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Pesquisa : A02.835.232.087.090.850.600 [Categoria DeCS]
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[PMID]:28904732
[Au] Autor:Oukhouya MA; El Jaoud HA; Andaloussi S; Abdellaoui H; Atarraf K; Chater L; Afifi MA
[Ad] Endereço:CHU Hassan II Fès, Maroc.
[Ti] Título:[Type III Monteggia lesion: a rare association, about a case].
[Ti] Título:Lésion Monteggia du groupe III association rare, à propos d'un cas..
[So] Source:Pan Afr Med J;27:208, 2017.
[Is] ISSN:1937-8688
[Cp] País de publicação:Uganda
[La] Idioma:fre
[Ab] Resumo:Type III Monteggia lesion is very rare, usually occurring within a context of violent trauma and often going unnoticed. We report the case of a 11-year old boy presenting to the Emergency Department with blunt trauma of the upper limb. The radiological evaluation showed olecranon fracture and radial epiphyseal separation associated with dislocation of the radial head. The patient underwent orthopedic treatment with good outcome after a mean follow-up of 3 months.
[Mh] Termos MeSH primário: Fratura de Monteggia/diagnóstico
Procedimentos Ortopédicos/métodos
Ferimentos não Penetrantes/complicações
[Mh] Termos MeSH secundário: Criança
Serviço Hospitalar de Emergência
Seguimentos
Seres Humanos
Masculino
Fratura de Monteggia/etiologia
Fratura de Monteggia/cirurgia
Olécrano/lesões
Ferimentos não Penetrantes/diagnóstico
Ferimentos não Penetrantes/cirurgia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170925
[Lr] Data última revisão:
170925
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170915
[St] Status:MEDLINE
[do] DOI:10.11604/pamj.2017.27.208.9272


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[PMID]:28763412
[Au] Autor:Duckworth AD; Clement ND; White TO; Court-Brown CM; McQueen MM
[Ad] Endereço:1Edinburgh Orthopaedic Trauma Unit, Royal Infirmary of Edinburgh, Edinburgh, United Kingdom.
[Ti] Título:Plate Versus Tension-Band Wire Fixation for Olecranon Fractures: A Prospective Randomized Trial.
[So] Source:J Bone Joint Surg Am;99(15):1261-1273, 2017 Aug 02.
[Is] ISSN:1535-1386
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The aim of this single-center, single-blinded, prospective randomized trial was to compare the outcomes of tension-band wire (TBW) and plate fixation for simple isolated, displaced fractures of the olecranon. METHODS: We performed a prospective randomized trial involving 67 patients who were ≥16 to <75 years of age and had an acute isolated, displaced fracture of the olecranon. Patients were randomized to either TBW (n = 34) or plate fixation (n = 33) and were evaluated at 6 weeks, 3 months, 6 months, and 1 year following surgery. The primary outcome measure was the Disabilities of the Arm, Shoulder and Hand (DASH) score at 1 year. RESULTS: The baseline demographic and fracture characteristics of the 2 groups were comparable, except for age, which was lower in the TBW group. The 1-year follow-up rate was 85% (n = 57), with 84% (n = 56) completing the DASH. There was a significant improvement in the DASH score over the 1-year period following surgery (p < 0.001). At 1 year, the DASH score for the TBW group (12.8) did not differ significantly from that of the plate group (8.5) (p = 0.315). The groups also did not differ significantly in terms of range of motion, the Broberg and Morrey score, the Mayo Elbow Score, or the DASH at all assessment points over the 1 year (all p ≥ 0.05). Complication rates were significantly higher in the TBW group (63% compared with 38%; p = 0.042), predominantly because of a significantly higher rate of metalwork removal in symptomatic patients (50.0% compared with 22%; p = 0.021). Four infections occurred, all in the plate group (0% versus 13%; p = 0.114), as did 3 revision surgeries (0% versus 9.4%; p = 0.238). CONCLUSIONS: Among active patients with a simple isolated, displaced fracture of the olecranon, no difference was found between TBW and plate fixation in the patient-reported outcome at 1 year following surgery. The complication rate was higher following TBW fixation and was due to a higher rate of implant removal in symptomatic patients. However, the more serious complications of infection and the need for revision surgery occurred exclusively following plate fixation in this trial. LEVEL OF EVIDENCE: Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.
