Surgical correction of metatarsal angular deviation in a Thoroughbred filly using wedge metatarsal ostectomy: a case report / Correção cirúrgica de desvio angular metatársico em uma potra Puro-Sangue utilizando ostectomia em cunha: um relato de caso

This study describes a corrective procedure for a metatarsal angular malformation using wedge ostectomy in a 41-day-old Thoroughbred filly. A 41.6 °angular malformation of the metatarsus was corrected with wedge ostectomy of the left hindlimb in association with a type II external fixator and methyl methacrylate resin. The animal was subjected to the surgical procedure under general anesthesia. The filly was placed in dorsal recumbency with the left hind limb free for manipulation. A bone saw was used for the wedge ostectomy, while the bars for external fixation were placed using a drill. A Kirschner pin and acrylic resin were then applied. Radiographic images obtained immediately after surgery confirmed a total malformation reduction of 32.6 (from 41.6° to 9°). With medication and a Robert Jones bandage, intensive postoperative care was instituted to ensure that the animal adapted properly to the linear external fixator without overloading the pins and connection bars. No postoperative complications were observed. On the day after surgery, the filly was standing and walking with no signs of pain. After 180 days, total osseous calcification was achieved, and the implants were removed during the second surgery. The filly demonstrated adequate locomotion, performed all the movements, and ran without any difficulty in the paddock. The remaining discrete angular deviations were partially corrected using hoof trimming.

O objetivo desse estudo é descrever o procedimento de correção da malformação de desvio angular metatársico, utilizando ostectomia em cunha, em uma potra puro-sangue de 41 dias de idade. Uma malformação metatársica angular de 41.6º foi corrigida com a técnica de ostectomia em cunha, em associação com fixador externo tipo II e resina de metilmetacrilato, no membro pélvico esquerdo. O animal foi submetido à cirurgia sob protocolo de anestesia geral. A potra foi posicionada em decúbito dorsal, com o membro pélvico esquerdo livre para manipulação. Para a realização da ostectomia em cunha, foi utilizada uma serra óssea. Para a instalação das barras do fixador externo, uma furadeira foi utilizada e, para fixá-los, pinos de Kirschner e resina acrílica foram aplicados. Logo após a cirurgia, imagens radiográficas foram obtidas para confirmar a redução total de 32,6º (de 41,6º para 9º) de angulação. Para garantir que o animal se adaptasse ao fixador externo linear e não sobrecarregasse os pinos e barras, foram instituídos cuidados pós-operatórios intensos, com medicações e bandagem de Robert Jones. Não houve complicações no pós-operatório. No dia seguinte à cirurgia, a potra estava em pé, caminhando e sem sinais de dor. Após 180 dias, alcançou total calcificação óssea e os implantes puderam ser removidos em um segundo tempo cirúrgico. A potra demonstrou locomoção adequada, realizando todos os movimentos normais e pôde correr pelo pasto sem dificuldades. Um discreto desvio angular remanescente foi parcialmente corrigido por casqueamento.

La ostectomía proximal del peroné en el tratamiento de la gonartrosis

Introducción: La técnica de la ostectomía proximal del peroné como tratamiento del genu varo doloroso fue publicada por primera vez en Cuba en el año 2017. Es un proceder simple, minitraumático y efectivo que reduce el dolor cuando se padece de osteoartrosis medial de rodilla. Objetivos: Evaluar el estado de los pacientes al cabo tres años de intervenidos teniendo en cuenta que en la literatura revisada solo dos autores informan resultados con más de dos años. Métodos: Se llevaron a cabo las encuestas a través de la consulta externa y vía telefónica. Se elaboraron tablas univariadas para describir el comportamiento de cada variable y tablas de contingencia bivariadas para la asociación entre pares de variables. Resultados: En las 68 intervenciones realizadas, predominó el sexo femenino; el grupo etario más representativo fue el de 70 años o más y la edad media fue de 68,59 años. El 93,3 % de los casos tenían obesidad y sobrepeso. El tiempo de seguimiento medio fue de 48,7 meses. El 32,3 % de la muestra fue evaluado como no satisfactorio. Conclusiones: A pesar de mantenerse los resultados satisfactorios en las dos terceras partes de los casos, la obesidad es un factor negativo que influye en los cambios degenerativos de la rodilla.

