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[PMID]:29169602
[Au] Autor:Shearin JW; Chapman TR; Miller A; Ilyas AM
[Ad] Endereço:Hand & Upper Extremity Surgery, Department of Orthopedic Surgery, Arnot Health, Elmira, NY, USA.
[Ti] Título:Ulnar Nerve Management with Distal Humerus Fracture Fixation: A Meta-Analysis.
[So] Source:Hand Clin;34(1):97-103, 2018 02.
[Is] ISSN:1558-1969
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Ulnar nerve dysfunction following distal humerus fractures is a well-recognized phenomenon. There is no consensus regarding optimal handling of the ulnar nerve during surgical management of these fractures between in situ management and transposition. Using an electronic database to identify retrospective studies involving surgical fixation of distal humerus fractures yielded 46 studies, 5 trials meeting the authors' inclusion criteria, totaling 362 patients. An overall incidence of 19.3% for ulnar neuropathy was identified. Of those patients undergoing in situ release, the incidence was 15.3%. Of those who underwent transposition, there was a 23.5% incidence of ulnar neuropathy.
[Mh] Termos MeSH primário: Fixação de Fratura/efeitos adversos
Fraturas do Úmero/cirurgia
Neuropatias Ulnares/etiologia
Neuropatias Ulnares/prevenção & controle
[Mh] Termos MeSH secundário: Seres Humanos
Fraturas do Úmero/complicações
Cuidados Intraoperatórios
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; REVIEW
[Em] Mês de entrada:1712
[Cu] Atualização por classe:180303
[Lr] Data última revisão:
180303
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171125
[St] Status:MEDLINE


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[PMID]:29169590
[Au] Autor:Tulipan JE; Ilyas AM
[Ad] Endereço:Department of Orthopaedic Surgery, Thomas Jefferson University, 925 Chestnut Street, Philadelphia, PA 19107, USA. Electronic address: jacob.tulipan@gmail.com.
[Ti] Título:Open Fractures of the Hand: Review of Pathogenesis and Introduction of a New Classification System.
[So] Source:Hand Clin;34(1):1-7, 2018 02.
[Is] ISSN:1558-1969
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Open fractures of the hand are a common and varied group of injuries. Although at increased risk for infection, open fractures of the hand are more resistant to infection than other open fractures. Numerous unique factors in the hand may play a role in the altered risk of postinjury infection. Current systems for the classification of open fractures fail to address the unique qualities of the hand. This article proposes a novel classification system for open fractures of the hand, taking into account the factors unique to the hand that affect its risk for developing infection after an open fracture.
[Mh] Termos MeSH primário: Fraturas Expostas/classificação
Fraturas Expostas/cirurgia
Traumatismos da Mão/cirurgia
Infecção da Ferida Cirúrgica/prevenção & controle
[Mh] Termos MeSH secundário: Antibacterianos/uso terapêutico
Desbridamento
Fixação de Fratura
Seres Humanos
Infecção da Ferida Cirúrgica/etiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Anti-Bacterial Agents)
[Em] Mês de entrada:1712
[Cu] Atualização por classe:180303
[Lr] Data última revisão:
180303
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171125
[St] Status:MEDLINE


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[PMID]:29297667
[Au] Autor:Byvaltsev VA; Kalinin AA; Okoneshnikova AK; Kerimbaev TT; Belykh EG
[Ti] Título:Facet Fixation Combined with Lumbar Interbody Fusion: Comparative Analysis of Clinical Experience and A New Method of Surgical Treatment of Patients with Lumbar Degenerative Diseases.
[So] Source:Vestn Ross Akad Med Nauk;71(5):375-84, 2016.
