacillus spp. by conventional methods and confirmation by mass spectrometry MALDI-TOF (matrix-assisted laser desorption/ionization time-of-flight mass) of Corynebacterium striatum is presented. Diagnostic methods, clinical manifestations, and resistance pattern of these infections are described.


Se presenta el caso de una adolescente con osteomielitis crónica postraumática de la tibia derecha con aislamiento microbiológico por métodos convencionales de Bacillus spp. y confirmación por espectrometría de masas MALDI-TOF de Corynebacterium striatum, microorganismo considerado generalmente saprófito. Se describen las presentaciones clínicas de estas infecciones descritas en la literatura científica, la necesidad del diagnóstico etiológico por técnicas no convencionales y el patrón de resistencia comúnmente expresado.


Subject(s)
Humans , Female , Adolescent , Osteomyelitis/diagnostic imaging , Surgical Wound Infection/diagnostic imaging , Tibia/injuries , Corynebacterium/isolation & purification , Corynebacterium Infections/diagnostic imaging , Osteomyelitis/microbiology , Surgical Wound Infection/microbiology , Tibia/surgery , Tibia/microbiology , Magnetic Resonance Imaging , Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization
8.
Arq. bras. med. vet. zootec ; 68(6): 1586-1594, nov.-dez. 2016. tab, ilus
Article in English | LILACS, VETINDEX, LILACS, VETINDEX | ID: biblio-827944

ABSTRACT

There are few studies about the treatment options for cranial cruciate ligament rupture in growing dogs, especially with epiphysiodesis techniques. The aim of this study was to evaluate the electrocautery technique for proximal tibial epiphysiodesis in Labrador retriever puppies. The novel electrocautery technique was compared with the screw technique regarding the efficacy for tibial plateau leveling in growing dogs. Six healthy Labrador retriever puppies were divided into two groups. The screw technique was used in one group and the electrocautery technique was used in the other group. Both proximal tibial epiphysiodesis techniques for tibial plateau leveling were effective in achieving reduced tibial plateau angle and did not cause significant joint changes. The screw technique was more invasive and caused slightly greater morbidity than the electrocautery technique. The electrocautery technique seems to be a good alternative for proximal tibial epiphysiodesis in young dogs.(AU)


São descritos poucos estudos sobre as opções de tratamento para a ruptura do ligamento cruzado cranial em cães na fase de crescimento, especialmente em relação às técnicas de epifisiodese. O objetivo deste estudo foi avaliar a técnica de eletrocauterização para epifisiodese proximal da tíbia em cães filhotes da raça Labrador Retriever. A nova técnica de eletrocauterização foi comparada com a do parafuso em relação à eficácia para nivelamento do platô tibial em cães na fase de crescimento. Seis filhotes saudáveis da raça Labrador foram selecionados e divididos aleatoriamente em dois grupos. A técnica do parafuso foi usada em um grupo, enquanto no outro foi usada a da eletrocauterização. Ambas as técnicas de epifisiodese proximal da tíbia para nivelamento do platô tibial foram eficazes na redução do ângulo do platô tibial e não causaram alterações articulares importantes. A técnica do parafuso foi considerada mais invasiva e causou morbidade um pouco mais acentuada do que a da eletrocauterização. Assim, a técnica da eletrocauterização parece ser uma boa alternativa para a epifisiodese proximal da tíbia em cães jovens.(AU)


Subject(s)
Animals , Dogs , Electrocoagulation/methods , Epiphyses, Slipped/surgery , Knee Joint/surgery , Tibia/injuries , Electrocoagulation/veterinary
9.
Artrosc. (B. Aires) ; 23(2): 81-86, mayo 2016.
Article in Spanish | LILACS, BINACIS | ID: lil-786945

