RESUMO
Apesar de não muito frequente, nos últimos 20 anos, houve um aumento significativo dos relatos sobre rotura do peitoral maior, normalmente associadas à prática de atividade física em que ocorre contração intensa e/ou uso de cargas pesadas exercendo resistência sobre o músculo. Neste relato de caso temos um paciente de 51 anos referindo dor no tórax à direita e no braço direito há 3 dias após tentar consertar o guidão da moto. Apresentava assimetria dos peitorais, perda de força do membro superior direito, dificuldade de movimentação e hematoma. A ressonância magnética demonstrou rotura completa da junção miotendínea do peitoral maior, com tendinopatia com fissuras insercionais e intrasubstanciais infraespinhal e tendinopatia com rotura parcial do tendão subescapular. Foi indicado por médico ortopedista o acompanhamento com o uso de medicação analgésica.
Although not very common, in the last 20 years, there has been a significant increase in reports of rupture of the pectoralis major, normally associated with the practice of physical activity in which intense contraction occurs and/or the use of heavy loads exerting resistance on the muscle. In this case report we have a 51-year-old patient reporting pain in his right chest and right arm for 3 days after trying to fix his motorcycle's handlebars. He had asymmetry of the pectorals, loss of strength in the right upper limb, difficulty moving and hematoma. Magnetic resonance imaging demonstrated complete rupture of the myotendinous junction of the pectoralis major, with tendinopathy with insertional and intrasubstantial infraspinatus fissures and tendinopathy with partial rupture of the subscapularis tendon. An orthopedic doctor recommended follow-up with the use of analgesic medication.
Aunque no es muy común, en los últimos 20 años se ha observado un aumento significativo en los reportes de rotura del pectoral mayor, normalmente asociado a la práctica de actividad física en la que se produce una contracción intensa y/o al uso de cargas pesadas ejerciendo resistencia sobre el mismo. el músculo. En este caso clínico tenemos un paciente de 51 años que refiere dolor en el pecho derecho y en el brazo derecho durante 3 días después de intentar arreglar el manillar de su motocicleta. Presentó asimetría de pectorales, pérdida de fuerza en miembro superior derecho, dificultad de movimiento y hematoma. La resonancia magnética demostró rotura completa de la unión miotendinosa del pectoral mayor, con tendinopatía con fisuras de inserción e intrasustancial del infraespinoso y tendinopatía con rotura parcial del tendón subescapular. Un médico ortopédico recomendó seguimiento con el uso de medicación analgésica.
Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Músculos Peitorais/lesões , Músculos Peitorais/diagnóstico por imagem , Extremidade Superior/lesões , Extremidade Superior/diagnóstico por imagem , Junção Miotendínea/lesões , Junção Miotendínea/diagnóstico por imagemRESUMO
INTRODUÇÃO: O manejo dos pacientes vítimas de PAF possui vertentes divergentes a respeito do tratamento cirúrgico, que pode ser realizado de forma imedata ou tardia. Em lesões auto-infligidas, a distância entre a arma e a região acometida é menor, causando consequências estéticas e funcionais mais devastadoras. Aliado ao fato desse tipo de trauma criar uma ferida suja devido à comunicação com a cavidade oral e seios paranasais, o manejo das lesões representam um desafio mesmo à cirurgiões experientes. OBJETIVO: Estre trabalho relata o manejo cirúrgico de uma ferida auto-infligida por arma de fogo que resultou em avulsão dos tecidos moles na região maxilofacial. DESCRIÇÃO DO CASO: Paciente do sexo masculino, 35 anos, vítima de projétil de arma de fogo auto-infligido em região maxilofacial, cursando com extenso ferimento em região de língua e mento. Clinicamente, o paciente não apresentava sinais de fratura em ossos da face. Ambos os ferimentos apresentavam secreção purulenta e o paciente manifestava disfonia devido a grande destruição tecidual. CONSIDERAÇÕES FINAIS: O tratamento de ferimentos por arma de fogo não só é um grande desafio para o cirurgião, como para toda a equipe multidisciplinar requerida para tais casos, visto que não há protocolos bem definidos para o tratamento dessas lesões(AU)
INTRODUCTION: The management of patients who are victims of FAP has divergent aspects regarding surgical treatment, which can be performed immediately or late. In self-inflicted injuries, the distance between the weapon and the affected region is smaller, causing more devastating aesthetic and functional consequences. Allied to the fact that this type of trauma creates a dirty wound due to the communication with the oral cavity and paranasal sinuses, the management of injuries represents a challenge even for experienced surgeons. OBJECTIVE: This paper reports the surgical management of a self-inflicted gunshot wound that resulted in soft tissue avulsion in the maxillofacial region. CASE DESCRIPTION: Male patient, 35 years old, victim of a self-inflicted firearm projectile in the maxillofacial region, coursing with extensive injury in the region of the tongue and chin. Clinically, the patient did not show signs of facial bone fractures. Both wounds had purulent secretion and the patient had dysphonia due to extensive tissue destruction. FINAL CONSIDERATIONS: The treatment of gunshot wounds is not only a great challenge for the surgeon, but also for the entire multidisciplinary team required for such cases, since there are no well-defined protocols for the treatment of these injuries(AU)