Introduction: The technique of proximal fibular ostectomy of the as a treatment of painful genu varo was published for the first time in Cuba in 2017. It is a simple, mini-traumatic and effective procedure that reduces pain when suffering from medial osteoarthritis of the knee. Objectives: To assess the status of patients after three years of surgery, taking into account that in the literature reviewed only two authors report results with more than two years. Methods: Surveys were conducted through outpatient consultation and telephone. Univariate tables were developed to describe the behaviour of each variable and bivariate contingency tables for the association between pairs of variables. Results: In the 68 interventions performed, the female sex predominated; the most representative age group was 70 years or older and the mean age was 68.59 years. 93.3 % of the cases were obese and overweight people. The mean follow-up time was 48.7 months. 32.3 % of the sample was evaluated as unsatisfactory. Conclusions: Despite maintaining satisfactory results in two thirds of cases, obesity is a negative factor that influences degenerative changes in the knee.

Capital femoral physeal dysplasia in cats submited to ostectomy of the femoral head and neck / Displasia femoral capital em felinos submetidos a ostectomia da cabeça e colo femoral

This report described pathological fracture of the femoral head (physeal dysplasia) in four male cats (three mixed breed and one Bengal), with an average age of 16 months, treated by an ostectomy of the femoral head and neck. Three cats were neutered and one entire. All presented with mild intermittent lameness in the pelvic limbs. Displacement of the femoral epiphysis and resorption of the femoral neck were present and excision of the femoral head and remaining neck was performed in all cases. Hstological examination showed mild foci of compaction and trabecular fibrosis with deposition of fibrous connective tissue, permeated by granulation tissues, consistent with the original diagosis. Limb function improved in all patients from 2 to 4 weeks postoperatively. Diagnosis of physeal dysplasia is challenging and treatment is different from acute traumatic fractures. Femoral head and neck excision was considered a good alternative in these patients.(AU)

Este trabalho descreve a fratura patológica da cabeça do femur (displasia fiseal) em quatro machos (três raças mistas e um Bengal), com idade média de 16 meses, que foram tratados com ostectomia da cabeça e colo femorais. Três gatos eram castrados e um inteiro. Todos apresentaram leve claudicação intermitente nos membros pélvicos. O deslocamento da epífise femoral e a reabsorção do colo femoral estavam presentes, a excisão da cabeça e colo femoral foi realizada em todos os casos. O exame histológico mostrou focos de compacteção e fibrose trabecular com deposição de tecido conjuntivo fibroso, permeado por tecidos de granulação, consistentes com o suposto diagnóstico. A função dos membros melhorou em todos os paciente entre dois a quatro semanas pós-operatório. O diagnóstico da displasia fiseal pe desafiador e o tratamento é diferente das fraturas traumáticas agudas. A excisão de cabeça e colo femoral é considerada uma boa alternativa nesses pacientes.(AU)

Capital femoral physeal dysplasia in cats submited to ostectomy of the femoral head and neck / Displasia femoral capital em felinos submetidos a ostectomia da cabeça e colo femoral

ABSTRACT: This report described pathological fracture of the femoral head (physeal dysplasia) in four male cats (three mixed breed and one Bengal), with an average age of 16 months, treated by an ostectomy of the femoral head and neck. Three cats were neutered and one entire. All presented with mild intermittent lameness in the pelvic limbs. Displacement of the femoral epiphysis and resorption of the femoral neck were present and excision of the femoral head and remaining neck was performed in all cases. Hstological examination showed mild foci of compaction and trabecular fibrosis with deposition of fibrous connective tissue, permeated by granulation tissues, consistent with the original diagosis. Limb function improved in all patients from 2 to 4 weeks postoperatively. Diagnosis of physeal dysplasia is challenging and treatment is different from acute traumatic fractures. Femoral head and neck excision was considered a good alternative in these patients.

RESUMO: Este trabalho descreve a fratura patológica da cabeça do femur (displasia fiseal) em quatro machos (três raças mistas e um Bengal), com idade média de 16 meses, que foram tratados com ostectomia da cabeça e colo femorais. Três gatos eram castrados e um inteiro. Todos apresentaram leve claudicação intermitente nos membros pélvicos. O deslocamento da epífise femoral e a reabsorção do colo femoral estavam presentes, a excisão da cabeça e colo femoral foi realizada em todos os casos. O exame histológico mostrou focos de compacteção e fibrose trabecular com deposição de tecido conjuntivo fibroso, permeado por tecidos de granulação, consistentes com o suposto diagnóstico. A função dos membros melhorou em todos os paciente entre dois a quatro semanas pós-operatório. O diagnóstico da displasia fiseal pe desafiador e o tratamento é diferente das fraturas traumáticas agudas. A excisão de cabeça e colo femoral é considerada uma boa alternativa nesses pacientes.