ABSTRACT

Introducción: Dado lo infrecuente y la falta de consenso del tratamiento de niños y adolescentes con estas lesiones, decidimos redactar esta publicación con el objetivo de presentar un caso avulsión tibial de LCP en adolescente deportista de contacto con fisis abierta y realizar una revisión de la bibliografía publicada. Materiales y Métodos: RF. masculino, 13 años, rugby, sufre tackle francés y caída sobre rodillas en flexión. Consulta 3 meses post-trauma con gonalgia izquierda, derrame y limitación deportiva. Sin inestabilidad pero “no la siente bien”. Al examen cajón posterior ++/++++, test gravitacional+. Rx cajón posterior: 8 mm de diferencia entre ambas rodillas. RMN: avulsión tibial LCP. Se interpreta como lesión sintomática del LCP en deportista, se decide cirugía (artroscopia + abordaje posterior) con reinserción de fragmento condral en 1 tiempo. P.OP: sin carga 4 semanas. Calza de yeso en extensión 6 semanas, luego inmovilizador 3 meses y movilidad pasiva progresiva. Resultados: Logro movilidad 0-90° en 8ª semana. Al 3ª mes cajón Rx traslación posterior de 4 mm. RMN al 4ª mes reinserción de LCP con anclaje suprafisario. Sexto mes cajón posterior mínimamente alargado con tope neto, 11ª mes actividades deportivas recreativas y continúa fortalecimiento. Discusión y Conclusión: La mayoría de avulsiones de LCP en pacientes con fisis abiertas probablemente sea por mayor fuerza y resistencia del ligamento respecto fisis y hueso a esta edad. Debemos sospecharlo en pacientes con gonalgia vaga, con o sin inestabilidad, con antecedente traumático y Rx normal, siendo indispensable un correcto examen y RMN para su diagnóstico. Creemos que en deportistas con fisis abiertas, debido al riesgo de degeneración articular, se justifica la cirugía para restaurar la cinemática, evitar artrosis y retomar la actividad previa a la lesión. Tipo de estudio: Reporte de caso y Revisión bibliográfica. Nivel de evidencia: IV


Introduction: Given the infrequency and lack of consensus in the treatment of children and adolescents with these injuries, we decided to write this report with the aim of present a case of PCL tibial avulsion in a contact athlete teen with open physis and a review of the literature published. Materials and Methods: RF. male, 13 years, rugby, suffers French tackle and fall on knees flexed. 3 months post-trauma consultation with left knee pain, joint fluid and sport limitation. Whidout instability but “not feeling well”. The posterior drawer test ++ / ++++, gravitational test +. Rx posterior drawer: 8mm difference between the two nenes. MRI: tibial avulsion PCL. We interpreted as symptomatic PCL injury in athletes, surgery (arthroscopy + posterior approach) is decided reintegration of chondral fragment in 1 time P.OP: no load 4 Weeks. Plaster wedge extension 6 weeks, then 3 months and passive immobilizer progressive mobility. Results: 0-90 mobility achieving in 8th week. The 3rd month drawer Rx 4 mm. MRI posterior translation of the 4th month reintegration of LCP with anchor. 6ª month later minimally elongated drawer with stop net. 11th month continuous strengthening recrearional and sports activities. Discussion and Conclusion: Most avulsion of PCL in patients with open physis probably be for greater strength and endurance ligament compared with the physis and bone at this age. We suspected in patients with vague knee pain, with or without instability, history of trauma and normal Rx a correct examination and MRI to be essential for diagnosis. We believe that athletes with open physis, because of the risk of joint degeneration, surgery is justified to restore kinematics, prevent osteoarthritis and resume activity prior to the injury. Type of study: Case report and literature review. Level of evidence: IV


Subject(s)
Adolescent , Posterior Cruciate Ligament/surgery , Posterior Cruciate Ligament/injuries , Tibia/surgery , Tibia/injuries , Knee Injuries/surgery , Athletic Injuries/surgery , Treatment Outcome
10.
Article in English | WPRIM | ID: wpr-46335

ABSTRACT

Antegrade transmalleolar drilling method is one of the options for the treatment of osteochondral lesion of talus (OLT). We present five patients who underwent tibial drilling for treatment of OLT and later developed distal tibial cystic formation induced by cartilage opening or heat necrosis during drilling. Antegrade transmalleolar drilling can be a possible option for the treatment of OLT if the lesion is not easily reachable; however, other viable treatment should be considered due to its possibility of distal tibial pathologic change.


