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1.
Rev. cuba. anestesiol. reanim ; 20(3): e751, 2021. tab
Article in Spanish | LILACS, CUMED | ID: biblio-1351978

ABSTRACT

Introducción: La epicondilitis constituye uno de los motivos de consulta más frecuentes tanto en la asistencia primaria como especializada y sin duda alguna, es uno de los problemas que tiene mayor repercusión en la persona que la padece. El tratamiento de las epicondilitis constituye un reto para la medicina debido a enormes implicaciones sanitarias, sociolaborales y el dolor e impotencia funcional que provoca. Objetivo: Evaluar la efectividad del lisado plaquetario autólogo como alternativa de tratamiento en pacientes enfermos con epicondilitis. Método: Se realizó un estudio cuasi experimental analítico longitudinal prospectivo en el que se evaluó el uso de lisado plaquetario autólogo como alternativa de tratamiento en pacientes con epicondilitis. El universo estuvo constituido por los pacientes que acudieron a consulta de Ortopedia y traumatología con el diagnóstico de epicondilitis, durante el periodo comprendido entre octubre de 2014 y julio de 2018. La muestra quedo constituida por 80 pacientes que cumplieron con los criterios de inclusión y exclusión. Resultados: El grupo de edad entre 36-56 años y del sexo femenino son los de mayor representación en padecer esta enfermedad. Las infiltraciones de lisado plaquetario autólogo aportan mejores resultados al convencional y se observa la mayor representación de pacientes que tuvieron una remisión total. Las complicaciones fueron mucho más evidentes en el tratamiento convencional. También es relevante el costo-beneficio del tratamiento con lisado plaquetario autólogo. Conclusiones: El tratamiento con lisado plaquetario autólogo puede ser una alternativa para mejorar la calidad de vida de los pacientes con epicondilitis(AU)


Introduction: Epicondylitis is one of the most frequent reasons for attending consultation in both primary and specialized care; while it is undoubtedly one of the problems with the greatest impact on the person who suffers from it. The managment epicondylitis is a challenge for medicine, due to the enormous health-related and social implications, as well as the pain and functional impotence that it causes. Objective: To assess the effectiveness of autologous platelet lysate as a treatment alternative in patients with epicondylitis. Method: A prospective, longitudinal, analytical and quasiexperimental study was carried out, in which the use of autologous platelet lysate as an alternative treatment in patients with epicondylitis was assessed. The universe consisted of patients who attended the orthopedics and traumatology consultation, during the period between October 2014 and July 2018, with a diagnosis of epicondylitis. The sample was made up of eighty patients who met the inclusion criteria; exclusion criteria were also considered. Results: The age group between 36 and 56 years, together with the female sex, are the most represented with respect to suffering from this disease. Infiltrations of autologous platelet lysate provide better outcomes than the conventional one, while greater representation of remitted patients is observed. Complications were much more evident in conventional treatment. The cost-benefit relationship of treatment with autologous platelet lysate is also relevant. Conclusions: Treatment with autologous platelet lysate can be an alternative to improve the quality of life of patients with epicondylitis(AU)


Subject(s)
Humans , Orthopedics , Primary Health Care , Quality of Life , Blood Platelets/physiology , Traumatology , Referral and Consultation
2.
Cuad. Hosp. Clín ; 62(2): 26-34, dic. 2021. ilus.
Article in Spanish | LILACS | ID: biblio-1358049

ABSTRACT

INTRODUCCIÓN: la displasia de cadera es una de las causas más importantes y prevenibles de discapacidad durante la primera infancia. Es una enfermedad que se presenta en niños menores de 1 año, pero puede tener consecuencias importantes en la edad adulta, incluso puede desencadenar una osteoartrosis de cadera y/o invalidez en adultos jóvenes. OBJETIVO: determinar la correlación entre displasia de cadera con sus factores de riesgo en lactantes de 2 a 12 meses, evaluados en consultorio externo de Traumatología del Hospital Municipal Achacachi en el periodo de mayo ­ 2017 hasta abril ­ 2018. MATERIAL Y MÉTODOS: el tipo de investigación es descriptivo, diseño de tipo caso ­ control. Se estudiaron 128 pacientes lactantes de ambos sexos, que asistieron a su control en el consultorio de traumatología. La correlación entre factores de riesgo y displasia de cadera se determinó mediante la fórmula de Odds Ratio. RESULTADOS: el género femenino es el factor de riesgo con mayor asociación con la displasia de cadera, con un Odds Ratio de 139.04 veces más de padecer de displasia de cadera, seguida de la presentación podálica o transversa (12.58), las gestantes primíparas (4.52), los productos gemelares (3.71), los antecedentes familiares (2.54) y el Oligohidramnios (2.06). CONCLUSIÓN: existe relación importante entre los factores de riesgo (clínicos, obstétricos y fetales), con el desarrollo de displasia de cadera.(AU)


