Doctor, When Should I Start Walking? Revisiting Postoperative Rehabilitation and Weight-Bearing Protocols in Operatively Treated Acetabular Fractures: A Systematic Review and Meta-Analysis.

Background and Objectives: Management of acetabular fractures is aimed at anatomically reducing and fixing all displaced or unstable fractures, as the accuracy of fracture reduction has been demonstrated to strongly correlate with clinical outcomes. However, there is a noticeable gap in the literature concerning the perioperative and postoperative care of patients with acetabular fractures, which ultimately can be potential risk factors for adverse outcomes and permanent disabilities. This study aimed to systematically review the available literature regarding rehabilitation practices, including weight-bearing protocols, across time points in surgically treated acetabular fracture patients and correlate these practices with functional outcomes. Methods: We systematically reviewed the Medline and PubMed databases and the Cochrane Central Register of Controlled Trials in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The inclusion criteria were studies with adult patients (19+ years), publications from the last 10 years, articles focusing on rehabilitation or mentioning any aspect related to rehabilitation (such as weight-bearing or muscle training), and describing the surgical management of acute, isolated acetabulum fractures. Specific information was collected, including the fracture classification, time to surgery, surgical approach, surgical time, blood loss, fixation strategy, quality of reduction, postoperative rehabilitation protocol, complication rate, type(s) of complication, and outcome measurement(s). The choice(s) of surgical approach, surgical time, blood loss, and fixation strategy were stratified based on the fracture classification. The complication rate and type(s) of complication were calculated for all studies. Fractures were classified based on the Letournel classification. Results: A total of 494 articles were identified from the initial search, of which 22 (1025 patients) were included in the final review. The most common rehabilitation protocol favored isometric quadriceps and abductor strengthening exercises starting on the first postoperative day, with passive hip movement at 1-3 days postoperatively and active hip movement ranging from the first postoperative day to 4 weeks postoperatively. Partial weight-bearing with a walker or a pair of crutches was permitted from 1 to 12 weeks after surgery, and full weight-bearing was allowed depending on the patient's general condition and fracture healing state (generally at the end of 3 months). In only three studies did the patients start bearing weight in the early postoperative period (≤1 week). Meta-regression analysis was not performed due to the discrepancy between studies that reported a weight-bearing protocol ≤1 week and >1 week postoperatively. Conclusions: Our study suggests that an accelerated postoperative rehabilitation protocol, including early permissive weight-bearing, does not appear to increase the risk of loss of reduction or the rate of complications after surgical treatment of acetabular fractures. However, a proper meta-analysis was not possible, and the heterogeneity of the included studies did not allow us to conclude anything about the potential biomechanical and clinical benefits nor the negative effects related to this rehabilitation regimen in terms of functional results. There is an inconsistent use of PROMs for objectively calculating the effect size of the accelerated protocol compared with restricted weight-bearing regimes. We pose the need for higher-level evidence to proof our hypothesis.

Application of the participatory design in the testing of a baropodometric insole prototype for weight-bearing asymmetry after a stroke: A qualitative study.

Introduction: Currently studies indicate the need to incorporate the user`s perspective in the testing of new assistive technologies. The objective of this paper is to test a baropodometric insole prototype for monitoring and treatment weight-bearing asymmetry, according to the Participatory Design. Methods: We used a qualitative case study approach during the testing phase of the baropodometric insole prototype. The focus group approach addressed topics related to the experience and accessibility of the potential user in conjunction with professionals, researchers, and physiotherapy students. Facilitators, barriers, and requirements for the device were collected through audio recordings of the discussions during and after prototype testing. Results: Key steps in the prototype testing process were divided into (1) Test of the prototype according to the Participatory Design, divided into Who, When, How, and Why the potential user was involved in the study; and (2) Facilitators, barriers and requirements to improve the prototype. Conclusions: The baropodometric insole prototype can be seen as a promising device for monitoring and treating weight-bearing asymmetry.

Assessment of knee instability in ACL-injured knees using weight-bearing computed tomography (WBCT): a novel protocol and preliminary results.

OBJECTIVE: To propose a protocol for assessing knee instability in ACL-injured knees using weight-bearing computed tomography (WBCT). MATERIALS AND METHODS: We enrolled five patients with unilateral chronic ACL tears referred for WBCT. Bilateral images were obtained in four positions: bilateral knee extension, bilateral knee flexion, single-leg stance with knee flexion and external rotation, and single-leg stance with knee flexion and internal rotation. The radiation dose, time for protocol acquisition, and patients' tolerance of the procedure were recorded. A blinded senior radiologist assessed image quality and measured the anterior tibial translation (ATT) and femorotibial rotation (FTR) angle in the ACL-deficient and contralateral healthy knee. RESULTS: All five patients were male, aged 23-30 years old. The protocol resulted in a 16.2 mGy radiation dose and a 15-min acquisition time. The procedure was well-tolerated, and patient positioning was uneventful, providing good-quality images. In all positions, the mean ATT and FTR were greater in ACL-deficient knees versus the healthy knee, with more pronounced differences observed in the bilateral knee flexion position. Mean lateral ATT in the flexion position was 9.1±2.8 cm in the ACL-injured knees versus 4.0±1.8 cm in non-injured knees, and mean FTR angle in the bilateral flexion position was 13.5°±7.7 and 8.6°±4.6 in the injured and non-injured knees, respectively. CONCLUSION: Our protocol quantitatively assesses knee instability with WBCT, measuring ATT and FTR in diverse knee positions. It employs reasonable radiation, is fast, well-tolerated, and yields high-quality images. Preliminary findings suggest ACL-deficient knees show elevated ATT and FTR, particularly in the 30° flexion position.

3D Foot Anthropometric Measurements Under Two Weight- Bearing Conditions for Ergonomic Design of Foot-Related Products / Mediciones Antropométricas del Pie en 3D Bajo Dos Condiciones de Soporte de Peso para el Diseño Ergonómico de Productos Relacionados con los Pies

SUMMARY: This study collected 3D models of the left and right feet from 317 Chinese youth (155 females and 162 males) under half weight-bearing and no weight-bearing conditions. Thirteen dimensions and one angle were taken for each sample. By measuring 13 foot dimensions and 1 angle, this study comprehensively investigated the differences in foot shape between genders and the bilateral differences, as well as the foot shape differences under different conditions. The results showed that regardless of the condition, male foot dimensions were significantly larger than those of females. However, female foot shape was not simply a scaled-down version of male foot shape. On the contrary, the average angle of female feet was greater than that of males under both conditions, indicating a higher prevalence of hallux valgus in females. Both males and females exhibited significant correlation in foot dimensions between the left and right feet, with minimal differences. Under the half weight-bearing condition, the average foot length, width, and circumference were significantly larger than the corresponding measurements under the no weight-bearing condition, while the average height and angle were significantly smaller. Therefore, when designing footwear and foot-related medical rehabilitation aids, it is important to consider foot shape and dimensions under different conditions as a reference. The results of this study provide manufacturers of foot- related products with more detailed data support and are of significant value to the field of medical foot morphology research.