[Mh] Termos MeSH primário: Placas Ósseas
Fios Ortopédicos
Fixação Interna de Fraturas/instrumentação
Olécrano/lesões
Fraturas da Ulna/cirurgia
[Mh] Termos MeSH secundário: Adulto
Avaliação da Deficiência
Feminino
Seguimentos
Fixação Interna de Fraturas/métodos
Seres Humanos
Masculino
Meia-Idade
Estudos Prospectivos
Recuperação de Função Fisiológica
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171005
[Lr] Data última revisão:
171005
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170802
[St] Status:MEDLINE
[do] DOI:10.2106/JBJS.16.00773


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[PMID]:28663405
[Au] Autor:Duckworth AD; Clement ND; McEachan JE; White TO; Court-Brown CM; McQueen MM
[Ad] Endereço:Royal Infirmary of Edinburgh, 51 Little France Crescent, Edinburgh EH16 4SU, UK.
[Ti] Título:Prospective randomised trial of non-operative operative management of olecranon fractures in the elderly.
[So] Source:Bone Joint J;99-B(7):964-972, 2017 Jul.
[Is] ISSN:2049-4408
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:AIMS: The aim of this prospective randomised controlled trial was to compare non-operative and operative management for acute isolated displaced fractures of the olecranon in patients aged ≥ 75 years. PATIENTS AND METHODS: Patients were randomised to either non-operative management or operative management with either tension-band wiring or fixation with a plate. They were reviewed at six weeks, three and six months and one year after the injury. The primary outcome measure was the Disabilities of the Arm, Shoulder and Hand (DASH) score at one year. RESULTS: A total of 19 patients were randomised to non-operative (n = 8) or operative (n = 11; tension-band wiring (n = 9), plate (n = 2)) management. The trial was stopped prematurely as the rate of complications (nine out of 11, 81.8%) in the operative group was considered to be unacceptable. There was, however, no difference in the mean DASH scores between the groups at all times. The mean score was 23 (0 to 59.6) in the non-operative group and 22 (2.5 to 57.8) in the operative group, one year after the injury (p = 0.763). There was no significant difference between groups in the secondary outcome measures of the Broberg and Morrey Score or the Mayo Elbow Score at any time during the one year following injury (all p ≥ 0.05). CONCLUSION: These data further support the role of primary non-operative management of isolated displaced fractures of the olecranon in the elderly. However, the non-inferiority of non-operative management cannot be proved as the trial was stopped prematurely. Cite this article: 2017;99-B:964-72.
[Mh] Termos MeSH primário: Fixação de Fratura/métodos
Olécrano/lesões
Fraturas da Ulna/terapia
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Placas Ósseas
Fios Ortopédicos
Avaliação da Deficiência
Feminino
Seres Humanos
Masculino
Estudos Prospectivos
Resultado do Tratamento
Fraturas da Ulna/cirurgia
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170828
[Lr] Data última revisão:
170828
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170701
[St] Status:MEDLINE
[do] DOI:10.1302/0301-620X.99B7.BJJ-2016-1112.R2


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[PMID]:28602435
[Au] Autor:Uçkay I; von Dach E; Perez C; Agostinho A; Garnerin P; Lipsky BA; Hoffmeyer P; Pittet D
[Ad] Endereço:Orthopaedic Surgery Service, Medico-Economic Control, University of Geneva Hospitals and Faculty of Medicine, University of Geneva, Geneva, Switzerland; Service of Infectious Diseases, Medico-Economic Control, University of Geneva Hospitals and Faculty of Medicine, University of Geneva, Geneva, Swit
[Ti] Título:One- vs 2-Stage Bursectomy for Septic Olecranon and Prepatellar Bursitis: A Prospective Randomized Trial.
[So] Source:Mayo Clin Proc;92(7):1061-1069, 2017 Jul.
