Fraturas mandibulares na cidade de Pelotas, Rio Grande do Sul / Mandibular fracture cases in Pelotas, Rio Grande do Sul, Brazil

Objetivos: Analisar os dados existentes na literatura, que mostra uma alta incidência de fraturas mandibulares e elucidar o contexto de sua ocorrência no universo dos pacientes atendidos pelo Pronto Socorro Municipal de Pelotas, Rio Grande do Sul, Brasil. Métodos: A partir dos registros referentes ao período de junho de 2001 a agosto de 2007, obtivemos 1 345 pacientes com fraturas faciais. Foram selecionados para este estudo 116 pacientes com fraturas mandibulares, nos quais os itens analisados foram: faixa etária, sexo, sítio mandibular fraturado, etiologia e período do ano. Resultados: Assim, encontramos 86,2% de indivíduos do sexo masculino. A faixa etária mais atingida foi a dos 20 aos 29 anos, com 36,2%, e os sítios mandibulares mais afetados foram o corpo com 29 casos (25%) e o côndilo com 26 casos (22,4%). As causas mais comuns destas fraturas foram as agressões físicas, com 37,1%. O verão foi o período do ano com a maior incidência de fraturas mandibulares, com 38 casos (32,8%). Conclusão: Observou-se, então, que os pacientes com fratura mandibular, atendidos no Pronto Socorro Municipal de Pelotas, Rio Grande do Sul, geralmente são homens, na faixa etária dos 20 aos 29 anos, com fratura do corpo mandibular e que foram vítimas de agressão física.

Objectives: To analyze the data in the literature, which show a high incidence of mandibular fractures. The aim of this research was to elucidate the context in which these fractures occur among patients attended at the first aid center of "Pronto Socorro Municipal de Pelotas", Rio Grande do Sul, Brazil. Methods: From the records referring to the period of June, 2001 to August, 2007, there were 1 345 patients with facial fractures. Of this total, 116 patients with mandibular fracture were selected for this study and the items analysed were: age, gender, mandibular fracture site, etiology and period of the year. Results: It was found that 86.2% of the sample were men. The most prevalent age was 20 to 29 years old representing 36.2%, and the most affected mandibular sites were the body, with 29 cases (25%), and the condyle, with 26 cases (22.4%). The most common cause of fractures was the physical aggression representing 37.1%. The period of the year with the highest incidence of mandibular fractures was the summer, with 38 cases (32.8%). Conclusion: It was therefore observed that the patients with mandibular fracture assisted at Pronto-Socorro Municipal de Pelotas, Rio Grande do Sul, Brazil, were generally men, 20 to 29 years old with mandibular body fracture and they were victims of physical aggression.

Clinical investigation of contrala teral C_7root transfer to the radial nerve for total brachial plexus root avulsion injury / 中华骨科杂志

Objective To observe the effect of contralateral C 7 root transfer to the radial nerve for the treatment of total brachial plexus root avulsion injury.Methods One hundred and seven patients with total brachial plexus root avulsion injury were treated by contralatera l C 7 root transfer to the radial nerve fro m1993to 1999.Among them 36patients were followed-up for more than 2years;there were 31male and 5female patients,with age ranged fro m 7to 44years,and 27years in average.The time of initial surgery from the time of injury was between 3to 36months,among which 4patients were tr eated between 3to 6months,29between 6to 12months,2between 12to24months and 1between 24to 36months;9.4months on the average.The whole surgical procedure was divided into three phases.Phase I:The exploration of the brachial plexus both above and below the clavicle;the phrenic nerve was transferr ed to the anterior branch of the su-perior trunk or was anastomosed with the musculocutaneous nerve;the accessory nerve was transferred to the supraclavicular nerve;the median nerve was previously placed subcutaneously at the anterior re gion of the arm-pit.PhaseⅡ:The contralateral C 7 nerve root was transferred to the uln ar nerve which was used for the bridging.PhaseⅢ:The intercostal nerve was transferred to the median nerve and the thorac odorsal nerve,the ulnar nerve and the radial nerve was a nastomosed.Patients were followed-up for 24months to 84months,38months on average.The follow-up sta ndards included:the recovery of the motor function of the muscles in-nervated by the radial nerve;the rec overy of the regeneration potential of the muscles;the change in the sensory function in the cutaneous re gion innervated by the radial nerve.Results Twenty-nine patients(80.6%of all)was improved in motor function,and 27patients(75.0%)in sensory function.Conclusion The overall effect of contralateral C 7 root transfer to the radial nerve for total brachial plexus root avulsion injury was satisfactory,while the functio nal recovery of triceps was not as exp ected.[