Região metafisária da tíbia de coelhos: uma opção para estudos dos substitutos ósseos / Metaphyseal region of the tibia of rabbits: an option for bone substitutes studies

Apresenta-se um modelo experimental de ostectomia de tíbia em coelhos para estudo de biomateriais em processos de reparação óssea. Foi realizada falha segmentar de 6mm de diâmetro na região metafisária medial proximal de tíbia de 72 coelhos as quais foram preenchidas com substituto ósseo e avaliadas clinicamente, por exame radiográfico e por meio de tomografia computadorizada feixe cônico, em diferentes tempos. Conclui-se que a metáfise medial proximal de tíbia de coelhos é adequada como modelo para estudos que avaliem o comportamento de enxertos e/ou biomateriais em falhas ósseas.

Is presented an experimental model of tibial ostectomy in rabbits to study biomaterials during bone repair process. Segmental failure of 6 mm diameter was performed in the medial proximal tibial metaphyseal region of 72 rabbits, which were filled with bone substitute and evaluated by clinical exam, X-ray, and cone beam computed tomography at different times. It is concluded that the medial proximal tibial metaphysis region of rabbits is suitable as a model for studies that evaluate the behavior of grafts and/or biomaterials on bone defects.

Região metafisária da tíbia de coelhos: uma opção para estudos dos substitutos ósseos / Metaphyseal region of the tibia of rabbits: an option for bone substitutes studies

Apresenta-se um modelo experimental de ostectomia de tíbia em coelhos para estudo de biomateriais em processos de reparação óssea. Foi realizada falha segmentar de 6mm de diâmetro na região metafisária medial proximal de tíbia de 72 coelhos as quais foram preenchidas com substituto ósseo e avaliadas clinicamente, por exame radiográfico e por meio de tomografia computadorizada feixe cônico, em diferentes tempos. Conclui-se que a metáfise medial proximal de tíbia de coelhos é adequada como modelo para estudos que avaliem o comportamento de enxertos e/ou biomateriais em falhas ósseas.

Is presented an experimental model of tibial ostectomy in rabbits to study biomaterials during bone repair process. Segmental failure of 6 mm diameter was performed in the medial proximal tibial metaphyseal region of 72 rabbits, which were filled with bone substitute and evaluated by clinical exam, X-ray, and cone beam computed tomography at different times. It is concluded that the medial proximal tibial metaphysis region of rabbits is suitable as a model for studies that evaluate the behavior of grafts and/or biomaterials on bone defects.

Região metafisária da tíbia de coelhos: uma opção para estudos dos substitutos ósseos / Metaphyseal region of the tibia of rabbits: an option for bone substitutes studies

Apresenta-se um modelo experimental de ostectomia de tíbia em coelhos para estudo de biomateriais em processos de reparação óssea. Foi realizada falha segmentar de 6mm de diâmetro na região metafisária medial proximal de tíbia de 72 coelhos as quais foram preenchidas com substituto ósseo e avaliadas clinicamente, por exame radiográfico e por meio de tomografia computadorizada feixe cônico, em diferentes tempos. Conclui-se que a metáfise medial proximal de tíbia de coelhos é adequada como modelo para estudos que avaliem o comportamento de enxertos e/ou biomateriais em falhas ósseas.(AU)

Is presented an experimental model of tibial ostectomy in rabbits to study biomaterials during bone repair process. Segmental failure of 6 mm diameter was performed in the medial proximal tibial metaphyseal region of 72 rabbits, which were filled with bone substitute and evaluated by clinical exam, X-ray, and cone beam computed tomography at different times. It is concluded that the medial proximal tibial metaphysis region of rabbits is suitable as a model for studies that evaluate the behavior of grafts and/or biomaterials on bone defects.(AU)

Premaxillary Setback With Posterior Vomerine Ostectomy: Outcomes of Single-Stage Repair of Complete Bilateral Cleft Lip With a Severely Protruding Premaxilla.

