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1.
Arch Bone Jt Surg ; 12(2): 123-127, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38420525

RESUMO

Objectives: Displaced acetabular fractures are complex injuries that necessitate precise surgical intervention. Obturator nerve injuries occur in approximately 2% of cases. The modified Stoppa approach, offering enhanced exposure of the quadrilateral plate, has gained attraction as an alternative technique for anterior acetabular fractures. However, its proximity to the obturator nerve poses a risk of iatrogenic injury. This study aimed to investigate the incidence of nerve injuries and functional outcomes in patients undergoing the modified Stoppa approach for traumatic acetabular fractures. Methods: This retrospective study involved 86 patients with anterior column fractures, whose data were prospectively collected. The fractures were treated using the modified Stoppa approach. Exclusion criteria were pathological fractures, alternative surgical approaches, prior nerve injuries, hip issues, refusal to participate, or inadequate follow-up. Data collection involved pre-operative imaging, thorough post-operative neurological assessments, and post-operative radiographic evaluation. Functional outcomes were assessed using the Harris Hip Score (HHS). Results: Most patients were male (n=54) with a mean age of 40±17.3 years. Post-operative infection occurred in six cases, with resolution in four through antibiotics and two necessitating device removal. Obturator nerve damage was detected in 14 patients, comprising nine traumatic and five iatrogenic cases. During the follow-up, symptoms improved in all patients, except for the four patients with iatrogenic nerve damage. Conclusion: Traumatic nerve injuries generally heal naturally over time. In contrast, iatrogenic injuries have a less optimistic prognosis, potentially resulting in lasting neurological deficits.

2.
Pain Res Manag ; 2024: 3720344, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38223902

RESUMO

Background: Acetabular fracture surgeries are frequently accompanied by protracted and severe perioperative pain, and there is no consensus on optimal pain relief management. Aim: This study aimed at comparing the analgesic efficacy of fascia iliaca compartment block (FICB) and quadratus lumborum block (QLB) in patients with acetabular fractures undergoing surgery using the Stoppa method. Methods: In this double-blind, randomized, noninferiority clinical trial, adult patients undergoing spinal anesthesia for acetabular fracture surgery, in Imam Hossein Hospital, Tehran, Iran (IRCT20191114045435N1), were randomly divided into two groups: FICB (n = 22) and QLB (n = 24). The visual analog scale (VAS) was used to assess the pain intensity at different times for all participants. In addition, the dose of fentanyl required to induce the patient to sit for spinal anesthesia and the pain intensity were evaluated. Moreover, the duration of analgesia and the total amount of morphine consumed in the first 24 h following surgery were evaluated, analyzed, and compared between the two study groups. Results: FICB and QLB demonstrated effective comparative postoperative analgesic profiles following acetabular fracture surgery; however, no significant differences in VAS values were observed between the two groups during the study. FICB experienced reduced cumulative fentanyl consumption during spinal anesthetic placement, whereas QLB had a significantly lower total morphine demand in the initial postoperative 24 h period. Conclusion: The lateral QLB and FICB can be introduced as effective routes for analgesia in acetabular fracture surgery using the Stoppa method. Clinical Trial Registration. The study was prospectively registered in the clinical trials registry system, on 2021-02-17, with registration number: IRCT20191114045435N1.


Assuntos
Fraturas do Quadril , Dor Pós-Operatória , Adulto , Humanos , Analgésicos Opioides/uso terapêutico , Fáscia , Fentanila , Fraturas do Quadril/cirurgia , Irã (Geográfico) , Morfina , Dor Pós-Operatória/tratamento farmacológico , Dor Pós-Operatória/etiologia , Método Duplo-Cego
3.
Arthroplast Today ; 24: 101277, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-38058385