[Is] ISSN:1942-5546
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To assess the optimal surgical approach and costs for patients hospitalized with septic bursitis. PATIENTS AND METHODS: From May 1, 2011, through December 24, 2014, hospitalized patients with septic bursitis at University of Geneva Hospitals were randomized (1:1) to receive 1- vs 2-stage bursectomy. All the patients received postsurgical oral antibiotic drug therapy for 7 days. RESULTS: Of 164 enrolled patients, 130 had bursitis of the elbow and 34 of the patella. The surgical approach used was 1-stage in 79 patients and 2-stage in 85. Overall, there were 22 treatment failures: 8 of 79 patients (10%) in the 1-stage arm and 14 of 85 (16%) in the 2-stage arm (Pearson χ test; P=.23). Recurrent infection was caused by the same pathogen in 7 patients (4%) and by a different pathogen in 5 (3%). Outcomes were better in the 1- vs 2-stage arm for wound dehiscence for elbow bursitis (1 of 66 vs 9 of 64; Fisher exact test P=.03), median length of hospital stay (4.5 vs 6.0 days), nurses' workload (605 vs 1055 points), and total costs (Swâ‚£6881 vs Swâ‚£11,178; all P<.01). CONCLUSION: For adults with moderate to severe septic bursitis requiring hospital admission, bursectomy with primary closure, together with antibiotic drug therapy for 7 days, was safe, effective, and resource saving. Using a 2-stage approach may be associated with a higher rate of wound dehiscence for olecranon bursitis than the 1-stage approach. TRIAL REGISTRATION: Clinicaltrials.gov Identifier: NCT01406652.
[Mh] Termos MeSH primário: Antibacterianos/administração & dosagem
Bursite/tratamento farmacológico
Olécrano/cirurgia
Patela/cirurgia
[Mh] Termos MeSH secundário: Bursite/economia
Bursite/patologia
Bursite/cirurgia
Articulação do Cotovelo/cirurgia
Feminino
Hospitalização
Seres Humanos
Masculino
Meia-Idade
Olécrano/patologia
Patela/patologia
Estudos Prospectivos
Infecções Estafilocócicas/tratamento farmacológico
Infecções Estafilocócicas/microbiologia
Staphylococcus aureus/isolamento & purificação
Suíça
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Anti-Bacterial Agents)
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170731
[Lr] Data última revisão:
170731
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170613
[St] Status:MEDLINE


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[PMID]:28514292
[Au] Autor:Persiani P; Ranaldi FM; Graci J; De Cristo C; Zambrano A; D'Eufemia P; Martini L; Villani C
[Ad] Endereço:aDepartment of Anatomical Sciences, Histological, Forensic Medicine and Locomotive System bDepartment of Pediatrics, Sapienza University of Rome, Rome, Italy.
[Ti] Título:Isolated olecranon fractures in children affected by osteogenesis imperfecta type I treated with single screw or tension band wiring system: Outcomes and pitfalls in relation to bone mineral density.
[So] Source:Medicine (Baltimore);96(20):e6766, 2017 May.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The purpose of this study is to compare the results of 2 techniques, tension band wiring (TBW) and fixation with screws, in olecranon fractures in children affected with osteogenesis imperfecta (OI) type I. Between 2010 and 2014, 21 olecranon fractures in 18 children with OI (average age: 12 years old) were treated surgically. Ten patients were treated with the screw fixation and 11 with TBW. A total of 65% of olecranon fractures occurred as a result of a spontaneous avulsion of the olecranon during the contraction of the triceps muscle. The average follow-up was 36 months. Among the children treated with 1 screw, 5 patients needed a surgical revision with TBW due to a mobilization of the screw. In this group, the satisfactory results were 50%. In patients treated with TBW, the satisfactory results were 100% of the cases. The average Z-score, the last one recorded in the patients before the trauma, was -2.53 in patients treated with screw fixation and -2.04 in those treated with TBW. TBW represents the safest surgical treatment for patients suffering from OI type I, as it helps to prevent the rigidity of the elbow through an earlier recovery of the range of motion, and there was no loosening of the implant. In analyzing the average Z-score before any fracture, the fixation with screws has an increased risk of failure in combination with low bone mineral density.