[Is] ISSN:0869-6047
[Cp] País de publicação:Russia (Federation)
[La] Idioma:eng
[Ab] Resumo:Background: For the treatment of patients with degenerative diseases of the lumbar spine the technique of pedicle fixation is widespread, when after open decompression channel structure locking screws are introduced into the vertebral body through the back vertebra legs. We first used a fundamentally new way of fixing the rear using the facet-boards Cage «Facet Wedge¼, when posterior fixation is done by closing the facet joints with minimally invasive, percutaneous method. We have not found data on the clinical efficacy of facet fixation in scientific literature. Aims: To compare the clinical efficacy of facet fixation combined with interbody fusion in the treatment of patients with degenerative lumbar spine disease. Materials and Methods: The study included 145 patients who were divided into 2 groups. The study group with long-term observation included patients (n=100) who underwent a new method for lumbar fixation; the method comprises unilateral or bilateral implantation of titanium Cage «facet Wedge¼ in the joint space facet joint in combination with the anterior, lateral, and transforaminal interbody fusion. Clinical comparison group (n=45) included retrospectively recruited patients who were performed titanium pedicle screw installation after open decompression and interbody fusion posterior lumbar fixation. Dynamic observation and comprehensive evaluation of the treatment clinical results was carried out for 18 months after surgery. Results: Cage facet installation technology is quite simple, universal for the stabilization of the rear of the complex after interbody fusion from the front, side, and rear access; and does not require the intraoperative application of expensive high-tech equipment. Comparative analysis of the main group showed significantly better results in terms of the duration of the operation [CG 125 (90; 140) min, the CCG 205 (160; 220) min; p=0.01], the volume of blood loss [CG 80 (70; 120) ml, CCG 350 (300; 550) ml; p=0.008], activation time [CG 2 (1; 2) days, 4 CCG (3; 5) days; p=0.02], length of hospitalization [CG 9 (10; 11) days, the CCG 13 (12; 15) days; p=0.03], the level of pain on a visual analog scale [CG 3 (2; 4) mm, CCG 15 (12; 18) mm; p=0.001], quality of life (by index Oswestry) [CG 8 (6; 8) points, the CCG 23 (20; 28) points, p=0.003], and labor rehabilitation [CG 3 (2; 6) months, CCG 9 (6; 12) months; p=0.0001]. The number of postoperative complications in group 1 was 13%, in the 2nd ­ 31,1% (p=0,0012). The new method involves fixing the back with considerably less surgical trauma of paravertebral soft tissue that results in early activation of patients, reduction of stay in hospital period, and better functional recovery of patients. Conclusions: The application of facet fixation combined with interbody fusion in the treatment of patients with degenerative diseases of the lumbar spine allows achieving the best clinical outcomes and fewer postoperative complications during the short and long-term follow-up if compared with the traditional method of transpedicular stabilization. The combination of low-impact and reliability facet fixation techniques for posterior stabilization of the operated segment creates favorable conditions for the restoration of a functional condition of patients, full social and physical rehabilitation.
[Mh] Termos MeSH primário: Fixação de Fratura
Degeneração do Disco Intervertebral
Deslocamento do Disco Intervertebral
Vértebras Lombares
Complicações Pós-Operatórias
Fusão Vertebral
Articulação Zigapofisária/cirurgia
[Mh] Termos MeSH secundário: Adulto
Feminino
Fixação de Fratura/efeitos adversos
Fixação de Fratura/instrumentação
Fixação de Fratura/métodos
Seres Humanos
Degeneração do Disco Intervertebral/diagnóstico
Degeneração do Disco Intervertebral/psicologia
Degeneração do Disco Intervertebral/cirurgia
Deslocamento do Disco Intervertebral/diagnóstico
Deslocamento do Disco Intervertebral/psicologia
Deslocamento do Disco Intervertebral/cirurgia
Vértebras Lombares/diagnóstico por imagem
Vértebras Lombares/patologia
Vértebras Lombares/cirurgia
Masculino
Meia-Idade
Parafusos Pediculares
Complicações Pós-Operatórias/diagnóstico
Complicações Pós-Operatórias/etiologia
Qualidade de Vida
Recuperação de Função Fisiológica
Estudos Retrospectivos
Federação Russa
Fusão Vertebral/efeitos adversos
Fusão Vertebral/métodos
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180220
[Lr] Data última revisão:
180220
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180104
[St] Status:MEDLINE
[do] DOI:10.15690/vramn738


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[PMID]:29437067
[Au] Autor:Ohmori T; Kitamura T; Nishida T; Matsumoto T; Tokioka T
[Ad] Endereço:Kochi Health Sciences Center, 2125-1, Ike, Kochi 781-8555, Japan.