OBJECTIVE: Evaluating the safety and outcomes of premaxillary setback with posterior vomerine ostectomy in single-stage repair of complete bilateral cleft lip (CBCL) with severe premaxillary protrusion. DESIGN: Retrospective case series. SETTING: Multiple outreach surgical sites. PATIENTS/PARTICIPANTS: From 2012 to 2016, 41 patients with CBCL and severe premaxillary protrusion underwent posterior vomerine premaxillary setback (PVPS) by a single surgeon in Brazil, Ecuador, and Peru. Patients 4 months to 18 years old undergoing primary or revision CBCL surgery were eligible for inclusion in the study. Patients with diagnosed syndromes were excluded. INTERVENTIONS: Posterior vomerine premaxillary setback. MAIN OUTCOME MEASURES: Postoperative complications and postoperative aesthetic outcomes. RESULTS: The mean age at surgery was 3.7 ± 3.8 years, with an average follow-up time of 17.0 ± 13.9 months. Patients underwent their procedures in Brazil (71%), Ecuador (22%), and Peru (7%). The majority of patients were aged 2 years or less (56%), were males (54%), had undergone prior surgery (56%), and had not undergone preoperative surgical orthopedics (95%). None of the patients developed major complications. All patients were able to undergo PVPS with concomitant required procedures and had good aesthetic outcomes. CONCLUSIONS: Few reports have evaluated single-stage CBCL repair or revision with severe premaxillary protrusion using PVPS. Our study shows that this technique is safe and results in good aesthetic outcomes. Further follow-up with anthropometric patient data is needed to evaluate long-term postoperative outcomes.

Complicaciones de la ostectomía proximal del peroné en pacientes con genu varo doloroso / Complications of proximal fibular ostectomy in patients with painful genu varum

Introducción: En el proceder quirúrgico del tratamiento del genu varo doloroso, la osteotomía del peroné es un paso común que acompaña a la osteotomía valguizante de la tibia, con un porcentaje de complicaciones conocidas. Los autores del presente trabajo comenzaron a aplicar un nuevo enfoque en el tratamiento de esta afección, con la ostectomía del peroné, donde también se presentan complicaciones. Objetivo: Identificar las complicaciones en pacientes operados mediante ostectomía del peroné. Métodos: Fueron evaluados 116 pacientes portadores de cambios degenerativos del compartimento interno de la rodilla; operados mediante ostectomía del peroné, durante el período de abril del 2016 a abril del 2018. Las complicaciones fueron recogidas desde el momento de la intervención quirúrgica, su evolución y tratamiento, a través del seguimiento por consulta externa. Resultados: En los pacientes obesos se observó el mayor número de complicaciones (9), de ellas 4 referentes a neuropraxia de la rama profunda del nervio peroneo o fibular, 2 con hematomas de la herida y una con infección. Hubo 2 pacientes con linfangitis. Hubo 11 pacientes con 14 complicaciones (9,4 por ciento de los intervenidos). Conclusiones: Las complicaciones más importantes fueron neuropraxia de las ramas superficial y profunda del nervio peroneo, el hematoma e infección de la herida(AU)

Introduction: In the surgical procedure of genu varum pain treatment, the osteotomy of the fibula is a common step that accompanies the valgus tibial osteotomy, with a percentage of known complications. The authors of this work began to apply a new approach in the treatment of this condition, with fibular ostectomy, where complications also occur. Objective: To identify the complications that may appear in the ostectomy of the fibula. Methods: 116 patients with degenerative changes of the internal compartment of the knee were evaluated; operated by fibular ostectomy, during the period from April 2016 to April 2018. Complications were collected from the moment of surgery, its evolution and treatment, through follow-up by external consultation. Result: In the obese patients, the greatest number of complications was observed (9), of which 4 related to neuropraxia of the deep branch of the peroneal or fibular nerve, 2 with wound hematomas and one with infection. There were 2 patients with lymphangitis. There were 11 patients with 14 complications (9.4 percent of those who underwent surgery). Conclusions: The most important complications were neuropraxia of the superficial and deep branches of the peroneal nerve, the hematoma of the wound and infection(AU)

Variación del espacio articular externo de la rodilla posterior a la ostectomía del peroné / Change of the external intra joint space of posterior knee after fibular ostectomy

