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1.
Rev. esp. cir. ortop. traumatol. (Ed. impr.) ; 66(1): T3-T9, Ene-Feb 2022. tab, graf, ilus
Artigo em Inglês | IBECS | ID: ibc-204919

RESUMO

Background: Scapular Notching is a problem frequently seen in Reverse shoulder arthroplasties (RSAs), produced by a collision between the humeral component and the scapula. The main objective of this study is to analyze whether this problem decreases with the surgeons experience. As secondary objectives, assessing whether there is a relationship between its appearance and the clinical and functional outcome of patients. Methods: We retrospectively reviewed 101 patients with 105 RSAs; we analyzed complications, focusing on scapular notching. Main follow-up time was 36 month (12-72). The clinical and functional outcomes were evaluated with the Constant scale and the QuickDash questionnaire. Results: Forty-two patients (40%) had some degree of scapular notching. Of these, 25 patients had grade I, 14 had grade II and 3 had grade III notching. The average postoperative Constant score for the entire series was 60.72. A tendency toward a reduced incidence of notching was observed with increasing numbers of operated cases and experience of the surgeon (p=0.04). In the group of patients who had notching, the average postoperative Constant score was 56, and in the group that developed notching, the average score was 63. Patients with notching had significantly lower pain scores (p=0.012). Conclusions: Scapular notching is a common problem of RSA. In RSA, the experience of the surgeon reduces the appearance of problems and complications. Scapular notching is related to poorer clinical outcomes with respect to pain.(AU)


Introducción: La erosión o muesca escapular (notching escapular) es un problema que se observa con frecuencia en las prótesis invertidas de hombro, producido por un choque entre el componente humeral y el cuello de la escápula. El objetivo principal de nuestro trabajo es analizar si disminuye el notching escapular con el aumento de la experiencia del cirujano. Como objetivos secundarios, el valorar si existe una relación entre su aparición y el resultado funcional y clínico en los pacientes. Material y método: Se realiza una revisión retrospectiva de 101 pacientes con 105 prótesis invertidas de hombro, valorando radiográficamente la aparición de notching escapular. El tiempo medio de seguimiento fue de 36 meses (rango, 12-72). Se objetivan los resultados clínico-funcionales con la escala Constant y el cuestionario QuickDash. Resultados: Cuarenta y dos pacientes (40%) presentaron algún grado de notching escapular. De ellos, 25 pacientes tenían un grado I, 14 un grado II y tres un grado III. El Constant postoperatorio medio para toda la serie fue de 60,72. Se observó una tendencia a disminuir la incidencia de notching conforme aumentaba el número de casos intervenidos y la experiencia del cirujano (p = 0,04). En el grupo de los pacientes que presentaban notching escapular, el Constant postoperatorio fue de 56 y en el grupo que no desarrolló notching fue del 63. Los pacientes con notching presentaban puntuaciones inferiores en cuanto al dolor siendo la diferencia estadísticamente significativa (p = 0,012). Conclusiones: El notching escapular es un problema frecuente en las prótesis invertidas de hombro, en las cuales la curva de aprendizaje influye positivamente en la diminución de su aparición. La aparición de notching escapular está relacionado con peores resultados clínicos en cuanto al dolor se refiere.(AU)


Assuntos
Humanos , Masculino , Feminino , Prótese de Ombro , Ombro/diagnóstico por imagem , Ombro/cirurgia , Articulação do Ombro/cirurgia , Dor de Ombro/terapia , Lesões do Ombro , Curva de Aprendizado , Cirurgiões Ortopédicos , Estudos Retrospectivos , Ortopedia , Traumatologia
2.
Rev. esp. cir. ortop. traumatol. (Ed. impr.) ; 66(1): 3-9, Ene-Feb 2022. tab, ilus, graf
Artigo em Espanhol | IBECS | ID: ibc-204920