Este estudio recolectó modelos 3D de los pies izquierdo y derecho de 317 jóvenes chinos (155 mujeres y 162 hombres) en condiciones de carga media de peso y sin carga de peso. Para cada muestra se tomaron trece dimensiones y un ángulo. Al medir 13 dimensiones del pie y 1 ángulo, se investigó exhaustivamente las diferencias en la forma del pie entre ambos sexos y sus diferencias bilaterales, así como las diferencias en la forma del pie en diferentes condiciones. Los resultados mostraron que, independientemente de la condición, las dimensiones del pie de los hombres, estos eran significativamente más grandes que los de las mujeres. Sin embargo, la forma del pie femenino no era simplemente una versión reducida de la forma del pie masculino. Por el contrario, el ángulo promedio de los pies de las mujeres fue mayor que el de los hombres en ambas condiciones, lo que indica una mayor prevalencia de hallux valgus en las mujeres. Tanto hombres como mujeres exhibieron una correlación significativa en las dimensiones del pie, entre el pie izquierdo y el derecho, con diferencias mínimas. Bajo la condición de medio soporte de peso, la longitud, el ancho y la circunferencia promedio del pie fueron significativamente mayores que las medidas correspondientes bajo la condición sin soporte de peso, mientras que la altura y el ángulo promedio fueron significativamente más pequeños. Por lo tanto, al diseñar calzado y dispositivos médicos de rehabilitación relacionados con los pies, es importante tener en consideración la forma y las dimensiones del pie en diferentes condiciones como referencia. Los resultados de este estudio, brindan a los fabricantes de productos relacionados con los pies un soporte de datos más detallado y son de gran valor para el campo de la investigación médica de la morfología del pie.

Strategies Adopted by Stroke Patients to Maintain Balance in Dynamic Tasks in a Video Game.

Postural instability affects motor tasks after a stroke. We investigated the strategies used to maintain balance during quiet standing posture and dynamic tasks in a video game. Sixteen stroke volunteers (12 males, 56 ± 9 years, post-stroke time 35 ± 10 months) and sixteen matched healthy volunteers had their biomechanical data collected to obtain the variables: center of mass, base of support, margin of stability, and weight symmetry. Healthy individuals and stroke patients showed similar dynamic stability. However, they adopted different motor strategies to achieve this: healthy individuals increased their base of support as they progressed to more challenging tasks, and stroke volunteers maintained the same base. The margin of stability of stroke volunteers was correlated with the MiniBEST scale.

Impacts of muscle training loads on college students' physical fitness / Impactos de cargas no treinamento muscular sobre a aptidão física dos estudantes universitários / Impacto de cargas en el entrenamiento muscular sobre la aptitud física de los estudiantes universitarios

ABSTRACT Introduction: Due to the excessive value of contemporary intellectual education, the physical fitness of college students has become precarious. This gradual deficit requires innovative solutions to inhibit the negative impacts on the physical quality that inevitably impact students' learning ability. Objective: Verify the impacts of varied loads in muscular strength exercise on college students and their practical repercussions on the diversified development of physical education classes. Methods: We selected 90 non-sporting college students, sedentary and without physical diseases, divided into experimental group 1 with medium intensity load, experimental group 2 with a low-intensity load, and a control group. Before and after the experiment, the relevant fitness indicators were evaluated, and finally, the data were statistically integrated and analyzed. Results: Group 1 increased from 52.25 ± 5.57kg before training to 54.56 ± 6.02kg, with a very significant change; experimental group 2 increased from 53.32 ± 4.89kg before training to 54.21 ± 5.22kg, showing a very significant change as well. Conclusion: Establishing the intensity of load muscle training scientifically and rationally can improve college students' physical quality and muscle strength, and promote the healthy and coordinated development of their psychological and physical quality. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.

RESUMO Introdução: Em detrimento da supervalorização da educação intelectual contemporânea, o condicionamento físico dos estudantes universitários tem se tornado precário. Este déficit gradual requer soluções inovadoras visando inibir os impactos negativos à qualidade física que inevitavelmente repercutiram sobre a capacidade de aprendizagem dos estudantes. Objetivo: Verificar os impactos de cargas variadas no exercício de força muscular sobre os estudantes universitários e sua repercussão prática sobre o desenvolvimento diversificado das aulas de educação física. Métodos: Foram selecionados 90 estudantes universitários de áreas não esportivas, sedentários e sem doenças físicas, divididos em grupo experimental 1 com carga de média intensidade, grupo experimental 2 com carga de baixa intensidade e grupo de controle. Antes e depois do experimento, os indicadores de aptidão física relevantes foram avaliados, e finalmente os dados foram integrados estatisticamente e analisados. Resultados: O grupo 1 aumentou de 52,25 ± 5,57kg antes do treinamento para 54,56 ± 6,02kg, com uma mudança muito significativa; o grupo experimental 2 aumentou de 53,32 ± 4,89kg antes do treinamento para 54,21 ± 5,22kg, apresentando alteração também muito significativa. Conclusão: Estabelecer a intensidade do treinamento muscular de carga no treinamento muscular de forma científica e racional pode melhorar a qualidade física e a força muscular dos estudantes universitários, além de promover o desenvolvimento sadio e coordenado da qualidade psicológica e física desses estudantes. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.

RESUMEN Introducción: En detrimento de la sobrevaloración de la formación intelectual contemporánea, la forma física de los universitarios se ha vuelto precaria. Este déficit gradual requiere soluciones innovadoras destinadas a inhibir los impactos negativos sobre la calidad física, que inevitablemente repercuten en la capacidad de aprendizaje de los alumnos. Objetivo: Verificar los impactos de cargas variadas en ejercicios de fuerza muscular en estudiantes universitarios y su repercusión práctica en el desarrollo diversificado de las clases de educación física. Métodos: Se seleccionaron 90 estudiantes universitarios de áreas no deportivas, sedentarios y sin enfermedades físicas, divididos en grupo experimental 1 con carga de intensidad media, grupo experimental 2 con carga de intensidad baja y grupo control. Antes y después del experimento, se evaluaron los indicadores de aptitud pertinentes y, por último, se integraron y analizaron estadísticamente los datos. Resultados: El grupo 1 aumentó de 52,25 ± 5,57 kg antes del entrenamiento a 54,56 ± 6,02 kg, con un cambio muy significativo; el grupo experimental 2 aumentó de 53,32 ± 4,89 kg antes del entrenamiento a 54,21 ± 5,22 kg, mostrando también un cambio muy significativo. Conclusión: Establecer la intensidad del entrenamiento muscular de carga de forma científica y racional puede mejorar la calidad física y la fuerza muscular de los estudiantes universitarios, así como promover el desarrollo saludable y coordinado de su calidad psicológica y física. Nivel de evidencia II; Estudios terapéuticos - investigación de los resultados del tratamiento.