RESUMO

Background: There is still debate over whether to sacrifice the posterior cruciate ligament (PCL) during total knee arthroplasty (TKA). Several studies reported the costs and benefits of each approach regarding technical difficulties in PCL balancing and postoperation complications. In this study, we aimed to evaluate PCL needling as a safe method for balancing the cruciate-retained TKA (CR-TKA). Methods: In this comparative study, 120 patients underwent CR-TKA and were divided into 2 groups. Fifty-four patients with an acceptable PCL tightness were included in group A, and 66 cases with a tight PCL were included in group B. In group B, needle pie-crusting of the PCL was performed instead of releasing the PCL from its insertions as the standard procedure. The participants' functional outcomes, pain severity, knee range of motion, and PCL laxity were evaluated during multiple follow-ups in 3 years postoperatively. Results: The participants' age, weight, and body mass index did not differ between the 2 groups. The mean age of the patients was 69 ± 5.9 years. The functional outcomes and range of motion of the patients in the 2 groups significantly improved after the operation compared to the preoperative status, but the postoperative score was not significantly different between groups (P > .05). Clinical examinations were normal in all patients in both groups in all follow-up stages. Conclusions: PCL balancing is a time-consuming yet essential step for the outcome of CR-TKA and patient satisfaction. PCL needling technique shows promising results and a few complications for PCL balancing in CR-TKA.

4.
PLoS One ; 18(11): e0293686, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37988350

RESUMO

BACKGROUND: Intertrochanteric fracture is a common injury among the elderly, causing fundamental lifestyle derangements, influencing the patients' social and psychological functioning. We aimed to study the quality of life (QoL) and its different parameters in patients with this type of injury. MATERIALS AND METHODS: In this cross-sectional study, all patients hospitalized with intertrochanteric fracture aged above 50 from 2020 to 2022 at the Shahid Beheshti Hospital in Babol, Iran, were included. Patients were primarily managed surgically and, in exceptional cases non-surgically, were followed up for at least 12 months after receiving treatment. During the follow-up period, patients were dialled and completed a questionnaire to assess the patient's QoL by the 36-item Short Form Health Survey (SF-36). QoL parameters were analyzed based on patients' sex, age, type of treatment, and height of fall causing fracture. RESULT: A total number of 200 patients, including 101 (50.5%) males and 99 (49.5%) females, with a mean age of 74.76±11.36 years (range: 50-99), were included. Regarding the received treatment, 192 (96.0%) patients underwent surgery, and 8 (4.0%) underwent non-surgical treatment. In the study of SF-36 scores, the mean score of male patients was 42.31±14.58, and females scored 37.83±15.35, and the difference was statistically significant (P = 0.04). The mean score of QoL and its subscales among the 50-75 group patients was significantly higher than the 76-99 group (P<0.001). The average score of QoL was considerably higher in patients who had surgery (40.75±14.57) compared to those who had non-surgical treatment (24.30±19.85) (P = 0.01). Patients having a fall from a higher height had higher QoL after treatment. CONCLUSION: This study revealed that patients with an intertrochanteric femoral fracture had poor QoL in all aspects. The overall QoL was significantly higher among male patients, younger patients, those who underwent surgical treatment, and the falls from higher heights. These findings highlight the necessity of long-term follow-up and support in patients with intertrochanteric fractures.


Assuntos
Artroplastia de Quadril , Fixação Intramedular de Fraturas , Fraturas do Quadril , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Idoso de 80 Anos ou mais , Qualidade de Vida , Estudos Transversais , Fraturas do Quadril/cirurgia , Fraturas do Quadril/etiologia , Fixação Interna de Fraturas , Artroplastia de Quadril/efeitos adversos , Resultado do Tratamento , Estudos Retrospectivos , Pinos Ortopédicos
5.
Eur J Orthop Surg Traumatol ; 33(8): 3603-3609, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-37248436

RESUMO

PURPOSE: We aimed to investigate the relationship between spinopelvic imbalances and functional disabilities after total hip arthroplasty in an at least two years of follow-up. METHODS: Patients with normal sagittal alignment and normal motion (PI-LL < 10°, APP < 13°, ∆SS > 10°) were defined as control, and patients with any of sagittal alignment or motion abnormalities were defined as case groups. Visual Analog Scale, SF-36, Harris hip score, HOOS-JR, and complications were recorded. RESULTS: The differences of the means of Harris hip score, HOOS-JR, SF-36, and VAS score in the control and case groups were statistically significant. The mean of these parameters in patients with sagittal balanced (PI-LL < 10°) was much better than patients with sagittal unbalanced (PI-LL > 10°). Same results were noted in patients with decreased (∆SS < 10°) and normal spinopelvic motions (∆SS > 10°). CONCLUSION: Our observations indicate that spinopelvic imbalances are associated with worse postoperative functional outcomes in patients undergoing total hip arthroplasty.