INTRODUCTION: hip dysplasia is one of the most important and preventable causes of disability during early childhood. It is a disease that occurs in children younger than 1 year, but it can have important consequences in adulthood, it can even trigger hip osteoarthritis and / or disability in young adults. OBJECTIVE: to determine the correlation between Hip Dysplasia with its risk factors in infants from 2 to 12 months, evaluated in an external Traumatology office of the Hospital Municipal Achacachi in the period from May - 2017 to April - 2018. MATERIAL AND METHODS: the type of research is descriptive, case control type design. 128 lactating patients of both sexes were studied, who attended their control in the traumatology office. The correlation between risk factors and hip dysplasia was determined using the Odds Ratio formula. RESULTS: female gender is the risk factor with the highest association with hip dysplasia, with an Odds Ratio of 139.04 times more than having Hip dysplasia, followed by breech or transverse presentation (12.58), primiparous pregnant women (4.52), twin products (3.71), Family History (2.54) and Oligohydramnios (2.06). CONCLUSIONS: there is an important relationship between risk factors (clinical, obstetric and fetal), with the development of Hip Dysplasia.(AU)


Subject(s)
Infant , Traumatology , Risk Factors , Hip , Odds Ratio
3.
Rev. cuba. ortop. traumatol ; 35(2): e434, 2021. ilus
Article in Spanish | LILACS-Express | LILACS, CUMED | ID: biblio-1357336

ABSTRACT

Introducción: El presente trabajo aborda la historia de la especialidad de Ortopedia y Traumatología desde el momento de su aparición en la provincia de Matanzas en el período pre revolucionario, hasta la actualidad. Objetivos: Exponer las evidencias históricas que muestran el derrotero de esta especialidad, y las figuras que jugaron y juegan un papel importante en la formación de especialistas. Métodos: Se utilizó el método de revisión documental sobre el tema, que contempló los documentos editados de 1941 al 2020. Se confeccionó un cuestionario para recoger la información aportada por los testigos entrevistados. Se revisaron los artículos publicados en la revista Médica que se encuentran en la Biblioteca Gener del Monte, de Matanzas (ejemplares únicos), así como otras investigaciones sobre la historia de la medicina matancera. Conclusiones: El esfuerzo desarrollado por la provincia desde el punto de vista asistencial, docente e investigativo ha contribuido a la preservación de la historia de la Ortopedia matancera y de sus actores para las actuales y futuras generaciones(AU)


Introduction: The present work addresses the history of the specialty of Orthopedics and Traumatology from the moment of its appearance in Matanzas province during the pre-revolutionary period, to the present day. Objectives: To show the historical evidence the historical evidence that displays the course of this specialty, and the personalities who played and play important roles in the training specialists. Methods: The document review method on the subject was used, considering the documents published from 1941 to 2020. A questionnaire was made to collect the information provided by the interviewed witnesses. The articles published in the Medical Journal found in Gener del Monte Library in Matanzas (single copies) were reviewed, as well as other investigations on the history of medicine in Matanzas. Conclusions: The effort established by the province, in care, teaching and research has contributed to the preservation of the history of Matanzas Orthopedics and its players for current and future generations(AU)


Subject(s)
Humans , History, 20th Century , Orthopedics/history , Traumatology/history , History, 20th Century
4.
Rev. bras. anal. clin ; 53(3): 299-306, 20210930. tab
Article in Portuguese | LILACS | ID: biblio-1370232

ABSTRACT

Objetivo: As infecções de sítios cirúrgicos (ISC) constituem a terceira maior classe de infecções relacionadas à assistência à saúde no Brasil e estão consideravelmente aumentadas em pacientes submetidos a procedimentos cirúrgicos ortopédicos. Grande parte das ISC ortopédicas relacionam-se a bactérias Gram-positivas, dentre elas Staphylococcus ssp. Outros microrganismos comumente encontrados são: Enterococcus ssp., assim como bactérias Gram-negativas, com destaque para Escherichia coli, e Pseudomonas aeruginosa. O presente estudo objetivou identificar a frequência de infecções bacterianas em sítios cirúrgicos e perfil de suscetibilidade antimicrobiana. Métodos: Estudo retrospectivo com análise de resultados microbiológicos de pacientes atendidos no serviço de traumato-ortopedia em hospital público de referência, entre agosto de 2016 a setembro de 2018. Resultados: Do total de 258 amostras enviadas ao laboratório, 138 isolados foram positivos, 84% foram pacientes masculinos, nos quais 32 espécies de bactérias foram identificadas, sendo as mais frequentes Staphylococcus aureus (25,2%), Enterococcus faecalis (10,8%), seguido das bactérias Gram-negativas Escherichia coli (9,9%) e Pseudomonas aeruginosa (9,9%). A suscetibilidade antimicrobiana revelou que 87,5% dos Staphylococcus aureus isolados eram MRSA (Staphylococcus aureus resistentes a meticilina) e sensíveis a vancomicina (96,4%) e Teicoplanina (98,2%). Considerando as Gram negativas, este estudo mostrou que houve frequência similar entre Escherichia coli (9,9%) e Pseudomonas aeruginosa (9,9%), seguido de Klebsiella pneumoniae (8,1%). A Escherichia coli, apresentou altas taxas de resistência às cefalosporinas e penicilinas. Conclusão: O perfil microbiológico e a suscetibilidade antimicrobiana devem ser considerados na determinação das terapias antimicrobianas adequadas para controle das infecções hospitalares, possibilitando uso racional de antibióticos e diminuição da resistência bacteriana.