Subject(s)
Adult , Ankle Joint/surgery , Cartilage, Articular/surgery , Female , Humans , Iatrogenic Disease , Male , Musculoskeletal Diseases/etiology , Orthopedic Procedures/adverse effects , Talus/surgery , Tibia/injuries , Young Adult
11.
Article in Spanish | LILACS, LIVECS | ID: biblio-1255195

ABSTRACT

Ante defectos masivos a nivel de la tibia, se consideran técnicas que comprometan mínimamente las partes blandas y garanticen la viabilidad, funcionalidad de la extremidad y sea accesible para la población. Por primera vez en la literatura, a propósito de un caso, se describe la técnica de Huntington y se modifica de manera netamente percutánea, tomando como criterio de selección una extremidad severamente lesionada, con gran defecto diafisiario, para lo cual se realizó centralización del peroné de manera percutánea y fijación externa con alambres de Kirschner y retiro de material a los 5 meses. Actualmente, presenta discrepancia de miembros inferiores de 5cms, y marcha independiente soportada con suela compensatoria. Esta técnica puede ser empleada en niños y adolescentes; no se recomienda en caso de zonas metafiso-epifisiarias. Se basa en el menor compromiso de partes blandas, menor desperiostización y posibilidad de lesiones vasculonerviosas; ofrece una solución viable ante grandes defectos tibiales a ser considerado por el cirujano ortopedista(AU)


Several techniques have been considered to improve major tibia defects, all of them have been in minimally invasive surgery with less injury on the soft tissue, ensuring function and viability of the extremity, as well as and easy treatment access by patients. This is first time in literature Huntington's technique is described and modified purely to the percutaneous level, with an evidence degree type IV. In this particular case we took into consideration the selection of a severely-injured extremity with a large diaphysis defect, which experienced centralization of the fibula to Huntington's technique, was rearranged at the percutaneous level, and externally fixated temporally with Kirschner needle. Lower discrepancy less than 5 centimeters between both extremities is showed as final results; supported independent walking with compensatory sole. This technique can be used in children and adolescents; however it is not recommended in cases where metaphyseal- epiphyseal zones are affected. Aiming to goal for the least damage and compromise of the soft tissue, as well as periosteomy, and possibilities of vascular or nervous lesions, this technique offers a viable solution against major tibia defects and could be considered by the orthopedic surgeon(AU)


Subject(s)
Humans , Male , Adult , Osteomyelitis , Tibia/surgery , Tibia/injuries , Bone Density , Fractures, Open , Tissues , Wounds and Injuries , Diaphyses , Camurati-Engelmann Syndrome
12.
Int. j. morphol ; 32(4): 1472-1476, Dec. 2014. ilus
Article in Spanish | LILACS | ID: lil-734701

ABSTRACT

La regeneración ósea en reconstrucción del proceso alveolar junto al uso de implantes oseointegrables son ampliamente utilizados, existiendo una amplia variabilidad de productos. El objetivo de esta investigación es estudiar la reparación ósea asociada a un sustituto óseo a base de sulfato de calcio cubierto con membrana biológica en defectos creados en tibia de conejos. Se seleccionaron 12 conejos de entre 3 y 6 meses para ser intervenidos; de acuerdo a protocolos de anestesia ya conocidos se realizó la técnica con acceso a ambas tibias donde se realizaron 2 defectos de 2,6 mm de diámetro; se formaron cuatro grupos siendo el grupo I de relleno con coágulo sanguíneo, grupo II relleno con coagulo cubierto con membrana de colágeno, grupo III relleno con sulfato de calcio y grupo IV relleno con sulfato de calcio cubierto con membrana biológica. Se realizó la eutanasia a los 21 y 42 días y posteriormente se procedió a procesar y analizar láminas histológicas con tinción de hematoxilina y eosina. Se realizó la histomorfometría comparativa analizando los datos con prueba ANOVA y prueba de Turkey considerando un valor de p<0,05 para significancia estadística. Los resultados demostraron que todos los defectos mostraron patrones regulares de reparación ósea; los grupos rellenados con coágulo mostraron formación ósea estadísticamente menor que el presentado por los defectos rellenos con el sulfato de calcio, aunque estos últimos presentaron mayores indicadores de presencia de proceso inflamatorio; el grupo IV fue el que presentó los mejores niveles de reparación ósea a los 21 y 42 días. Se concluye que la reparación ósea en defectos menores es viable de ser realizada con este biomaterial y que la cobertura con membrana de colágeno puede ser útil en la regeneración ósea guiada.