Assuntos
Artroplastia de Quadril , Lordose , Humanos , Artroplastia de Quadril/efeitos adversos , Estudos Retrospectivos , Lordose/etiologia
6.
Arch Bone Jt Surg ; 11(8): 524-530, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-38736722

RESUMO

Objectives: Excessive blood loss is a critical complication of total hip arthroplasty. We intended to determine whether preoperative fibrinogen administration reduces perioperative bleeding and the need for blood transfusion in total hip arthroplasty surgery. Methods: In 4 months, 178 patients who underwent total hip arthroplasty were randomly assigned equally to intervention and placebo-control groups in a double-blinded, parallel two-arm randomized controlled trial. Both intravenously, 30 min before the start of the surgery, the intervention group received two grams of fibrinogen concentrate dissolved in 100 ml of distilled water. In contrast, the control group received 100 ml of normal saline solution. The amount of postoperative blood loss served as the main result, and the requirement for blood transfusions served as the secondary outcome. Results: In comparison to the placebo, administering fibrinogen concentrate considerably reduced the amount of blood loss (P=0.001) and the requirement for blood transfusions (P=0.004). Patients who got fibrinogen concentrate experienced no side effects. In addition, patients in the fibrinogen group had significantly lower hemoglobin and higher fibrinogen levels in the recovery room and received lesser blood transfusions (P<0.005) than the placebo group. Conclusion: In total hip arthroplasty, fibrinogen concentrate lessens postoperative bleeding and the requirement for blood transfusions.

7.
Adv Biomed Res ; 11: 32, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35720211

RESUMO

Also known as intravascular papillary endothelial hyperplasia, Masson's tumor is a relatively rare soft-tissue vascular tumor that usually arises in the hand. Felon is an abscess formation in the distal phalanx that usually occurs following a penetrating microtrauma. We present a 30-year-old patient who was referred to our clinic with a palpable mass in the distal phalanx of the index finger after a needle stick injury. At first, the lesion was treated as a felon but finally and after treatment failure, a complete reevaluation revealed the lesion to be a Masson's tumor of the distal phalanx.

8.
Adv Biomed Res ; 11: 113, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36798916

RESUMO

Guillain-Barré syndrome is an autoimmune disorder presented by ascending paralysis and areflexia. The condition has been reported after many infections, but Guillain-Barré syndrome after spine surgery is rare. We, herein, present a case of Guillain-Barré syndrome after multiple spine surgeries for degenerative lumbar scoliosis. A 60-year-old woman with degenerative scoliosis underwent surgery for the third time and developed Guillain-Barré syndrome 3 weeks after the final operation. The patient received intravenous immune globulin therapy and needed mechanical ventilation and intensive care. She was discharged in good condition after 5 weeks.

9.
Orthop Traumatol Surg Res ; 108(1): 103135, 2022 02.
Artigo em Inglês | MEDLINE | ID: mdl-34715388

RESUMO

BACKGROUND: Fascia iliaca compartment block (FICB) is a common regional analgesic strategy in hip fracture surgery but, recently it has been suggested that FICB may not provide enough analgesia. Pericapsular nerve group block (PENG) is a novel method for hip analgesia which its efficacy is not well established yet. The aim of this study was to the effect of the PENG block in the control of the hip fracture pain as well as to compare the effectiveness of the PENG compared with FICB. HYPOTHESIS: The hypothesis of this study was that the PENG block could be a good alternative to the FICB in hip fracture analgesia. MATERIALS AND METHODS: This randomized controlled clinical trial was conducted in the Imam- Hossein Hospital, Tehran, Iran; between 2018 and 2019. Hip fracture patients were randomly divided into two groups; Group A (n=22) received FICB and Group B (n=30) received PENG block. RESULTS: There was no significant difference between VAS score before blocks procedure between two groups (p=0.37). After 15minutes of blocks and after 12hours of post-surgery, VAS score significantly reduced in the PENG block group compared with the FICB group (p=0.031; p=0.021, respectively). The first time of the analgesic consumption after surgery was significantly longer in the PENG block compared with the FCIB (p=0.007). Compared with the FICB group, the total dose of morphine consumption during 24hours significantly reduced in the PENG block (p=0.008). CONCLUSION: PENG block is a good method in hip fractures analgesia and provides better analgesia than FICB. However, further studies with larger sample sizes are required to validate the efficacy and superiority of the PENG blocks over conventional techniques. LEVEL OF EVIDENCE: I.