Effect of load training on physical fitness in running athletes / Efeito do treinamento de corrida com carga sobre a aptidão física em atletas de corrida / Efecto del entrenamiento de carrera con carga sobre la aptitud física en corredores

ABSTRACT Introduction: Cardiopulmonary capacity and sports endurance are very important for running athletes. Objective: Study whether running with load training can improve physical fitness, focusing on running athletes' cardiopulmonary capacity and exercise endurance. Methods: 36 professional athletes were selected. One group was trained with normal running and the other group was trained with running with a weight load. Results: In the weight-bearing training group, FVC went from 5.13 ± 0.20 to 5.68 ± 1.25, FEV1 went from 4.38 ± 0.33 to 4.56 ± 0.35, PEF went from 8.27 ± 0.98 to 8.88 ± 1.02, ERV went from 1.44 ± 0.37 to 1.68 ± 0.34, IVC went from 4.91 ± 0.45 to 5.28 ± 1.46, VT went from 1.10 ± 0.25 to 1.42 ± 1.26, systolic blood pressure varied from 115.16 ± 8.18 to 117.02 ± 5.47, diastolic blood pressure varied from 78.58 ± 8.97 78.16 ± 7.42, BPM varied from 73.42 ± 9.27 to 73.52 ± 9.02, serum lactic acid was from 1.36 ± 0.28 to 1.31 ± 0.27, and serum creatine kinase was from 21.85 ± 59.02 to 208.11 ± 49.20. Conclusion: Load running training positively impacts athletes' physical fitness and may be added to improve athletes' cardiorespiratory capacity and exercise endurance. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.

RESUMO Introdução: A capacidade cardiopulmonar e a resistência esportiva são muito importantes para os atletas de corrida. Objetivo: Estudar se o treinamento de corrida com carga pode melhorar a aptidão física, com enfoque na capacidade cardiopulmonar e a resistência ao exercício dos atletas de corrida. Métodos: Foram selecionados 36 atletas profissionais. Um grupo foi treinado com corrida normal e o outro grupo foi treinado com corrida com carga de peso. Resultados: No grupo de treinamento com rolamentos de peso, FVC passou de 5,13 ± 0.20 para 5,68 ± 1,25, FEV1 passou de 4,38 ± 0,33 para 4,56 ± 0,35, PEF passou de 8,27 ± 0,98 para 8,88 ± 1,02, ERV passou de 1,44 ± 0,37 para 1,68 ± 0,3431, IVC passou de 4,91 ± 0,45 para 5,28 ± 1,46, VT passou de 1,10 ± 0,25 para 1,42 ± 1,26, pressão arterial sistólica variou de 115,16 ± 8,18 para 117,02 ± 5,47, pressão arterial diastólica variou de 78,58 ± 8,97 78,16 ± 7,42, BPM variou de 73,42 ± 9,27 para 73,52 ± 9,02, o valor de ácido lático sanguíneo foi de 1,36 ± 0,28 para 1,31 ± 0,27, e a creatina quinase sérica foi de 219,85 ± 59,02 para 208,11 ± 49,20. Conclusão: O treinamento de corrida com carga impacta positivamente a aptidão física dos atletas, podendo ser acrescido para melhorar a capacidade cardiorrespiratória e a resistência ao exercício dos atletas. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.

RESUMEN Introducción: La capacidad cardiopulmonar y la resistencia al deporte son muy importantes para los atletas que corren. Objetivo: Estudiar si correr con entrenamiento de carga puede mejorar la forma física, centrándose en la capacidad cardiopulmonar y la resistencia al ejercicio en atletas corredores. Métodos: Se seleccionaron 36 atletas profesionales. Un grupo fue entrenado con carrera normal y el otro con carrera con carga de peso. Resultados: En el grupo de entrenamiento con carga de peso, la FVC pasó de 5,13 ± 0,20 a 5,68 ± 1,25, el FEV1 pasó de 4,38 ± 0,33 a 4,56 ± 0,35, el PEF pasó de 8,27 ± 0. 98 a 8,88 ± 1,02, ERV pasó de 1,44 ± 0,37 a 1,68 ± 0,34, IVC pasó de 4,91 ± 0,45 a 5,28 ± 1,46, VT pasó de 1,10 ± 0,25 a 1,42 ± 1. 2645, la presión arterial sistólica varió de 115,16 ± 8,18 a 117,021 ± 5,47, PPM varió de 78,58 ± 8,97 a 78,16 ± 7,42, las pulsaciones por minuto variaron de 73,42 ± 9,27 a 73,52 ± 9,02, el valor de ácido láctico en sangre fue de 1,36 ± 0,28 a 1,31 ± 0,27, y la creatina quinasa sérica fue de 219,85 ± 59,02 a 208,11 ± 49,20. Conclusión: El entrenamiento de carrera con carga influye positivamente en la forma física de los atletas, y puede añadirse para mejorar la capacidad cardiorrespiratoria y la resistencia al ejercicio de los atletas. Nivel de evidencia II; Estudios terapéuticos - investigación de los resultados del tratamiento.

Effect of weight training on lower limb strength in martial arts athletes / Efeito do treinamento com pesos sobre a força dos membros inferiores em atletas de artes marciais / Efecto del entrenamiento con pesas en la fuerza de las extremidades inferiores en atletas de artes marciales

ABSTRACT Introduction: It is believed that weight training on the lower limbs in martial arts athletes can contribute to a better performance of the whiplash, a specific movement that encompasses pliometry, balance and strength. Objective: Study the effects of weight training on lower limb strength in martial arts athletes when performing the whiplash. Methods: A controlled experiment was conducted involving 100 martial arts athletes, randomly divided into two groups of characteristics without statically relevant differences. The experimental group received weight training, while the control group received no additional intervention to their daily training. Results: The vertical jump in the experimental group increased from 31.24 ± 6.65 cm to 36.00 ± 9.62 cm; the vertical jump in horizontal standing position increased from 195.49 ± 4.16 cm to 196.51 ± 7.49 cm; the approach vertical jump varied from 32.94 ± 9.21 cm to 37.60 ± 11. 50 cm; the jump from the local half squat position was from 34.55 ± 6.40 cm to 40.30 ± 8.14 cm; the maximum force of a squat with weights was from 140.81 ± 10.05 kg to 142.06 ± 10.23 kg; the maximum number of supine leg raises in one minute increased from 43.43 ± 6.15 to 48.05 ± 7.29. Conclusion: Weight training positively influenced lower limb strength in martial arts athletes, whiplash performance was elevated. Weight training is recommended in the daily training of martial arts athletes. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.

RESUMO Introdução: Acredita-se que o treinamento com pesos nos membros inferiores em atletas de artes marciais possa contribuir para um melhor desempenho do whiplash, um movimento específico que engloba pliometria, equilíbrio e força. Objetivo: Estudar os efeitos do treinamento com pesos sobre a força dos membros inferiores em aletas de artes marciais na execução do whiplash. Métodos: Foi conduzida uma experiência controlada envolvendo 100 atletas de artes marciais, divididos aleatoriamente em dois grupos de características sem diferenças estaticamente relevantes. O grupo experimental recebeu treinamento com pesos, enquanto o grupo de controle não recebeu nenhuma intervenção adicional ao treino cotidiano. Resultados: O salto vertical no grupo experimental elevou-se de 31,24 ± 6,65 cm para 36,00 ± 9,62 cm; o salto vertical em pé horizontal elevou-se de 195,49 ± 4,16 cm para 196,51 ± 7,49 cm; o salto vertical de aproximação variou de 32,94 ± 9,21 cm para 37,60 ± 11. 50 cm; o salto da posição de meio agachamento local foi de 34,55 ± 6,40 cm para 40,30 ± 8,14 cm; a força máxima de um agachamento com pesos foi de 140,81 ± 10,05 kg para 142,06 ± 10,23 kg; o número máximo de elevações de pernas supinas em um minuto elevou-se de 43,43 ± 6,15 para 48,05 ± 7,29. Conclusão: O treinamento com pesos influenciou positivamente na força dos membros inferiores em atletas de artes marciais, o desempenho do whiplash foi elevado. Recomenda-se o treinamento de pesos no treinamento diário dos atletas de artes marciais. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.