RESUMO

Introducción: La erosión o muesca escapular (notching escapular) es un problema que se observa con frecuencia en las prótesis invertidas de hombro, producido por un choque entre el componente humeral y el cuello de la escápula. El objetivo principal de nuestro trabajo es analizar si disminuye el notching escapular con el aumento de la experiencia del cirujano. Como objetivos secundarios, el valorar si existe una relación entre su aparición y el resultado funcional y clínico en los pacientes. Material y métodos: Se realiza una revisión retrospectiva de 101 pacientes con 105 prótesis invertidas de hombro, valorando radiográficamente la aparición de notching escapular. El tiempo medio de seguimiento fue de 36 meses (rango, 12-72). Se objetivan los resultados clínico-funcionales con la escala Constant y el cuestionario QuickDash. Resultados: Cuarenta y dos pacientes (40%) presentaron algún grado de notching escapular. De ellos, 25 pacientes tenían un grado I, 14 un grado II y tres un grado III. El Constant postoperatorio medio para toda la serie fue de 60,72. Se observó una tendencia a disminuir la incidencia de notching conforme aumentaba el número de casos intervenidos y la experiencia del cirujano (p = 0,04). En el grupo de los pacientes que presentaban notching escapular, el Constant postoperatorio fue de 56 y en el grupo que no desarrolló notching fue del 63. Los pacientes con notching presentaban puntuaciones inferiores en cuanto al dolor siendo la diferencia estadísticamente significativa (p = 0,012). Conclusiones: El notching escapular es un problema frecuente en las prótesis invertidas de hombro, en las cuales la curva de aprendizaje influye positivamente en la diminución de su aparición. La aparición de notching escapular está relacionado con peores resultados clínicos en cuanto al dolor se refiere.(AU)


Background: Scapular Notching is a problem frequently seen in Reverse shoulder arthroplasties (RSAs), produced by a collision between the humeral component and the scapula. The main objective of this study is to analyze whether this problem decreases with the surgeons experience. As secondary objectives, assessing whether there is a relationship between its appearance and the clinical and functional outcome of patients. Methods: We retrospectively reviewed 101 patients with 105 RSAs; we analyzed complications, focusing on scapular notching. Main follow-up time was 36 month (12-72). The clinical and functional outcomes were evaluated with the Constant scale and the QuickDash questionnaire. Results: Forty-two patients (40%) had some degree of scapular notching. Of these, 25 patients had grade I, 14 had grade II and 3 had grade III notching. The average postoperative Constant score for the entire series was 60.72. A tendency toward a reduced incidence of notching was observed with increasing numbers of operated cases and experience of the surgeon (p=0.04). In the group of patients who had notching, the average postoperative Constant score was 56, and in the group that developed notching, the average score was 63. Patients with notching had significantly lower pain scores (p=0.012). Conclusions: Scapular notching is a common problem of RSA. In RSA, the experience of the surgeon reduces the appearance of problems and complications. Scapular notching is related to poorer clinical outcomes with respect to pain.(AU)


Assuntos
Humanos , Masculino , Feminino , Prótese de Ombro , Ombro/diagnóstico por imagem , Ombro/cirurgia , Articulação do Ombro/cirurgia , Dor de Ombro/terapia , Lesões do Ombro , Curva de Aprendizado , Cirurgiões Ortopédicos , Estudos Retrospectivos , Ortopedia , Traumatologia
3.
Rev Esp Cir Ortop Traumatol ; 66(1): 3-9, 2022.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-34147418