[Ti] Título:The impact of external fixation on mortality in patients with an unstable pelvic ring fracture: a propensity-matched cohort study.
[So] Source:Bone Joint J;100-B(2):233-241, 2018 Feb.
[Is] ISSN:2049-4408
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:AIM: There is not adequate evidence to establish whether external fixation (EF) of pelvic fractures leads to a reduced mortality. We used the Japan Trauma Data Bank database to identify isolated unstable pelvic ring fractures to exclude the possibility of blood loss from other injuries, and analyzed the effectiveness of EF on mortality in this group of patients. PATIENTS AND METHODS: This was a registry-based comparison of 1163 patients who had been treated for an isolated unstable pelvic ring fracture with (386 patients) or without (777 patients) EF. An isolated pelvic ring fracture was defined by an Abbreviated Injury Score (AIS) for other injuries of < 3. An unstable pelvic ring fracture was defined as having an AIS ≥ 4. The primary outcome of this study was mortality. A subgroup analysis was carried out for patients who required blood transfusion within 24 hours of arrival in the Emergency Department and those who had massive blood loss (AIS code: 852610.5). Propensity-score matching was used to identify a cohort like the EF and non-EF groups. RESULTS: With the use of propensity-score matching using the completed data, 346 patients were matched. When the propensity-score matching was adjusted, EF was associated with a significantly lower risk of death (p = 0.047). In the subgroup analysis of patients who needed blood transfusion within 24 hours and those who had massive blood loss, EF was associated with a significantly lower risk of death in patients who needed blood transfusion within 24 hours (p = 0.014) and in those with massive blood loss (p = 0.016). CONCLUSION: The use of EF to treat unstable pelvic ring fractures was associated with a significantly lower risk of death, especially in patients with severe fractures. Cite this article: 2018;100-B:233-41.
[Mh] Termos MeSH primário: Fixação de Fratura/métodos
Fraturas Ósseas/mortalidade
Fraturas Ósseas/terapia
Ossos Pélvicos/lesões
[Mh] Termos MeSH secundário: Escala Resumida de Ferimentos
Adolescente
Adulto
Idoso
Idoso de 80 Anos ou mais
Perda Sanguínea Cirúrgica/estatística & dados numéricos
Bases de Dados Factuais
Feminino
Seres Humanos
Japão/epidemiologia
Masculino
Meia-Idade
Pontuação de Propensão
Sistema de Registros
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180216
[Lr] Data última revisão:
180216
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180214
[St] Status:MEDLINE
[do] DOI:10.1302/0301-620X.100B2.BJJ-2017-0852.R1


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[PMID]:29437063
[Au] Autor:Pang EQ; Truntzer J; Baker L; Harris AHS; Gardner MJ; Kamal RN
[Ad] Endereço:Stanford Medicine, Orthopaedic Surgery, 300 Pasteur Drive, Room R144, Stanford, California 94305-5341, USA.
[Ti] Título:Cost minimization analysis of the treatment of distal radial fractures in the elderly.
[So] Source:Bone Joint J;100-B(2):205-211, 2018 Feb.
