RESUMO
OBJECTIVES: To introduce an alternative fixation technique for Neer type II fractures using Steinmann pins (S-pins). DESIGN: Retrospective case series study. SETTING: Operating room followed by clinic in tertiary hospital. PATIENTS/PARTICIPANTS: Between 2001 and 2013, among 66 consecutive patients diagnosed with Neer type II distal clavicle fractures, 11 patients were excluded and 56 clavicles of 55 patients who underwent surgical treatment with multiple transacromial S-pins were selected for analysis. INTERVENTION: Multiple transacromial S-pin (2.0-mm diameter) fixation was performed. Interfragmentary fixation was performed with 2.7-mm screws in case of oblique fractures. MAIN OUTCOME MEASURES: Radiographic results, complications, and clinical outcomes including the Constant-Murley score, the University of California at Los Angeles Shoulder score, and the disabilities of the arm, shoulder, and hand score were evaluated. RESULTS: Radiologic union was achieved in all patients. Coracoclavicular distance was increased by 6.4% compared with that of the uninjured side (P < 0.001). Fourteen patients had lateral migrations of 1 pin (mean migration distance, 11.6 mm). The mean Constant-Murley score was 94.3 (range, 85-100), mean University of California at Los Angeles score was 33.1 (range, 29-35), and mean disabilities of the arm, shoulder, and hand score was 2.7 (range, 0-8.3). The average follow-up period was 30.5 months (range, 24-81 months). CONCLUSIONS: Good functional and radiologic results were achieved by the insertion of multiple transacromial S-pins with interfragmentary screw fixation. With its wide indication and relatively simple procedure, this technique may be a possible surgical option for the treatment of Neer type II distal clavicle fractures. LEVEL OF EVIDENCE: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Assuntos
Pinos Ortopédicos , Clavícula/lesões , Fixação Interna de Fraturas/instrumentação , Fraturas Ósseas/cirurgia , Instabilidade Articular/prevenção & controle , Adulto , Clavícula/diagnóstico por imagem , Clavícula/cirurgia , Estudos de Coortes , Feminino , Seguimentos , Fixação Interna de Fraturas/métodos , Consolidação da Fratura/fisiologia , Fraturas Ósseas/diagnóstico por imagem , Humanos , Escala de Gravidade do Ferimento , Masculino , Pessoa de Meia-Idade , Amplitude de Movimento Articular/fisiologia , Estudos Retrospectivos , Lesões do Ombro/diagnóstico por imagem , Lesões do Ombro/cirurgia , Tomografia Computadorizada por Raios X/métodos , Resultado do TratamentoAssuntos
Transportadores de Cassetes de Ligação de ATP/genética , Cálculos Biliares/genética , Lipoproteínas/genética , Membro 5 da Subfamília G de Transportadores de Cassetes de Ligação de ATP , Membro 8 da Subfamília G de Transportadores de Cassetes de Ligação de ATP , Transportadores de Cassetes de Ligação de ATP/fisiologia , Predisposição Genética para Doença , Humanos , Polimorfismo de Nucleotídeo ÚnicoRESUMO
Ovarian metastasis from early-stage squamous cervical cancer is rare. We report a case of unilateral ovarian metastasis from squamous cervical cancer IA1. Although ovarian metastasis from early-stage squamous cervical cancer is rare, gynecological oncologists should not overlook its possibility.