Objective: Surgical site infections (SSIs) represent the third largest class of infections related to health care in Brazil. Risk of SSIs increase in patients undergoing orthopedic surgical procedures. Most orthopedic SSI are related to Gram-positive bacteria, among them Staphylococcus ssp. Other microorganisms commonly found are Enterococcus, as well as Gram-negative bacteria, especially Escherichia coli e Pseudomonas aeruginosa. The present study aimed to identify the frequency of bacterial infections in surgical sites and antimicrobial susceptibility profile. Methods: Retrospective study analyzed microbiological results from patients attending the orthopedic trauma service in a public referral hospital from August 2016 to September 2018. Results: Of the 258 samples sent to the laboratory, 138 isolates were positive, 84% were from male patients and more than 31 species of bacteria were identified, with the most frequent being Gram positive Staphylococcus aureus (25,2%) and the second most frequent being Enterococcus faecalis (10.8%), followed by Gram negative bacteria Escherichia coli (9.9%) and Pseudomonas aeruginosa (9.9%). The antimicrobial susceptibility showed that 87.5% of Staphylococcus aureus isolates were MRSA (methicillin resistant Staphylococcus aureus) and presented sensitivity to vancomycin (96.4%) and Teicoplanine (98.2%). Considering gram-negative bacteria, this study showed that there was a technical tie between Escherichia coli (9.9%) and Pseudomonas aeruginosa (9.9%) followed by Klebsiella pneumoniae (8.1%). Regarding the antimicrobial susceptibility profile, Escherichia coli presented high resistance to cephalosporin and Penicillin. Conclusion: Microbiological profile and susceptibility to antimicrobials must be considered when determining the most appropriate antibiotic therapies to control hospital infections and decrease emergence of bacterial resistance.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Surgical Wound Infection , Orthopedics , Staphylococcus aureus , Traumatology , Drug Resistance, Bacterial , Escherichia coli
6.
Rev. cuba. ortop. traumatol ; 35(1): e360, 2021. ilus
Article in Spanish | LILACS, CUMED | ID: biblio-1289559

ABSTRACT

Introducción: En la búsqueda de la historia del desarrollo de la especialidad de Ortopedia y Traumatología en la provincia de Matanzas, aparece el nombre del Dr. Alberto Jiménez Pla, un profesional que no se conoce como debería, si se tiene en cuenta la importancia del trabajo que desarrolló en las primeras cuatro décadas del siglo pasado en la atención de esta población, y el ejemplo que constituye su desarrollo profesional. Objetivo: Exponer las evidencias históricas que muestran la vida profesional del destacado ortopédico matancero Alberto Jiménez Plá. Método: Se utilizó el método de revisión documental que contempló documentos editados desde 1941 hasta 2009. Se revisaron los artículos del Dr. Jiménez Plá publicados en la Revista de Médica que se encuentran en la Biblioteca Gener del Monte, de Matanzas (ejemplares únicos), y otras investigaciones sobre la historia de la medicina matancera. Conclusiones: El presente trabajo constituye un homenaje de los ortopédicos matanceros a la memoria de Alberto Jiménez Plá, para llevar su vida y obra a las nuevas generaciones de ortopédicos(AU)


Introduction: Searching in the history of the development of Orthopedics and Traumatology as an specialty in Matanzas province, the name of Dr. Alberto Jiménez Plá rises, a professional who is not known as he should, if one takes into account the importance of his work during the first four decades of the last century in the care of Matanzas population, he is an example of professional growth. Objective: To show the historical evidence of the outstanding professional life of Matanzas orthopedic Alberto Jiménez Plá. Method: The document review method was used, which included documents published from 1941 to 2009. We reviewed the articles by Dr. Jiménez Plá published in Revista de Médica found in the Gener del Monte at Matanzas Library (unique copies), and other investigations on the history of Matanzas medicine. Conclusions: This paper constitutes a tribute from Matanzas orthopedists to the memory of Alberto Jiménez Plá, to bring his life and work to new generations of specialists(AU)


Subject(s)
Humans , Orthopedics/history , Personality , Traumatology/history , Social Desirability
9.
Rev. cuba. ortop. traumatol ; 35(1): e341, 2021.
Article in Spanish | LILACS, CUMED | ID: biblio-1289549

ABSTRACT

Introducción: El torniquete es ampliamente usado en la cirugía ortopédica y traumatológica con el objetivo de disminuir las pérdidas sanguíneas intraoperatorias y mejorar la visibilidad de las estructuras anatómicas, aunque su empleo es controversial. Objetivo: Describir las aplicaciones prácticas y las limitaciones del torniquete en la cirugía ortopédica y traumatológica. Método: Se realizó una revisión no sistemática de la literatura en bases de datos científicas como Cochrane Database of Systematic Reviews, Pubmed/Medline, EMBASE, Scopus, Web of Science, EBSCOhost, ScienceDirect, OVID y el buscador académico Google Scholar, en el mes de septiembre de 2020. Conclusiones: Aunque el torniquete es ampliamente utilizado durante la cirugía ortopédica y traumatológica, debido a que contribuye a reducir las pérdidas hemáticas intraoperatorias, se ha demostrado su efecto en el aumento de las pérdidas sanguíneas totales, así como su asociación con dolor perioperatorio, pérdida de la fuerza muscular del miembro, lesiones de nervios periféricos, trombosis venosa profunda y daño a órganos a distancia por el fenómeno de isquemia-reperfusión(AU)


