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Pesquisa : A02.835.232.087.319.550 [Categoria DeCS]
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  1 / 1143 MEDLINE  
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[PMID]:29252749
[Au] Autor:Mahan MC; Frisch N; Durrant B; Parsons T; Woods T; Mott M
[Ad] Endereço:Department of Orthopaedic Surgery, Henry Ford Health System, Detroit, Michigan.
[Ti] Título:Ewing Sarcoma in the Fifth Metacarpal of an Adult Woman: A Case Report.
[So] Source:JBJS Case Connect;6(4):e95, 2016 Oct-Dec.
[Is] ISSN:2160-3251
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:CASE: Atypical presentations of Ewing sarcoma (ES) can lead to misdiagnosis and delays in treatment. We present a rare case of ES in the hand of an adult woman who underwent multiple interventions prior to referral to our institution. At 22 months after definitive treatment, the patient remained pleased with the result and had no evidence of recurrence. CONCLUSION: To our knowledge, ES of the hand in an adult woman has not yet been reported in the literature, and a lack of recognition of this condition might be secondary to the absence of features traditionally associated with malignant bone neoplasms. A broader differential diagnosis after intervention failures offers the opportunity for diagnosis and appropriate treatment.
[Mh] Termos MeSH primário: Neoplasias Ósseas/terapia
Ossos Metacarpais/cirurgia
Sarcoma de Ewing/terapia
[Mh] Termos MeSH secundário: Neoplasias Ósseas/diagnóstico por imagem
Neoplasias Ósseas/patologia
Feminino
Seres Humanos
Ossos Metacarpais/diagnóstico por imagem
Ossos Metacarpais/patologia
Meia-Idade
Sarcoma de Ewing/diagnóstico por imagem
Sarcoma de Ewing/patologia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180216
[Lr] Data última revisão:
180216
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171219
[St] Status:MEDLINE
[do] DOI:10.2106/JBJS.CC.16.00051


  2 / 1143 MEDLINE  
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[PMID]:28467335
[Au] Autor:Pogliacomi F; Mijno E; Pedrazzini A; Tocco S; Tonani M; Ceccarelli F; Vaienti E
[Ad] Endereço:PARMA UNIVERSITY DEPARTMENT OF MEDICINE AND SURGERY ORTHOPAEDIC AND TRAUMATOLOGY SECTION. fpogliacomi@yahoo.com.
[Ti] Título:Fifth metacarpal neck fractures: fixation with antegrade locked flexible intramedullary nailing.
[So] Source:Acta Biomed;88(1):57-64, 2017 Apr 28.
[Is] ISSN:0392-4203
[Cp] País de publicação:Italy
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Fifth metacarpal neck fractures (commonly named "boxer's fractures") are the most common metacarpal injuries and usually affect young active people. These lesions are mainly treated conservatively. Their surgical management, if indicated, is still a matter of debate. Different procedures have been described. The aim of this study was to evaluate the outcomes of 18 boxer's fractures which were synthesized with antegrade locked flexible intramedullary nailing. MATERIALS AND METHODS: All patients, at a mean follow-up of 45 months, were clinically evaluated using the Disabilities of the Arm, Shoulder and Hand (DASH) score and the Patient Rated Wrist/Hand Evaluation (PRWHE). Active and passive range of motion (ROM) of metacarpo-phalangeal (MP), proximal and distal interphalangeal (PIP and DIP) joints and Total Active Motion (TAM), and grip strength were also analyzed. Apex dorsal angulation and axial shortening were radiologically measured preoperatively and at final follow-up. RESULTS: Clinical and radiological results which were observed were satisfactory. No TAM and grip strength differences were recorded between the operated and healthy contralateral hand. CONCLUSIONS: According to the positive outcomes and the low rate of complications of this study, antegrade locked flexible intramedullary nailing can be considered a valid treatment option in boxer's fractures.
