RESUMO
The authors report their experience of treating complex elbow fracture-dislocations in elderly people, using a minimally-invasive approach with a new articulated external fixator that is associated with minimal internal fixation. The clinical results for 19 patients are presented according to outcome factors, such as range of motion, pain and function, rate and type of complications, and reoperation rate. The results indicate that this treatment strategy should be considered as a good alternative to other treatment options reported in the literature, including conservative treatment, ORIF with angular stable plates and total elbow arthroplasty.
Assuntos
Articulação do Cotovelo/cirurgia , Fixadores Externos , Fixação de Fratura , Fraturas Ósseas/cirurgia , Luxações Articulares/cirurgia , Osteoporose/cirurgia , Idoso , Avaliação da Deficiência , Feminino , Seguimentos , Fixação de Fratura/instrumentação , Fraturas Ósseas/fisiopatologia , Fraturas Ósseas/reabilitação , Humanos , Luxações Articulares/fisiopatologia , Luxações Articulares/reabilitação , Masculino , Osteoporose/complicações , Osteoporose/fisiopatologia , Estudos Prospectivos , Qualidade de Vida , Amplitude de Movimento Articular , Resultado do Tratamento , Lesões no CotoveloRESUMO
High rates of injury, particularly those for back injuries, at an offshore petroleum unit were addressed through an intensive wellness program initiated in 1991. The number of all types of injuries, including back injuries, decreased between 1991 and 1995. The number of back injuries decreased from nine in 1987 to four in 1992 and was zero in 1993. Although there are inadequate data to provide power for a significant result, other criteria suggest a causal relationship. The results are consistent with the few published studies that suggest a decrease in the number of injuries in association with exercise and perhaps with modification of psychosocial risk factors. Calculations suggest a cost savings of over $800,000 and a return on investment of $2.51, as well as avoidance of pain and injury.