Assuntos
Humanos , Masculino , Adulto , Língua/lesões , Infecção dos Ferimentos , Ferimentos por Arma de Fogo , Palato Duro/lesões , Ferimentos e Lesões , Ferimentos Penetrantes , Palato Duro , Equimose , Edema , Traumatismos MaxilofaciaisRESUMO
OBJECTIVE: To analyze the skin injuries of hospitalized newborns and identify factors related to the number of lesions. METHOD: This was a cross-sectional epidemiological study carried out over a period of one year in a Neonatal Intensive Care Unit in the west of Paraná. The study included 74 newborns with a score ≥5 on the Newborn Skin Condition Scale. Data analysis by chi-square and Pearson's test (p < 0.05). RESULTS: The frequency was 25.4%, 59.4% had more than one lesion, mainly dermatitis and pressure injury. Birth characteristics were not related to the number of lesions. Not using antibiotics and parenteral nutrition, hemoglobin >11g/dl, phototherapy, pain score <4 and hospitalization >30 days were related to the number of lesions. The presence of two injuries led to longer healing time and three to longer hospitalization. A higher score on the Skin Condition Scale was related to healing time and late start of the diet. CONCLUSION: Skin injuries were found to be infrequent among newborns, but there is still a need to improve practices to prevent and maintain skin integrity.
Assuntos
Unidades de Terapia Intensiva Neonatal , Humanos , Estudos Transversais , Recém-Nascido , Masculino , Feminino , Pele/lesões , Úlcera por Pressão/epidemiologia , Hospitalização/estatística & dados numéricos , Tempo de Internação/estatística & dados numéricosRESUMO
Tendons, complex fibrous structures, are subjected to great tensions, which can give rise to the so-called tendinopathies. This study aimed to evaluate photobiomodulation and human Amniotic Membrane applied as single or combined therapies to treat induced Achilles tendon lesions. Seventy-five rats were divided into five groups (n=15): C- control Sham surgery; I- tendon injury; LA- tendon injury treated with photobiomodulation; AM- tendon injury treated with Amniotic Membrane; LAM- tendon injury + photobiomodulation and Amniotic Membrane, subdivided into three groups (n=5) with analysis at 3, 7, and 14 days. The tendon injuries were made with a 20 g weight released from a mini guillotine onto the ankle in dorsiflexion. AM and LAM groups received an Amniotic Membrane fragment while LA and LAM groups received transcutaneous photobiomodulation, using a 660 nm wavelength laser. The inflammatory cells showed statistical differences between groups C and I (p<0.05), I and AM (p<0.01), I and LA (p<0.05), and I and LAM (p<0.01). Both photobiomodulation and Amniotic Membrane were shown to enhance tendon repair, and the association of photobiomodulation plus Amniotic Membrane was the most effective treatment. We conclude that the association of photobiomodulation plus Amniotic Membrane was effective in accelerating and improving the tendon regeneration process.
Assuntos
Tendão do Calcâneo , Âmnio , Terapia com Luz de Baixa Intensidade , Ratos Wistar , Traumatismos dos Tendões , Animais , Terapia com Luz de Baixa Intensidade/métodos , Âmnio/transplante , Âmnio/efeitos da radiação , Traumatismos dos Tendões/terapia , Traumatismos dos Tendões/radioterapia , Tendão do Calcâneo/lesões , Tendão do Calcâneo/efeitos da radiação , Ratos , Cicatrização/efeitos da radiação , Cicatrização/fisiologia , Masculino , Humanos , Modelos Animais de DoençasRESUMO
PURPOSE: To develop and assess three-dimensional models of physeal fractures in dog femurs (3D MPFDF) using radiographic imaging. METHODS: The study was conducted in three phases: development of 3D MPFDF; radiographic examination of the 3D MPFDF; and comparative analysis of the anatomical and radiographic features of the 3D MPFDF. RESULTS: The base model and the 3D MPFDF achieved high fidelity in replicating the bone structures, accurately maintaining the morphological characteristics and dimensions such as length, width, and thickness, closely resembling natural bone. The radiographs of the 3D MPFDF displayed distinct radiopaque and radiolucent areas, enabling clear visualization of the various anatomical structures of the femur. However, in these radiographs, it was challenging to distinguish between the cortical and medullary regions due to the use of 99% internal padding in the printing process. Despite this limitation, the radiographs successfully demonstrated the representation of the Salter-Harris classification. CONCLUSIONS: This paper presents a pioneering project focused on technological advancement aimed at developing a method for the rapid and cost-effective production of three-printed models and radiographs of physeal fractures in dogs.
