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[PMID]:29390549
[Au] Autor:Yasuda T; Kawaguchi Y; Suzuki K; Nakano M; Seki S; Watabnabe K; Kanamori M; Kimura T
[Ad] Endereço:Departments of Orthopaedic Surgery, Faculty of Medicine, University of Toyama.
[Ti] Título:Five-year follow up results of posterior decompression and fixation surgery for delayed neural disorder associated with osteoporotic vertebral fracture.
[So] Source:Medicine (Baltimore);96(51):e9395, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Usually, after osteoporotic vertebral fracture (OVF), bone healing follows a normal clinical course leading to bone union with conservative treatment using a brace. However, some patients with OVF do not undergo the normal fracture healing process for a few months, possibly leading to delayed union and/or pseudoarthrosis. In these cases, we performed posterior surgery with combined decompression, vertebroplasty, and posterior spinal fusion with spinal instrumentation. This study aimed to determine the clinical results of posterior surgery for delayed neural disorder secondary to OVF over a 5-year follow-up.Forty-one Japanese patients who had posterior surgery for delayed paralysis secondary to OVF were enrolled in this study. All patients were followed for ≥5 years (mean, 67 months; range, 61-86 months). Patients comprised 12 men and 29 women with an average age of 76.3 ± 6.2 years (range 63-87 years) at the time of operation. We performed posterior fixation from 2 levels above to 1 level below the decompression and vertebroplasty as an all in one procedure. Vertebral height index (VHI) and kyphotic angle (KA) were evaluated on radiogram. For clinical symptoms, a visual analog scale of back and leg pain and the Frankel classification and Japanese Orthopaedic Association scores were used.During the operation and perioperative period, no serious complications occurred. In all patients, symptoms improved within 1 month and were maintained for 5 years postoperatively. In all patients, VHI and KA improved after surgery; however, reduction losses of 7.7% of VHI and 23% of KA were recognized. Five of 41 patients required reoperation due to adjacent vertebral fracture (AVF) and recollapse of the vertebral body.Operation time and blood loss were acceptable, even for elderly patients. In all patients, alignment and subjective symptoms improved. However, reoperation owing to AVF and recollapse was necessary within 1 year in 5 of 41 (12%) patients. Careful follow-up is required within 1 year after surgery for OVF.
[Mh] Termos MeSH primário: Laminectomia/métodos
Fraturas por Osteoporose/complicações
Paralisia/cirurgia
Pseudoartrose/complicações
Fraturas da Coluna Vertebral/complicações
Fusão Vertebral/métodos
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Estudos de Casos e Controles
Feminino
Seguimentos
Seres Humanos
Masculino
Meia-Idade
Fraturas por Osteoporose/cirurgia
Paralisia/etiologia
Pseudoartrose/cirurgia
Fraturas da Coluna Vertebral/cirurgia
Fusão Vertebral/instrumentação
Resultado do Tratamento
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180214
[Lr] Data última revisão:
180214
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180203
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009395


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[PMID]:29310362
[Au] Autor:Yan A; Mei HB; Liu K; Wu JY; Tang J; Zhu GH; Ye WH
[Ad] Endereço:Department of Pediatric Orthopaedics, Hunan Children's Hospital, The Pediatric Academy of University of South China, Changsha, Hunan Province, P.R. China.
[Ti] Título:Wrapping grafting for congenital pseudarthrosis of the tibia: A preliminary report.