Assuntos
Nervo Femoral , Fraturas do Quadril , Analgésicos , Fáscia , Fraturas do Quadril/complicações , Fraturas do Quadril/cirurgia , Humanos , Irã (Geográfico) , Dor , Dor Pós-Operatória/tratamento farmacológico , Dor Pós-Operatória/etiologia , Dor Pós-Operatória/prevenção & controle , Estudos Prospectivos
10.
Immun Inflamm Dis ; 10(2): 201-208, 2022 02.
Artigo em Inglês | MEDLINE | ID: mdl-34762351

RESUMO

INTRODUCTION: Hyperinflammatory state has a role in the pathogenesis of COVID-19. Anakinra could reduce inflammation and help to combat the condition. In this study, we aimed to assess the safety and efficacy of anakinra (PerkinRA®) in severe COVID-19. METHOD: The study was an open-label, randomized, controlled trial conducted in Imam Hossein Medical Center from May to July 2020. Patients with a confirmed diagnosis of COVID-19 were included in this study. We administered anakinra 100 mg daily intravenously. All patients received COVID-19 pharmacotherapy based on the represented national guideline. The need for invasive mechanical ventilation is considered the primary outcome. RESULTS: Thirty patients were included in this study, and 15 of them received Anakinra. Nineteen patients were male (63.3%), and 11 were female (36.7%). The mean age of patients was 55.77 ± 15.89 years. In the intervention group, the need for invasive mechanical ventilation was significantly reduced compared to the control group (20.0% vs. 66.7%, p = .010). Also, these patients had a significantly lower length of hospital stay (p = .043). No significant higher rate of infection was recorded. CONCLUSION: Anakinra as an immunomodulatory agent has been associated with the reduced need for mechanical ventilation in patients admitted to intensive care units because of severe COVID-19. The medication reduced the hospital length of stay. Furthermore, no increased risk of infection was observed. Further randomized placebo-controlled trials with a larger sample size are needed to confirm these findings.


Assuntos
COVID-19 , Proteína Antagonista do Receptor de Interleucina 1 , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Respiração Artificial , SARS-CoV-2 , Resultado do Tratamento
11.
Arch Bone Jt Surg ; 8(3): 378-382, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32766396

RESUMO

BACKGROUND: Surgery in the time of COVID-19 pandemic is a challenging issue while treatment of affected fracture patients is inevitable. The present study summarizes the challenges that an orthopedic surgeon is confronting during the surgical treatment of fracture patients with concomitant COVID-19 infection. METHODS: Demographic and fracture related data of 13 fracture patients with concomitant COVID-19 infection who were treated with surgery was collected from three trauma centers in Tehran and Kermanshah cities from 21, February 2020 to April 3, 2020. RESULTS: All patients were male with mean age of 38.6±19.5 years. Eight patients had high energy fracture and seven patients had multiple fractures and trauma. Wrist and hand were the common sites of fracture following hip and pelvis. The mean interval time period between the diagnosis of COVID-19 infection and surgery was 2.3±1.5 days. Before surgery, all patients except one had been admitted to the corona dedicated wards, while two patients were admitted to the intensive care unit (ICU). One of the ICU admitted patients died. All the 12 alive patients remained in home isolation after discharge. CONCLUSION: Fracture surgery in COVID-19 patients has many challenges such as lack of medical resources, delay of surgery, medial staff fear, and patient isolation. However, a multidisciplinary approach using all potential hospital resources would lead to successful operation and acceptable outcome.

12.
Arch Bone Jt Surg ; 8(Suppl 1): 286-290, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32733984

RESUMO

After the COVID-19 outbreak worldwide, we will sooner or later encounter trauma patients with COVID-19 in the developing countries. It is a challenging decision-making process for an orthopedic surgeon to provide the patients with the best practice in the crisis. Here we discuss the issue in terms of clinical severity of COVID-19 pneumonia, priority of orthopedic surgical trauma procedures and standard of care for the treatment of trauma injuries. We finally propose an algorithm for better management of trauma patients in the setting of COVID-19 mass spread.