[Mh] Termos MeSH primário: Densidade Óssea
Fixação Interna de Fraturas
Olécrano/lesões
Olécrano/cirurgia
Osteogênese Imperfeita/complicações
[Mh] Termos MeSH secundário: Adolescente
Parafusos Ósseos
Fios Ortopédicos
Criança
Feminino
Seguimentos
Seres Humanos
Masculino
Olécrano/diagnóstico por imagem
Olécrano/metabolismo
Osteogênese Imperfeita/diagnóstico por imagem
Osteogênese Imperfeita/metabolismo
Osteogênese Imperfeita/cirurgia
Falha de Prótese
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170613
[Lr] Data última revisão:
170613
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170518
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000006766


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[PMID]:28303286
[Au] Autor:Gierer P; Wichelhaus A; Rotter R
[Ad] Endereço:Klinik und Poliklinik für Chirurgie, Abteilung für Unfall-, Hand- & Wiederherstellungschirurgie, Universitätsmedizin Rostock, Schillingallee 35, 18057, Rostock, Deutschland. philip.gierer@med.uni-rostock.de.
[Ti] Título:[Fractures of the olecranon].
[Ti] Título:Die Olekranonfraktur..
[So] Source:Oper Orthop Traumatol;29(2):107-114, 2017 Apr.
[Is] ISSN:1439-0981
[Cp] País de publicação:Germany
[La] Idioma:ger
[Ab] Resumo:OBJECTIVE: Fractures of the olecranon are the most common fractures of the elbow in adults. Due to the dislocating force of the triceps muscle, internal fixation is the treatment of choice. INDICATIONS: All fractures of the olecranon without contraindications. CONTRAINDICATIONS: Infection and severe soft tissue damage. SURGICAL TECHNIQUE: Dorsal approach to the olecranon with the patient in a prone position. Open reduction and internal fixation with tension band wiring or plate fixation according to fracture pattern. POSTOPERATIVE MANAGEMENT: Treatment goal is early functional mobilization. No load bearing allowed for 6-8 weeks; full load bearing is allowed after fracture healing. RESULTS: The quality of published studies concerning the surgical treatment of olecranon fractures is poor. Published functional results are predominantly good and excellent. Hardware removal was often required.
[Mh] Termos MeSH primário: Fixação Interna de Fraturas/instrumentação
Olécrano/lesões
Olécrano/cirurgia
Redução Aberta/instrumentação
Fraturas da Ulna/reabilitação
Fraturas da Ulna/cirurgia
[Mh] Termos MeSH secundário: Terapia Combinada/métodos
Articulação do Cotovelo/lesões
Articulação do Cotovelo/cirurgia
Medicina Baseada em Evidências
Fixação Interna de Fraturas/métodos
Fixação Interna de Fraturas/reabilitação
Consolidação da Fratura
Seres Humanos
Redução Aberta/reabilitação
Recuperação de Função Fisiológica
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171113
[Lr] Data última revisão:
171113
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170318
[St] Status:MEDLINE
[do] DOI:10.1007/s00064-017-0490-z


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[PMID]:28090003
[Au] Autor:Sakai K; Shirahama M; Shiba N; Yoshida K; Yoshida S
[Ad] Endereço:Department of Orthopedic Surgery, St. Mary's Hospital.
[Ti] Título:Primary Hinged External Fixation of Terrible Triad Injuries and Olecranon Fracture-Dislocations of the Elbow.
[So] Source:Kurume Med J;63(1.2):7-14, 2017 Apr 13.
[Is] ISSN:1881-2090
[Cp] País de publicação:Japan
[La] Idioma:eng
[Ab] Resumo:This study aimed to introduce a new treatment that apples primary hinged external fixation for complex fracture-dislocations of the elbow in 12 cases. We retrospectively assessed the functional outcomes of eight patients with terrible triad injuries and three patients with an olecranon fracture-dislocation of the elbow, who were treated at our hospital using a primary hinged external fixator between June 2012 and December 2014. Ten patients underwent repair or replacement of the radial head, while three underwent repair of the olecranon. In principle, they were treated without reconstruction of the coronoid fracture and collateral ligament injury. The patients were evaluated for a mean follow-up period of 16 months after the initial surgery. Early mobilization was encouraged while the hinged external fixator was in place. At the follow-up, the mean Mayo Elbow Performance Score was 93 points; the results were "excellent" in six cases and "good" in five. No patients had recurrent elbow instability. Only one patient needed an additional procedure after the initial operation. These results suggested that primary hinged external fixation without repair of the ligament and soft tissue is an effective minimally invasive surgery for the management of terrible triad injuries and olecranon fracture-dislocations of the elbow.