[So] Source:Medicine (Baltimore);96(48):e8835, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: Treatment of congenital pseudarthrosis of the tibia (CPT) remains a challenge. The autogenic iliac bone graft is important consistent of treatment for CPT. The purpose of this study was to investigate the role of wrapping autogenic iliac bone graft in improvement of the curing opportunities of CPT. METHODS: We combined Ilizarov fixator with intramedullary rodding of the tibia and wrapping autogenic iliac bone graft for treatment 51 cases of CPT between 2007 and 2010. The mean age is 3.2 years at index operation, of which 31 patients (61%) were below 3 years old. According to Crawford classification, 5 tibia had type-II morphology; 3, type-III; 43, type-IV. RESULTS: In the postoperative follow-up of 3.5 months (range from 3 to 4.5 months), all cases were found that the bone graft sites of pseudarthrosis of the tibia showed a significant augmentation and spindle-shaped expansion as obvious change. All cases of this series have been followed-up, average followed-up time were 1.6 years (range from 7 to 3.1 years), of which 19 cases were more than 2 years. The average time of removed the Ilizarov ring fixator was 3.5 months (range from 3 to 4.5 months). According to Johnston Clinical evaluation system, 26 cases had grade I, 21 cases, grade II, 4 cases, grade III. Following the Ohnishi X-ray evaluation criteria, union of pseudarthrosis of the tibia were 42 cases, delayed union 5 cases, nonunion 4 cases. CONCLUSION: Autogenic iliac bone graft is able to offer the activity of osteoblasts and osteogenesis induced by bone morphogenetic protein (BMP) and glycoprotein, meanwhile enclosing bone graft could help keep cancellous bone fragments in close contact around pseudarthrosis of the tibia, allowing the formation of high concentration of glycoprotein and BMP induced by chemical factors because of established the sealing environment in location, all of which could enhance the healing of pseudarthrosis of the tibia.
[Mh] Termos MeSH primário: Transplante Ósseo/métodos
Pseudoartrose/congênito
Tíbia/cirurgia
[Mh] Termos MeSH secundário: Pré-Escolar
Feminino
Seres Humanos
Técnica de Ilizarov
Fixadores Internos
Masculino
Pseudoartrose/cirurgia
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180115
[Lr] Data última revisão:
180115
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180110
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000008835


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[PMID]:27770774
[Au] Autor:Zhu GH; Mei HB; He RG; Liu YX; Liu K; Tang J; Wu JY
[Ad] Endereço:Department of Orthopedics, Hunan Children's Hospital, 86 Ziyuan road, Changsha, Hunan, People's Republic of China.
[Ti] Título:Combination of intramedullary rod, wrapping bone grafting and Ilizarov's fixator for the treatment of Crawford type IV congenital pseudarthrosis of the tibia: mid-term follow up of 56 cases.
[So] Source:BMC Musculoskelet Disord;17(1):443, 2016 10 22.
[Is] ISSN:1471-2474
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The purpose of this study was to investigate the initial union rate, refracture rate and residual deformities of congenital pseudarthrosis of the tibia (CPT), using combined surgery including pseudarthrosis resection, intramedullary rodding, autogenous iliac bone grafting and Ilizarov's fixator, with a mean 5.2 years follow-up. METHODS: We retrospectively reviewed the records and diagrams of patients with Crawford type IV congenital pseudarthrosis of the tibia between February 2007 and March 2010. Patients managed by pseudarthrosis resection, intramedullary rod of the tibia, wrapping autogenous iliac bone grafting and Ilizarov's fixator were enrolled. We evaluated the bone union rate, tibial alignment, limb length discrepancy (LLD), valgus deformity of the ankle and the frequencies of refracture during period of follow-up. RESULTS: There were 56 cases enrolled in the study, with a mean follow-up 5.2 years (range, 3 to 6.7 years). The mean age of the patients at surgery was 3.5 years (range, 1.5 to 12.4 years). Fifty (89.2 %) of the 56 patients had primary bone union at site of pseudarthrosis, while 5 obtained union after second surgery and 1 failed. The average time spent to obtain pseudarthrosis initial union was 4.5 months (range, 3.0 to 10.0 months) and mean duration of Ilizarov treatment was 4.7 months (range, 3.2 to 10.4 months). Eleven (19.6 %) patients had proximal tibial valgus with a mean angle of 9.5° (range, 5 to 24°), while 10 (17.9 %) patients had ankle valgus deformities with a mean of 12.3° (range, 6 to 21°). Sixteen (28.6 %) patients had an average 2.2 cm LLD (range, 1.5-4.2 cm). Of the 50 cases who obtained initial bone union of pseudarthrosis, 13 (26.0 %) had refracture which need cast immobilization or secondary surgery. CONCLUSIONS: This combined surgery obtained initial union rate of 89.2 % at primary surgery while the refracture rate is 26.0 %. However, residual deformities such as proximal tibial valgus, LLD and ankle valgus were also existed which should be pay more attention to and dealt with. TRIAL REGISTRATION: This study was registered in ClinicalTrials.gov under the name "The Effect of Combined Surgery in Management of Congenital Pseudarthrosis of Tibia" ( NCT02640040 ), which was released on August 31, 2015.