[Mh] Termos MeSH primário: Fixação Intramedular de Fraturas
Fraturas Ósseas/cirurgia
Ossos Metacarpais/cirurgia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Avaliação da Deficiência
Feminino
Seguimentos
Consolidação da Fratura
Força da Mão
Seres Humanos
Masculino
Ossos Metacarpais/lesões
Meia-Idade
Amplitude de Movimento Articular
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180125
[Lr] Data última revisão:
180125
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170504
[St] Status:MEDLINE
[do] DOI:10.23750/abm.v88i1.6195


  3 / 1143 MEDLINE  
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[PMID]:28963156
[Au] Autor:Yalizis MA; Ek ETH; Anderson H; Couzens G; Hoy GA
[Ad] Endereço:Melbourne Orthopaedic Group and Department of Upper Limb Surgery, 33 The Avenue, Windsor VIC 3181, Australia.
[Ti] Título:Early unprotected return to contact sport after metacarpal fixation in professional athletes.
[So] Source:Bone Joint J;99-B(10):1343-1347, 2017 Oct.
[Is] ISSN:2049-4408
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:AIMS: To determine whether an early return to sport in professional Australian Rules Football players after fixation of a non-thumb metacarpal fracture was safe and effective. PATIENTS AND METHODS: A total of 16 patients with a mean age of 25 years (19 to 30) identified as having a non-thumb metacarpal fracture underwent open reduction and internal plate and screw fixation. We compared the players' professional performance statistics before and after the injury to determine whether there was any deterioration in their post-operative performance. RESULTS: Of the 16, 12 sustained their fracture during the season: their mean time to return to unrestricted professional play was two weeks (1 to 5). All except two of the 48 player performance variables showed no reduction in performance post-operatively. CONCLUSION: Our data suggest that professional athletes who sustained a non-thumb metacarpal fracture can safely return to professional play without restriction two weeks after internal fixation. Cite this article: 2017;99-B:1343-7.
[Mh] Termos MeSH primário: Atletas
Placas Ósseas
Parafusos Ósseos
Fixação Interna de Fraturas/métodos
Fraturas Ósseas/cirurgia
Ossos Metacarpais/lesões
Recuperação de Função Fisiológica
[Mh] Termos MeSH secundário: Adulto
Feminino
Seguimentos
Fraturas Ósseas/diagnóstico
Fraturas Ósseas/fisiopatologia
Seres Humanos
Masculino
Ossos Metacarpais/diagnóstico por imagem
Estudos Retrospectivos
Fatores de Tempo
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171012
[Lr] Data última revisão:
171012
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171001
[St] Status:MEDLINE
[do] DOI:10.1302/0301-620X.99B10.BJJ-2016-0686.R3


  4 / 1143 MEDLINE  
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[PMID]:28816972
[Au] Autor:Yokoi T; Uemura T; Kazuki K; Onode E; Shintani K; Okada M; Nakamura H
[Ad] Endereço:aDepartment of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, Osaka bGakuen-minami Clinic, Nara, Japan.
[Ti] Título:Low second to fourth digit ratio in Dupuytren disease.
[So] Source:Medicine (Baltimore);96(33):e7801, 2017 Aug.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The ratio of the lengths of the second and fourth digits (2D:4D) has been described as reflecting endogenous prenatal androgen exposure. In general, 2D:4D is lower in men than in women and has potential as a biomarker or predictor for various diseases, athletic ability, and academic performance. Dupuytren disease has digital flexion contractures and is known to predominate in men, but the pathogenesis of the disease remains unclear. To clarify the relationships between Dupuytren disease and endogenous androgens, we performed a retrospective analysis of hand radiographs to investigate 2D:4D in Dupuytren disease. The study included male patients with Dupuytren disease (n = 22) and a control group (n = 18) of male patients with carpal tunnel syndrome. Only unaffected hands, without contractures or osteoarthritis, were evaluated for the purpose of radiographic assessment. The lengths of the phalanx and metacarpal bones in the second and fourth digits were measured by 2 independent observers who each performed 2 sets of measurements separated by a minimum 1-week interval. The 2D:4D was calculated separately for the phalanges and metacarpals, and a combined (phalanx + metacarpal) 2D:4D was also calculated. The reliability of the observer measurements was established using the intraclass correlation coefficient, and both the intra- and interobserver reliability showed excellent agreement. We found that compared with control group, the Dupuytren disease group had significantly lower phalanx and combined 2D:4D. These findings suggest that endogenous prenatal androgens could contribute to the development of Dupuytren disease, leading to its characteristic clinical presentation predominantly in men and affecting the ulnar rays.