RESUMEN Introducción: en el diagnóstico y tratamiento del genu varo doloroso es importante el estudio radiográfico de la rodilla, se pueden visualizar los cambios estructurales que aparecen en las superficies articulares de la rodilla. Objetivo: demostrar desde el punto de vista radiológico la variación que ocurre posterior a la ostectomía del peroné en los pacientes operados de genus varos. Materiales y métodos: se realiza un estudio descriptivo, prospectivo y lineal en el Hospital Militar Dr. Mario Muñoz Monroy de Matanzas desde abril del 2016 -2017 donde se aplica la técnica de ostectomía del peroné, del Dr. Zhang Ying-Ze, se presentan los primeros 51 pacientes operados, un total de 57 rodillas, a los cuales se les realizó radiografía previa a la operación y posterior a ella al cabo de los 6 meses, donde se midió la altura del espacio articular externo. Resultados: el promedio de edad es de 67,2 años (50 años el menor y 84 años el mayor), de los cuales 23 eran hombres y 28 mujeres, previo al tratamiento quirúrgico el promedio de este espacio fue de 8,84 mm±1,01 mm (18 mm el mayor y el menor 2 mm) y al cabo de los 6 meses fue de 6,08 mm±0,9 mm(el mayor 10 mm y el menor 2 mm), en 6 pacientes no hubo variación de esta medida. Conclusiones: con la ostectomía proximal del peroné se logra disminuir el espacio articular externo modificando el eje mecánico y anatómico del miembro inferior, lo que se traduce por una disminución de la compresión interna articular (AU).

ABSTRACT Background: the radiographic study of the knee is very important in the painful genu varum diagnosis and treatment: structural changes appearing in the knee joint surfaces may be observed. Objective: to show the changes taking place after fibular ostectomy in the patients surgically treated of genu varum from the radiological point of view. Material and methods: a lineal, prospective, descriptive study was carried out in the Military Hospital "Dr. Mario Muñoz Monroy" of Matanzas from April 2016 to April 2017, in 51 patients operated on applying Dr Zhang Ying-Ze's fibular ostectomy technique: a total of 57 knees. X-rays were taken before the surgery and six months after it, measuring the height of the external intra joint space. Results: the average age was 67.2 years (50 years the youngest and 84 the eldest patients); 23 were men and 28 women. Before the surgical treatment the average space was 8.84 mm±1.01 mm (18 mm the biggest and 2 mm the smallest); six months after surgery, it was 6.08 mm±0.9 mm (10 mm the biggest and 2 mm the smallest); six patients did not showed changes of the space. Conclusions: with the proximal fibular ostectomy we achieved the reduction of the external fibular space, modifying the anatomical and mechanical axis of the lower limb, what leads to a reduction of the internal joint compression (AU).

Variación del espacio articular externo de la rodilla posterior a la ostectomía del peroné / Change of the external intra joint space of posterior knee after fibular ostectomy

RESUMEN Introducción: en el diagnóstico y tratamiento del genu varo doloroso es importante el estudio radiográfico de la rodilla, se pueden visualizar los cambios estructurales que aparecen en las superficies articulares de la rodilla. Objetivo: demostrar desde el punto de vista radiológico la variación que ocurre posterior a la ostectomía del peroné en los pacientes operados de genus varos. Materiales y métodos: se realiza un estudio descriptivo, prospectivo y lineal en el Hospital Militar Dr. Mario Muñoz Monroy de Matanzas desde abril del 2016 -2017 donde se aplica la técnica de ostectomía del peroné, del Dr. Zhang Ying-Ze, se presentan los primeros 51 pacientes operados, un total de 57 rodillas, a los cuales se les realizó radiografía previa a la operación y posterior a ella al cabo de los 6 meses, donde se midió la altura del espacio articular externo. Resultados: el promedio de edad es de 67,2 años (50 años el menor y 84 años el mayor), de los cuales 23 eran hombres y 28 mujeres, previo al tratamiento quirúrgico el promedio de este espacio fue de 8,84 mm±1,01 mm (18 mm el mayor y el menor 2 mm) y al cabo de los 6 meses fue de 6,08 mm±0,9 mm(el mayor 10 mm y el menor 2 mm), en 6 pacientes no hubo variación de esta medida. Conclusiones: con la ostectomía proximal del peroné se logra disminuir el espacio articular externo modificando el eje mecánico y anatómico del miembro inferior, lo que se traduce por una disminución de la compresión interna articular (AU).