Introduction: Although controversial, tourniquets are widely used in orthopedic and trauma surgery with the aim of reducing intraoperative blood losses and improving the visibility of anatomical structures. Objective: To describe the practical applications and limitations of tourniquets in orthopedic and trauma surgery. Method: A non-systematic review of the literature was carried out, in scientific databases such as Cochrane Database of Systematic Reviews, Pubmed / Medline, EMBASE, Scopus, Web of Science, EBSCOhost, ScienceDirect, OVID and the academic search engine Google Scholar, in the month of September 2020. Conclusions: Although tourniquets are widely used during orthopedic and trauma surgery, since they contribute to reducing intraoperative blood loss, the effect on increasing total blood loss has been demonstrated, as well as the association with perioperative pain, blood loss, limb muscle strength, peripheral nerve injuries, deep vein thrombosis and damage to distant organs due to the ischemia-reperfusion phenomenon(AU)


Subject(s)
Humans , Tourniquets/classification , Orthopedics , Traumatology
10.
Rev. venez. cir. ortop. traumatol ; 53(1): 35-41, jun. 2021. tab
Article in Spanish | LILACS, LIVECS | ID: biblio-1252919

ABSTRACT

El acortamiento y la rotación del peroné son las deformidades más frecuentemente encontradas cuando se presentan maluniones postraumáticas del tobillo resultando en ensanchamiento de la mortaja e inestabilidad astragalina, con consecuentes cambios artrósicos. Los pacientes acuden por presentar dolor y limitación en sus actividades diarias y deportivas. En el presente estudio retrospectivo se hace una evaluación de los resultados clínicos y radiológicos de 9 pacientes que se sometieron a tratamiento quirúrgico posterior a maluniones de fracturas de peroné, en los cuales se realizaron osteotomías de alargamiento y desrotación para reconstrucción del tobillo, en la Unidad de Cirugía de Pie y Tobillo del Hospital Universitario de Caracas, entre junio de 2014 y agosto del 2019. Se realizaron mediciones radiológicas pre y postoperatorias de los ángulos de inclinación astragalina, talocrural y bimaleolar, y se reportaron los cambios degenerativos articulares. Para la evaluación clínica y funcional se aplicó la Escala Análoga Visual (VAS) para el dolor, y la Escala AOFAS de retropié, evidenciándose mejoría en cuanto a dolor, función y alineación. El objetivo del tratamiento fue restituir la longitud inicial del peroné, mediante osteototomías oblicuas en el sitio de la fractura anterior, o transversas suprasindesmales, con lo cual también se corrige la alineación del astrágalo, y de esta manera prevenir o disminuir los síntomas y signos inherentes a degeneración articular progresiva(AU)


The shortening and rotation of the fibula are the most frequent deformities found when post-traumatic ankle malunions occur, resulting in widening of the mortise and talus instability, with consequent arthritic changes. Patients have pain and limitation in their daily activities and sports. In the present retrospective study, an evaluation of the clinical and radiological results of 9 patients who underwent surgical treatment after fibular fracture malunions was performed, in which osteotomies of lengthening and de-rotation were performed for reconstruction of the ankle, in the Unit of Foot and Ankle Surgery at the University Hospital of Caracas, between June 2014 and August 2019. Pre and postoperative radiological measurements of the astragaline, talocrural and bimaleolar inclination angles were performed, and degenerative joint changes were reported. For the clinical and functional evaluation, the Visual Analog Scale (VAS) was applied for pain, and the AOFAS Hindfoot Scale, evidencing improvement in pain, function, and alignment. The objective of the treatment was to restore the initial length of the fibula by means of oblique osteotomies at the site of the previous fracture or suprasindesmal transverse osteotomy, which also corrects the alignment of the talus and thus prevents or decreases the symptoms and signs inherent to joint progressive degeneration(AU)


Subject(s)
Humans , Male , Adult , Middle Aged , Aged , Osteotomy , Bone Lengthening , Fractures, Malunited , Traumatology , Fractures, Bone , Fibula/surgery
11.
Rev. venez. cir. ortop. traumatol ; 53(1): 27-34, jun. 2021. tab
Article in Spanish | LILACS, LIVECS | ID: biblio-1252908

ABSTRACT

Las técnicas quirúrgicas mínimamente invasivas ayudan a que el proceso natural de la consolidación ósea ocurra proporcionando estabilidad biomecánica suficiente para obtener los mejores resultados. El objetivo de este trabajo es mostrar los resultados clínicos y radiológicos del tratamiento de las fracturas diafisiarias de tibia con osteosíntesis mínimamente invasiva con placa por cara lateral. Se realizó un estudio clínico observacional, prospectivo, longitudinal y no concurrente. Se incluyeron pacientes mayores de 18 años, de ambos sexos, con diagnósticos de fracturas diafisiarias de tibia 42A, 42B ó 42C, abiertas o cerradas. Se estableció tiempo de seguimiento mínimo de 6 meses. Se incluyeron 23 pacientes, 82,60% de sexo masculino. Promedio de edad de 21±5,63(16­49) años. La fractura más frecuente fue la 42B2 en 26,00% de los casos, y 34,80% fracturas fueron abiertas. A las 12 semanas, 65,10% habían alcanzado consolidación Montoya III; y para la semana 16, 91,30% de los pacientes. De acuerdo a la escala ASAMI, se alcanzaron resultados excelentes en 100,00% pacientes para la semana 16. No se presentaron complicaciones como infección, aflojamiento séptico o aséptico del implante, ni fatiga del mismo. El uso de la técnica MIPO para tratamiento de fracturas diafisiarias de la tibia, por cara lateral es una técnica efectiva y segura, con alta tasas de consolidación, mínimas complicaciones y buenos resultados finales(AU)