[Is] ISSN:2049-4408
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:AIMS: The aim of this study was to test the null hypothesis that there is no difference, from the payer perspective, in the cost of treatment of a distal radial fracture in an elderly patient, aged > 65 years, between open reduction and internal fixation (ORIF) and closed reduction (CR). MATERIALS AND METHODS: Data relating to the treatment of these injuries in the elderly between January 2007 and December 2015 were extracted using the Humana and Medicare Advantage Databases. The primary outcome of interest was the cost associated with treatment. Secondary analysis included the cost of common complications. Statistical analysis was performed using a non-parametric -test and chi-squared test. RESULTS: Our search yielded 8924 patients treated with ORIF and 5629 patients treated with CR. The mean cost of an uncomplicated ORIF was more than a CR ($7749 $2161). The mean additional cost of a complication in the ORIF group was greater than in the CR group ($1853 $1362). CONCLUSION: These findings show that there are greater payer fees associated with ORIF than CR in patients aged > 65 years with a distal radial fracture. CR may be a higher-value intervention in these patients. Cite this article: 2018;100-B:205-11.
[Mh] Termos MeSH primário: Controle de Custos
Fixação de Fratura/economia
Fixação de Fratura/métodos
Fraturas do Rádio/cirurgia
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Feminino
Seres Humanos
Masculino
Complicações Pós-Operatórias/economia
Estados Unidos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180216
[Lr] Data última revisão:
180216
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180214
[St] Status:MEDLINE
[do] DOI:10.1302/0301-620X.100B2.BJJ-2017-0358.R1


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[PMID]:29341571
[Au] Autor:Vukomanovic A; Durovic A; Brdareski Z
[Ti] Título:Diagnostic accuracy of the A-test and cutoff points for assessing outcomes and planning acute and post-acute rehabilitation of patients surgically treated for hip fractures and osteoarthritis.
[So] Source:Vojnosanit Pregl;73(12):1139-48, 2016 Dec.
[Is] ISSN:0042-8450
[Cp] País de publicação:Serbia
[La] Idioma:eng
[Ab] Resumo:Background/Aim: The A-test is used in daily clinical practice for monitoring functional recovery of orthopedic patients during early rehabilitation. The aim of this study was to determine the accuracy of A-test and cutoff point at which the test can separate patients with and without functional disability at the end of early rehabilitation. Also, it was important to determine whether A-test has that discriminative ability (and at which cutoff points) in the first days of early rehabilitation in order to have time to plan post acute rehabilitation. Methods: This measurement-focused study was conducted in the Orthopedic Ward during early inpatient rehabilitation (1st−5th day after the operation) of 60 patients with hip osteoarthritis (HO) that underwent arthroplasty and 60 surgically treated patients with hip fracture (HF). For measurements we used the A-test and the University of Iowa Level of Assistance Scale (ILAS) as the gold standard. For statistical analysis we used the receiver operating characteristic (ROC) curve and the area under the curve (AUC) with 95% confidence interval for the results of A-test from the first to the fifth day of rehabilitation, sensitivity, specificity, the rate of false positive and false negative errors, positive and negative predictive value, ratio of positive and negative likelihood ratio, accuracy, point to the ROC curve closest to 0.1 and Youden index for all the cutoff points. Results: The AUC was 0.825 (0.744−0.905) for the first day of rehabilitation, 0.922 (0.872−0.972) for the second day of rehabilitation, 0.980 (0.959−1.000) for the third day of rehabilitation, 0.989 (0.973−1.004) for the fourth day, and 0.999 (0.996−1.001) for the fifth day of rehabilitation. The optimal cutoff for the results of A-test was: 7/8 for the first day, 29/30 for the fourth day, and 34/35 for the fifth day of rehabilitation. On the second and the third day A-test had two cutoff points, the lower point safely separated the patients with functional disability, while the upper point ruled out functional disability. On the 2nd rehabilitation day the cutoff points were 12/13 and 17/18, on the 3rd rehabilitation day cutoff points were 13/14 and 18/19. Conclusion: The A-test has all characteristics of an accurate tool which can be used for separating patients with and without functional disability at all stages of early rehabilitation after surgically treated hip disease or fracture. Based on the results of A-test within the first days of early rehabilitation, it is possible to make a plan for postacute rehabilitation.