[Mh] Termos MeSH primário: Transplante Ósseo/métodos
Fixação Intramedular de Fraturas/métodos
Técnica de Ilizarov
Pseudoartrose/congênito
Fraturas da Tíbia/cirurgia
[Mh] Termos MeSH secundário: Moldes Cirúrgicos
Criança
Pré-Escolar
Feminino
Seguimentos
Fixação Intramedular de Fraturas/instrumentação
Seres Humanos
Ílio/transplante
Lactente
Fixadores Internos
Masculino
Pseudoartrose/diagnóstico por imagem
Pseudoartrose/cirurgia
Radiografia
Reoperação/estatística & dados numéricos
Estudos Retrospectivos
Fraturas da Tíbia/diagnóstico por imagem
Transplante Autólogo/métodos
[Pt] Tipo de publicação:CLINICAL TRIAL; JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171209
[Lr] Data última revisão:
171209
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161025
[Cl] Clinical Trial:ClinicalTrial
[St] Status:MEDLINE


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[PMID]:28341497
[Au] Autor:Di Gennaro GL; Cravino M; Martinelli A; Berardi E; Rao A; Stilli S; Trisolino G
[Ad] Endereço:Department of Paediatric Orthopedics and Traumatology, Rizzoli Orthopedic Institute, Bologna, Italy.
[Ti] Título:Congenital pseudarthrosis of the clavicle: a report on 27 cases.
[So] Source:J Shoulder Elbow Surg;26(3):e65-e70, 2017 Mar.
[Is] ISSN:1532-6500
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:HYPOTHESIS: We aimed to report our experience in treating congenital pseudarthrosis of the clavicle (CPC). MATERIALS AND METHODS: A retrospective search of the archive of our institute was performed; 27 cases (12 male and 15 female patients) affected by CPC were recorded. Among these patients, 19 underwent surgical intervention for cosmetic appearance between 1960 and 2015. Of 19 patients, 18 were treated by pseudarthrosis resection and stabilization with a Kirschner wire, whereas in 1 case, the osteosynthesis was performed with a plate. Iliac crest bone autograft was used in 15 patients, whereas 4 patients were treated with a fibular allograft. RESULTS: The mean follow-up period was 36.3 ± 49.1 months. Bone healing was achieved in 14 of 19 operated cases (74%); none of the patients had complaints regarding cosmetic abnormalities or unesthetic appearance. All the operated patients were pain free, range of motion was complete, and no other subjective anomalies were found. No vascular or neurologic complications were observed. However, the use of allograft was associated with high rates of nonunion in this case series (P = .037). CONCLUSION: CPC can be satisfactorily treated by K-wire fixation and autologous iliac crest bone grafting, which showed better results in terms of functional and cosmetic outcome.