Bone regeneration in the alveolar process and dental implant are widely used and there are a lot of different products. The aim of this research was to know the bone reparation associated to bone substitute with calcium sulfate and a biological membrane in created defects in rabbit tibiae. Were selected 12 rabbit between 3 and 6 month to be operated; using previous anesthesia protocols was do it a surgical defect in the right and left tibiae with 2.6 mm diameter; four groups were created: group I with blood clot fill, group II with blood clot fill plus biological membrane, group III with calcium sulfate and group IV with calcium sulfate plus biological membrane. The euthanasia was made in 21 and 42 days before surgery and was obtained histological plate using hematoxillin and eosin. The histomorphometry was made and statistical analysis using ANOVA and Turkey test with p<0.05 to obtain statistical differences. Were observed in the all created defects a regular bone reparation; the group I and II, with blood clot, showed a minor bone reparation than group III and IV with calcium sulfate, but these last one show an important inflammatory process; the group IV presented the better results at 21 and 42 euthanasia days in term of bone formation. It´s conclude that calcium sulfate can be used in bone reparation of minor defects and the biological membrane can be used in guide bone regeneration with success.


Subject(s)
Animals , Female , Rabbits , Tibia/surgery , Tibia/injuries , Calcium Sulfate/therapeutic use , Bone Substitutes/therapeutic use , Biocompatible Materials , Calcium Sulfate/chemistry , Bone Substitutes/chemistry
13.
Pesqui. vet. bras ; 34(2): 173-178, fev. 2014. ilus
Article in Portuguese | LILACS | ID: lil-709862

ABSTRACT

Foi realizada falha segmentar com 6mm de diâmetro na região metafisária medial de tíbias de 12 coelhos, onde foi implantado uma associação de micro e macrofragmentos de matriz óssea cortical heteróloga fragmentada conservada em glicerina (98%) e polimetilmetacrilato autoclavados, para a sua reconstrução, e avaliados radiológica e macroscopicamente aos 30, 60, 90 e 120 dias. Houve adesão, em relação ao tempo, dos micro e macrocompósitos ao leito receptor, em 100% dos casos, mostrando ser biologicamente biocompatível, pois promoveram a reparação de falhas ósseas, sem sinais de infecção, migração e/ou rejeição, podendo, dessa forma, ser mais uma opção como substituto para preencher grandes defeitos ósseos.


A segmental defect of 6mm diameter was performed in the medial metaphyseal region of the tibia of 12 rabbits. For the bone defect reconstruction there was implanted a combination of micro and macro fragments of heterologous fragmented cortical bone matrix preserved in glycerin (98%) and polymethylmethacrylate, both autoclaved. Radiological and macroscopic evaluation was performed at 30, 60, 90 and 120 days. Adhesion in relation to time of the micro and macro composites to the recipient bed was observed in 100% of the cases. This showed that this implant is biologically biocompatible, since it promoted bone defects repair, with no signs of infection, migration and/or rejection. In this way, this implant can be classified as one more option of substitute to fill large bone defects.


Subject(s)
Animals , Bone Matrix , Rabbits/injuries , Polymethyl Methacrylate/therapeutic use , Tibia/injuries , Biocompatible Materials/therapeutic use , Technology, Radiologic
14.
Acta cir. bras ; 28(6): 412-418, June 2013. ilus, tab
Article in English | LILACS | ID: lil-675574