[Mh] Termos MeSH primário: Contratura de Dupuytren/patologia
Falanges dos Dedos da Mão/anatomia & histologia
Ossos Metacarpais/anatomia & histologia
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Androgênios/sangue
Estudos de Casos e Controles
Falanges dos Dedos da Mão/diagnóstico por imagem
Seres Humanos
Masculino
Ossos Metacarpais/diagnóstico por imagem
Meia-Idade
Reprodutibilidade dos Testes
Estudos Retrospectivos
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Nm] Nome de substância:
0 (Androgens)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170911
[Lr] Data última revisão:
170911
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170818
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000007801


  5 / 1143 MEDLINE  
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[PMID]:28767568
[Au] Autor:Shen H; Shen XQ; Lv Y; Lu H; Xu JH; Wu SC
[Ad] Endereço:aDepartment of Hand Surgery and Microsurgery Center, The First Affiliated Hospital, College of Medicine, ZheJiang University bThe Children's Hospital, Zhejiang University School of Medicine cDepartment of Plastic Surgery, The First Affiliated Hospital, College of Medicine, ZheJiang University, HangZhou, ZheJiang Province, China.
[Ti] Título:Three-dimensional virtual planning in precise chimeric fibula free flap for metacarpal defects: A case report.
[So] Source:Medicine (Baltimore);96(31):e7364, 2017 Aug.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Metacarpal and phalanx defects with soft tissue loss were suggested to be reconstructed by vascularized bone flap. The fibular osteocutaneous flap is a preferred method. Three-dimensional virtual planning has successfully applied in mandibular reconstruction with fibular free flap. We applied three-dimensional virtual planning in precise fibula flap harvest to maintain the continuity of the fibula and to achieve accurate metacarpal and phalanx reconstruction. PATIENT CONCERNS: A 35-year-old male presented with extensive soft tissue defects and first metacarpal defect involving the first metacarpophalangeal joint. DIAGNOSES: There were 4 cm of first metacarpal defect involving the first metacarpophalangeal joint and soft tissue defects of 5cm × 3cm + 3cm × 2cm. INTERVENTIONS: By combining three-dimensional virtual planning, we harvested a chimeric fibular flap. The precise fibula partial osteotomies were performed with cutting guides designed in virtual planning. OUTCOMES: All the chimeric flaps survived and no significant donor-site morbidity was noted. Michigan Hand Outcome Questionnaire scores indicated acceptable functional results. LESSONS: Our preliminary experience with the approach of three-dimensional virtual planning in precise chimeric fibula free flap is practical and efficient. Although more cases and follow-up are needed to evaluate it, this approach is expected to benefit patients.
[Mh] Termos MeSH primário: Fíbula/transplante
Retalhos de Tecido Biológico
Ossos Metacarpais/diagnóstico por imagem
Ossos Metacarpais/cirurgia
Procedimentos Cirúrgicos Reconstrutivos
Cirurgia Assistida por Computador
[Mh] Termos MeSH secundário: Adulto
Lesões por Esmagamento/diagnóstico por imagem
Lesões por Esmagamento/cirurgia
Retalhos de Tecido Biológico/irrigação sanguínea
Traumatismos da Mão/diagnóstico por imagem
Traumatismos da Mão/cirurgia
Seres Humanos
Imagem Tridimensional
Masculino
Ossos Metacarpais/lesões
Procedimentos Cirúrgicos Reconstrutivos/métodos
Interface Usuário-Computador
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:171013
[Lr] Data última revisão:
171013
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170803
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000007364


  6 / 1143 MEDLINE  
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[PMID]:28682860
[Au] Autor:Liodaki E; Wendlandt R; Waizner K; Schopp BE; Mailänder P; Stang F
[Ad] Endereço:aDepartment of Plastic, Hand Surgery and Burn Care Unit, University Hospital Schleswig-Holstein bLaboratory for Biomechanics, University Medical Center Schleswig-Holstein, Lübeck, Germany.
[Ti] Título:A biomechanical analysis of plate fixation using unicortical and bicortical screws in transverse metacarpal fracture models subjected to 4-point bending and dynamical bending test.
