Tendon grafts with preserved muscle demonstrate similar biomechanical properties to tendon grafts stripped of muscular attachments: a biomechanical evaluation in a porcine model.

PURPOSE: (1) To evaluate the biomechanical properties of a porcine flexor digitorum superficialis tendon graft with preserved muscle fibers and (2) to compare these results with the biomechanical properties of a porcine tendon graft after removal of associated muscle. METHODS: Eighty-two porcine forelegs were dissected and the flexor digitorum superficialis muscle tendons were harvested. The study comprised of two groups: Group 1 (G1), harvested tendon with preserved muscle tissue; and Group 2 (G2), harvested contralateral tendon with removal of all muscle tissue. Tests in both groups were conducted using an electro-mechanical material testing machine (Instron, model 23-5S, Instron Corp., Canton, MA, USA) with a 500 N force transducer. Yield load, stiffness, and maximum load were evaluated and compared between groups. RESULTS: The behavior of the autografts during the tests followed the same stretching, deformation, and failure patterns as those observed in human autografts subjected to axial strain. There were no significant differences in the comparison between groups for ultimate load to failure (p = 0.105), stiffness (p = 0.097), and energy (p = 0.761). CONCLUSION: In this porcine model biomechanical study, using autograft tendon with preserved muscle showed no statistically significant differences for yield load, stiffness, or maximum load compared to autograft tendon without preserved muscle. The preservation of muscle on the autograft tendon did not compromise the mechanical properties of the autograft. LEVEL OF EVIDENCE: Level III Controlled laboratory study.

Estudo epidemiológico retrospectivo das fraturas do terço proximal do fêmur na regiäo de Botucatu / Retrospective epidemiological study of fractures of the proximal third of the femur in Botucatu region

Foram estudados, retrospecivamente, 208 pacientes com 210 fraturas do 1/3 proximal do fêmur (fratura do colo do fêmur, transtrocanteriana e subtrocanteriana), submetidos à cirurgia no Hospital das Clínicas da Faculdade de Medicina de Botucatu (HC-FMB)-UNESP, de 1978 a 1991. Os seguintes atributos foram analisados: idade, sexo, cor, diagnóstico da fratura, lado acometido, mecanismo do trauma, tempo de internaçäo hospitalar e mortalidade. Da observaçäo desses itens, concluímos que essas fraturas säo causadas mais freqüentemente por traumas banais, sendo que as transtrocanterianas foram as mais comuns. Houve predominância a partir da sétima década e foram raras em negros. A média do tempo de internaçäo foi de 15,69 dias e a taxa de mortalidade após um ano foi de 16,69 por cento. Os pacientes com fraturas do colo do fêmur tiveram maior sobrevida do que os portadores de fraturas transtrocanterianas.