RESUMEN Introducción: Se cree que el entrenamiento con pesas sobre los miembros inferiores en atletas de artes marciales puede contribuir para una mejor ejecución del whiplash, un movimiento específico que engloba pliometría, equilibrio y fuerza. Objetivo: Estudiar los efectos del entrenamiento con pesas en la fuerza de los miembros inferiores en atletas de artes marciales al realizar el whiplash. Métodos: Se realizó un experimento controlado con 100 atletas de artes marciales, divididos aleatoriamente en dos grupos de características sin diferencias estadísticamente relevantes. El grupo experimental recibió entrenamiento con pesas, mientras que el grupo de control no recibió ninguna intervención adicional a su entrenamiento diario. Resultados: El salto vertical en el grupo experimental aumentó de 31,24 ± 6,65 cm a 36,00 ± 9,62 cm; el salto vertical horizontal de pie aumentó de 195,49 ± 4,16 cm a 196,51 ± 7,49 cm; el salto vertical de aproximación varió de 32,94 ± 9,21 cm a 37,60 ± 11. 50 cm; el salto desde la posición de media sentadilla local fue de 34,55 ± 6,40 cm a 40,30 ± 8,14 cm; la fuerza máxima de una sentadilla con pesas fue de 140,81 ± 10,05 kg a 142,06 ± 10,23 kg; el número máximo de elevaciones de piernas en decúbito supino en un minuto aumentó de 43,43 ± 6,15 a 48,05 ± 7,29. Conclusión: El entrenamiento con pesas influyó positivamente en la fuerza de las extremidades inferiores de los atletas de artes marciales y elevó el rendimiento de los whiplashs. Se recomienda el entrenamiento con pesas en el entrenamiento diario de los atletas de artes marciales. Nivel de evidencia II; Estudios terapéuticos-investigación de los resultados del tratamiento.

Strength training of long jump athletes / Treinamento da força dos atletas de salto longo / Entrenamiento de fuerza de los atletas de salto de longitud

ABSTRACT Introduction Lower limb strength training is one of the daily exercises of jumpers. Heavy squats are a standard method of lower body strength training. The squat is the only compound movement that directly trains "hip strength." Objective This study aimed to analyze the effect of weighted squats on lower body strength training in long jumpers. Methods 20 jumpers were selected and randomly divided into a general training group and a weighted squat group. Then, the changes in standing triple jump, lateral jump, and Y-axis swing were analyzed before and after training under an experimental protocol. Results The performance of the weighted squat group was better than that of the general training group about the explosive power of the lower body of long jumpers. The data were statistically divergent (P<0.05). There was no significant difference between the two groups in the Y-balance test related to the lower limbs (P>0.05). Conclusion Squatting exercises with weight can improve the explosive power of lower limbs in jumpers. Long jumpers use a variety of jumping exercises to develop the rapid strength needed for their specialties, and this protocol can be added to training for a better athletic outcome. Level of evidence II; Therapeutic studies - investigating treatment outcomes.

RESUMO Introdução O treinamento de força nos membros inferiores é um dos exercícios diários dos saltadores. Os agachamentos pesados são um método padrão de treinamento da força inferior do corpo. O agachamento é o único movimento composto que treina diretamente a "força do quadril". Objetivo Este estudo teve como objetivo analisar o efeito dos agachamentos ponderados no treinamento da força inferior do corpo em saltadores de salto em distância. Métodos 20 saltadores foram selecionados e aleatoriamente divididos em um grupo de treinamento geral e um grupo de agachamento ponderado. Em seguida, as mudanças no salto triplo em pé, salto lateral e balanço no eixo Y foram analisados antes e depois do treinamento sob um protocolo experimental. Resultados O desempenho do grupo de agachamento com peso foi melhor que o do grupo de treinamento geral no que se refere ao poder explosivo da parte inferior do corpo dos saltadores de salto em distância. Os dados foram estatisticamente divergentes (P<0,05). Não houve diferença significativa entre os dois grupos no teste de balanço em Y relacionados aos membros inferiores (P>0,05). Conclusão Os exercícios de agachamento com peso podem melhorar o poder explosivo dos membros inferiores nos saltadores. Os saltadores de salto longo utilizam uma variedade de exercícios de salto para desenvolver a força rápida necessária para suas especialidades e esse protocolo pode ser adicionado ao treino para um melhor resultado atlético. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.

RESUMEN Introducción El entrenamiento de la fuerza de los miembros inferiores es uno de los ejercicios diarios de los saltadores. Las sentadillas pesadas son un método estándar de entrenamiento de la fuerza de la parte inferior del cuerpo. La sentadilla es el único movimiento compuesto que entrena directamente la "fuerza de la cadera". Objetivo Este estudio tiene como objetivo analizar el efecto de las sentadillas con peso en el entrenamiento de la fuerza del tren inferior en saltadores de longitud. Métodos Se seleccionaron 20 saltadores y se dividieron aleatoriamente en un grupo de entrenamiento general y un grupo de sentadillas con peso. A continuación, se analizaron los cambios en el triple salto de pie, el salto lateral y el equilibrio en el eje Y antes y después del entrenamiento con un protocolo experimental. Resultados El rendimiento del grupo de sentadillas con peso fue mejor que el del grupo de entrenamiento general en lo que respecta a la potencia explosiva de la parte inferior del cuerpo de los saltadores de longitud. Los datos fueron estadísticamente divergentes (P<0,05). No hubo diferencias significativas entre los dos grupos en la prueba de equilibrio en Y relacionada con las extremidades inferiores (P>0,05). Conclusión Los ejercicios de sentadilla con peso pueden mejorar la potencia explosiva de los miembros inferiores en los saltadores. Los saltadores de longitud utilizan una variedad de ejercicios de salto para desarrollar la fuerza rápida requerida para sus especialidades y este protocolo puede añadirse al entrenamiento para un mejor resultado atlético. Nivel de evidencia II; Estudios terapéuticos - investigación de los resultados del tratamiento.