[So] Source:Medicine (Baltimore);96(27):e6926, 2017 Jul.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:In the published literature there are controversial data to the biomechanical stability of monocortical comparing to the bicortical fixation of metacarpal fractures. The aim of this study was to compare the biomechanical stability of monocortical and bicortical locking osteosynthesis in quasi-static and dynamic 4-point bending tests of composite third metacarpal bone (4th Gen third metacarpal, Sawbones, Malmö, Sweden) fixed with 7-hole locking plate (XXS System, Biotech-Ortho, Wright, Memphis, TN). The tests to determine quasi-static yield and bending strength as well as fatigue strength were conducted in 4 groups of 10 samples after creating standardized mid-shaft transverse osteotomies using a diamont belt grinder (0.3 mm saw blade). The force applied was the dorsal apex loading, similar to the forces applied to metacarpals during normal finger flexion and extension.In the quasi-static testing, no plate breakage was observed in each group. All metacarpals broke at their thinnest part. The average bending strength of the bicortical samples (10.54 ±â€Š0.998 Nm) was significantly higher comparing to the monocortical samples (8.57 ±â€Š0.894 Nm) (P < .001).In the dynamic loading test, all constructs (8 monocortical samples and 7 bicortical) that failed broke at the osteotomy site and the average fatigue strength did not differ in both groups.Consequently, a unicortical plating method may provide adequate strength and stability to metacarpal fractures based on the results of the cyclical loading representative of in vivo loading.
[Mh] Termos MeSH primário: Placas Ósseas
Parafusos Ósseos
Fraturas Ósseas/cirurgia
Ossos Metacarpais/lesões
Ossos Metacarpais/cirurgia
Modelos Teóricos
[Mh] Termos MeSH secundário: Fenômenos Biomecânicos
Substitutos Ósseos
Elasticidade
Análise de Falha de Equipamento
Dedos/fisiopatologia
Dedos/cirurgia
Fixação Interna de Fraturas
Fraturas Ósseas/fisiopatologia
Seres Humanos
Ossos Metacarpais/fisiopatologia
Movimento/fisiologia
Osteotomia
Falha de Prótese
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Bone Substitutes)
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170724
[Lr] Data última revisão:
170724
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170707
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000006926


  7 / 1143 MEDLINE  
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[PMID]:28654615
[Au] Autor:Wong VW; Higgins JP
[Ad] Endereço:Baltimore, Md. From The Curtis National Hand Center.
[Ti] Título:Evidence-Based Medicine: Management of Metacarpal Fractures.
[So] Source:Plast Reconstr Surg;140(1):140e-151e, 2017 Jul.
[Is] ISSN:1529-4242
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:LEARNING OBJECTIVES: After reading this article, the participant should be able to: 1. Understand metacarpal anatomy and its role in fracture pathology. 2. Determine when surgical intervention is needed for metacarpal fractures. 3. Understand the various treatment options for surgical fixation of metacarpal fractures. 4. Describe the role for external fixation in managing difficult metacarpal fractures. BACKGROUND: Metacarpal fractures are common injuries that plastic surgeons should be able to evaluate and treat. The goal of this review is to highlight current evidence for managing metacarpal fractures. This Continuing Medical Education article consists of a literature review, illustrations, videos, and an online Continuing Medical Education examination. METHODS: The authors reviewed the scientific literature from 2000 to 2015 regarding treatment of metacarpal fractures. Cadaver models were used for instructional videography demonstrating common surgical techniques. Multiple-choice questions were created to review pertinent topics. A discussion and references are provided. RESULTS: Numerous treatment options have been described for metacarpal fractures, including splinting, percutaneous fixation, open reduction with internal fixation, and external fixation. All modalities are acceptable strategies for treating metacarpal fractures. The ultimate goal is to maximize hand function with minimal morbidity. CONCLUSIONS: A thorough understanding of treatment modalities is helpful in evaluating and managing metacarpal fractures. Although the current literature supports a wide array of treatment strategies, high-level evidence to guide fracture management remains lacking.