[Mh] Termos MeSH primário: Articulação do Cotovelo/lesões
Fixadores Externos
Fixação de Fratura/métodos
Fraturas Ósseas/cirurgia
Luxações Articulares/cirurgia
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Cotovelo/lesões
Cotovelo/cirurgia
Articulação do Cotovelo/cirurgia
Feminino
Seguimentos
Fratura-Luxação
Seres Humanos
Instabilidade Articular/fisiopatologia
Masculino
Meia-Idade
Olécrano/cirurgia
Rádio (Anatomia)/cirurgia
Fraturas do Rádio/cirurgia
Amplitude de Movimento Articular
Estudos Retrospectivos
Ulna/cirurgia
Fraturas da Ulna/cirurgia
Articulação do Punho
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170928
[Lr] Data última revisão:
170928
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170117
[St] Status:MEDLINE
[do] DOI:10.2739/kurumemedj.MS6300003


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[PMID]:27886684
[Au] Autor:Hopkins CM; Calandruccio JH; Mauck BM
[Ad] Endereço:Department of Orthopaedic Surgery and Biomedical Engineering, University of Tennessee-Campbell Clinic, 1211 Union Avenue, Suite 510, Memphis, TN 38104, USA.
[Ti] Título:Controversies in Fractures of the Proximal Ulna.
[So] Source:Orthop Clin North Am;48(1):71-80, 2017 Jan.
[Is] ISSN:1558-1373
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The olecranon process, coronoid process, and greater sigmoid notch are important components of the complex proximal ulna. Along with providing bony stability to the ulnohumeral joint, the proximal ulna serves as the attachment site of many important muscles and ligaments that impart soft tissue stability to the elbow joint. Management of proximal ulnar fractures continues to evolve as advances in imaging and anatomic and biomechanical studies have led to improvements in available implants; however, controversies remain, as shown in the current relevant literature.
[Mh] Termos MeSH primário: Fixação Interna de Fraturas/métodos
Olécrano/lesões
Fraturas da Ulna/cirurgia
[Mh] Termos MeSH secundário: Seres Humanos
Olécrano/cirurgia
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1701
[Cu] Atualização por classe:170131
[Lr] Data última revisão:
170131
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:161126
[St] Status:MEDLINE


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[PMID]:27876362
[Au] Autor:Robinson PM; Loosemore M; Watts AC
[Ad] Endereço:Upper Limb Unit, Wrightington Hospital, Wigan, Lancashire, UK. Electronic address: paulrobinson79@doctors.org.uk.
[Ti] Título:Boxer's elbow: internal impingement of the coronoid and olecranon process. A report of seven cases.
[So] Source:J Shoulder Elbow Surg;26(3):376-381, 2017 Mar.
[Is] ISSN:1532-6500
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Boxer's elbow has been described in the literature as an extension and hyperextension injury. However, in our experience, there is a coexisting impingement lesion in the anterior compartment of the elbow that has not previously been described. We report a series of professional boxers with elbow disease treated arthroscopically. The aim of the paper was to accurately describe the pathoanatomy of the condition, the key points in its diagnosis, and the outcomes of surgical treatment. METHODS: Seven professional boxers were treated for symptomatic elbow disease. Clinical evaluation included range of motion and Disabilities of the Arm, Shoulder, and Hand score. The arthroscopic findings and procedures were documented. RESULTS: Symptoms were mainly those of anterior and posterior impingement; 6 elbows had an anterior impingement lesion and 6 had a posterior impingement lesion. Postoperatively, the mean Disabilities of the Arm, Shoulder, and Hand score was 2.7 (range, 0-13.3) at a median of 15 (range, 6-36) months postoperatively. All boxers returned to their previous level of competition and 5 won their next bout. All of the boxers used an orthodox stance, and in all but 1 case the left elbow was the pathologic elbow. CONCLUSION: Boxers are prone to development of anterior and posterior elbow impingement. The side of the pathologic process is related to the boxer's stance, with the lead arm being more vulnerable. Arthroscopic débridement is an effective treatment, enabling return to a high competitive level. Surgeons, sports medicine physicians, and physiotherapists should be aware of the condition.
