RESUMO
Background: The objective of this study was to review the outcomes of patients who underwent one-bone forearm (OBF) reconstruction. Methods: A retrospective review of patients who underwent OBF surgery between 1994 and 2014 was undertaken. Patient demographics, etiology, associated injuries, number of surgeries prior to OBF surgery, surgical details, and postoperative information were collected. A telephone interview was conducted at final follow-up, including a Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) questionnaire, a 10-point scoring system used by Peterson et al, and a series of questions concerning pain and patient satisfaction. Results: There were 6 males and 2 females with a mean age of 44 years (range, 20-66 years). All patients had traumatic etiology, with 6 having open wounds and 2 having closed wounds. All patients had union with a mean follow-up of 83.6 months (range, 16-218 months). The mean pain score was 3 (range, 0-8), of which 3 were painless (score 0). The mean QuickDASH score was 39 (range, 7-75), and 4 patients had good or excellent results according to the 10-point score system used by Peterson et al. All patients were satisfied with the result. Five of 8 had complications related to soft tissues that were residual from their prior injuries and surgeries. One patient had post healing fracture requiring revision fixation and 1 had a postoperative infection requiring parenteral antibiotics. Conclusions: OBF surgery is an effective salvage procedure for complicated forearm instability, particularly after trauma. While union rates are high, complications are typically related to pain and soft tissue secondary to the previous injury and reconstructive procedures.
Assuntos
Traumatismos do Antebraço/cirurgia , Instabilidade Articular/cirurgia , Adulto , Idoso , Transplante Ósseo/efeitos adversos , Transplante Ósseo/métodos , Feminino , Traumatismos do Antebraço/diagnóstico por imagem , Fixação Interna de Fraturas/efeitos adversos , Fixação Interna de Fraturas/métodos , Fraturas Expostas/diagnóstico por imagem , Fraturas Expostas/cirurgia , Fraturas não Consolidadas/diagnóstico por imagem , Fraturas não Consolidadas/cirurgia , Humanos , Instabilidade Articular/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Satisfação do Paciente , Radiografia , Estudos Retrospectivos , Terapia de Salvação/efeitos adversos , Terapia de Salvação/métodos , Resultado do Tratamento , Adulto JovemRESUMO
OBJECTIVE: To analyze through tomographic studies, the morphology and dimensions of the C1-C2 vertebrae in pediatric patients, to evaluate the possibility of application of Magerl's technique in these patients, and to contribute with data for the usage of the technique in safety. METHOD: Forty normal cervical tomographies, from patients at an age range of 24-120 months of age and from both genders, were retrospectively analyzed. Data was statistically analyzed to obtain mean value and variations of each measurement: length from the C2's pedicle to C1's lateral mass, thickness of the pedicle of C2, the attack angle of the screw at the C2 isthmus with the horizontal axis and the distance from the odontoid to the anterior arch of C1. RESULTS: THE MEAN VALUES OBTAINED WERE: length right 30.86 mm, left 31.47 mm; thickness right 5.28 mm, left 5.26 mm; attack angle right 46.25(0) , left 44.50(0) ; distance from odontoid to anterior arch of C1 2,17 mm. CONCLUSION: The Magerl technique, after tomographic study, seems to be a viable option to be used in pediatric patients. Level of Evidence IV, Case Series.
RESUMO
OBJETIVO: Analisar a morfologia e as dimensões, por meios tomográficos, das vértebras C1 e C2, nos pacientes pediátricos, avaliar a possibilidade de utilização da técnica de Magerl nesses pacientes, bem como fornecer dados para realização dessa técnica com maior segurança.MÉTODOS: Foram analisadas retrospectivamente 40 tomografias cervicais de pacientes entre 24 e 120 meses de idade de ambos os sexos e sem deformidades cervicais. Os dados foram analisados estatisticamente para obtenção dos valores médios e da variação de cada medida: do comprimento do pedículo de C2 até a massa lateral de C1, da espessura do pedículo de C2, do ângulo de ataque do parafuso no istmo de C2 com a horizontal e da distância do odontoide ao arco anterior de C1.RESULTADOS: Os valores médios encontrados foram respectivamente: lado direito 30,68 mm e esquerdo 31,47 mm; direito 5,28 mm e esquerdo 5,26 mm; direito 46,250, esquerdo 44,500 e 2,17mm.CONCLUSÃO: A técnica de Magerl, segundo análise tomográfica, parece ser utilizável nos pacientes pediátricos. Nível de Evidência IV, Série de Casos.
OBJECTIVE: To analyze through tomographic studies, the morphology and dimensions of the C1-C2 vertebrae in pediatric patients, to evaluate the possibility of application of Magerl's technique in these patients, and to contribute with data for the usage of the technique in safety.METHOD: Forty normal cervical tomographies, from patients at an age range of 24-120 months of age and from both genders, were retrospectively analyzed. Data was statistically analyzed to obtain mean value and variations of each measurement: length from the C2's pedicle to C1's lateral mass, thickness of the pedicle of C2, the attack angle of the screw at the C2 isthmus with the horizontal axis and the distance from the odontoid to the anterior arch of C1.RESULTS: The mean values obtained were: length right 30.86 mm, left 31.47 mm; thickness right 5.28 mm, left 5.26 mm; attack angle right 46.250 , left 44.500 ; distance from odontoid to anterior arch of C1 2,17 mm.CONCLUSION: The Magerl technique, after tomographic study, seems to be a viable option to be used in pediatric patients. Level of Evidence IV, Case Series.
Assuntos
Humanos , Masculino , Feminino , Pré-Escolar , Criança , Instabilidade Articular/diagnóstico , Instabilidade Articular/reabilitação , Fusão Vertebral , Vértebras Cervicais/anatomia & histologia , Prontuários Médicos , Estudos Retrospectivos , Interpretação Estatística de Dados , Tomografia Computadorizada por Raios XRESUMO
BACKGROUND: The purpose of this study was to analyze the effectiveness and safety of silver nitrate pleurodesis (SNP) in patients with recurrent malignant pleural effusion (RMPE) when performed in an outpatient setting. MATERIALS AND METHODS: Prospective study including patients with RMPE recruited in a tertiary university-based hospital from February 2008 to June 2009. Elected patients underwent pleural catheter insertion (Day 1) followed by 0.5% SNP (Day 2), and on 7th day the drain was removed. All procedures were performed in an outpatient facility. Pleurodesis was considered successful when no additional pleural procedure was necessary by the 30th day. Complications were registered and graded according to the CTCAE3.0. Quality of life was evaluated before and 30 days after SNP. RESULTS: A total of 68 patients (54 female, 14 male, mean age: 57.3 years) were included. In addition, 7 had bilateral pleural effusions; therefore, 75 hemithoraces were drained. Also, 5 were excluded, and 70 hemithoraces (63 patients) underwent SNP. During the period of 30 days postpleurodesis, 8 deaths not related to the procedure occurred, and we lost contact with 10 patients who were followed elsewhere. At the 30th day, 48 hemithoraces (45 patients) were reevaluated, and 2 recurrences observed. The most frequent complication was pain--graded as 3 or more in 7 patients; infection occurred in 2 patients. Physical and environmental aspects of quality of life improved significantly after pleurodesis. CONCLUSIONS: In this study, SNP could be performed safely in an outpatient setting, with pain the most frequent complication. Recurrences occurred in 4% of the patients.