[Mh] Termos MeSH primário: Medicina Baseada em Evidências
Fixação de Fratura/métodos
Fraturas Ósseas/terapia
Ossos Metacarpais/lesões
[Mh] Termos MeSH secundário: Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW; VIDEO-AUDIO MEDIA
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170907
[Lr] Data última revisão:
170907
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170628
[St] Status:MEDLINE
[do] DOI:10.1097/PRS.0000000000003470


  8 / 1143 MEDLINE  
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[PMID]:28606622
[Au] Autor:Chi Z; Song DJ; Tian L; Hu FH; Shen XF; Chim H
[Ad] Endereço:Department of Orthopedic Surgery, The Second Affiliated Hospital of Wenzhou Medical College, Wenzhou, China.
[Ti] Título:Reconstruction of combined thumb amputation at the metacarpal base level and index amputation at the metacarpal level with pollicization and bilateral double toe composite transfer.
[So] Source:J Plast Reconstr Aesthet Surg;70(8):1009-1016, 2017 Aug.
[Is] ISSN:1878-0539
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: This study aimed to describe the technique and report our experience with the reconstruction of combined proximal thumb amputations at the metacarpal base level and index finger amputation at the metacarpal level with pollicization and bilateral double toe composite transfer. METHODS: The technique consists of pollicization of the remnant index ray. Then a contralateral composite medial great toe pulp and vascularized second toe proximal interphalangeal joint flap are harvested to reconstruct the metacarpophalangeal joint of the thumb. Subsequently, an ipsilateral composite great toe wrap-around and second toe proximal interphalangeal joint flap are harvested to reconstruct the thumb interphalangeal joint and the distal thumb. A neurotized superthin anterolateral thigh flap is used to reconstruct the ipsilateral toe defect, while the bone defects of the bilateral second toes are reconstructed with corticocancellous iliac crest bone grafts. Between 2010 and 2014, eight patients underwent reconstruction. Four patients could be recalled for follow-up, with a mean duration of 22 months. RESULTS: All flaps survived. The contour and length of the reconstructed thumbs was similar to the contralateral one. The mean Michigan hand outcomes questionnaire score was 80.5. The mean disabilities of the arm, shoulder and hand score was 7.5. The mean foot and ankle disability index score was 94.2. CONCLUSIONS: Reconstruction of thumb amputations at the metacarpal base level with pollicization and double toe composite transfer results in excellent contour and functional outcome, with a natural-appearing thumb. In addition, all toes are preserved. LEVEL OF EVIDENCE: Therapeutic, Level IV.
[Mh] Termos MeSH primário: Traumatismos dos Dedos/cirurgia
Hálux/transplante
Procedimentos Cirúrgicos Reconstrutivos/métodos
Retalhos Cirúrgicos
Polegar/cirurgia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Amputação Traumática/cirurgia
Feminino
Seres Humanos
Masculino
Ossos Metacarpais/lesões
Articulação Metacarpofalângica/cirurgia
Estudos Retrospectivos
Polegar/lesões
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170906
[Lr] Data última revisão:
170906
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170614
[St] Status:MEDLINE


  9 / 1143 MEDLINE  
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[PMID]:28581022
[Au] Autor:Beauchesne P; Agarwal SC
[Ad] Endereço:Department of Behavioral Sciences, University of Michigan, Dearborn, Michigan.
[Ti] Título:A multi-method assessment of bone maintenance and loss in an Imperial Roman population: Implications for future studies of age-related bone loss in the past.
[So] Source:Am J Phys Anthropol;164(1):41-61, 2017 Sep.
[Is] ISSN:1096-8644
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: One of the hallmarks of contemporary osteoporosis and bone loss is dramatically higher prevalence of loss and fragility in females post-menopause. In contrast, bioarchaeological studies of bone loss have found a greater diversity of age- and sex-related patterns of bone loss in past populations. We argue that the differing findings may relate to the fact that most studies use only a single methodology to quantify bone loss and do not account for the heterogeneity and complexity of bone maintenance across the skeleton and over the life course. METHODS: We test the hypothesis that bone mass and maintenance in trabecular bone sites versus cortical bone sites will show differing patterns of age-related bone loss, with cortical bone sites showing sex difference in bone loss that are similar to contemporary Western populations, and trabecular bone loss at earlier ages. We investigated this hypothesis in the Imperial Roman population of Velia using three methods: radiogrammetry of the second metacarpal (N = 71), bone histology of ribs (N = 70), and computerized tomography of trabecular bone architecture (N = 47). All three methods were used to explore sex and age differences in patterns of bone loss. RESULTS: The suite of methods utilized reveal differences in the timing of bone loss with age, but all methods found no statistically significant differences in age-related bone loss. DISCUSSION: We argue that a multi-method approach reduces the influence of confounding factors by building a reconstruction of bone turnover over the life cycle that a limited single-method project cannot provide. The implications of using multiple methods beyond studies of bone loss are also discussed.
