RESUMO
Resumo Contexto A arterialização do arco venoso dorsal do pé é uma técnica indicada em casos de isquemia crítica de membros inferiores sem leito distal adequado que possibilite tratamento convencional, como revascularização, angioplastia ou tratamento clínico. Objetivos O propósito do trabalho foi apresentar o resultado da arterialização do arco venoso do pé em 16 pacientes submetidos a essa técnica. Métodos Tratou-se de um estudo analítico descritivo retrospectivo transversal, baseado na revisão de prontuários de 16 pacientes submetidos à arterialização do arco venoso dorsal do pé para salvamento de membro, entre janeiro de 2016 a janeiro de 2021. Resultados Dos 16 pacientes submetidos à arterialização do arco venoso do pé, 25% (4) evoluíram para amputação maior durante a mesma internação, e 6,25% (1) pacientes evoluíram para amputação maior após 6 meses. Os demais pacientes (68,75%, 11) tiveram seus membros preservados, sendo que 10 foram submetidos a amputações menores (pododáctilos e antepé), e 1 paciente não necessitou de procedimento adicional. Conclusões A técnica de arterialização do arco venoso dorsal do pé deve ser considerada em casos selecionados. Trata-se de uma alternativa válida para a preservação do membro na impossibilidade de tratamento convencional.
Abstract Background Arterialization of the dorsal venous arch of the foot is a technique indicated in cases of critical lower limb ischemia that do not have a distal bed that is adequate to enable conventional treatment such as revascularization, angioplasty, or clinical treatment. Objectives The purpose of this study is to present the result of arterialization of the venous arch of the foot in 16 patients who underwent treatment with this technique. Methods This is a cross-sectional retrospective descriptive analytical study based on a review of the medical records of 16 patients who underwent arterialization of the dorsal venous arch of the foot for limb salvage from January 2016 to January 2021. Results Four (25%) of the 16 patients who underwent arterialization of the venous arch of the foot underwent a major amputation during the same hospital stay and one patient (6.25%) had a major amputation within 6 months. The other 11 patients (68.75%) had their limbs preserved, with 10 undergoing minor amputations (toes and forefoot) and one patient having no additional procedures. Conclusions We conclude that the technique of arterialization of the dorsal venous arch of the foot should be considered in selected cases. It is a valid alternative for limb salvage when conventional treatment is impossible.
RESUMO
El arco plantar longitudinal medial del pie (APLM) es el componente más importante en estática y dinámica de la bóveda plantar. Su altura define pies normales, planos y cavos, estos últimos son factores predisponentes de lesiones. El objetivo de este estudio fue describir y relacionar en una población de estudiantes universitarios chilenos la prevalencia de pies normales, cavos y planos según índice de masa corporal (IMC), sexo y actividad física (AF) semanal y la distribución de asimetrías entre pies. Se estudió a 209 sujetos (128 hombres y 81 mujeres), estudiantes universitarios, cuya edad, estatura, peso e IMC fue de 20,4 años (±3,4); 1,68 m (±0,09); 67,6 Kg (±12,4) y 23,77 (±3,0) respectivamente. Por medio de cuestionario se determinó los hábitos de AF de la muestra. La impresión plantar se obtuvo mediante fotopodoscopía, la cual fue evaluada empleando el Arch Index (AI) de Cavanagh y Rodgers. Los hombres presentan mayor prevalencia de pie plano (31,3 % contra 11,1 %). Hay correlación positiva estadísticamente significativa entre AI e IMC en ambos sexos. Se obtuvo mayor correlación entre AI izquierdo y AF en hombres y mujeres con significancia estadística. El 31,25 % de los hombres y el 37,04 % de las mujeres presentaron asimetrías en APLM. Hombres con IMC normal tienen 64,20 % de pies asimétricos. Las mujeres que practican entre 6 y 10 horas de AF a la semana presentan 50,98 % de pies asimétricos. El IMC se relaciona con una disminución de la altura del APLM, se sugiere el control de esta variable en sujetos con diagnóstico de pie plano flexible y pie plano valgo. La práctica de AF se relaciona con aumento de la altura del APLM en hombres y mujeres y se sabe que también contribuye a disminuir el IMC, actuando en concordancia hacia estas dos variables.
The (MPLA) is the most important component in statics and dynamics of the vault plant. Its height defines normal, flat and cavus feet, which are predisposing factors for injuries. The objective of this research was to describe and relate in a population of Chilean university students the prevalence of normal, cavus and flat feet according to body-mass index (BMI), sex, and weekly physical activity (PA) and the distribution of asymmetries between feet. 209 subject were studied (128 men and 81 women), university students, whose age, height, weight and BMI was of 20.4 years (±3.4); 1,68 m (±0.09); 67.6 kg (±12.4) and 23.77 (±3.0) respectively. The PAs habits of the sample were determined by means of questionnaire. The footprint is obtained by photo-podoscopy, which was evaluated by the Arch Index (AI) of Cavanagh and Rodgers. Men have higher prevalence of flat foot (31.3 % against 11.1 %). There are both statistically significant positive correlations between AI and BMI in both sexes. Greater correlation between left AI and PA in both men and women was obtained with statistical significance. The 31.25 % of men and 37.04 % of women presented asymmetries in MPLA. Men with normal BMI have 64.20 % of asymmetric feet. Women that practice between 6 and 10 hours of PA a week presented 50.98 % of asymmetric feet. The BMI is related to a decrease of the height of MPLA, suggesting the control of this variable in subjects with flexible flat foot and valgus flat foot diagnosis. The practice of PA is related to the height of the MPLA increased in men and women and it is known that it also helps to reduce BMI, acting in accordance to these two variables.