Minimally invasive surgical techniques help the natural bone healing process to occur, by providing enough biomechanical stability to obtain the best results. The objective is to show the clinical and radiological results of the treatment of diaphyseal tibial fractures with minimally invasive osteosynthesis with lateral plating. An observational, prospective, longitudinal and non-concurrent clinical study was made. Patients older than 18 years, both sexes, with diagnoses of open or closed tibial shaft fractures 42A, 42B or 42C, were included. A minimum follow-up time of 6 months was established. 23 patients were included, 82,60% male. Average age of 21 years. The most frequent fracture was 42B2 in 26,00% cases, and 34,80% were open fractures. At 12 weeks, 65,10% had reached Montoya III consolidation criterias; and for week 16, 91,30% of the patients. According to the ASAMI scale, excellent results were achieved in 100,00% patients. There were no complications such as infection, septic or aseptic loosening of the implant, or fatigue of the implant. The use of the MIPO technique for the treatment of diaphyseal fractures of the tibia on the lateral aspect is an effective and safe technique, with high rates of union, minimal complications and good final results(AU)


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Orthopedic Fixation Devices , Tibial Fractures , Fracture Fixation, Internal , Growth Plate , Traumatology , Orthopedic Procedures
12.
Rev. venez. cir. ortop. traumatol ; 53(1): 10-19, jun. 2021. ilus
Article in Spanish | LILACS, LIVECS | ID: biblio-1252872

ABSTRACT

El manejo de pseudoartrosis infectadas, osteomielitis y defectos óseos representa un reto enorme para el cirujano ortopedista. Hace diez años, Masquelet presentó la técnica de inducción de membrana como alternativa al manejo de las complicaciones mencionadas arriba con excelentes tasas de consolidación y erradicación del proceso infeccioso. Estudiamos una de serie de 14 casos, prospectiva, con seguimiento clínico y radiológico mínimo de 2 años (enero 2015-diciembre 2018), donde evaluamos múltiples variables en pacientes a quienes se les realizó el protocolo de Masquelet. Obtuvimos una tasa de consolidación de 85,7% (12/14). Con un tiempo promedio para alcanzarla de 6,1 meses (3-9m). Todos los pacientes que lograron la consolidación se encontraban libres de infección al final del seguimiento. Por su reproducibilidad y alta tasa de consolidación, consideramos la técnica de inducción de membrana, como una excelente opción en el manejo de pseudoartrosis infectadas complejas(AU)


The management of infected nonunions, osteomyelitis, and bone defects represents an enormous challenge for the orthopedic surgeon. Ten years ago, Masquelet presented the membrane induction technique as an alternative to the management of the complications afore mentioned with excellent rates of consolidation and eradication of the infectious process. We prospectively studied a series of 14 cases, with a clinical and radiological follow-up of at least 2 years (january 2015-december 2018). Where we evaluated multiple variables in patients who underwent the Masquelet protocol. We obtained a consolidation rate of 85.7% (12/14). With an average time to reach it of 6.1 months (3-9m). All patients who achieved union were free of infection at the end of follow-up. Due to its reproducibility and high consolidation rate, we consider the membrane induction technique an excellent option in the management of complex infected nonunions(AU)


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Osteomyelitis/complications , Pseudarthrosis/complications , Bone Transplantation , Orthopedic Procedures , Bone Diseases , Traumatology
14.
Rev. bras. ortop ; 56(3): 379-383, May-June 2021. tab, graf
Article in English | LILACS | ID: biblio-1288684

ABSTRACT

Abstract Introduction The possibility of perforation of gloves during orthopedic surgeries can reach 56.8%, and it mainly related to the manipulation of blunt instruments. Surgeries for the treatment of fractures and trauma present additional risk due to contact with bone spires. Objective Analysis of the prevalence of loss of integrity of surgical gloves in orthopedic trauma procedures, especially fractures, and evaluation of the surgeon's exposure and contact with secretions from the patient. Methods Macroscopic inspection of the gloves of two surgeons specialized in trauma, over a period of 4 months. Both used two gloves for all procedures and, at the end of the surgery, analyzed the presence or absence of blood stains on the internal gloves and/or fingers. The procedures were categorized according to the time and type of surgery. The intercurrence investigated was the perforation of one or two gloves; if the tear was perceived immediately or only at the end of the surgery, and the location of and reason for the tear, if identified. Results A total of 210 surgeries were included, 87 of which presented perforations, with 17 cases occurring in both gloves and 70 only in the outer glove. Finally, there was a more significant relationship with open focus surgeries and duration > 60 minutes. Conclusion Our results suggest that greater care and inspection of gloves to look for damage are needed in prolonged surgeries with an open focus.