ABSTRACT

PURPOSE: To evaluate the bone repair process in ovariohysterectomized rabbit submitted to an ovarian transplant to stomach that may supplying some quantity of estrogen occurs to improve bone healing. METHODS: In 20 female rabbits three holes of 1, 2 and 3mm diameter in tibial shaft were made and after that all animals received OHE through a ventral incision and they were randomly divided into two groups of ten rabbits each. In group one, animals received one of their self-ovaries that transplanted on serosal layer of stomach and group two did not receive treatment. Animals were kept during bone healing for a period of 45 days and radiological, biochemical, biomechanical and histopathological evaluation. RESULTS: The tibial defects in group one healed completely after 45 days and had more callous than second group. There is significant difference between two groups after operation in 21, 28 and 35 days about estrogen, progesterone and phosphatase Alkaline. The maximum forces in group one, were significantly higher than that for the group two. CONCLUSION:Ovarian transplantation prevents the effects of ovariohysterectomized on bone healing of rabbit tibia, suggesting that unilateral transplanted ovaries can substitute for the action of ovaries on the skeleton in ovariohysterectomized animals.


Subject(s)
Animals , Female , Rabbits , Bone Regeneration/physiology , Hysterectomy , Ovariectomy , Ovary/transplantation , Stomach/surgery , Tibia/injuries , Wound Healing/physiology , Alkaline Phosphatase/metabolism , Estrogens/metabolism , Progesterone/metabolism , Time Factors
15.
Acta cir. bras ; 27(10): 694-701, Oct. 2012. ilus, tab
Article in English | LILACS | ID: lil-650558

ABSTRACT

PURPOSE: To investigate the osteoconductive properties and biological performance of Poly L-lactic acid (PLLA) with omentum in bone defects. METHODS: PLLA nanofiber scaffolds were prepared via electrospinning technique. Forty four New Zealand white female rabbits randomly divided into three groups of 18 rabbits each. Created defects in right tibias were filled in group I with omentum, in group II with PLLA nanofiber scaffold and in group III with combination of the omentum and PLLA. The same defects were created in left tibia of all groups but did not receive any treatment (control group). Histological and histomorphometric evaluations were performed at two, four and six weeks after the implantation. RESULTS: Histological changes on all groups along with the time course were scored and statistical analysis showed that the average scores in group III were significantly higher than the other groups. CONCLUSION: Histomorphometric analysis of bone healing was shown to be significantly improved by the combined PLLA with omentum compared with the other groups, suggesting this biomaterial promote the healing of cortical bone, presumably by acting as an osteoconductive scaffold.


OBJETIVO: Investigar as propriedades de osteocondução e desempenho biológico do ácido L láctico-Poly (PLLA) com omento em defeitos ósseos. MÉTODOS: Andaimes PLLA nanofibras foram preparados via eletrofiação técnica. Cinquenta e quatro coelhos fêmeas Nova Zelândia brancos foram distribuídos aleatoriamente em três grupos de 18 coelhos cada. Defeitos criados em tíbias direitas foram preenchidos no grupo I com omento, no grupo II com PLLA nanofibras e no grupo III com a combinação do omento e PLLA. Os mesmos defeitos foram criados na tíbia esquerda de todos os grupos, mas não receberam qualquer tratamento (grupo controle). As avaliações histológicas e histomorfométricas foram realizadas em duas, quatro e seis semanas após a implantação. RESULTADOS: As alterações histológicas em todos os grupos, juntamente com o curso de tempo foram marcados e análise estatística mostrou que as pontuações médias do grupo III foram significativamente mais elevadas do que os outros grupos. CONCLUSÃO: Análise histomorfométrica da cicatrização óssea mostrou-se significativamente melhor com o PLLA combinado com omento em comparação com os outros grupos, sugerindo que este biomaterial promove a cicatrização do osso cortical, provavelmente atuando como osteocondutor.