Effects of variable exercise on strength training in throwing athletes / Efeitos do exercício variável no treinamento de força em praticantes de arremesso / Efectos del ejercicio variable en el entrenamiento de fuerza en practicantes de lanzamiento

ABSTRACT Introduction: Throwing is a physical phenomenon with its base resistance and speed, demanding the high explosive force of its practitioners. Objective: Observe the implications of exercise with speed and variable load on the explosive strength training of throwing practitioners. Methods: The author uses scientific literature to execute an experiment on throwing techniques, dividing 24 athletes randomly into control and experimental groups. Variations of discus weight and throwing distances were applied in the groups. The results were compared in SPSS and Excel to perform the corresponding statistical processing. Results: The athletes showed throwing performance with an increasing trend, but not evident enough among the control group. The increase in the experimental group was evident compared to the performance before the experiment. Conclusion: Training with variable speed and variable load exercises positively affects strength training in throwing events. It is recommended to perform variable speed and variable load exercises for athletes in throwing practitioners. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.

RESUMO Introdução: O arremesso é um fenômeno físico que tem como base a resistência e a velocidade, exigindo elevada força explosiva corporal de seus praticantes. Objetivo: Observar as implicações do exercício com velocidade e carga variável no treinamento de força explosiva dos praticantes de arremesso. Métodos: O autor utiliza embasamento na literatura científica para executar um experimento de técnicas de arremesso esportivo, dividindo 24 atletas aleatoriamente em grupos controle e experimental. Variações de peso dos discos e distâncias de lançamento foram aplicadas nos grupos e a comparação dos resultados foi executada no software SPSS e Excel para realizar o processamento estatístico correspondente. Resultados: Os atletas apresentaram desempenho de lançamento com uma tendência crescente, mas não suficiente evidente entre o grupo controle. Comparado ao desempenho prévio do experimento, o aumento do grupo experimental foi evidenciado. Conclusão: O treinamento com exercícios de velocidade variável e carga variável tem um efeito positivo no treinamento de força em eventos de arremesso, é recomendado realizar exercícios de velocidade variável e carga variável para atletas em praticantes de arremesso. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.

RESUMEN Introducción: El lanzamiento es un fenómeno físico que tiene como base la resistencia y la velocidad, exigiendo una alta fuerza corporal explosiva de sus practicantes. Objetivo: Observar las implicaciones del ejercicio con velocidad y carga variable en el entrenamiento de la fuerza explosiva de los lanzadores. Métodos: El autor utiliza la literatura científica para ejecutar un experimento de técnicas de lanzamiento, dividiendo a 24 atletas al azar en grupos de control y experimental. Se aplicaron variaciones de peso de los discos y distancias de lanzamiento en los grupos y la comparación de los resultados se ejecutó en el software SPSS y Excel para realizar el correspondiente tratamiento estadístico. Resultados: Los atletas mostraron un rendimiento de lanzamiento con una tendencia al alza, pero no es suficientemente evidente entre el grupo de control. En comparación con el rendimiento anterior al experimento, se evidenció el aumento en el grupo experimental. Conclusión: El entrenamiento con ejercicios de velocidad variable y carga variable tiene un efecto positivo en el entrenamiento de la fuerza en las pruebas de lanzamiento, se recomienda la realización de ejercicios de velocidad variable y carga variable para los atletas en las prácticas de lanzamiento. Nivel de evidencia II; Estudios terapéuticos - investigación de los resultados del tratamiento.

Effects of closed and open kinetic chain exercises on pain, muscle strength, function, and quality of life in patients with knee osteoarthritis

SUMMARY OBJECTIVE: Therapeutic exercises are well documented for the treatment of osteoarthritis; there is less evidence on what the effect of closed kinetic chain exercises is for knee osteoarthritis. The aim of this study was to investigate the effects of open kinetic chain exercises and closed kinetic chain exercises on pain, muscle strength, functional status, and quality of life in patients with knee osteoarthritis. METHODS: The study included a total of 60 patients with primary unilateral knee osteoarthritis grade I and II. The patients were categorized into three groups as open kinetic chain exercises (n=20), closed kinetic chain exercises (n=20), and control group (n=20). The outcome measures, including pain, isokinetic muscle strength, functional status, and quality of life, were collected at baseline and at the end of 6 and 12 weeks. RESULTS: Closed kinetic chain exercises and open kinetic chain exercises had significant improvement in pain, muscle strength, WOMAC, and SF-36 scores after the treatment and at their 6th and 12th week follow-ups compared to their baseline values and compared to the control group (p<0.05). CONCLUSION: The changes in all outcome measures were similar between closed kinetic chain exercises and open kinetic chain exercises (p>0.05). Closed kinetic chain exercises and open kinetic chain exercises were similar for knee osteoarthritis grade I and II. Closed kinetic chain exercises could be safely added to the exercise programs of patients with low-grade knee osteoarthritis.

RADIOGRAPHIC EVALUATION OF IMMEDIATE LOADING SAFETY AFTER SURGICAL REDUCTION IN ACETABULAR FRACTURES: A COMPARATIVE-RETROSPECTIVE STUDY.

Objective: Radiographically evaluate the quality of reduction over six weeks of follow-up in patients with surgically treated deviated acetabular fractures who underwent rehabilitation with immediate loading as tolerated and compare this with the results of the unloaded protocol. Methods: We retrospectively evaluated the records of 137 patients with deviated acetabular fractures treated with open reduction and internal fixation. Sixty-six (48.2%) patients underwent postoperative rehabilitation with immediate loading as tolerated, while 71 (51.8%) patients completed rehabilitation using a no-load protocol. The quality of the reduction was assessed radiographically by measuring the fracturing step and gap on radiographs taken immediately after surgery and three and six weeks after surgery. Results: Comparing the joint step, group 1 had an average of 0.44 ± 1.4 mm, 0.47 ± 1.5 mm, and 0.51 ± 1.6 mm immediately, three and six weeks after surgery, respectively. Group 2 had a mean step of 0.24 ± 0.8 mm, 0.27 ± 0.9 mm, and 0.37 ± 1.2 mm immediately, three, and six weeks after surgery. No statistically significant differences were observed between the groups. With a joint gap, group 1 had a mean of 1.89 ± 1.7 mm, 2.12 ± 1.8 mm, and 2.36 ± 2.1 mm; and group 2 had a mean of 2.16 ± 2.4 mm, 2.47 ± 2.6 mm, and 2.67 ± 2.8 mm in the immediate postoperative period, three, and six weeks, respectively. There was also no statistical difference between groups in these measurements. Conclusion: Immediate loading after surgical treatment of deviated acetabular fracture had no negative impact on radiographic reduction parameters and had similar results to the protocol without weight bearing. Level of evidence III; Therapeutic Retrospective Cohort Study .

