RESUMO
Although limited carpal fusion is a choice of treatment in several wrist disorders, little is known about the biomechanics of these procedures, especially the loads carried by the ligaments. In a finite element study, four types of limited carpal fusions (scaphotrapeziotrapezoid, capitohamate, four corner fusion with and without scaphoid excision) were simulated and the loads carried by the ligaments were recorded. Measurements were repeated with and without implantation. The load transmission through the ligaments varied by the type of the fusion but, radioscaphoid and long radiolunate ligaments carried significantly more loads if not excised during the operation. Implantation did not affect the results in most cases. The model of the present study may be useful in preoperative planning.
Assuntos
Fenômenos Biomecânicos/fisiologia , Simulação por Computador , Análise de Elementos Finitos , Ligamentos Articulares/fisiopatologia , Articulação do Punho/fisiopatologia , Artrodese/métodos , Ossos do Carpo/cirurgia , Humanos , Masculino , Radiografia , Rádio (Anatomia)/fisiopatologia , Ulna/fisiopatologia , Articulação do Punho/diagnóstico por imagem , Articulação do Punho/cirurgia , Adulto JovemRESUMO
PURPOSE: to inform healthy women about breast cancer and screen them, as well as to look for any relationship between demographic and clinical findings and breast cancer. METHODS: thirty-five health teams were created prior to the study. The teams were primarily trained for breast examination and for screening methods to detect breast cancer. RESULTS: a total of 77,934 subjects were evaluated. Clinical breast examination (CBE) was performed in 66% (n=51,706) of the participants. The characteristics of the subjects in the examined group were similar to those in the group refusing examination. The percentage of the subjects who declined examination was 2-fold higher in the ≥ 60 year age group compared to younger women. A breast mass was detected in 2,838 (6%) subjects who had undergone breast examination. Lower educational level and urban dwellers showed higher incidence of suspicious mass in CBE. Fifty-eight women were diagnosed with breast cancer. The cumulative incidence of breast cancer was 7.5/10.000 for all of the study population and 10.1/10.000 for women with CBE. CONCLUSION: elderly subjects, those living in rural areas and women with low educational and lower socio-economic levels should be convinced to undergo screening for breast cancer.