Subject(s)
Animals , Female , Rabbits , Bone Regeneration/drug effects , Lactic Acid/therapeutic use , Nanofibers/therapeutic use , Omentum/transplantation , Polymers/therapeutic use , Tibia/injuries , Wound Healing/drug effects , Biocompatible Materials/therapeutic use , Materials Testing , Microscopy, Electron, Scanning , Models, Animal , Time Factors , Tissue Scaffolds , Treatment Outcome
16.
Clinics ; 67(9): 1023-1028, Sept. 2012. tab
Article in English | LILACS | ID: lil-649380

ABSTRACT

OBJECTIVE: To analyze and compare the vertical component of ground reaction forces and isokinetic muscle parameters for plantar flexion and dorsiflexion of the ankle between long-distance runners, triathletes, and nonathletes. METHODS: Seventy-five males with a mean age of 30.26 (±6.5) years were divided into three groups: a triathlete group (n=26), a long-distance runner group (n = 23), and a non-athlete control group. The kinetic parameters were measured during running using a force platform, and the isokinetic parameters were measured using an isokinetic dynamometer. RESULTS: The non-athlete control group and the triathlete group exhibited smaller vertical forces, a greater ground contact time, and a greater application of force during maximum vertical acceleration than the long-distance runner group. The total work (180º/s) was greater in eccentric dorsiflexion and concentric plantar flexion for the non-athlete control group and the triathlete group than the long-distance runner group. The peak torque (60º/s) was greater in eccentric plantar flexion and concentric dorsiflexion for the control group than the athlete groups. CONCLUSIONS: The athlete groups exhibited less muscle strength and resistance than the control group, and the triathletes exhibited less impact and better endurance performance than the runners.


Subject(s)
Adult , Female , Humans , Male , Young Adult , Ankle/physiology , Muscle Strength/physiology , Running/physiology , Analysis of Variance , Ankle Joint/physiology , Biomechanical Phenomena , Kinetics , Muscle Fatigue/physiology , Range of Motion, Articular/physiology , Statistics, Nonparametric , Torque , Tibia/injuries
17.
Rev. Méd. Clín. Condes ; 23(3): 267-273, may 2012.
Article in Spanish | LILACS | ID: lil-733901

ABSTRACT

El aumento en la actividad deportiva de niños y adolescentes ha derivado en un aumento de las lesiones esqueléticas atribuidas a la actividad física. El aparato locomotor infantil presenta particularidades que hacen que los patrones de lesión difieran a lo que ocurre en los adultos. Se producen lesiones agudas y de sobrecarga que se presentan en edades y sitios específicos. Debido a la alta frecuencia de aparición de ellas, es necesario que los médicos que atienden niños estén familiarizados con los cuadros más frecuentes. En este artículo se revisan los aspectos más importantes de las principales lesiones deportivas en niños y adolescentes resumiendo las principales consideraciones diagnósticas, terapéuticas y pronósticas.


The increase in sport activity of children and adolescents has led to an increase in skeletal lesions attributed to physical activity. The children’s musculoskeletal system presents particularities that make injury patterns defer to those that occur in adults. Acute and overluse injuries are produced, which occur in specific locations and ages. Due to the high frequency of their occurrence, it is necessary that physicians who treat children are familiar with the most frequent conditions. In this article the most important aspects of major sports injuries in children and adolescents are reviewed by summarizing the main diagnostic, therapeutic and prognostic considerations.


Subject(s)
Humans , Adolescent , Child , Cumulative Trauma Disorders , Fractures, Stress , Osteochondritis , Osteochondrosis , Athletic Injuries/therapy , Calcaneus/injuries , Elbow/injuries , Anterior Cruciate Ligament/injuries , Pelvis/injuries , Patella/injuries , Tibia/injuries
18.
Rev. bras. ortop ; 47(3): 381-383, 2012. ilus
Article in Portuguese | LILACS | ID: lil-649678

ABSTRACT

A fratura avulsão bilateral e simultânea da tuberosidade tibial em uma adolescente é uma lesão rara. Os autores relatam o primeiro caso da literatura em uma menina adolescente que caiu enquanto saltava durante uma partida de voleibol. Não foram diagnosticados fatores predisponentes. As lesões foram tratadas com a redução cruenta e a fixação interna. O objetivo desta pesquisa foi o de apresentar um caso de fratura avulsão bilateral e simultânea da tuberosidade tibial em uma adolescente e a terapêutica adotada.