RESUMO

BACKGROUND: Scapular Notching is a problem frequently seen in Reverse shoulder arthroplasties (RSAs), produced by a collision between the humeral component and the scapula. The main objective of this study is to analyze whether this problem decreases with the surgeons experience. As secondary objectives, assessing whether there is a relationship between its appearance and the clinical and functional outcome of patients. METHODS: We retrospectively reviewed 101 patients with 105 RSAs; we analyzed complications, focusing on scapular notching. Main follow-up time was 36 month (12-72). The clinical and functional outcomes were evaluated with the Constant scale and the QuickDash questionnaire. RESULTS: Forty-two patients (40%) had some degree of scapular notching. Of these, 25 patients had grade I, 14 had grade II and 3 had grade III notching. The average postoperative Constant score for the entire series was 60.72. A tendency toward a reduced incidence of notching was observed with increasing numbers of operated cases and experience of the surgeon (p=0.04). In the group of patients who had notching, the average postoperative Constant score was 56, and in the group that developed notching, the average score was 63. Patients with notching had significantly lower pain scores (p=0.012). CONCLUSIONS: Scapular notching is a common problem of RSA. In RSA, the experience of the surgeon reduces the appearance of problems and complications. Scapular notching is related to poorer clinical outcomes with respect to pain.

4.
J Hand Surg Br ; 23(2): 275-8, 1998 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-9607682

RESUMO

Recurrent giant-cell tumours of bone have a higher risk of malignancy than primary giant-cell tumours of bone, and giant-cell tumours of bone in the hand are more likely to recur than those that arise elsewhere. Therefore, en bloc resection and reconstruction, or amputation, have been the accepted treatments for recurrent giant-cell tumours of bone in the hand. We describe two cases of successful transplantation of a metatarsal to a metacarpal, which was the site of a recurrent giant-cell tumour. The patients had satisfactory results 3 years later without problems in the foot. En bloc resection of the tumour and reconstruction with an autograft should be considered in the treatment of recurrent giant cell tumour of the hand.


Assuntos
Transplante Ósseo , Tumor de Células Gigantes do Osso/cirurgia , Metacarpo/cirurgia , Recidiva Local de Neoplasia/cirurgia , Transplante Ósseo/métodos , Seguimentos , Tumor de Células Gigantes do Osso/diagnóstico , Humanos , Masculino , Metacarpo/patologia , Metatarso , Recidiva Local de Neoplasia/diagnóstico , Reoperação
5.
J Orthop Trauma ; 10(8): 575-7, 1996.
Artigo em Inglês | MEDLINE | ID: mdl-8915922

RESUMO

Fracture-separation of the capital femoral epiphysis is an extremely rare lesion, representing approximately 8% of femoral neck fractures according to the Delbet and Colonna classification. The prognosis is generally quite poor when it is associated with hip dislocation. Traumatic disruption of the triradiate cartilage is an uncommon lesion and may be associated with fusion of the physis with the possibility of progressive subluxation of the hip. We report an exceptional case combining a capital femoral transepiphyseal fracture and Salter-Harris type 2 triradiate cartilage injury that required surgical management. The anatomy of the lesion, the mechanism involved, and treatment options are discussed, along with a review of the literature.


Assuntos
Acetábulo/lesões , Cartilagem Articular/lesões , Fraturas Ósseas/diagnóstico por imagem , Fraturas de Cartilagem , Fraturas do Quadril/diagnóstico por imagem , Acetábulo/diagnóstico por imagem , Adolescente , Fraturas Ósseas/cirurgia , Fraturas do Quadril/cirurgia , Humanos , Masculino , Traumatismo Múltiplo/cirurgia , Radiografia
6.
Int Orthop ; 18(2): 114-5, 1994 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-8039954

RESUMO

We describe a patient with a sagittal fracture of the second cervical vertebral without neurological involvement. The mechanism is likely to be axial compression and lateral displacement. The fracture was treated in a Minerva plaster cast.


Assuntos
Vértebras Cervicais/lesões , Fraturas da Coluna Vertebral/diagnóstico por imagem , Adolescente , Moldes Cirúrgicos , Vértebras Cervicais/diagnóstico por imagem , Feminino , Humanos , Fraturas da Coluna Vertebral/cirurgia , Tomografia Computadorizada por Raios X
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