Assuntos
Fraturas do Fêmur , Imageamento Tridimensional , Modelos Anatômicos , Impressão Tridimensional , Animais , Cães , Fraturas do Fêmur/diagnóstico por imagem , Imageamento Tridimensional/métodos , Radiografia , Fêmur/diagnóstico por imagem , Fêmur/anatomia & histologia , Fêmur/lesões , Medicina Veterinária/métodos , Reprodutibilidade dos TestesAssuntos
Miotomia , Humanos , Miotomia/métodos , Miotomia/efeitos adversos , Acalasia Esofágica/cirurgia , Instrumentos Cirúrgicos , Masculino , Cirurgia Endoscópica por Orifício Natural/métodos , Cirurgia Endoscópica por Orifício Natural/efeitos adversos , Mucosa/cirurgia , Mucosa/lesões , Pessoa de Meia-Idade , FemininoRESUMO
INTRODUCTION: Postoperative fracture site infection can lead to notable patient morbidity, increase cost of care, and further contribute to healthcare disparities globally. Dogma suggests surgical blades as a vehicle for introducing bacteria into the surgical site; however, there is a paucity of literature to support this claim. This study uses advanced DNA sequencing to detect bacterial DNA on surgical blades used in upper extremity fracture surgeries. METHODS: This was a prospective study, conducted at a high-volume level 1 trauma center. All acute, closed upper extremity fractures requiring surgical stabilization were consecutively enrolled in a prospective fashion. The primary end point was the presence of bacterial DNA on the surgical blade using next-generation sequencing (NGS). At the time of surgery, two blades were sterilely opened. One blade served as the control while the other was used for the initial skin incision. Two negative control blades were opened directly into a sterile container. Two positive control blades were used for skin incision through known infections. All samples were sent for NGS analysis. RESULTS: Forty patients were enrolled in this study. The median age was 33.5 years, and 30% were female; the median body mass index was 26.52. Humerus fractures were the most common injury (N = 17, 42.5%), followed by clavicle fractures (13, 32.5%) and radius/ulna fractures (10, 25.0%). NGS analysis revealed no contamination of test blades used for skin incision. Three control blades tested positive for bacterial DNA. Negative control blades tested negative for bacterial DNA (0/2); the positive control blades resulted positive for bacterial DNA contamination (2/2). CONCLUSION: Surgical blades used for skin incision in the upper extremity are not contaminated with bacterial DNA as analyzed by NGS. This finding challenges previous surgical dogma regarding surgical blade contamination and supports that the same surgical blade can safely be used for deeper dissection. LEVEL OF EVIDENCE: Level II study: IRB approval-IRB#848938.
Assuntos
Sequenciamento de Nucleotídeos em Larga Escala , Infecção da Ferida Cirúrgica , Humanos , Estudos Prospectivos , Infecção da Ferida Cirúrgica/prevenção & controle , Infecção da Ferida Cirúrgica/microbiologia , Feminino , Masculino , Adulto , Pessoa de Meia-Idade , Fraturas Ósseas/cirurgia , DNA Bacteriano/análise , Adulto Jovem , Extremidade Superior/cirurgia , Extremidade Superior/lesões , Contaminação de Equipamentos , Estudos de Coortes , Fraturas do Úmero/cirurgiaRESUMO
With over 250 million players worldwide, soccer is the most popular sport in the world. The overall number of players at professional, amateur, and recreational levels has increased along with an increase in player diversity, including age and sex. These increases in player numbers, as well as a variety of demographics, have resulted in an increase in soccer-related injuries. Injury in the professional setting can lead to time off the field and an effect on team results and earnings. Injury at the amateur and recreational levels can lead to time off work, away from other activities, and change in activities of daily living. We provide an extensive list of common injuries sustained by soccer players, their pathophysiology, diagnosis, treatment, and general guidelines on return to play.
Assuntos
Traumatismos em Atletas , Futebol , Humanos , Futebol/lesões , Traumatismos em Atletas/terapia , Traumatismos em Atletas/diagnóstico , Volta ao Esporte , Músculo Esquelético/lesões , Ligamentos/lesõesRESUMO
Groin injuries and femoroacetabular impingement are common among soccer players and can provide a challenge in diagnosis, as well as treatment. Nonoperative and operative measures are the 2 predominant treatments. This current review investigates the recent literature on groin and femoroacetabular impingement injuries in soccer players, as well as potential treatment modalities.