[Mh] Termos MeSH primário: Clavícula/anormalidades
Clavícula/cirurgia
Pseudoartrose/congênito
[Mh] Termos MeSH secundário: Adolescente
Autoenxertos
Placas Ósseas
Fios Ortopédicos
Criança
Pré-Escolar
Clavícula/lesões
Feminino
Fixação de Fratura
Fraturas Espontâneas/complicações
Fraturas Espontâneas/cirurgia
Seres Humanos
Ílio/transplante
Lactente
Masculino
Meia-Idade
Pseudoartrose/diagnóstico por imagem
Pseudoartrose/cirurgia
Estudos Retrospectivos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170609
[Lr] Data última revisão:
170609
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170326
[St] Status:MEDLINE


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[PMID]:28244906
[Au] Autor:Ebata S; Takahashi J; Hasegawa T; Mukaiyama K; Isogai Y; Ohba T; Shibata Y; Ojima T; Yamagata Z; Matsuyama Y; Haro H
[Ad] Endereço:1Departments of Orthopaedic Surgery (S.E., T.O., and H.H.) and Health Science for Clinical Medicine (Z.Y.), Graduate School of Medicine, University of Yamanashi, Chuo, Yamanashi, Japan 2Department of Orthopaedic Surgery, Shinshu University School of Medicine, Matsumoto, Nagano, Japan 3Departments of Orthopaedic Surgery (T.H. and Y.M.) and Community Health and Preventive Medicine (Y.S. and T.O.), Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan 4Medical Affairs Department, Pharmaceutical Business Administration Division, Asahi Kasei Pharma Corporation, Tokyo, Japan.
[Ti] Título:Role of Weekly Teriparatide Administration in Osseous Union Enhancement within Six Months After Posterior or Transforaminal Lumbar Interbody Fusion for Osteoporosis-Associated Lumbar Degenerative Disorders: A Multicenter, Prospective Randomized Study.
[So] Source:J Bone Joint Surg Am;99(5):365-372, 2017 Mar 01.
[Is] ISSN:1535-1386
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: For elderly patients, posterior lumbar interbody fusion (PLIF) or transforaminal lumbar interbody fusion (TLIF) is usually performed to treat lumbar degenerative diseases. However, some patients exhibit pseudarthrosis following such procedures. The anabolic agent teriparatide is an approved treatment for promoting bone formation in osteoporotic patients. Our multicenter, prospective randomized study assessed the role of once-weekly teriparatide administration on patient outcomes following interbody fusion. METHODS: Patients were females who were ≥50 years of age, had a bone mineral density (BMD) of <80% of the sex-matched young adult mean and/or previous spinal compression or femoral fractures, and had lumbar degenerative disease. Patients were randomly allocated to receive either weekly teriparatide, administered subcutaneously starting at week 1, for 6 months postoperatively (the teriparatide arm), or no teriparatide (the control arm). Blinded radiographic evaluations were performed using dynamic radiography and computed tomography (CT) and assessed by modified intention-to-treat analysis and per-protocol analysis. Clinical and neurological symptoms were evaluated using the Japanese Orthopaedic Association Back Pain Evaluation Questionnaire (JOA-BPEQ) and the Oswestry Disability Index (ODI). RESULTS: Seventy-five patients were randomized to treatment, and 66 patients completed treatment. At 4 months postoperatively, bone fusion in the 2 center CT slices was significantly higher in the teriparatide arm compared with the control arm in the age-adjusted modified intention-to-treat analysis and was significantly higher at 6 months in the per-protocol analysis. Radiographic examinations showed no disc-space narrowing and no intervertebral disc instability. JOA-BPEQ and ODI results were improved postoperatively in both treatment arms. CONCLUSIONS: Weekly administration of teriparatide promoted bone formation at the surgical fusion site and decreased bone resorption, as indicated by bone metabolic marker results, within the early postoperative period. Our findings suggest that combining lumbar interbody fusion and teriparatide treatment may be an effective option for managing lumbar degenerative disease in elderly patients. LEVEL OF EVIDENCE: Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.
