Utilização de retalho baseado na artéria genicular lateral superior na cobertura de lesões de membros inferiores: relato de casos / Use of a flap based on the superior lateral genicular artery to cover lower limb injuries: case reports

O joelho é uma das principais articulações do corpo humano e, em função de sua conformação e funcionalidade, é facilmente suscetível a lesões. A reconstrução cirúrgica de lesões ao redor do joelho e região proximal da perna representa um grande desafio devido à exposição de estruturas osteoarticulares, tendinomusculares e neurovasculares e tem sido realizada com uso de diversos retalhos musculares e musculocutâneos. Outros retalhos também são descritos para tratamento dessas lesões, embora em menor frequência na literatura, como o retalho cutâneo baseado no pedículo da artéria genicular lateral superior. A seguir, é apresentado o relato de cinco casos de pacientes vítimas de acidentes motociclísticos nos quais realizou-se a cobertura da lesão ao redor do joelho e região proximal da perna com o uso do retalho cutâneo baseado no pedículo da artéria genicular lateral superior, nos quais foram obtidos uma boa cobertura das lesões, alta taxa de sobrevida do retalho, bons resultados clínicos e estéticos. O uso do artéria genicular lateral superior apresenta vantagens estéticas, visto que a cor e a textura do retalho são semelhantes às da região do joelho e conferem uma aparência de melhor qualidade, além de não causarem problemas de mobilidade articular.

The knee is one of the main joints in the human body, and due to its conformation and functionality, it is easily susceptible to injuries. Surgical reconstruction of injuries around the knee and proximal region of the leg represents a major challenge due to the exposure of osteoarticular, tendinomuscular and neurovascular structures and has been performed using various muscle and musculocutaneous flaps. Other flaps are also described for treating these lesions, although less frequently in the literature, such as the cutaneous flap based on the pedicle of the superior lateral genicular artery. Next, It presents a report of five cases of patients who were victims of motorcycle accidents in which the lesion was covered around the knee and proximal region of the leg using a skin flap based on the pedicle of the superior lateral genicular artery, in which good coverage of lesions, high flap survival rate, good clinical and aesthetic results. The use of the superior lateral genicular artery presents aesthetic advantages since the color and texture of the flap are similar to those of the knee region and provide a better quality appearance, in addition to not causing joint mobility problems.

Surgical approach and the use of cryotherapy in a keratocystic odontogenic tumor after 12 months of decompression

Introduction: The Keratocystic Odontogenic Tumor (KOT) is a pathology classified as an odontogenic cyst and began to be considered an odontogenic tumor in 2005, because of the presence of intrinsic characteristics compatible with neoplasm, such as its high rate of recurrence and differentiated mechanism of growth. Although its etiology is still unknown, its origin is believed to be related to the remnants of the dental lamina. Clinically it presents aggressive behavior and high rates of recurrence. Various types of treatment have been related, ranging from more conservative methods to radical surgery. With the goal of diminishing the potential for recurrence of these lesions, some authors have recommended the use of adjunct therapies such as peripheral osteotomy with burs, treatment of the surgical site with Carnoy’s solution, electrocauterization, cryotherapy and resection. Objective:The aim of the present study is to report the case of a patient with a KOT of large proportions in the mandible. Case report: Treatment was taken to perform decompression of the lesion for 12 months, and after this treatment comprised curettage and cryotherapy. Conclusion: This procedure is considered useful and conservative, as it avoids traumatisms to the noble structures close to the lesion.

Epidemiology of maxillofacial injuries at a regional hospital in Goiania, Brazil, between 2008 and 2010

Introduction and objective: Facial lesions assume an outstanding role in the attendance of polytraumatized patients in hospital emergency services. The aim of this study was to conduct and epidemiologic study of patients attended at the Buccomaxillofacial Surgery and Traumatology Service of a regional hospital in Goiania/GO, Brazil, between 2008 and 2010. Material and methods: 521 files of patients, who had suffered maxillofacial traumatisms that resulted in a total of 615 fractures, were evaluated. The files were used to analyze gender, age, etiologic agents and distribution of fractured bones. Results: About 80% of patients were male, whereas 20% of the affected individuals were women. The most frequently etiologic factor found in the two groups was automobile accidents, followed by physical aggressions and falls. Concerning to fractured bones, the zygomatic complex, followed by fractures of the mandible, the nasal bones themselves, condyle and Le Fort type fractures were the most prevalent ones, in both groups. Conclusion: Knowledge of the incidence and etiology of maxillofacial fractures is of great importance to the professionals involved in the treatment of these patients. Within this context, Buccomaxillofacial Surgery and Traumatology is increasingly being affirmed as one of the most important specialties at the emergency centers of regional hospitals concerning to the treatment of patients who are victims of traumatisms.