[Mh] Termos MeSH primário: Artroplastia de Quadril/reabilitação
Técnicas de Apoio para a Decisão
Fixação de Fratura/reabilitação
Fraturas do Quadril/reabilitação
Fraturas do Quadril/cirurgia
Osteoartrite do Quadril/reabilitação
Osteoartrite do Quadril/cirurgia
Planejamento de Assistência ao Paciente
Cuidados Pós-Operatórios/métodos
[Mh] Termos MeSH secundário: Atividades Cotidianas
Adulto
Idoso
Idoso de 80 Anos ou mais
Área Sob a Curva
Artroplastia de Quadril/efeitos adversos
Tomada de Decisão Clínica
Avaliação da Deficiência
Feminino
Fixação de Fratura/efeitos adversos
Fraturas do Quadril/diagnóstico
Fraturas do Quadril/fisiopatologia
Seres Humanos
Masculino
Meia-Idade
Osteoartrite do Quadril/diagnóstico
Osteoartrite do Quadril/fisiopatologia
Valor Preditivo dos Testes
Estudos Prospectivos
Curva ROC
Recuperação de Função Fisiológica
Reprodutibilidade dos Testes
Fatores de Tempo
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180213
[Lr] Data última revisão:
180213
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180118
[St] Status:MEDLINE
[do] DOI:10.2298/VSP150819056V


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[PMID]:29182002
[Au] Autor:Richards T; Clement R; Russell I; Newington D
[Ad] Endereço:Department of Orthopaedic Hand Surgery, Morriston Hospital , Swansea , UK.
[Ti] Título:Acute hand injury splinting - the good, the bad and the ugly.
[So] Source:Ann R Coll Surg Engl;100(2):92-96, 2018 Feb.
[Is] ISSN:1478-7083
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Injuries to the hand comprise 20% of all emergency department attendances, with an estimated annual treatment cost of over £100 million in the UK. The initial assessment and management of hand injuries is usually undertaken by junior staff, many of whom have little or no training or experience in splinting hand fractures. In the Department of Orthopaedic Hand Surgery, Morriston Hospital, we regularly observe patients presenting to the specialist hand fracture clinics having had initial management that shows no appreciation for the treatment objectives or the safe positions for splinting. This article aims to provide guidance for frontline staff on the management of hand fractures, with particular emphasis on the appropriate nonoperative care to avoid any unnecessary morbidity.
[Mh] Termos MeSH primário: Fixação de Fratura
Fraturas Ósseas/cirurgia
Traumatismos da Mão/cirurgia
Contenções
[Mh] Termos MeSH secundário: Fixação de Fratura/instrumentação
Fixação de Fratura/métodos
Fraturas Ósseas/diagnóstico por imagem
Traumatismos da Mão/diagnóstico por imagem
Seres Humanos
Contenções/efeitos adversos
Contenções/estatística & dados numéricos
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180209
[Lr] Data última revisão:
180209
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171129
[St] Status:MEDLINE
[do] DOI:10.1308/rcsann.2017.0195


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[PMID]:28467588
[Au] Autor:Ertürk C; Altay MA; Altay N; Öztürk IA; Baykara I; Sert C; Isikan UE
[Ad] Endereço:Department of Orthopedics and Traumatology, Istanbul Health Sciences University Kanuni Sultan Süleyman Training and Research Hospital, Küçükçekmece, Istanbul, Turkey. erturkc@yahoo.com.
[Ti] Título:The effect of 2 different surgical methods on intracompartmental pressure value in tibial shaft fracture: An experimental study in a rabbit model.
[So] Source:Ulus Travma Acil Cerrahi Derg;23(2):85-90, 2017 Mar.