[Mh] Termos MeSH primário: Conservadores da Densidade Óssea/administração & dosagem
Consolidação da Fratura/efeitos dos fármacos
Degeneração do Disco Intervertebral/cirurgia
Vértebras Lombares/efeitos dos fármacos
Fusão Vertebral
Teriparatida/administração & dosagem
[Mh] Termos MeSH secundário: Idoso
Feminino
Seres Humanos
Degeneração do Disco Intervertebral/etiologia
Vértebras Lombares/diagnóstico por imagem
Vértebras Lombares/cirurgia
Meia-Idade
Osteogênese/efeitos dos fármacos
Osteoporose/complicações
Osteoporose/tratamento farmacológico
Estudos Prospectivos
Pseudoartrose/etiologia
Pseudoartrose/prevenção & controle
Cicatrização/efeitos dos fármacos
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Bone Density Conservation Agents); 10T9CSU89I (Teriparatide)
[Em] Mês de entrada:1703
[Cu] Atualização por classe:170308
[Lr] Data última revisão:
170308
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170301
[St] Status:MEDLINE
[do] DOI:10.2106/JBJS.16.00230


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[PMID]:28213747
[Au] Autor:Hissnauer TN; Stiel N; Babin K; Rupprecht M; Hoffmann M; Rueger JM; Stuecker R; Spiro AS
[Ad] Endereço:Department of Trauma-, Hand-, and Reconstructive Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
[Ti] Título:Bone morphogenetic protein-2 for the treatment of congenital pseudarthrosis of the tibia or persistent tibial nonunion in children and adolescents: A retrospective study with a minimum 2-year follow-up.
[So] Source:J Mater Sci Mater Med;28(4):60, 2017 Apr.
[Is] ISSN:1573-4838
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:There is a lack of studies reporting on rhBMP-2 application in pediatric orthopaedics, although few reports demonstrated promising results of the use of rhBMP-2 in children, especially for spine fusion and for the treatment of congenital pseudarthrosis of the tibia. The objectives of this study were (1) to examine clinical and radiographic healing after rhBMP-2 application for the treatment of congenital pseudarthrosis of the tibia (CPT) or persistent tibial nonunion in children and adolescents, and (2) to investigate the safety of rhBMP-2 use in these cases. Therefore we reviewed the medical records of ten patients with a mean age of 8.6 years (2.3-21) with CPT (n = 7) or persistent tibial nonunion for at least six months (n = 3) who had been treated with rhBMP-2. Nine of ten patients had union at final follow-up, after a mean of 72.9 months (25-127). In the CPT group, primary healing of the pseudarthrosis occurred in six of seven patients at a mean of 5.2 months (3-12). Repeat rhBMP-2 application was performed in three patients; two patients had one additional application each, and one patient had three additional applications. Complications that may be attributed to the use of rhBMP-2 were seen in two of fifteen applications, including a compartmemt syndrome and a hematoma. In this retrospective case series rhBMP-2 has been used successfully to treat CPT or persistent tibial nonunion in pediatric patients. However, prospective randomized controlled trials are warranted to investigate the long-term efficacy and safety of rhBMP-2 use in these cases.
[Mh] Termos MeSH primário: Proteína Morfogenética Óssea 2/uso terapêutico
Pseudoartrose/congênito
Fraturas da Tíbia/terapia
Fator de Crescimento Transformador beta/uso terapêutico
[Mh] Termos MeSH secundário: Adolescente
Transplante Ósseo/métodos
Criança
Pré-Escolar
Feminino
Seguimentos
Seres Humanos
Masculino
Período Pós-Operatório
Pseudoartrose/terapia
Proteínas Recombinantes/uso terapêutico
Estudos Retrospectivos
Tíbia/patologia
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (BMP2 protein, human); 0 (Bone Morphogenetic Protein 2); 0 (Recombinant Proteins); 0 (Transforming Growth Factor beta); 0 (recombinant human bone morphogenetic protein-2)
[Em] Mês de entrada:1707
[Cu] Atualização por classe:171021
[Lr] Data última revisão:
171021
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170219
[St] Status:MEDLINE
[do] DOI:10.1007/s10856-017-5868-9


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[PMID]:28195886
[Au] Autor:Mongon MLD; Ribera FC; de Souza AMA; Sposito AL; Belangero WD; Livani B
[Ad] Endereço:*State Hospital of Sumare of the State University of Campinas, HES-UNICAMP †Paulo Sacramento Hospital, Jundiaí ‡The Department of Orthopedics and Traumatology Surgery of the State University of Campinas, UNICAMP, Maxsuelton Alves de Souza §The State University of Campinas, HC-UNICAMP, Campinas, SP, Brazil.
