RESUMEN
Surgical site infections (SSI) constitute 31% of all hospital-acquired conditions, with ankle and foot surgical procedures showing an incidence of SSI ranging from 0.5% to 6.5%. This study aimed to assess the incidence of both superficial and deep surgical site infections in foot and ankle surgery, along with associated factors. Conducted as a retrospective cohort study, it included 2180 patients undergoing foot and ankle surgery in a private hospital between 2014 and 2020, encompassing elective and trauma cases. Outcome variables comprised SSI, while predictor variables encompassed sex, age, diabetes mellitus, systemic arterial hypertension, smoking, American Society of Anesthesiologists (ASA) score, and body mass index. Logistic regression models were employed to identify associations between study variables. The incidence of surgical site infections stood at 4% (83/2180), comprising a rate of 2.8% (57/2180) for superficial infections and 1.2% (26/2180) for deep infections. Smoking (OR 2.9, 95%CI 1.4-5.3) and ASA score >2 (OR 3.4, 95%CI 1.2-8.4) emerged as independent factors associated with surgical site infections. The group with deep infections exhibited higher proportions of smokers (p = 0.002), systemic arterial hypertension (p = 0.018), trauma surgery (p = 0.049), and an ASA score >2 (p = 0.011). Overall infection incidence in this cohort reached 4%, with trauma cases, smoking, hypertension, and an ASA score >2 independently linked to deep infections. Surgeons should be cognizant of these risk factors when managing prophylactic antibiotic regimens for patients.
Asunto(s)
Pie , Infección de la Herida Quirúrgica , Humanos , Infección de la Herida Quirúrgica/epidemiología , Masculino , Femenino , Incidencia , Persona de Mediana Edad , Estudios Retrospectivos , Factores de Riesgo , Pie/cirugía , Adulto , Anciano , Tobillo/cirugía , Estudios de Cohortes , Procedimientos Ortopédicos/efectos adversosRESUMEN
Abstract Osteonecrosis is a disease that rarely affects the bones of the foot. When present, it is more common in the talus and in the navicular. Cases of osteonecrosis of the intermediate cuneiform are extremely rare, and after a thorough bibliographic review, we found only five reports in the literature, all of them in pediatric patients. Below, we present the case of an adult patient with osteonecrosis of the intermediate cuneiform that was resistant to conservative treatment. Thus, we proposed a surgical approach with good results. Level of Evidence V; Therapeutic Studies; Expert Opinion.
Resumo A osteonecrose é uma doença que raramente afeta os ossos do pé. Quando presente, ela é mais comum no tálus e no navicular. Casos de osteonecrose do cuneiforme intermédio são extremamente raros, e após uma revisão bibliográfica minuciosa encontramos apenas cinco relatos na literatura, sendo todos eles em pacientes pediátricos. A seguir, apresentamos o caso de um paciente adulto com osteonecrose do cuneiforme intermédio resistente ao tratamento conservador. Portanto, propusemos uma abordagem cirúrgica com bom resultado. Nível de Evidência V; Estudos Terapêuticos; Opinião de Especialista.
Asunto(s)
Humanos , Adulto , Osteonecrosis , Huesos Tarsianos , Tratamiento ConservadorRESUMEN
ABSTRACTObjective:To establish the injury profile of soccer players from a first division Brazilian soccer team. In addition, we investigated the association between the characteristics of the injuries and the player's age and position.Method: Forty-eight players from a Brazilian first division soccer team were followed during one season. Descriptive statistics were used to characterize the injury profile. Spearman's tests were used to verify the association between the number and severity of injuries and the player's age. Chi-square test was used to verify the association between type of injury and player's position. Fisher's exact test was used to verify the association between the severity of injuries and player's position.Results: The incidence of injuries was 42.84/1000 hours in matches and 2.40/1000 hours in training. The injury severity was 19.5±34.4 days off competition or training. Lower limb was the most common location of injury and most injuries were muscular/tendinous, overuse, non-recurrent, and non-contact injuries. Player's age correlated with the amount and severity of muscle and tendon injuries. Defenders had more minimal injuries (1-3 days lost), while forwards had more moderate (8-28 days lost) and severe injuries (>28 days lost). Furthermore, wingbacks had more muscle and tendon injuries, while midfielders had more joint and ligament injuries.Conclusion: The injury profile of the Brazilian players investigated in this study reflected regional differences in soccer practices. Results confirm the influence of the player's age and position on the soccer injuries profile.
Asunto(s)
Humanos , Traumatismos en Atletas , Fútbol/fisiología , Extremidad Inferior/fisiopatología , Traumatismos en Atletas/epidemiología , Brasil , Incidencia , Estudios Prospectivos , Estudios de CohortesRESUMEN
Este relato de caso apresenta um atleta de futebol de 15 anos de idade diagnosticado com fratura de estresse do púbis e tratado conservadoramente, com resultados satisfatórios. Uma vez realizada revisão da literatura, os autores descreveram quadro clínico, diagnóstico e tratamento. A importância desta publicação reside no fato de a lesão descrita ser raramente encontrada na literatura.
This case report presents a 15-year-old football player who was diagnosed with a pubis stress fracture and underwent conservative treatment with satisfactory results. After a review of the literature, the clinical picture, diagnosis and treatment are described. The importance of this paper comes from the rarity of finding reports about this kind of injury in the literature.
Asunto(s)
Humanos , Masculino , Adolescente , Fracturas por Estrés , Hueso Púbico/lesiones , Osteítis/fisiopatologíaRESUMEN
Os autores analisaram 100 radiografias de ombros assintomáticos realizadas em 74 pacientes, com idades variando entre 25 e 77 anos (idade média de 45 anos). O acrômio do tipo I foi identificado em 54 por cento das radiografias, o do tipo II em 45 por cento e do tipo III em 1 por cento. O achado mais comum foi o esporäo subacromial, presente em 42 por cento dos casos. A média do intervalo acromiumeral foi de 10,3mm. Um total de 63 por cento das radiografias apresentou alteraçöes. Näo houve significância estatística em relaçäo ao número de radiografias com alteraçöes e sexo, idade, profissäo e lazer. Os achados foram mais comuns em pacientes com 56 a 65 anos do que em pacientes com 25 a 45 anos. Näo houve relaçäo entre os achados radiográficos e a dominância do membro. Concluem dizendo ser fundamental uma correlaçäo clínico-radiográfica antes de indicaçäo cirúrgica em ombro doloroso, já que muitos achados ditos patológicos podem ser identificados em radiografias de ombros normais.
Asunto(s)
Humanos , Masculino , Adulto , Persona de Mediana Edad , Femenino , Articulación del Hombro , HombroRESUMEN
A utilizaçäo de curativos em feridas infectadas é um procedimento controverso na literatura. Através de um estudo experimental em ratos, avaliou-se a eficácia do tratamento de feridas infectadas utilizando-se curativos diários, em comparaçäo com a evoluçäo de feridas sem curativos. Ocorreu uma reduçäo bacteriana em ambos os grupos estudados. No grupo com curativos houve uma reduçäo da superfície da ferida infectada significativamente maior do que no grupo sem curativos. Concluindo, parece que o uso de curativos diários promove uma cicatrizaçäo mais rápida das feridas infectadas.