[Is] ISSN:1306-696X
[Cp] País de publicação:Turkey
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Intracompartmental pressure (ICP) monitoring is a widely used modality, particularly after intramedullary nailing of tibial shaft fractures. It was hypothesized that ICP value in fracture fixed with Ilizarov circular fixator (ICF) might be lower than in fracture fixed with intramedullary pin (IMP). The present study is a comparison of ICP value in tibial fractures in a rabbit model fixed with ICF and IMP. METHODS: Twenty male New Zealand White rabbits were randomly divided into 2 groups of equal size: ICF group (Group 1) and IMP group (Group 2). Under anesthesia, half of proximal part of the right tibia of all rabbits was fractured. Tibial fractures were fixed with ICF in Group 1 and IMP in Group 2. ICP values were monitored at 6-hour intervals for 48 hours. RESULTS: There was statistically significant difference in ICP value between groups (p<0.001). While there was statistically significant increase in ICP values 24 hours post surgery, there was statistically significant decrease during second 24 hours following surgery. Most importantly, ICP values of ICF group were significantly lower than those of IMP group at 30, 36, and 42 hours post surgery (p<0.05). CONCLUSION: At 24th hour after fixation, ICP values measured in ICF group were lower compared with those of IMP group. These results indicate that use of ICF in tibial fractures provides additional decompression in the anterior compartment. In light of these findings, ICF may be preferable for treatment of tibial fractures with high risk for compartment syndrome.
[Mh] Termos MeSH primário: Fixação de Fratura
Fraturas da Tíbia
[Mh] Termos MeSH secundário: Animais
Modelos Animais de Doenças
Fixação de Fratura/efeitos adversos
Fixação de Fratura/métodos
Fixação de Fratura/estatística & dados numéricos
Masculino
Pressão
Coelhos
Fraturas da Tíbia/fisiopatologia
Fraturas da Tíbia/cirurgia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180209
[Lr] Data última revisão:
180209
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170504
[St] Status:MEDLINE
[do] DOI:10.5505/tjtes.2016.82177


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[PMID]:28467582
[Au] Autor:Sönmez MM; Gülabi D; Ugurlar M; Uzun M; Sarban S; Seker A
[Ti] Título:Minimal invasive fixation of distal tibial fractures does not result in rotational malalignment: A report of 24 cases with CT imaging.
[So] Source:Ulus Travma Acil Cerrahi Derg;23(2):144-149, 2017 Mar.
[Is] ISSN:1306-696X
[Cp] País de publicação:Turkey
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Tibial torsion is rotation of the proximal versus the distal articular axis in the transverse plane. This study used computed tomography (CT) to examine rotational malalignment in the crus following use of minimally invasive plate osteosynthesis (MIPO) technique in distal tibial fractures and evaluated effect of rotational difference on clinical outcomes and VAS scores. METHODS: Analysis of 24 patients who were operated on for closed distal tibial fracture with MIPO technique between 2010 and 2012 was conducted. Malrotation was defined as rotational difference >10°. Operated knees were evaluated with 0.5-mm, fine-cut, 3-dimensional CT scan performed in cooperation with radiology department. Side-to-side difference in tibial torsion angle >10° was considered significant degree of malrotation. All patients were assessed clinically (visual analogue scale [VAS] and American Orthopaedic Foot and Ankle Society [AOFAS] scores) and radiologically at final visit. RESULTS: Mean follow-up period was 20.00±9.46 months (range: 18-51 months). Mean VAS score was 2.58±0.83 (range: 1-4) and mean AOFAS score was 87.50±4.05 (range: 78-93). Mean tibial rotation angle was 31.54±6.00° (range: 18-45°) on healthy side and 32.00±6.24° (range: 10-43°) on the operated side. No statistically significant difference was determined (p>0.05). CONCLUSION: Use of intraoperative fluoroscopy, cable technique, and uninjured extremity as reference, can reduce incidence of rotational malalignment of distal tibial fractures treated with MIPO.