ABSTRACT Background: the radiographic study of the knee is very important in the painful genu varum diagnosis and treatment: structural changes appearing in the knee joint surfaces may be observed. Objective: to show the changes taking place after fibular ostectomy in the patients surgically treated of genu varum from the radiological point of view. Material and methods: a lineal, prospective, descriptive study was carried out in the Military Hospital "Dr. Mario Muñoz Monroy" of Matanzas from April 2016 to April 2017, in 51 patients operated on applying Dr Zhang Ying-Ze's fibular ostectomy technique: a total of 57 knees. X-rays were taken before the surgery and six months after it, measuring the height of the external intra joint space. Results: the average age was 67.2 years (50 years the youngest and 84 the eldest patients); 23 were men and 28 women. Before the surgical treatment the average space was 8.84 mm±1.01 mm (18 mm the biggest and 2 mm the smallest); six months after surgery, it was 6.08 mm±0.9 mm (10 mm the biggest and 2 mm the smallest); six patients did not showed changes of the space. Conclusions: with the proximal fibular ostectomy we achieved the reduction of the external fibular space, modifying the anatomical and mechanical axis of the lower limb, what leads to a reduction of the internal joint compression (AU).

Ostectomía del peroné en el genu varo doloroso de rodilla. Resultados preliminares al año de operado / Fibula ostectomy in painful genu varum of the knee. Preliminary results after a year of the surgery

Introducción: la artrosis de rodilla puede llegar a ser una patología muy invalidante por sus síntomas, caracterizados por dolor, inseguridad y pérdida funcional. Es una patología degenerativa que ha aumentado su prevalencia en las últimas décadas, muy ligada al envejecimiento poblacional.Objetivo: validar la técnica de la ostectomía del peroné en el genu varo doloroso como nueva opción de tratamiento.Materiales y Métodos: se realizó un estudio, prospectivo y lineal en el Hospital Militar “Dr. Mario Muñoz Monroy” de Matanzas, desde abril del 2016 hasta agosto del 2017. Se aplicó la nueva técnica del Dr. Ying‑Ze Zhang, del Departamento de Cirugía Ortopédica del Tercer Hospital de la Universidad Médica de Hebei en Shijiazhuang, China. En la actualidad ya existe una casuística de 75 pacientes, con 84 rodillas operadas de los cuales se presentan los resultados de los primeros 11 pacientes, posterior al año de operado.Resultados: el promedio de edad fue de 64,3 años, (45 años el menor y 84 años el mayor); de los cuales 8 eran hombres y 3 mujeres. Se aplicó la escala visual analógica para el dolor pre y post-operatorio en cuanto a la marcha y al subir escalones; estando todos los pacientes al caminar, por encima de 6 y al subir escaleras por encima de 7. Después de un año de operados 10 pacientes se encontraban evaluados al caminar entre 0 y 3 puntos, y al subir escalones 9 en igual puntuación; 1 en 5, y solamente 1 paciente mantuvo igual puntuación antes de operarse. Valorando estas puntuaciones se evaluaron 9 pacientes de bien, 2 de regular, y se presentaron 3 complicaciones.Conclusiones: al año de seguimiento ocurre gran mejoría del dolor, mejorando la seguridad del paciente durante la marcha (AU).

Introduction: the fibular osteoarthritis could be a very invalidating disease due to its symptoms, characterized by pain, insecurity and functional loss. It is a degenerative disease whose prevalence has increased during the last decades, tightly linked to population ageing.Objective: to validate the technique of fibular ostectomy in the painful genu varum as a new treatment option.Materials and Methods: a prospective, lineal study was carried out in the Military Hospital “Dr. Mario Muñoz Monroy”, of Matanzas, from April 2016 to August 2017. It was used the new technique of Dr. Ying-Ze Zhang, from the Department of Orthopedic Surgery of the Third Hospital of Hebei Medical University in Shijiazhuang, China. Currently there is a series of cases of 75 patients, with 84 operated knees; the results of the first 11 operated patients, are presented here after a year of the surgery.Results: the average age was 64.3 years, 45 years the youngest and 84 years the eldest; from them, 8 were men and 3 women. The analogical visual scale for the pre and post-surgical pain was applied during the gait and when going upstairs. During the gait all the patients were above 6, and when climbing upstairs above 7. After a year from the operation 10 patients got an evaluation between 0 and 3 points during the gait, and 9 got the same score when climbing steps; one got 5, and only 1 patient kept the same score than before the operation. Taking into account these scores, 9 patients were evaluated as good, 2 regular, and there were 3 complications.Conclusions: after a one-year follow-up, the pain greatly improves, improving patients security during the gait (AU).