Simultaneous bilateral avulsion fracture of the tibial tuberosity in teenagers is a rare lesion. We describe the first case in the literature, in a teenage girl who sustained a fall while jumping during a volleyball match. No predisposing factors were identified. The lesions were treated with open surgical reduction and internal fixation. The aim of the present study was to present a case of simultaneous bilateral avulsion fracture of the tibial tuberosity in a teenage girl and the therapy used.


Subject(s)
Humans , Female , Adolescent , Athletic Injuries , Fractures, Bone , Tibia/injuries , Volleyball
20.
Rev. bras. ortop ; 46(supl.1): 18-22, 2011. ilus, graf, tab
Article in Portuguese | LILACS | ID: lil-596372

ABSTRACT

OBJETIVO: Apresentar os resultados preliminares com técnicas de abordagem posterior para fraturas do platô tibial, com traço de cisalhamento no plano sagital. MÉTODOS: Doze pacientes com fraturas do platô tibial tratados cirurgicamente através de um acesso posterior direto foram incluídos no estudo. Foram revisados os prontuários, as radiografias e tomografias dos pacientes bem como as avaliações clínicas. Todos os casos foram acompanhados até o momento da consolidação óssea, definido como aquele em que o paciente apresentava sinais radiográficos compatíveis sendo capaz de apoiar carga total sobre o membro sem referir dor. RESULTADOS: Entre julho de 2009 e abril de 2010, foram atendidos em nosso serviço 89 pacientes com fraturas da extremidade proximal da tíbia. Desses, 80 (89,9 por cento) foram tratados cirurgicamente. Doze pacientes (13,6 por cento) apresentavam uma fratura com um componente de cisalhamento posterior e, portanto, foram submetidos a abordagens posteriores para redução e fixação da fratura. Em três destes casos associou-se uma abordagem antero-lateral. A média de idades dos pacientes foi de 35 anos. O acompanhamento médio foi de 12 meses (entre 8 e 23 meses). As fraturas foram classificadas de acordo com o sistema AO/OTA: cinco como 41 B1, quatro como 41 B3, duas como 41 C1 e uma como 41 C3. Dentre as complicações, tivemos uma deiscência de sutura, tratada com curativos, e uma perda de redução que necessitou de uma reoperação. Em nenhum caso ocorreu lesão neurovascular, retarde de consolidação, pseudartrose ou instabilidade articular residual. Em 4 casos a redução foi considerada ruim (> 2mm de degrau articular), em 5 casos foi considerada imperfeita (< 2 mm de degrau articular) e em 3 casos obtivemos uma redução anatômica. CONCLUSÃO: Os autores concluem que o uso da abordagem posterior deve ser considerada em casos de fraturas com onde haja componente de cisalhamento posterior do planalto da tíbia. Uma casuística ampliada é necessária para avaliar o real benefício desta abordagem.


OBJECTIVE: To describe our preliminary results of posterior shearing tibia plateau fractures treated by a direct dorsal approach and plate fixation. METHODS: A consecutive series of twelve patients with tibia plateau fractures treated by direct posterior approach was selected from our database. Conventional radiographies, computed tomography scans and medical records were reviewed. All cases were followed to union, as defined by painless weight bearing and radiographic healing. RESULTS: Between July 2009 and April 2010, our trauma service received 89 tibia plateau fractures and treated 80 (89,9 percent) operatively. Twelve patients (13,5 percent) sustained posterior shearing tibia plateau fractures. All fractures were treated through the posterior approach, although 3 required association with an anterolateral approach as well. The mean age of patients was 35 years and mean follow-up was 12 (range 8-23) months. The fractures were classified according to AO/OTA: five 41 B1, four 41 B3, two 41 C1 and one 41 C3. There was one wound dehiscence, managed with local wound care, and one loss of reduction treated by reoperation. No patient sustained neurovascular injury, nonunion, malunions or knee instability. In four cases the reduction was rated as poor (> 2 mm step off), in five cases reduction was rated as imperfect (<2 mm step off) and in three cases the reduction was rated as anatomic (absolutely no step-off). CONCLUSION: Authors conclude that posterior approaches should be considered when tibial plateau fractures result in posterior displaced fragments. A larger sample is needed to get definitive conclusions.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Bone Plates , Fracture Fixation , Tibia/injuries
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