Objetivo: Avaliar radiograficamente a qualidade da redução ao longo de 6 semanas de acompanhamento em pacientes com fratura desviada do acetábulo tratados cirurgicamente e submetidos à reabilitação com carga imediata conforme tolerado e comparar com os resultados do protocolo sem carga. Métodos: Avaliamos retrospectivamente os prontuários de 137 pacientes com fraturas desviadas do acetábulo que foram tratadas com redução aberta e fixação interna. Sessenta e seis (48,2%) pacientes foram submetidos à reabilitação pós-operatória com carga imediata conforme tolerado, enquanto 71 (51,8%) pacientes completaram a reabilitação utilizando um protocolo sem carga. A qualidade da redução foi avaliada radiograficamente pela medição do degrau da fratura e do gap nas radiografias feitas imediatamente após a cirurgia e três e seis semanas após a cirurgia. Resultados: Comparando o degrau articular, o grupo 1 teve uma média de 0,44 ± 1,4 mm, 0,47 ± 1,5 mm e 0,51 ± 1,6 mm imediatamente, três e seis semanas após a cirurgia, respectivamente. O grupo 2 teve um degrau médio de 0,24 ± 0,8 mm, 0,27 ± 0,9 mm e 0,37 ± 1,2 mm imediatamente, três e seis semanas após a cirurgia. Não foram observadas diferenças estatísticas significantes entre os grupos. Com gap articular, o grupo 1 teve uma média de 1,89 ± 1,7 mm, 2,12 ± 1,8 mm e 2,36 ± 2,1 mm; e o grupo 2 de 2,16 ± 2,4 mm, 2,47 ± 2,6 mm e 2,67 ± 2,8 mm nos pós-operatório imediato, três e seis semanas, respectivamente. Também não houve diferença estatística entre os grupos nessas medidas. Conclusão: A carga imediata após o tratamento cirúrgico da fratura do acetábulo desviada não teve impacto negativo nos parâmetros de redução radiográfica e teve resultados semelhantes em comparação com o protocolo sem descarga de peso. Nível De Evidência III; Estudo Terapêutico de Coorte Retrospectivo .

Influence of abutment angulation on implant failure in immediately placed and restored implants in the esthetic zone: a randomized clinical trial

Background: Tooth extraction socket in the aesthetic area is a major indication for immediate implant placement greatly improving patient satisfaction and preserving the alveolar ridge. However, the effect of non-axial force on the peri-implant bone with subsequent early implant failure remains unclear. Objective:Evaluate the prognosis of tilted implants immediately placed and restored with angled abutments in comparison to straight implants restored with straight abutments in the esthetic area (anterior or premolars) using computer-aided surgical guides. Material and methods: Badly decayed non-restorable teeth in the aesthetic zone (anterior or premolars) were extracted atraumatically. Immediately after guided implant insertion, the abutments were adjusted and placed according to the allocation group (0, 15, or 25-degree angle) then a temporary crown was performed out of occlusion in centric and eccentric relation. Early implant failure was assessed at three and six months. Results:There was no statistically significant difference between the two groups (P=0.305). Straight and angled abutment groups showed 6 (14.3%) and 8 (20%) failed cases, respectively. The post-hoc subgroup analysis showed no statistically significant difference between angle 15 and angle 25 degree groups where (P=0.686) or between Anterior and Premolar groups (P=0.853). Conclusion: There was no statistically significant difference in the failure rate when comparing angled to straight immediately placed & restored implants. This applies to both anterior and premolar implants

Effect of weight training on lower limb strength in soccer players / Efeito da musculação sobre a força nos membros inferiores dos jogadores de futebol / Efecto de la musculación en la fuerza de los miembros inferiores de los jugadores de fútbol

ABSTRACT Introduction: There are many methods for lower limb explosive strength training in soccer athletes, and the most common is strength gain training by load increase. There is still no consensus on whether this type of training can influence jumping performance in soccer athletes. Objective: To explore the influence of muscle gain by added weight on jumping performance and lower limb muscle strength in soccer athletes. Methods: 60 participants were equally divided between high, low, and control training groups. The load was implemented with a weight vest for eight weeks. The training frequency was 40 to 60 minutes three times a week, and the training protocols and schedules of the two groups were the same, while the control group was not involved in any sports training. Results: The isokinetic muscle strength test of the left knee extensor before and after eight weeks of training showed no significant interaction between maximum torque and time to reach maximum torque at 60°/s and 180°/s (P > 0.05). After the jump test, a significant difference appears in the main effects on time factors between group A and group B. Conclusion: Strength training by load addition is an effective training method to improve the sport's ability in the lower limbs of soccer athletes. Evidence Level II; Therapeutic Studies - Investigating the result.

RESUMO Introdução: Existem muitos métodos para o treinamento de força explosiva do membro inferior nos atletas de futebol e o mais comum é o treinamento de ganho de força por aumento de carga. Ainda não há um consenso se esse tipo de treino pode influenciar no desempenho do salto nos atletas de futebol. Objetivo: Explorar a influência do ganho muscular por adição de peso no desempenho de salto e a força muscular nos membros inferiores dos atletas de futebol. Métodos: 60 participantes foram igualmente divididos entre grupos de treinamento de alta carga, baixa carga e grupo controle. A carga foi implementada com um colete de peso por 8 semanas. A frequência de treinamento foi de 40 a 60 minutos três vezes por semana e os protocolos de treinamento e horários dos dois grupos eram os mesmos, enquanto o grupo de controle não estava envolvido em nenhum treinamento esportivo. Resultados: Os resultados do teste isocinético de força muscular do extensor do joelho esquerdo antes e depois de 8 semanas de treinamento mostraram que não houve interação significativa entre o torque máximo e o tempo para atingir o torque máximo a 60°/s e 180°/s (P > 0,05). Após o teste de salto, verificou-se que houve diferença significativa nos principais efeitos dos fatores de tempo entre o grupo A e o grupo B. Conclusão: O treinamento de reforço por adição de carga é um método eficaz de treinamento para melhorar a capacidade esportiva nos membros inferiores dos atletas de futebol. Nível de evidência II; Estudos Terapêuticos - Investigação de Resultados.

RESUMEN Introducción: Existen muchos métodos para el entrenamiento de la fuerza explosiva del miembro inferior en los deportistas de fútbol y el más común es el entrenamiento de la fuerza por aumento de carga. Todavía no hay consenso sobre si este tipo de entrenamiento puede influir en el rendimiento de salto en los atletas de fútbol. Objetivo: Explorar la influencia de la ganancia muscular por peso añadido en el rendimiento de salto y la fuerza muscular de las extremidades inferiores en atletas de fútbol. Métodos: 60 participantes se dividieron por igual entre los grupos de entrenamiento de alta carga, baja carga y control. La carga se implementó con un chaleco de peso durante 8 semanas. La frecuencia de entrenamiento fue de 40-60 minutos tres veces por semana y los protocolos y horarios de entrenamiento de los dos grupos fueron los mismos, mientras que el grupo de control no realizó ningún entrenamiento deportivo. Resultados: Los resultados de la prueba de fuerza muscular isocinética del extensor de la rodilla izquierda antes y después de 8 semanas de entrenamiento mostraron que no había una interacción significativa entre el par máximo y el tiempo para alcanzar el par máximo a 60°/s y 180°/s (P > 0,05). Tras la prueba de salto, se comprobó que había una diferencia significativa en los efectos principales de los factores temporales entre el grupo A y el grupo B. Conclusión: El entrenamiento de fuerza por adición de carga es un método de entrenamiento eficaz para mejorar la capacidad deportiva en los miembros inferiores de los atletas de fútbol. Nivel de evidencia II; Estudios terapéuticos - Investigación de resultados.

