Preferences of orthopedic surgeons for treating midshaft clavicle fracture in adults.

OBJECTIVE: To determine the current clinical practice in Latin America for treating midshaft clavicle fractures, including surgical and non-surgical approaches. METHODS: A cross-sectional study using a descriptive questionnaire. Shoulder and elbow surgeons from the Brazilian Society of Shoulder and Elbow Surgery and from the Latin American Society of Shoulder and Elbow were contacted and asked to complete a short questionnaire (SurveyMonkey®) on the management of midshaft fractures of the clavicle. Incomplete or inconsistent answers were excluded. RESULTS: The type of radiographic classification preferably used was related to description of fracture morphology, according to 41% of participants. Allman classification ranked second and was used by 24.1% of participants. As to indications for surgical treatment, only the indications with shortening and imminence of skin exposure were statistically significant. Conservative treatment was chosen in cortical contact. Regarding immobilization method, the simple sling was preferred, and treatment lasted from 4 to 6 weeks. Although the result was not statistically significant, the blocked plate was the preferred option in surgical cases. CONCLUSION: The treatment of midshaft clavicle fractures in Latin America is in accordance with the current literature.

Preferences of orthopedic surgeons for treating midshaft clavicle fracture in adults / Preferências dos cirurgiões ortopédicos para o tratamento da fratura do terço médio da clavícula em adultos

ABSTRACT Objective To determine the current clinical practice in Latin America for treating midshaft clavicle fractures, including surgical and non-surgical approaches. Methods A cross-sectional study using a descriptive questionnaire. Shoulder and elbow surgeons from the Brazilian Society of Shoulder and Elbow Surgery and from the Latin American Society of Shoulder and Elbow were contacted and asked to complete a short questionnaire (SurveyMonkey®) on the management of midshaft fractures of the clavicle. Incomplete or inconsistent answers were excluded. Results The type of radiographic classification preferably used was related to description of fracture morphology, according to 41% of participants. Allman classification ranked second and was used by 24.1% of participants. As to indications for surgical treatment, only the indications with shortening and imminence of skin exposure were statistically significant. Conservative treatment was chosen in cortical contact. Regarding immobilization method, the simple sling was preferred, and treatment lasted from 4 to 6 weeks. Although the result was not statistically significant, the blocked plate was the preferred option in surgical cases. Conclusion The treatment of midshaft clavicle fractures in Latin America is in accordance with the current literature.

RESUMO Objetivo Determinar a prática clínica atual na América Latina para o tratamento das fraturas do terço médio da clavícula, incluindo abordagens cirúrgicas e não cirúrgicas. Métodos Estudo transversal com aplicação de questionário descritivo. Cirurgiões de ombro e cotovelo da Sociedade Brasileira de Cirurgia do Ombro e Cotovelo e da Sociedade Latino-Americana de Ombro e Cotovelo foram contatados e convidados a completar um breve questionário (SurveyMonkey®) sobre o manejo das fraturas do terço médio da clavícula. Foram excluídas as respostas incompletas ou inconsistentes. Resultados O tipo de classificação radiográfica utilizada de preferência esteve de acordo com a descrição da morfologia da fratura, representando 41% do total dos participantes. Em segundo lugar, apareceu a classificação de Allman, que foi utilizada por 24,1% dos participantes. Nas indicações de tratamento cirúrgico, as indicações com encurtamento e iminência de exposição da pele foram estatisticamente significativas. Tratamento conservador foi prescrito em caso de contato entre as corticais. Como método de imobilização, a tipoia simples foi a preferência, e o tempo de tratamento foi de 4 a 6 semanas. Apesar do resultado sem significância estatística, a placa bloqueada foi a opção preferencial nos casos cirúrgicos. Conclusão A metodologia de tratamento das fraturas do terço médio da clavícula nos países da América Latina é semelhante, assim como com a literatura atual.

Update on biological therapies for knee injuries: osteoarthritis.

Osteoarthritis (OA) is a progressive disease that causes functional impairment of the joints. Chronic forms of knee OA have been increasing worldwide, limiting patients' quality of life. Recent studies have sought to increase effectiveness and quality in the development of new therapies, such as platelet-rich plasma, hyaluronic acid, stem cells, and nuclear factor κB, aimed principally at reducing proinflammatory activity, pain, and degeneration of the knee joints. The goal of this review is to present an update on biological therapies for knee OA and to provide guidance for future OA studies.