[Ti] Título:Pedicled Sensate Composite Calcaneal Flap in Children With Congenital Tibial Pseudoarthrosis.
[So] Source:J Pediatr Orthop;37(4):e271-e276, 2017 Jun.
[Is] ISSN:1539-2570
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The preservation and functionality of a limb affected by a malformation (such as congenital pseudoarthrosis of the tibia) or a severely mangled lower limb in children, despite modern reconstructive techniques, remains challenging, often eventually requiring amputation to achieve a better outcome. The classical Syme and Boyd procedures are functionally better than transtibial (TT) amputation, but are not feasible for congenital tibial pseudoarthrosis. TT amputation delivers an excellent, effective, and functional stump that usually leads, after prosthetization, to a functional gait. Unfortunately, in some situations, particularly when amputation is performed conventionally, the stump is also associated with complications. Future surgical revisions are often needed, particularly in children, because of stump overgrowth. METHODS: Between 2008 and 2010, three patients diagnosed with congenital pseudoarthrosis of the tibia associated with neurofibromatosis who were indicated for TT amputation with calcaneal flap after failure of all previous surgical reconstructive procedures were selected. The chosen method for osteosynthesis was an external fixator of Ilizarov. RESULTS: At 12 weeks of follow-up, the stump had healed in all three patients, and tibiocalcaneal fusion was achieved without complications. All patients were prosthetized and had an asymptomatic gait. After a minimum follow-up of 6 years, all three cases with the pedicled sensate composite calcaneal flap still had a strong, full weight-bearing surface and have adapted easily to the conventional prosthesis, providing a painless stump with excellent functionality. CONCLUSION: With a 0 rate of needed revisions, all 3 cases with the pedicled sensate composite calcaneal flap preserving the hind foot still have a strong, full weight-bearing surface and have easily adapted to the conventional prosthesis, providing a painless and excellent functional stump that could last a lifetime. LEVEL OF EVIDENCE: Level IV.
[Mh] Termos MeSH primário: Cotos de Amputação/inervação
Amputação/métodos
Calcâneo/cirurgia
Pseudoartrose/congênito
Tíbia/cirurgia
Fraturas da Tíbia/congênito
[Mh] Termos MeSH secundário: Criança
Feminino
Seres Humanos
Masculino
Dor
Pseudoartrose/cirurgia
Procedimentos Cirúrgicos Reconstrutivos/métodos
Reoperação
Estudos Retrospectivos
Retalhos Cirúrgicos
Fraturas da Tíbia/cirurgia
Suporte de Carga
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170912
[Lr] Data última revisão:
170912
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170215
[St] Status:MEDLINE
[do] DOI:10.1097/BPO.0000000000000942


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[PMID]:27900474
[Au] Autor:Vaz S; Ferreira TC; Salgado L; Paycha F
[Ad] Endereço:Nuclear Medicine Department, Instituto Português de Oncologia Francisco Gentil, E.P.E. Lisbon, Rua Prof. Lima Basto, 1099-023, Lisbon, Portugal. sofiacarrilhovaz@gmail.com.
[Ti] Título:Bone scan usefulness in patients with painful hip or knee prosthesis: 10 situations that can cause pain, other than loosening and infection.
[So] Source:Eur J Orthop Surg Traumatol;27(2):147-156, 2017 Feb.