Zygomatic implants in intra-sinus versus extra-maxillary approaches for prosthetic rehabilitation in severely atrophic maxillae: finite element analysis / Implantes cigomáticos en abordajes intra sinusal versus extra maxilar para rehabilitación protésica en maxilares severamente atróficos: análisis de elementos finitos

Objetive: To compare the stresses and deformations generated on the surrounding bone of the zygomatic implants when using an intra sinusal and extra-maxillary approach, through the finite element method. Material and Methods: Computer aided designs (CADs) were constructed using SolidWorks Software of a skull with bone resorption to be rehabilitated through a fixed hybrid prosthesis using two zygomatic and two conventional straight implants. For the boundary conditions (load conditions), symmetry in the sagittal plane was assumed and that all the materials were isotropic, homogeneous and linearly elastic. Two zygomatic implantation techniques were simulated: intra sinusal (Is) and extra maxillary (Em). Vertical and lateral loads of 150 N and 50 N were applied to the finite element models to obtain Von Mises equivalent stress and strain (displacement). Results: The average measurement of the Von Mises stress (MPa) recorded were as follows: Approach of the implant body (Is: 0.24- Em: 0.28,) effort of implant body with vertical load: Is: 0.69 - Em: 0.96; effort of peri-implant surface under horizontal load: Is: 2.11 - Em: 0.94. Average displacement under vertical load of peri-implant surface Is: 0.35 - Em: 0.40, and of implant body Is: 1.34 - Em: 2.04. Average total deformation in approach Is: 2.23 mm - Em: 0.80mm, and average total deformation in the implant body under horizontal load was Is: 0.14 - Em: 0.21. Conclusion: The results of this study indicate that despite the differences that occurred in both stress and strain (displacement) between the intra-sinus and extra-maxillary approaches, the static strength of the bone, which is approximately 150 MPa in tension and 250 MPa in compression was not exceeded. Considering the limitations of finite element analysis, there seems to be no biomechanical reason to choose one approach over the other.

Objetivo: Comparar por el método de elementos finitos los esfuerzos y deformaciones generados sobre el hueso circundante de implantes cigomáticos tratados con un abordaje intra sinusal y extra maxilar. Material y Métodos: Se construyeron los diseños asistidos por computadora (CAD) utilizando el Software SolidWorks de un cráneo con una reabsorción ósea para ser rehabilitado, a través de una prótesis híbrida fija, mediante dos implantes cigomáticos y dos rectos convencionales. Para las condiciones de frontera (condiciones de carga) se asumió simetría en el plano sagital y que todos los materiales eran isotrópicos, homogéneos y linealmente elásticos. Se simularon dos técnicas de implantación cigomática: una intra sinusal (Is) y otra extra maxilar (Em). Se aplicaron cargas verticales y laterales de 150 N y 50 N a los modelos de elementos finitos para obtener el esfuerzo equivalente de Von mises y la deformación (desplazamiento). Resultados: La medición promedio del esfuerzo de Von Mises (MPa) registró: abordaje del cuerpo de implante (Is: 0.24-Em: 0.28) esfuerzo del cuerpo de implante con carga vertical: (Is:0.69 ­ Em: 0.96); esfuerzo de la superficie peri implantar ante carga horizontal (lateral):( Is:2.11 ­ Em:0.94). Desplazamiento promedio ante carga vertical de la superficie peri implantar (Is:0.35 ­ Em:0.40) y del cuerpo del implante (Is:1.34 ­ Em:2.04). Deformación total promedio en mm en abordaje (Is: 2.23 ­ Em:0.80) y deformación total promedio en el cuerpo del implante ante carga horizontal (Is:0.14 ­ Em:0.21). Conclusión: Los resultados de este estudio indican que a pesar de las diferencias que se presentaron tanto en el esfuerzo como en la deformación (desplazamiento) entre los abordajes intra sinusal y extra maxilar, la resistencia estática del hueso, que es de aproximadamente 150 MPa en tensión y 250 MPa en compresión no se superó. Considerando las limitaciones de los AEF, parece no haber razones biomecánicas para elegir uno u otro enfoque.

Velocity-Based Resistance Training on 1-RM, Jump and Sprint Performance: A Systematic Review of Clinical Trials.

Weight resistance training (RT) has been shown to positively influence physical performance. Within the last two decades, a methodology based on monitoring RT through movement velocity (also called velocity-based resistance training, VBRT) has emerged. The aim of this PRISMA-based systematic review was to evaluate the effect of VBRT programs on variables related to muscle strength (one-repetition maximum, 1-RM), and high-speed actions (vertical jump, and sprint performance) in trained subjects. The search for published articles was performed in PubMed/MEDLINE, SPORT Discus/EBSCO, OVID, Web of Science, Scopus, and EMBASE databases using Boolean algorithms independently. A total of 22 studies met the inclusion criteria of this systematic review (a low-to-moderate overall risk of bias of the analyzed studies was detected). VBRT is an effective method to improve 1-RM, vertical jump and sprint. According to the results of the analyzed studies, it is not necessary to reach high muscle failure in order to achieve the best training results. These findings reinforce the fact that it is possible to optimize exercise adaptations with less fatigue. Future studies should corroborate these findings in female population.

Imaging of progressive collapsing foot deformity with emphasis on the role of weightbearing cone beam CT.

The term progressive collapsing foot deformity (PCFD) is currently recommended as the replacement to adult-acquired flatfoot deformity and posterior tibial tendon dysfunction to better reflect its pathology, which consists of a complex three-dimensional deformity involving the foot and ankle. The new consensus has also provided a new classification that requires clinical and radiographic findings for patient stratification into each class. However, conventional radiographs are susceptible to errors resulting from the inadequate positioning of patients, incorrect angulation of the X-ray tube, and overlapping of bone structures. Weightbearing cone beam computed tomography (WBCBCT), which has greater diagnostic accuracy than conventional radiograph, is useful for evaluating progressive collapsing foot deformity to determine medial arch collapse, hindfoot alignment, peritalar subluxation, posterior subtalar joint valgus, intrinsic talus valgus, and lateral extra-articular bone impingement. The present review aimed to discuss the new recommendations for nomenclature, classification, and imaging evaluation of PCFD, with an illustrative and quantitative focus on the measurements used in conventional radiography and WBCBCT. The measurements presented here are important criteria for decision-making.

Radiographic evaluation of immediate loading safety after surgical reduction in acetabular fractures: a comparative-retrospective study / Avaliação radiográfica da segurança na carga imediata após redução cirúrgica em fraturas acetabulares: estudo comparativo-retrospectivo

ABSTRACT Objective Radiographically evaluate the quality of reduction over six weeks of follow-up in patients with surgically treated deviated acetabular fractures who underwent rehabilitation with immediate loading as tolerated and compare this with the results of the unloaded protocol. Methods We retrospectively evaluated the records of 137 patients with deviated acetabular fractures treated with open reduction and internal fixation. Sixty-six (48.2%) patients underwent postoperative rehabilitation with immediate loading as tolerated, while 71 (51.8%) patients completed rehabilitation using a no-load protocol. The quality of the reduction was assessed radiographically by measuring the fracturing step and gap on radiographs taken immediately after surgery and three and six weeks after surgery. Results Comparing the joint step, group 1 had an average of 0.44 ± 1.4 mm, 0.47 ± 1.5 mm, and 0.51 ± 1.6 mm immediately, three and six weeks after surgery, respectively. Group 2 had a mean step of 0.24 ± 0.8 mm, 0.27 ± 0.9 mm, and 0.37 ± 1.2 mm immediately, three, and six weeks after surgery. No statistically significant differences were observed between the groups. With a joint gap, group 1 had a mean of 1.89 ± 1.7 mm, 2.12 ± 1.8 mm, and 2.36 ± 2.1 mm; and group 2 had a mean of 2.16 ± 2.4 mm, 2.47 ± 2.6 mm, and 2.67 ± 2.8 mm in the immediate postoperative period, three, and six weeks, respectively. There was also no statistical difference between groups in these measurements. Conclusion Immediate loading after surgical treatment of deviated acetabular fracture had no negative impact on radiographic reduction parameters and had similar results to the protocol without weight bearing. Level of evidence III; Therapeutic Retrospective Cohort Study.