[Mh] Termos MeSH primário: Fixação de Fratura
Procedimentos Cirúrgicos Minimamente Invasivos
Fraturas da Tíbia
[Mh] Termos MeSH secundário: Fixação de Fratura/métodos
Fixação de Fratura/estatística & dados numéricos
Seres Humanos
Procedimentos Cirúrgicos Minimamente Invasivos/métodos
Procedimentos Cirúrgicos Minimamente Invasivos/estatística & dados numéricos
Amplitude de Movimento Articular
Fraturas da Tíbia/diagnóstico por imagem
Fraturas da Tíbia/fisiopatologia
Fraturas da Tíbia/cirurgia
Tomografia Computadorizada por Raios X
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180209
[Lr] Data última revisão:
180209
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170504
[St] Status:MEDLINE
[do] DOI:10.5505/tjtes.2016.59153


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[PMID]:28468133
[Au] Autor:Cohen SM; Rosett BE; Shifrin DA
[Ad] Endereço:Division of Plastic and Reconstructive Surgery, University of Illinois at Chicago, Chicago, IL.
[Ti] Título:An Analysis of Independent Variables Affecting Surgical Outcomes in Patients Undergoing Repair of Maxillofacial Trauma: An American College of Surgeons National Surgical Quality Improvement Program Study.
[So] Source:J Craniofac Surg;28(3):596-599, 2017 May.
[Is] ISSN:1536-3732
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: Facial fractures, from straightforward closed nasal reductions to complex pan facial fractures, are commonly encountered in the Plastic Surgical community. However, very little has been discussed in the literature regarding the outcomes of facial fractures relating to contributing factors. Our aim was to evaluate a battery of independent variables in order to identify, which, if any, factors correlate with suboptimal outcomes in patients who have undergone facial fracture surgery. METHODS: Under the data use agreement of the American College of Surgeons public use files of the NSQIP, patients involving repair of facial fractures, Current Procedural Terminology codes 21310 to 21470 inclusive, were queried. The outcomes examined included: wound dehiscence, superficial surgical site infection, deep surgical site infection, readmission, open wound/wound infection and return to the operating room. RESULTS: There were 2069 facial fracture patients in the National Surgical Quality Improvement Program datasets (2005-2013). Thirteen perioperative risk factors and patient comorbidities were evaluated for correlation with the 6 outcomes. Of the 6 outcomes evaluated, open wound/wound infection was the most prevalent outcome (6%). Factors statistically significant for presence of open wound/wound infection were American Society of Anesthesiology classification (P = 0.002), presence of bleeding disorder (P = 0.008), emergency patient (P = 0.001), chronic alcohol use (P = 0.002), and chronic steroid use (P = 0.034). DISCUSSION: Several factors correlated with presence of an open wound/wound infection; however, variables such as diabetes and active tobacco use, which are often thought to contribute to wound infections, were shown to be statistically nonsignificant. Although this study was limited by its observational nature, these data may indicate a change in perception of the factors correlated with wound infections.
[Mh] Termos MeSH primário: Ossos Faciais/lesões
Fixação de Fratura
Traumatismos Maxilofaciais/cirurgia
Fraturas Cranianas/cirurgia
[Mh] Termos MeSH secundário: Bases de Dados Factuais
Ossos Faciais/cirurgia
Seguimentos
Seres Humanos
Readmissão do Paciente/estatística & dados numéricos
Complicações Pós-Operatórias/etiologia
Melhoria de Qualidade
Reoperação/estatística & dados numéricos
Fatores de Risco
Resultado do Tratamento
Estados Unidos
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180202
[Lr] Data última revisão:
180202
[Sb] Subgrupo de revista:D
[Da] Data de entrada para processamento:170505
[St] Status:MEDLINE
[do] DOI:10.1097/SCS.0000000000003545



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