[Is] ISSN:1633-8065
[Cp] País de publicação:France
[La] Idioma:eng
[Ab] Resumo:In recent years, with the higher median life expectancy, the number of hip and knee replacements has increased. Clinical examination and morphological studies are essential to evaluate patients with a painful arthroplasty. Nuclear medicine examinations also play an important role, their main usefulness being the exclusion of prosthesis complications. Nevertheless, conventional examinations, namely bone scan and white blood cell scintigraphy, can also identify complications, such as loosening and infection. This study describes the normal and pathologic patterns of a bone scan and exemplifies ten common situations that can cause pain in patients with hip or knee arthroplasty, other than loosening and infection, which can be disclosed on a bone scintigraphy. The ten situations that should be considered and looked for when analysing a bone scan are: referred pain, patellofemoral pain syndrome, fractures, fissures, abscess/haematoma, bone insert behaviour, heterotopic ossification, greater trochanter pseudarthrosis, osteoarthritis extension in a knee with an unicompartmental prosthesis, and systemic disease with bone involvement.
[Mh] Termos MeSH primário: Prótese de Quadril/efeitos adversos
Prótese do Joelho/efeitos adversos
Dor Pós-Operatória/etiologia
[Mh] Termos MeSH secundário: Abscesso/diagnóstico por imagem
Abscesso/etiologia
Artroplastia de Quadril/efeitos adversos
Artroplastia do Joelho/efeitos adversos
Neoplasias Ósseas/complicações
Neoplasias Ósseas/diagnóstico por imagem
Neoplasias Ósseas/secundário
Substitutos Ósseos/efeitos adversos
Hematoma/diagnóstico por imagem
Hematoma/etiologia
Prótese de Quadril/classificação
Seres Humanos
Ossificação Heterotópica/complicações
Ossificação Heterotópica/diagnóstico por imagem
Osteoartrite do Joelho/complicações
Osteoartrite do Joelho/diagnóstico por imagem
Dor Pós-Operatória/diagnóstico por imagem
Dor Referida/diagnóstico por imagem
Dor Referida/etiologia
Síndrome da Dor Patelofemoral/diagnóstico por imagem
Síndrome da Dor Patelofemoral/etiologia
Fraturas Periprotéticas/complicações
Fraturas Periprotéticas/diagnóstico por imagem
Falha de Prótese/efeitos adversos
Infecções Relacionadas à Prótese/complicações
Infecções Relacionadas à Prótese/diagnóstico por imagem
Pseudoartrose/complicações
Pseudoartrose/diagnóstico por imagem
Tomografia Computadorizada com Tomografia Computadorizada de Emissão de Fóton Único/métodos
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Bone Substitutes)
[Em] Mês de entrada:1705
[Cu] Atualização por classe:171011
[Lr] Data última revisão:
171011
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161201
[St] Status:MEDLINE
[do] DOI:10.1007/s00590-016-1884-6


  9 / 4309 MEDLINE  
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[PMID]:27792039
[Au] Autor:Studer K; Baker MP; Krieg AH
[Ad] Endereço:aDepartment of Paediatric Orthopaedics, University Children's Hospital Basel (UKBB), Basel, Switzerland bYoung Adult Limb Preservation and Reconstruction, Royal National Orthopaedic Hospital (RNOH), Middlesex, UK.
[Ti] Título:Operative treatment of congenital pseudarthrosis of the clavicle: a single-centre experience.
[So] Source:J Pediatr Orthop B;26(3):245-249, 2017 May.
