Low Donor Site Morbidity Associated With Tricortical Calcaneal Bone Graft.

BACKGROUND: Autologous grafting is widely used in orthopaedic surgery because of its high osteogenic capacity, immunologic compatibility, for the absence of risk of disease transmission, and for not requiring a bone bank. The posterior-superior calcaneal tuberosity is an option for obtaining a cortical and cancellous structural bone. This study aims to describe the operative technique and complications observed at the donor site of the posterior-superior calcaneal tuberosity. METHODS: Patients who underwent graft harvesting from the posterior-superior calcaneal tuberosity were retrospectively evaluated by pain outcomes, imaging tests, and intra- and postoperative complications. RESULTS: Twenty patients with a median age of 69 years (range 48-77) and follow-up of 16 months (12-26) were assessed. Median postoperative pain at the donor site was 0 (0-6), with 2 patients reporting persistent local pain. No case of Achilles tendon rupture or intra- or postoperative calcaneal fracture were identified. One patient developed a superficial infection that was quickly resolved using oral antibiotic therapy. CONCLUSION: The posterior-superior calcaneal tuberosity is an alternative source of autologous graft with low donor site morbidity. LEVEL OF EVIDENCE: Level IV, case series.

Artéria tibial aberrante: revisão da literatura / Aberrant tibial artery: a literature review

A artéria tibial anterior, originária da artéria poplítea, normalmente se ramifica abaixo da articulação do joelho, passando posteriormente ao músculo poplíteo. Desta forma, a existência da artéria tibial aberrante ocorre quando sua ramificação está alterada, podendo se formar em diferentes alturas da artéria poplítea e realizar cursos alterados em relação aos músculos e articulações. Essas variações podem aumentar o risco de lesões intra-operatórias. O objetivo deste estudo foi realizar revisão de literatura sobre o tema pouco abordado, visando promover maior conhecimento e prevenção de iatrogenia nos atos operatórios. Foi realizada busca em bases de dados eletrônicas (PubMed, Scielo e Biblioteca Virtual em Saúde) utilizando os seguintes descritores: artérias da tíbia, artéria poplítea, e variação anatômica. Para a seleção dos artigos, foram utilizados os seguintes critérios de inclusão: resultados de pesquisa com relevância ao tema proposto, por meio de leitura crítica de cada artigo selecionado e em seguida, foram realizadas comparações das informações de cada um deles. Foram selecionados 10 artigos. Em conclusão, a presença de artéria tibial anterior aberrante é alteração anatômica de baixa incidência, mas é responsável por intercorrências durante procedimentos cirúrgicos, devido à sua localização próxima à tíbia. Sugere-se realização de exames de imagens para diagnóstico pré-operatório dessa anormalidade anatômica.

The anterior tibial artery, originating from the popliteal artery, normally branches below the knee joint, passing posteriorly to the popliteal muscle. In this way, the existence of the aberrant tibial artery occurs when its branch is altered, being able to form at different heights of the popliteal artery and carry out altered courses in relation to the muscles and joints. These variations can increase the risk of intraoperative injuries. So, the proposal to this review was to promote greater knowledge and prevention of iatrogenesis in surgical procedures. A search was performed in electronic databases (PubMed, Scielo and Virtual Health Library) using the following descriptors: tibial arteries, popliteal artery, and anatomical variation. For the selection of articles, the following inclusion criteria were used: research results with relevance to the proposed topic, through a critical reading of each selected article and then comparisons of the information on each of them were carried out. 10 articles were selected. In conclusion, the presence of an aberrant anterior tibial artery is an anatomical alteration of low incidence, but it is responsible for complications during surgical procedures, due to its location close to the tibia. It is suggested to perform imaging tests for preoperative diagnosis of this anatomical abnormality.

Radiological findings of fibrocartilaginous coalition of the third tarsometatarsal joint: a retrospective cross-sectional study with computed tomography and magnetic resonance imaging.

BACKGROUND: Fibrocartilaginous coalition of the third tarsometatarsal joint has been indicated as an extremely rare form of tarsal coalition in the radiological literature, and most articles concerned with tarsal coalition do not mention involvement of this joint. Only two reports written in the English language that approach this subject were found, an orthopedic report and an anthropological report. PURPOSE: To evaluate the prevalence of this finding and discuss and illustrate the radiological characteristics of this coalition. MATERIAL AND METHODS: A retrospective analysis of 614 computed tomography or magnetic resonance imaging scans of the ankle and/or foot, acquired at a health service within a period of three months, was performed to assess the prevalence of this coalition. RESULTS: Of the examinations characterized as valid for analysis for the purposes of the study, 17 cases compatible with fibrocartilaginous coalition of the third tarsometatarsal joint were found, thus indicating an involvement of approximately 2.97% of the examined feet. CONCLUSION: Our radiological findings are typical, and the prevalence found in this study was statistically significant, being similar to that described in the anthropological report (3.2%-6.8%).

Efeitos de dietas ricas em fibras sobre ratos em crescimento: estudo experimental / Effect of fiber enriched diets on growing rats: experimental study

Objetivo: avaliar ganho de peso e o crescimento de ratos recem desmamados, alimentados com duas dietas ricas em fibras e avaliar os efeitos destas dietas sobre a excrecao fecal de...