Resumo Introdução Cirurgias ortopédicas apresentam a possibilidade de perfuração das luvas, que pode chegar a 56,8%, relacionada principalmente à manipulação de instrumentos cortantes. O tratamento de fraturas e cirurgias de trauma apresenta risco adicional pelo contato com espiculas ósseas. Objetivo Análise da prevalência de perda de integridade das luvas cirÚrgicas em procedimentos ortopédicos de trauma, principalmente fraturas, avaliando a exposição do cirurgião e o contato com secreções provenientes do paciente. Métodos Inspeção macroscópica das luvas de dois cirurgiões especializados em trauma, durante um período de 4 meses. Ambos usaram duas luvas para todos os procedimentos e, ao término da cirurgia, analisaram a presença ou ausência de manchas de sangue nas luvas internas e/ou nos dedos. Os procedimentos foram categorizados quanto ao tempo e tipo de cirurgia. A intercorrência investigada foi a perfuração de uma ou duas luvas; se a perfuração foi percebida imediatamente ou apenas ao final da cirurgia, e qual o local e o motivo do rasgo, se identificado. Resultados Foram incluídas 210 cirurgias, das quais 87 apresentaram perfurações, sendo 17 casos em ambas as luvas e 70 apenas na luva externa. Um total de 27,5% dos danos foram descobertos apenas no final da cirurgia; os rasgos se concentraram no indicador esquerdo em 62,5% dos casos. Por Último, houve uma relação mais significativa com cirurgias de foco aberto e com duração superior a 60 minutos. Conclusão O nosso resultado sugere que em cirurgias prolongadas e com foco aberto, é necessário maior cuidado e inspeção à procura de danos nas luvas.


Subject(s)
Traumatology , Protection , Orthopedic Surgeons , Gloves, Surgical
15.
Rev. Ciênc. Plur ; 7(1): 88-102, jan. 2021. tab, graf
Article in Portuguese | LILACS, BBO | ID: biblio-1147683

ABSTRACT

Introdução:Existe um descompasso entre a oferta de serviços em ortopedia e a busca aos pronto-atendimentos por trauma.Objetivo:Assim, objetivou-se analisar o tempo entre o acesso ao serviço hospitalar ortopédico pós-trauma e a avaliação pelo ortopedista para os devidos encaminhamentos no Sistema Único de Saúdeno Estado do Rio Grande do Norte de 2017 a 2018.Metodologia:Para tanto, desenvolveu-se umainvestigação documental, na qualforam analisados, pelo cálculo das medidas de tendência central, dados do sistema de regulação estadual sobre os agendamentos para avaliação em ortopedia e sobre o perfil dos indivíduos que buscam o serviço.Resultados:No RN, em 2017, dos 499 registros na regulação em ortopedia, dois foram avaliados (0,4%). Em 2018, de 688, 149 foram avaliados (21,6%), com média de 67 dias de espera. Em Natal, no ano de 2017, o tempo médio de espera pela consulta foi de 119 dias e, em 2018, 22 dias.Conclusões:Verifica-se falha na oportunidade do cuidado, mediante o parâmetro de 5 a 10 dias após o trauma para os encaminhamentos (AU).


Introduction:There is a mismatch between the offer of services in orthopedics and the search in emergency rooms for trauma.Objective:Thus, the objective was to analyze the time between access to the post-trauma orthopedic hospital service and the evaluation by the orthopedist for the appropriate referrals to Unified Health System in the state of Rio Grande do Norte from 2017 to 2018.Methodology:To this end, a documentary investigation was developed, in whichdata from the state regulation system on the schedules for evaluation in orthopedics and on the profile of individuals seeking the service were analyzed by calculating the measures of central tendency.Results:In RN, in 2017, of the 499 records in orthopedics regulation, two were evaluated (0.4%). In 2018, of 688, 149 were evaluated (21.6%), with an average of 67 days of waiting. In Natal, the average waiting time for consultation was 119 days and, in 2018,22 days. Conclusions:There is a failure in the opportunity for care, using the parameter from 5 to 10 days after the trauma for referrals (AU).


Introducción: Existe un desajuste entre la oferta de servicios en ortopedia y la búsqueda de traumatismos en las salas de emergencia. Objetivo: Por lo tanto, el objetivo fueanalizar el tiempo transcurrido entre el acceso al servicio hospitalario de ortopedia postraumática y la evaluación del ortopedista para referencias apropiadas en el Sistema Único de Saluden el estado de Rio Grande do Norte de 2017 a 2018. Metodología: Para ello, se realizó unainvestigación documental, en la cual se analizaron,calculando medidas de tendencia central, datos del sistema de regulación estatal sobre los horarios de evaluación en ortopedia y sobre el perfil de las personas que buscan el servicio. Resultados:En RN, en 2017, de los 499 registros en regulación de ortopedia, se evaluaron dos (0.4%). En 2018, de 688, 149 fueron evaluados (21.6%), con un promedio de 67 días de espera. En Natal, el tiempo promedio de espera para la consulta fuede 119 días y, en 2018, de 22 días.Conclusiones: Hayuna falla en la oportunidad de atención, utilizando el parámetro de 5 a 10 días después del trauma para las derivaciones (AU).