13.
Arch Bone Jt Surg ; 8(1): 83-88, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32090150

RESUMO

BACKGROUND: Surgical techniques and rehabilitations after total hip arthroplasty (THA) play a significant role in the improvement of pain and limping. This study aimed to assess hip abductor muscle's diameter and its strength after 6 months postoperative THA performed by Hardinge approach. METHODS: After obtaining the patients' demographic characteristics, the preoperative values of patients' hip abductor muscle diameter were measured using magnetic resonance imaging, and were compared with postoperative values 6 months later. Moreover, the hip abductor muscle's strength was assessed using the Trendelenburg test. RESULTS: A total of 88 patients participated in this study with a mean age of 47.3±1.574 years. It should be noted that 55.7% of the participants were male. Muscle diameter decreased from a mean value of 27.07±7.485 preoperative to mean value of 25.64±7.353 mm postoperative (P<0.001). Moreover, the degrees of Trendelenburg test (i.e., mild or severe) decreased after surgery (P<0.001). There was no significant difference between the frequencies of different grades of limping according to the studied variables. CONCLUSION: A decrease was observed in gluteus medius muscle diameter, and the Trendelenburg test results were improved in this study. Moreover, the difference between pre- and postoperative gluteus medius muscle diameters were measured using MRI. It can be concluded that MRI is not an appropriate diagnostic tool for the assessment of abductor strength after THA in the 6-month postoperative visit. Accordingly, it is suggested to evaluate muscle strength before and after each surgery to schedule the following treatment protocol required for each patient.

14.
Arch Trauma Res ; 4(2): e12039, 2015 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-26401491

RESUMO

BACKGROUND: Preoperative skin traction is applied for many patients with hip fracture. However, the efficacy of this modality in pain relief is controversial. OBJECTIVES: The aim of the current study was to investigate the effects of skin traction on pain in patients with intertrochanteric fractures. PATIENTS AND METHODS: A total of 40 patients contributed in this randomized clinical trial. Patients were randomly allocated into two equal groups: the skin traction (3 kg) and control groups. The severity of pain was recorded at admission and 30 minutes, one, six, 12, and 24 hours after skin traction application utilizing a Visual Analogue Scale (VAS). In addition, the number of requests for analgesics was recorded. Finally, the mean severity of pain in each measurement and the mean number of analgesic requests were compared between the two groups. RESULTS: The severity of pain was significantly decreased in skin traction group only at the end of the first day after traction application (2.7 ± 0.8 vs. 3.3 ± 0.9; P = 0.042), while there was no significant difference between the two groups in other pain measurements. The number of requests for analgesics was the same between the two groups. CONCLUSIONS: Although skin traction had no effect on analgesic consumption, it significantly decreased the pain at the end of the first day. The application of skin traction in patients with intertrochanteric fractures is recommended.

15.
Anesth Pain Med ; 4(3): e17620, 2014 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-25237638

RESUMO

BACKGROUND: Infraclavicular brachial plexus block is an appropriate approach for distal arm and forearm surgeries. Local anesthetic adjuvant agents are used to improve the quality of nerve blocks. Dexmedetomidine and ketorolac are two different types of adjuvants, which have been used in some studies. OBJECTIVES: The purpose of this study was to examine the effects of dexmedetomidine and ketorolac as local anesthetic adjuvants on the onset and duration of infraclavicular brachial plexus block under ultrasound guide technique. PATIENTS AND METHODS: In a clinical trial study, 111 ASA class I and II patients who were candidates for elective distal arm and forearm surgeries under ultrasound guided infraclavicular brachial plexus block divided into three 37 patient groups. In dexmedetomidine group, 25 mL of lidocaine 1.5% plus 4 ml of normal saline and 100 mcg of dexmedetomidine was injected. Ketorolac group received 25 mL of Lidocaine 1.5% plus 5 mL of ketorolac, and placebo group received 25 mL of lidocaine 1.5% plus 5 mL of normal saline as local anesthetic solution. Sensory and motor onset blocks, duration of sensory and motor blocks and first time to analgesic request and hemodynamic parameters were all recorded. RESULTS: There were no significant differences in sensory block onset between three groups (P = 0.177). Motor block onset was statistically less in dexmedetomidine compared to ketorolac and placebo groups (both Ps < 0.001). Sensory block duration in dexmedetomidine group was significantly longer than ketorolac and placebo groups (both Ps < 0.001). Motor block duration in dexmedetomidine group was significantly longer than ketorolac and placebo groups (both Ps < 0.001). Time to first analgesic request after the procedures was longer in ketorolac compared to dexmedetomidine and placebo groups (P = 0.016, P < 0.001 respectively), but it was longer in dexmedetomidine compared to placebo group (P = 0.003). The differences of diastolic blood pressure in-between the 5th to 140th minutes after local anesthetic injection among the 3 groups were statistically significant and dexmedetomidine group shows the most reduction in diastolic blood pressure (P < 0.001). Dexmedetomidine showed the lowest mean arterial pressure (P = 0.016) and heart rate in dexmedetomidine group was significantly lower than ketorolac and placebo groups (P = 0.043). CONCLUSIONS: Our study showed that dexmedetomidine had better effects on sensory and motor block duration and motor block onset in comparison with ketorolac, as lidocaine adjuvants in infraclavicular brachial plexus block were present in both protocols. However, the first time to analgesic request by ketorolac was longer than dexmedetomidine.