[Is] ISSN:1473-5865
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Congenital pseudarthrosis of the clavicle (CPC) is a very rare condition with a predilection for the right clavicle. Young children are often only symptomatic with activities and as they grow. Operative management in an asymptomatic child is debatable, with various techniques reported in the literature. This is a retrospective, single-centre case series study. All children with CPC treated surgically by resection, bone grafting (nonvascular iliac crest) and plate fixation between 2004 and 2012 at our centre were included. Excluded conditions were traumatic or obstetric fractures of the clavicle, children with musculoskeletal or neurological disorders and children lost to follow-up. Clinical and radiological examination was performed at 6 weeks, 3 months and between 6 and 12 months postoperatively. A total of eight clavicles in seven children (four girls and three boys), with a mean age of 7.1 years (5-8 years), were operated with a mean follow-up of 7 years (4-10 years). In six children, the right (dominant) side was affected, with one child affected bilaterally. Overall, 85% of our patients showed good functional results 6 weeks postoperatively and complete radiographic consolidation at a mean of 8.5 months (3-25 months) postoperatively. One female child showed delayed union, but without clinical deficit. There was low donor-site morbidity. We recommend early operative treatment of CPC with a nonvascularized bone graft from the iliac crest and plate fixation. LEVEL OF EVIDENCE: IV.
[Mh] Termos MeSH primário: Clavícula/cirurgia
Pseudoartrose/congênito
[Mh] Termos MeSH secundário: Placas Ósseas
Criança
Pré-Escolar
Feminino
Seguimentos
Seres Humanos
Masculino
Ortopedia/métodos
Pseudoartrose/cirurgia
Estudos Retrospectivos
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171026
[Lr] Data última revisão:
171026
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161030
[St] Status:MEDLINE
[do] DOI:10.1097/BPB.0000000000000400


  10 / 4309 MEDLINE  
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[PMID]:27740398
[Au] Autor:Rahimizadeh A; Soufiani H; Hassani V; Rahimizadeh A
[Ad] Endereço:Pars Advanced and Minimally Invasive Manners Research Center, Pars Hospital, Iran University of Medical Sciences, Tehran, Iran; and.
[Ti] Título:Symptomatic pseudarthrosis in ochronotic spine: case report.
[So] Source:J Neurosurg Spine;26(2):220-228, 2017 Feb.
[Is] ISSN:1547-5646
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:In this study the authors report the first example of spinal pseudarthrosis in a patient with ochronosis, and they describe the application of posterior-only 360° surgery as an alternative approach to combined anterior-posterior surgery in the management of pseudarthrosis of an ankylosed spine, regardless of its etiology. Spinal involvement in ochronosis produces loss of flexibility and ankylosis of thoracic and lumbar segments. Pseudarthrosis is a serious complication of the diseases that present with ankylosis of the spine. However, its occurrence in ochronotic spine has not been reported previously. Evaluation of progressive paraparesis in a 68-year-old man with ochronosis revealed pseudarthrosis at the T11-12 level. Circumferential dural sac decompression, debridement of the disc space, interbody fusion, and screw-rod fixation were all done via a posterior-only approach. Postoperatively the patient exhibited a marked recovery in terms of pain and neurological status. At the 3-month follow-up, he was able to walk independently. Ochronosis should be included in the etiology of pseudarthrosis. With aggravation of back pain and the appearance of neurological deficits in an already stable patient with any ankylosing disease, pseudarthrosis should be suspected. Furthermore, single-stage, 360°, posterior-only surgery may obviate the need for single-stage or staged anterior-posterior surgical intervention in patients with pseudarthrosis of the thoracic and lumbar spine.
[Mh] Termos MeSH primário: Ocronose/complicações
Ocronose/cirurgia
Pseudoartrose/etiologia
Pseudoartrose/cirurgia
Vértebras Torácicas/cirurgia
[Mh] Termos MeSH secundário: Idoso
Descompressão Cirúrgica/métodos
Diagnóstico Diferencial
Evolução Fatal
Seres Humanos
Fixadores Internos
Masculino
Ocronose/patologia
Ocronose/urina
Pseudoartrose/patologia
Pseudoartrose/urina
Fusão Vertebral/métodos
Vértebras Torácicas/diagnóstico por imagem
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1702
[Cu] Atualização por classe:170817
[Lr] Data última revisão:
170817
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161015
[St] Status:MEDLINE
[do] DOI:10.3171/2016.5.SPINE15671



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