Subject(s)
Orthopedics , Traumatology , Universal Access to Health Care Services , Emergency Service, Hospital , Health Care Coordination and Monitoring , Referral and Consultation , Brazil , Sanitary Supervision
16.
Article in Spanish | LILACS, BINACIS | ID: biblio-1353896

ABSTRACT

Introducción: La enfermedad por coronavirus se expandió rápidamente, esto llevó a un aumento de la demanda de los servicios sanitarios, por lo cual fue necesario adaptarse de manera acorde. Nuestro objetivo es proporcionar una visión general del impacto en la atención y de nuestra experiencia, identificar aspectos positivos y aquellos por mejorar para futuras planificaciones. Materiales y métodos: Se registraron el número de consultas diarias, la edad, el sexo, la presencia de traumatismo, el lugar de la lesión, el motivo de consulta, el diagnóstico y el tratamiento. Se comparó la cantidad de atenciones con las flexibilizaciones y con igual período de 2019. Resultados: Se realizaron 120 consultas, 33 procedimientos quirúrgicos, 185 atenciones por guardia, 160 con traumatismo. El lugar más frecuente de traumatismo fue el domicilio (56,25%). El 30% eran fracturas de muñeca y el 28,8%, supracondíleas. Las consultas aumentaron con las flexibilizaciones del confinamiento. Conclusiones: Es fundamental adaptarse rápido teniendo en cuenta que las fracturas comunes seguirán ocurriendo, pese al confinamiento al igual que las infecciones osteoarticulares. No descuidar tampoco la enfermedad crónica impostergable. Nivel de Evidencia: III


Introduction: Coronavirus disease spreads rapidly, which leads to an increased demand for health services. Such services must be adapted accordingly. Our aim is to provide a general vision on the way these circumstances affect our practice, based on our experience and remarking the positive aspects as well as those which need to change in the future. Materials and methods: A record was kept of the daily number of consultations, age of the patient, gender, trauma history, place of injury, reason for consultation, diagnosis and treatment. These data were contrasted with the records for the different quarantine phases and with the records for the same period of 2019. Results: The number of consultations amounts to 120, the number of surgeries amounts to 33, and 185 emergency room consultations were carried out, 160 of them with trauma patients. The most frequent place of injury was the home (56.25%). 30% of the injuries were wrist fractures and 28.8% were supracondylar fractures. The number of patients increased over quarantine flexibilization. Conclusion: Fast adaptation is fundamental. Common fractures occur even during quar-antine, as well as infections. Professionals should avoid neglecting unpostponable attention to patients with a chronic condition. Level of Evidence: III


Subject(s)
Child , Orthopedics , Traumatology , Pandemics , COVID-19
17.
Article in Portuguese | LILACS | ID: biblio-1291978

ABSTRACT

Objetivo: comparar a ocorrência de fraturas de fêmur proximal atendidas em um hospital secundário e em um terciário. Método: a amostra deste estudo foi composta por todos os pacientes que apresentaram fratura de fêmur proximal atendidos em dois serviços hospitalares, no período de 2015 a 2017, sendo realizada a avaliação dos prontuários. Resultados: embora um maior número de cirurgias tenha sido realizado no hospital terciário, os pacientes atendidos no hospital secundário apresentaram maior número de complicações, provavelmente em decorrência de mais tempo de espera pelo procedimento, incluindo as cirurgias que precisaram ser remarcadas. É provável, também, que esse fato tenha implicado em maior tempo de internação e necessidade de encaminhamento para UTI no período pós-operatório imediato, fenômenos também observados no hospital secundário. Conclusão: estes resultados chamam atenção para a necessidade de reformulação dos protocolos de atendimento a pacientes com fratura proximal de fêmur, visando sanar os problemas aqui apresentados.


Aim: to compare the occurrence of femur fractures treated in a secondary and in a tertiary hospitals. Method: the sample of this study consisted of all patients who had fractures of the proximal femur treated at two hospital services, from 2015 to 2017, and the medical records were evaluated. Results: a greater number of surgeries has been performed at the tertiary hospital, although the secondary hospital patients had the highest number of complications, resulted probably by longer waiting times for the procedure, including surgeries that needed to be scheduled. It is also likely that this fact implied in a longer hospital stay and the need for referral to the Intensive Unit Care in the immediate postoperative period, also observed in secondary hospitals. Conclusion: these results call attention to the need to reformulate the protocols for the care of patients with proximal fracture of the femur, to solve the problems presented here.


Subject(s)
Humans , Male , Female , Femoral Fractures , Orthopedics , Health Profile , Secondary Care , Tertiary Healthcare , Traumatology , Orthopedic Procedures
18.
Article in English | WPRIM | ID: wpr-879664

ABSTRACT

The year 2020 is an extremely unusual year. The world lost more than one million lives due to the attack of COVID-19. Economic production has been greatly reduced, and daily activities are largely restricted. Luckily the work of Chinese Journal of Traumatology (CJTEE) has not been adversely affected. 2020 is a harvest year for the journal, which (1) was included in the high-quality academic journals by China Association for Science and Technology; (2) cover of each issue is newly designed; (3) submission increased by about 60% with more countries and regions covered; (4) usage in the ScienceDirect database exceeded a million; (5) the CiteScore rises to more than 2.0 the first time. This study reviewed the articles published in the year 2020 by CJTEE.