16.
Mol Biol Rep ; 41(1): 423-8, 2014 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-24281949

RESUMO

A combination of bioceramics and osteogenic factors is potentially useful for bone regeneration applications. In the present study, hydroxyapatite particles (HA) were loaded with dexamethasone (Dex) and then characterized using SEM and drug release study. The bone regeneration ability of Dex-loaded HA (Dex/HA) was investigated in a rat critical size bone defect using digital mammography, multislice spiral-computed tomography (MSCT) imaging, and histological analysis. The HA and Dex/HA showed nano and micro-scale morphology with a nearly homogenous distribution of diameter. In addition, about 90 % of the drug was released from Dex/HA over a period of three days. After 8 weeks of implantation in rat calvarial defects, no sign of inflammation or complication was observed at the site of surgery. According to digital mammography and MSCT, Dex/HA showed the highest bone regeneration in rat bone defects compared to those received drug-free HA. Histological studies confirmed these data and showed osteointegration to the surrounding tissue. Taking all together, it was demonstrated that Dex/HA can be used as an appropriate synthetic graft for bone tissue engineering applications. These newly developed bioceramics can be used as new bone graft substitutes in orthopaedic surgery and is capable of enhancing bone regeneration.


Assuntos
Regeneração Óssea/efeitos dos fármacos , Dexametasona/farmacologia , Portadores de Fármacos/farmacologia , Glucocorticoides/farmacologia , Hidroxiapatitas/farmacologia , Crânio/fisiologia , Animais , Dexametasona/química , Portadores de Fármacos/química , Avaliação Pré-Clínica de Medicamentos , Glucocorticoides/química , Hidroxiapatitas/química , Masculino , Tamanho da Partícula , Ratos , Ratos Sprague-Dawley , Crânio/efeitos dos fármacos
17.
Trauma Mon ; 17(4): 367-9, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-24350128

RESUMO

BACKGROUND: There is controversy regarding routine prophylaxis for deep vein thrombosis (DVT) in patients treated via a short leg cast or splint following lower extremity trauma. OBJECTIVES: The main aim of this study is to evaluate the incidence of DVT and need for chemoprophylaxis in these patients. MATERIALS AND METHODS: Patients with ankle sprains or stable foot/ankle fractures were entered in this cross-sectional study. Serum D-dimer levels were measured 2 weeks following fixation. If the D-dimer levels were above 0.2 micrograms/ml the test was considered positive and the patient was referred for Doppler ultrasound examination (DUE) to confirm or rule out the diagnosis of DVT. Finally, the incidence of DVT was calculated and the role of predisposing factors was investigated. RESULTS: There were 95 patients with an average age of 38 ± 13.7 (77.9% males); 46 patients had at least one risk factor for DVT. The D-dimer test was positive in 21(22.1%) patients. DVT was confirmed by DUE in 3 patients (3.1%). The incidence of DVT significantly increased in the presence of 3 or more risk factors (P = 0.01). CONCLUSIONS: It seems that DVT is not a common complication of below knee fixation and chemoprophylaxis is not necessary when the patient has less than 3 predisposing factors. With 3 or more risk factors chemoprophylaxis and periodic follow-ups must be considered.

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