[Mh] Termos MeSH primário: Artroscopia/métodos
Desbridamento/métodos
Articulação do Cotovelo/lesões
Articulação do Cotovelo/cirurgia
Olécrano/lesões
[Mh] Termos MeSH secundário: Adulto
Articulação do Cotovelo/diagnóstico por imagem
Feminino
Seres Humanos
Masculino
Olécrano/diagnóstico por imagem
Olécrano/cirurgia
Amplitude de Movimento Articular
Resultado do Tratamento
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1703
[Cu] Atualização por classe:170817
[Lr] Data última revisão:
170817
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161124
[St] Status:MEDLINE


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[PMID]:27832347
[Au] Autor:Lubberts B; Mellema JJ; Janssen SJ; Ring D
[Ad] Endereço:Orthopaedic Hand and Upper Extremity Service, Massachusetts General Hospital, Harvard Medical School, Boston, USA.
[Ti] Título:Fracture line distribution of olecranon fractures.
[So] Source:Arch Orthop Trauma Surg;137(1):37-42, 2017 Jan.
[Is] ISSN:1434-3916
[Cp] País de publicação:Germany
[La] Idioma:eng
[Ab] Resumo:PURPOSE: The association between specific olecranon fracture characteristics (e.g., displacement, fragmentation, subluxation) and fracture line distribution might help surgeons predict intra-articular fracture location based on fracture characteristics that can be determined on radiographs. We hypothesized that fracture mapping techniques would reveal different fracture patterns for minimally displaced fractures, displaced fractures, and fracture-dislocations of the olecranon. METHODS: A consecutive series of 78 patients with olecranon fractures were evaluated using initial radiographs and computed tomography scans and characterized according to the Mayo classification. Fracture lines were identified based on reduced three-dimensional computed tomography reconstructions and graphically superimposed onto a standard template to create two-dimensional fracture maps. The fracture maps were then converted into fracture heat maps. Based on fracture and heat maps, fracture line location and patterns were determined. RESULTS: Six (7.7%) patients had a non- or minimally displaced fracture, 22 (28%) a displaced fracture, and 50 (64%) a fracture-dislocation of the olecranon. There were 27 (54%) anterior and 23 (46%) posterior olecranon fracture-dislocations. Fracture lines of non- or minimally displaced fractures and posterior fracture-dislocations enter and exit the trochlear notch at the base of the coronoid, while fracture lines of displaced fractures and anterior fracture-dislocations were spread more broadly over the depths of the trochlear notch. CONCLUSIONS: Based on fracture characteristics depicted on radiographs, one can anticipate the amount of the olecranon involved (how close is the fracture line to the coronoid) and the orientation of the fracture line. Computer tomography could be reserved for when more specific knowledge of the fracture line might affect treatment. LEVEL OF EVIDENCE: III.
[Mh] Termos MeSH primário: Fraturas Intra-Articulares/diagnóstico por imagem
Olécrano/diagnóstico por imagem
Olécrano/lesões
Fraturas da Ulna/diagnóstico por imagem
[Mh] Termos MeSH secundário: Idoso
Articulação do Cotovelo/diagnóstico por imagem
Articulação do Cotovelo/cirurgia
Feminino
Fratura-Luxação/diagnóstico por imagem
Fratura-Luxação/cirurgia
Seres Humanos
Imagem Tridimensional
Fraturas Intra-Articulares/cirurgia
Masculino
Meia-Idade
Radiografia
Estudos Retrospectivos
Tomografia Computadorizada por Raios X
Fraturas da Ulna/cirurgia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1703
[Cu] Atualização por classe:170817
[Lr] Data última revisão:
170817
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161111
[St] Status:MEDLINE
[do] DOI:10.1007/s00402-016-2593-7



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