[Mh] Termos MeSH primário: Antropometria/métodos
Densidade Óssea/fisiologia
Remodelação Óssea/fisiologia
Osteoporose/patologia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Anatomia Transversal
Feminino
História Antiga
Seres Humanos
Itália
Masculino
Ossos Metacarpais/diagnóstico por imagem
Ossos Metacarpais/patologia
Meia-Idade
Osteoporose/diagnóstico por imagem
Osteoporose/história
Paleopatologia
Costelas/diagnóstico por imagem
Costelas/patologia
Mundo Romano/história
Tomografia Computadorizada por Raios X
Adulto Jovem
[Pt] Tipo de publicação:HISTORICAL ARTICLE; JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170911
[Lr] Data última revisão:
170911
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170606
[St] Status:MEDLINE
[do] DOI:10.1002/ajpa.23256


  10 / 1143 MEDLINE  
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[PMID]:28572044
[Au] Autor:Gillis JA; Williams JG
[Ad] Endereço:Division of Plastic and Reconstructive Surgery, Dalhousie University, Halifax, Nova Scotia, Canada. Electronic address: jgillis@dal.ca.
[Ti] Título:Cost analysis of percutaneous fixation of hand fractures in the main operating room versus the ambulatory setting.
[So] Source:J Plast Reconstr Aesthet Surg;70(8):1044-1050, 2017 Aug.
[Is] ISSN:1878-0539
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:PURPOSE: To date, there have been no studies identifying the cost differential for performing closed reduction internal fixation (CRIF) of hand fractures in the operating room (OR) versus an ambulatory setting. Our goal was to analyse the cost and efficiency of performing CRIF in these two settings and to investigate current practice trends in Canada. METHODS: A detailed analysis of the costs involved both directly and indirectly in the CRIF of a hand fracture was conducted. Hospital records were used to calculate efficiency. A survey was distributed to practicing plastic surgeons across Canada regarding their current practice of managing hand fractures. RESULTS: In an eight-hour surgical block we are able to perform five CRIF in the OR versus eight in an ambulatory setting. The costs of performing a CRIF in the OR under local anaesthetic, not including surgeon compensation, is $461.27 Canadian (CAD) compared to $115.59 CAD in the ambulatory setting, a 299% increase. The use of a regional block increases the cost to $665.49 CAD, a 476% increase. The main barrier to performing CRIFs in an outpatient setting is the absence of equipment necessary to perform these cases effectively, based on survey results. CONCLUSION: The use of the OR for CRIF of hand fractures is associated with a significant increase in cost and hospital resources with decreased efficiency. For appropriately selected hand fractures, CRIF in an ambulatory setting is less costly and more efficient compared to the OR and resources should be allocated to facilitate CRIF in this setting.
[Mh] Termos MeSH primário: Instituições de Assistência Ambulatorial/economia
Redução Fechada/economia
Fixação Interna de Fraturas/economia
Fraturas Ósseas/economia
Traumatismos da Mão/cirurgia
Custos de Cuidados de Saúde
Salas Cirúrgicas/economia
[Mh] Termos MeSH secundário: Anestesia Local/economia
Canadá
Custos e Análise de Custo
Eficiência
Falanges dos Dedos da Mão/lesões
Falanges dos Dedos da Mão/cirurgia
Traumatismos da Mão/economia
Seres Humanos
Ossos Metacarpais/lesões
Ossos Metacarpais/cirurgia
Bloqueio Nervoso/economia
Equipamentos Cirúrgicos
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170906
[Lr] Data última revisão:
170906
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170603
[St] Status:MEDLINE



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