RESUMO Objetivo Avaliar radiograficamente a qualidade da redução ao longo de 6 semanas de acompanhamento em pacientes com fratura desviada do acetábulo tratados cirurgicamente e submetidos à reabilitação com carga imediata conforme tolerado e comparar com os resultados do protocolo sem carga. Métodos Avaliamos retrospectivamente os prontuários de 137 pacientes com fraturas desviadas do acetábulo que foram tratadas com redução aberta e fixação interna. Sessenta e seis (48,2%) pacientes foram submetidos à reabilitação pós-operatória com carga imediata conforme tolerado, enquanto 71 (51,8%) pacientes completaram a reabilitação utilizando um protocolo sem carga. A qualidade da redução foi avaliada radiograficamente pela medição do degrau da fratura e do gap nas radiografias feitas imediatamente após a cirurgia e três e seis semanas após a cirurgia. Resultados Comparando o degrau articular, o grupo 1 teve uma média de 0,44 ± 1,4 mm, 0,47 ± 1,5 mm e 0,51 ± 1,6 mm imediatamente, três e seis semanas após a cirurgia, respectivamente. O grupo 2 teve um degrau médio de 0,24 ± 0,8 mm, 0,27 ± 0,9 mm e 0,37 ± 1,2 mm imediatamente, três e seis semanas após a cirurgia. Não foram observadas diferenças estatísticas significantes entre os grupos. Com gap articular, o grupo 1 teve uma média de 1,89 ± 1,7 mm, 2,12 ± 1,8 mm e 2,36 ± 2,1 mm; e o grupo 2 de 2,16 ± 2,4 mm, 2,47 ± 2,6 mm e 2,67 ± 2,8 mm nos pós-operatório imediato, três e seis semanas, respectivamente. Também não houve diferença estatística entre os grupos nessas medidas. Conclusão A carga imediata após o tratamento cirúrgico da fratura do acetábulo desviada não teve impacto negativo nos parâmetros de redução radiográfica e teve resultados semelhantes em comparação com o protocolo sem descarga de peso. Nível De Evidência III; Estudo Terapêutico de Coorte Retrospectivo.

Resultados funcionales en el tratamiento ortopédico de las roturas agudas del tendón de Aquiles / Functional results in the orthopedic treatment of acute ruptures of the Achilles tendon

Resumen: Objetivo: Analizar los resultados clínicos y funcionales de los pacientes con rotura aguda del cuerpo del tendón de Aquiles tratados de forma conservadora mediante bota ortopédica y carga precoz. Material y métodos: Estudio observacional prospectivo con 19 pacientes con rotura aguda de tendón de Aquiles tratados de forma ortopédica. Se analizaron las variables demográficas, la escala ATRS (Achilles tendon Total Rupture Score), la función mediante el test de puntillas, masa muscular gemelar y el equino en reposo residual. Los registros clínicos y funcionales se realizaron a las seis semanas, tres, seis y 12 meses. Se realizó un análisis estadístico mediante Stata 14. Resultados: A los 12 meses, 94% de los pacientes realizaban puntillas monopodales, la media de la atrofia gemelar fue de 1.03 cm ± 0.51 respecto a extremidad contralateral y la diferencia de equino residual respecto el lado sano era de 5.63 grados ± 4.17, 83.24% de los pacientes realizaban su práctica deportiva habitual previa a la rotura. La media de ATRS de la muestra era de 87.41 puntos ± 17.78. Se registraron dos rerroturas parciales (11%) a los tres meses de seguimiento que continuaron con tratamiento ortopédico. Conclusiones: El tratamiento ortopédico funcional mediante bota ortopédica y carga precoz presenta buenos resultados clínicos y funcionales, considerándolo un tratamiento válido para las roturas agudas del tendón de Aquiles.

Abstract: Objective: The purpose of this study is to assess the clinical and functional results of patients with acute middle third of Achilles tendon rupture treated conservatively by orthopedic boot and early weight-bearing. Material and methods: This is a prospective observational study with 19 patients with acute Achilles tendon rupture treated by conservative treatment. Demographic variables, ATRS score, function using heel-rise test, calf circumference and Achilles tendon resting angle were analyzed. The clinical and functional registration was performed at six weeks, three, six and 12 months of injury. A statistical analysis was performed. Results: At one year follow-up, the 94% of patients were capable of standing single heel rise, the mean of twin atrophy was 1.03 cm ± 0.51 compared to uninjured side and the difference of Achilles tendon resting angle was 5.63 degrees ± 4.17 compared to contralateral limb. The 83.24% of patients returned to play and the mean of ATRS score was 87.41 points ± 17.78. Two partial re-rupture (11%) were occurred at three months of follow-up, which continued with orthopedic treatment. Conclusions: Based on the results, functional orthopedic treatment using orthopedic boot and early weight-bearing presents good clinical and functional outcomes, considering it a valid treatment for acute Achilles tendon ruptures.

THE MISSING LINK IN THE HISTORY OF THE LOCKED INTRAMEDULLARY NAIL.

Femoral Shaft intramedullary nails were first described by the Aztecs in 16th century, but the modern use of intramedullary nails as the gold standard treatment for femoral shaft fractures began with Gerald Kuntcher in 1939. From the first Kuntcher's study in 1939, to the creation of interlocking nail, a long and some minor developments were described around the world. However, a major development is missing: the first nail to have a rotational and vertical stability locking system was described by Flavio Godoy Moreira, but was never published on an indexed journal for the correct historical reference. Level of Evidence V, Therapeutics Studies, Expert Opinion.

A história da haste intramedular bloqueada nas fraturas do fêmur se inicia com os Astecas no século 16, mas o uso moderno que a tornou o padrão ouro no tratamento destas fraturas se inicia com Gerald Kuntcher em 1939. Do estudo inicial de Kutcher até o desenvolvimento da haste bloqueada muitos pequenos desenvolvimentos foram descritos ao redor do mundo. Dentro deste desenvolvimento, a primeira haste a ter um controle vertical e rotacional foi descrito por Flavio Pires de Camargo, e nunca foi publicado em um jornal indexado que permita sua correta referência histórica. Nível de Evidência V, Estudos Terapêuticos, Opinião de especialista.