Subject(s)
COVID-19 , China , Humans , Periodicals as Topic , Science/organization & administration , Societies, Scientific/organization & administration , Technology/organization & administration , Time Factors , Traumatology/organization & administration , Wounds and Injuries/etiology
19.
Rev. méd. Maule ; 35(1): 60-71, oct. 2020. tab
Article in Spanish | LILACS | ID: biblio-1366696

ABSTRACT

The Coronavirus pandemic (COVID-19) triggered a global health emergency, and as a response, institutions and medical services have implemented different measures regarding the management of these patients in order to maintain medical care, and reduce the spread of the virus in patients and medical staff. The following review aims to present the current recommendations made by international, national and local societies regarding medical action from Traumatology and Orthopaedics. A literature review was done on Medline / Pubmed platforms, The Journal Bone and Joint Surgery (JBJS), Journal of the American Academy of Orthopedic Surgeons (JAAOS), Sociedad Chilena de Ortopedia y Traumatología (SCHOT). The literature was in Spanish and English, comparing it with reality on a local level. The current COVID-19 pandemic led to the complete reform of the trauma care units, starting with the development of subspecialty teams that rotate periodically, which are in charge of the emergency area, treating patients with all personal protection elements (PPE) and categorizing those patients who require emergency trauma surgery, from those that can be managed in a delayed manner. Regarding patients who are hospitalized, a COVID-19 PCR (Polymerase Chain Reaction) test is taken as screening, except for emergency surgeries where all intraoperative protection measures are taken. In addition, for greater safety, all elective surgery was suspended, which reduces the flow of patients in the ward and in the inpatient unit. Outpatient care was optimized in order to protect patients in their periodic check-ups.


Subject(s)
Humans , Traumatology/standards , Traumatology/organization & administration , Orthopedic Procedures/methods , Orthopedic Procedures/standards , Pandemics , COVID-19 , Emergency Medicine , Hospital Administration/methods , Hospitals/standards , Hospitals, General/organization & administration
20.
Vive (El Alto) ; 3(8): 95-103, ago 2020. ilus.
Article in Spanish | LILACS | ID: biblio-1254772

ABSTRACT

INTRODUCCIÓN: enfermería mediante el cumplimiento de su función docente promueve actitudes reflexivas en los pacientes para prevenir adicción a los narcóticos. OBJETIVO: información para la prevención de la adicción a narcóticos que tienen los pacientes que asisten a la unidad clínica de traumatología del Centro Médico. MATERIALES Y MÉTODOS: estudio descriptivo, de campo, cuya población estuvo conformada por 50 usuarios, se trabajó con la totalidad, se aplicó estadística descriptiva. Los datos se recogieron mediante cuestionario con 13 ítems con escala de Likert, la validez bajo el juicio de expertos y la confiabilidad por la prueba Alfa de Crombach. RESULTADOS: los resultados señalan que los pacientes ingieren analgésicos distintos a los de la prescripción médica en un 80%, aumentan la dosis diaria prescrita de analgésicos narcóticos siempre en un 50% de la población. Así como también 80% manifestaron la importancia de que los profesionales de enfermería aporten a los usuarios de traumatología información sobre la prevención de la adicción a analgésicos narcóticos. CONCLUSIÓN: los pacientes cumplen más de la dosis de analgésicos indicada por los médicos, además de combinarlos con otros no prescritos y no lo reconocen como una adicción por lo que es importante la información que los profesionales de enfermería puedan aportar al respecto.


INTRODUCTION: nursing by fulfilling its teaching role promotes reflexive attitudes in patients to prevent addiction to narcotics. OBJECTIVE: information for the prevention of narcotic addiction that have the patients who attend the trauma unit of the Medical Center. MATERIALS AND METHODS: descriptive, field study, whose population was made up of 50 users, we worked with all, descriptive statistics were applied. The data were collected by means of a questionnaire with 13 items with a Likert scale, validity under the judgment of experts and reliability by the Alpha test of Cronbach. RESULTS: the results indicate that patients ingest pain relievers other than those prescribed by a doctor by 80%, increase the prescribed daily dose of narcotic pain relievers always by 50% of the population. As well as 80% stated the importance that nursing professionals provide trauma users with information on the prevention of addiction to narcotic pain relievers. CONCLUSIONS: the patients fulfill more than the dose of analgesics indicated by the doctors, in addition to combining them with other non-prescribed ones and do not recognize it as an addiction, so it is important the information that nursing professionals can provide in this regard.


INTRODUÇÃO: a enfermagem, cumprindo seu papel educacional, promove atitudes reflexivas nos pacientes para evitar o vício em narcóticos. OBJETIVOS: facilitar informações objetivas para a prevenção de dependência de narcóticos realizadas por pacientes atendidos no centro de trauma do Centro Médico. MATERIAIS E MÉTODOS: estudo de campo descritivo, cuja população era composta por 50 pacientes, trabalhamos com todos, aplicamos estatística descritiva. Os dados foram coletados por meio de um questionário com 13 itens, tipo escala Likert, previamente avaliado por especialistas da área e com confiabilidade pelo teste Alpha de Crombach. RESULTADOS: os resultados indicam que os pacientes ingerem analgésicos diferentes dos prescritos por médicos em 80%, aumentam a dose diária prescrita de analgésicos narcóticos sempre em 50% da população. Da mesma forma, 80% afirmaram a importância de que os profissionais de enfermagem fornecerem aos pacientes de trauma, informações sobre a prevenção do vício em analgésicos narcóticos. CONCLUSÃO: os pacientes cumprem mais do que a dose de analgésicos indicada pelos médicos, além de combiná-los com outros não prescritos e não o reconhecem como um vício, por isso é importante a informação que os profissionais de enfermagem possam fornecer a esse respeito.


Subject(s)
Pain , Traumatology , Information , Analgesics , Narcotics , Patients , Surveys and Questionnaires
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