Ostectomía del peroné en el genu varo doloroso de rodilla. Resultados preliminares al año de operado / Fibula ostectomy in painful genu varum of the knee. Preliminary results after a year of the surgery

Introducción: la artrosis de rodilla puede llegar a ser una patología muy invalidante por sus síntomas, caracterizados por dolor, inseguridad y pérdida funcional. Es una patología degenerativa que ha aumentado su prevalencia en las últimas décadas, muy ligada al envejecimiento poblacional. Objetivo: validar la técnica de la ostectomía del peroné en el genu varo doloroso como nueva opción de tratamiento. Materiales y Métodos: se realizó un estudio, prospectivo y lineal en el Hospital Militar "Dr. Mario Muñoz Monroy" de Matanzas, desde abril del 2016 hasta agosto del 2017. Se aplicó la nueva técnica del Dr. Ying-Ze Zhang, del Departamento de Cirugía Ortopédica del Tercer Hospital de la Universidad Médica de Hebei en Shijiazhuang, China. En la actualidad ya existe una casuística de 75 pacientes, con 84 rodillas operadas de los cuales se presentan los resultados de los primeros 11 pacientes, posterior al año de operado. Resultados: el promedio de edad fue de 64,3 años, (45 años el menor y 84 años el mayor); de los cuales 8 eran hombres y 3 mujeres. Se aplicó la escala visual analógica para el dolor pre y post-operatorio en cuanto a la marcha y al subir escalones; estando todos los pacientes al caminar, por encima de 6 y al subir escaleras por encima de 7. Después de un año de operados 10 pacientes se encontraban evaluados al caminar entre 0 y 3 puntos, y al subir escalones 9 en igual puntuación; 1 en 5, y solamente 1 paciente mantuvo igual puntuación antes de operarse. Valorando estas puntuaciones se evaluaron 9 pacientes de bien, 2 de regular, y se presentaron 3 complicaciones. Conclusiones: al año de seguimiento ocurre gran mejoría del dolor, mejorando la seguridad del paciente durante la marcha (AU).

Introduction: the fibular osteoarthritis could be a very invalidating disease due to its symptoms, characterized by pain, insecurity and functional loss. It is a degenerative disease whose prevalence has increased during the last decades, tightly linked to population ageing. Objective: to validate the technique of fibular ostectomy in the painful genu varum as a new treatment option. Materials and Methods: a prospective, lineal study was carried out in the Military Hospital "Dr. Mario Muñoz Monroy", of Matanzas, from April 2016 to August 2017. It was used the new technique of Dr. Ying-Ze Zhang, from the Department of Orthopedic Surgery of the Third Hospital of Hebei Medical University in Shijiazhuang, China. Currently there is a series of cases of 75 patients, with 84 operated knees; the results of the first 11 operated patients, are presented here after a year of the surgery. Results: the average age was 64.3 years, 45 years the youngest and 84 years the eldest; from them, 8 were men and 3 women. The analogical visual scale for the pre and post-surgical pain was applied during the gait and when going upstairs. During the gait all the patients were above 6, and when climbing upstairs above 7. After a year from the operation 10 patients got an evaluation between 0 and 3 points during the gait, and 9 got the same score when climbing steps; one got 5, and only 1 patient kept the same score than before the operation. Taking into account these scores, 9 patients were evaluated as good, 2 regular, and there were 3 complications. Conclusions: after a one-year follow-up, the pain greatly improves, improving patients' security during the gait (AU).

Utilização de métodos não invasivos de imagem para avaliação da regeneração óssea em falhas ósseas induzidas experimentalmente em III/IV metacarpianos de ovinos / Use of non-invasive imaging methods for evaluation of bone regeneration in bone defects induced experimentally in III/IV metacarpus of sheep

Background: The events involved in the process of bone regeneration of fractures are influenced by physiological factors and a number of techniques can be used to assess bone tissue. The radiographic examination (ER) is often used in clinical practice to evaluate the consolidation process. Ultrasound (US) allows evaluation of the fibrous callus, present in early stages of consolidation. Thermograph is method of evaluation for image, which allows you to estimate activity of some tissue. The aim of this study was to evaluate bone fill process, during 60 days, through thermograph, ultrasound and x-ray of ostectomy induced experimentally.Materials, Methods & Results: Six female Santa Inês breed ewes were subjected to unicortical ostectomy of seven millimeters in diameter, in the proximal region of the dorsum-medial surface of III/IV metacarpal, chosen randomly. The animals were submitted to radiographic evaluations, ultrasound and thermograph, prior to the surgery and during 60 days, in between 7, 14, 21, 28, 35, 42, 49 and 56 days postoperatively. The radiographic images were evaluated by examiners “blind” (two radiologists and two sonographers), that didnt know the postoperative day that the image member evaluated. The thermograph images were processed in program for measuring the average temperature in the region of bone gap, over time. The Friedman test was applied to assess the progression of the studied variables over the period of the experiment. Over the period of 60 days it was possible to observe the difference of fault, fill scores by radiographic examination and ultrasound examination (P < 0.001). The Wilcoxon test was applied to observer the differences in scores between the examiners over the period of the experiment. Statistically significant difference was observed between the evaluators of radiographic images from day 14, not being observed between by the evaluators of ultrasound images.[...](AU)

Utilização de métodos não invasivos de imagem para avaliação da regeneração óssea em falhas ósseas induzidas experimentalmente em III/IV metacarpianos de ovinos / Use of non-invasive imaging methods for evaluation of bone regeneration in bone defects induced experimentally in III/IV metacarpus of sheep

Background: The events involved in the process of bone regeneration of fractures are influenced by physiological factors and a number of techniques can be used to assess bone tissue. The radiographic examination (ER) is often used in clinical practice to evaluate the consolidation process. Ultrasound (US) allows evaluation of the fibrous callus, present in early stages of consolidation. Thermograph is method of evaluation for image, which allows you to estimate activity of some tissue. The aim of this study was to evaluate bone fill process, during 60 days, through thermograph, ultrasound and x-ray of ostectomy induced experimentally.Materials, Methods & Results: Six female Santa Inês breed ewes were subjected to unicortical ostectomy of seven millimeters in diameter, in the proximal region of the dorsum-medial surface of III/IV metacarpal, chosen randomly. The animals were submitted to radiographic evaluations, ultrasound and thermograph, prior to the surgery and during 60 days, in between 7, 14, 21, 28, 35, 42, 49 and 56 days postoperatively. The radiographic images were evaluated by examiners “blind” (two radiologists and two sonographers), that didn’t know the postoperative day that the image member evaluated. The thermograph images were processed in program for measuring the average temperature in the region of bone gap, over time. The Friedman test was applied to assess the progression of the studied variables over the period of the experiment. Over the period of 60 days it was possible to observe the difference of fault, fill scores by radiographic examination and ultrasound examination (P < 0.001). The Wilcoxon test was applied to observer the differences in scores between the examiners over the period of the experiment. Statistically significant difference was observed between the evaluators of radiographic images from day 14, not being observed between by the evaluators of ultrasound images.[...]

Hipertrofia unilateral do músculo master: relato de caso / Unilateral Masseter Muscle Hypertrophy: Case Repor

A hipertrofia do músculo masseter é um crescimento excessivo uni ou bilateral do músculo, de etiopatogenia ainda não definida que, na maioria das vezes, gera um desconforto estético e em alguns casos, funcional. Os indivíduos afetados frequentemente exibem um aumento em volume ósseo em região de ramo e ângulo mandibular e o tratamento pode ser através de métodos cirúrgicos ou não cirúrgicos. A abordagem cirúrgica envolve intervenções que são realizadas, apenas, na musculatura comprometida, na estrutura óssea do ângulo mandibular ou ambos. O presente artigo descreve um caso de hipertrofia unilateral do músculo masseter, onde optou-se pela intervenção cirúrgica intraoral com ressecção de fibras musculares e osteotomia do ângulo mandibular. Após um período de dois meses de acompanhamento, observa-se que a modalidade cirúrgica para tratamento de hipertrofia do masseter está bem indicada pois proporciona ótimo resultado estético... (AU)

Masseter muscle hypertrophy is a unilateral or bilateral enlargement of the masseter muscle, of undefined etiology, which in most cases generates an aesthetic discomfort, and in some cases a functional one as well. The affected individuals often exhibit an increase in bone mass in the region of the branch and mandibular angle, and the treatment can use surgical or nonsurgical methods. The surgical approach involves intervetions performed in either the compromised muscle or the mandibular angle bone structure, or in both. This article describes a case of unilateral masseter muscle hypertrophy, where the surgical resection of the muscle fibers in an intraoral approach and a osteotomy with a reciprocating saw were performed in the mandibular angle region. After a two-month follow-up, it was observed that the surgical approach for the treatment of masseter hypertrophy is well advised, since the aesthetic results are excellent, with similarity to the contralateral side of mandibular angle... (AU)