COST ANALYSIS OF MOTORCYCLE ACCIDENT VICTIMS AT A UNIVERSITY HOSPITAL: PERSPECTIVES FROM 2017 AND 2020.

Introduction: Motorcycle accidents constitute a public health problem that affects public and private health services due to the expenses of the victim's treatment and rehabilitation. Objective: Evaluate the impact of motorcycle accident costs in a university hospital in 2020. Method: Comparative analysis of the costs of motorcycle accident patients in 2020 and 2017. Results: Among 151 patients included in the study, the average cost was U$3,083.54, and the average days of hospitalization were 5.3 days. The patient with the highest cost to the hospital spent U$22,504.05, and the patient with the lowest cost spent U$356.72. The longest stay among these patients was 41 days, and the shortest was one day. The average cost per patient per day for the entire sample was U$581.80. Conclusion: The formulation and application of strategies that promote the reduction of motorcycle accidents in the city of Campinas are necessary. Level of evidence II, Retrospective study.

Introdução: Acidentes motociclísticos constituem um problema de saúde pública que atinge os serviços públicos e privados de saúde, em função dos gastos com o tratamento e com o processo de reabilitação da vítima. Objetivo: Avaliar o impacto dos custos dos acidentes motociclísticos em um hospital universitário em 2020. Método: Análise comparativa dos custos dos pacientes vítimas de acidente motociclístico no ano de 2020 e 2017. Resultados: Dentre 151 pacientes incluídos no estudo, o custo médio foi de U$3.083,54 e a média de dias de internação foi de 5,3 dias. O paciente que apresentou maior custo para o hospital, teve um gasto de U$22.504,05 e o que teve o menor custo, gastou U$356,72. O maior tempo de internação, entre estes pacientes, foi de 41 dias e o menor tempo foi de 1 dia. O custo médio por paciente por dia, em toda a amostra, foi de U$581,80. Conclusão: Faz-se necessário a formulação e aplicação de estratégias que promovam a redução dos acidentes motociclísticos na cidade de Campinas. Nível de evidência II; Estudo retrospectivo.

Cost analysis of motorcycle accident victims at a university hospital: perspectives from 2017 and 2020 / Análise de custo das vítimas de acidente motociclístico em um hospital universitário: perspectivas de 2017 e 2020

ABSTRACT Introduction: Motorcycle accidents constitute a public health problem that affects public and private health services due to the expenses of the victim's treatment and rehabilitation. Objective: Evaluate the impact of motorcycle accident costs in a university hospital in 2020. Method: Comparative analysis of the costs of motorcycle accident patients in 2020 and 2017. Results: Among 151 patients included in the study, the average cost was U$3,083.54, and the average days of hospitalization were 5.3 days. The patient with the highest cost to the hospital spent U$22,504.05, and the patient with the lowest cost spent U$356.72. The longest stay among these patients was 41 days, and the shortest was one day. The average cost per patient per day for the entire sample was U$581.80. Conclusion: The formulation and application of strategies that promote the reduction of motorcycle accidents in the city of Campinas are necessary. Level of evidence II, Retrospective study.

RESUMO Introdução: Acidentes motociclísticos constituem um problema de saúde pública que atinge os serviços públicos e privados de saúde, em função dos gastos com o tratamento e com o processo de reabilitação da vítima. Objetivo: Avaliar o impacto dos custos dos acidentes motociclísticos em um hospital universitário em 2020. Método: Análise comparativa dos custos dos pacientes vítimas de acidente motociclístico no ano de 2020 e 2017. Resultados: Dentre 151 pacientes incluídos no estudo, o custo médio foi de U$3.083,54 e a média de dias de internação foi de 5,3 dias. O paciente que apresentou maior custo para o hospital, teve um gasto de U$22.504,05 e o que teve o menor custo, gastou U$356,72. O maior tempo de internação, entre estes pacientes, foi de 41 dias e o menor tempo foi de 1 dia. O custo médio por paciente por dia, em toda a amostra, foi de U$581,80. Conclusão: Faz-se necessário a formulação e aplicação de estratégias que promovam a redução dos acidentes motociclísticos na cidade de Campinas. Nível de evidência II; Estudo retrospectivo.

Reinsertion of Distal Brachial Biceps Tendon Rupture through Single Incision Using Anchors.

Objective To evaluate 15 patients with ruptured distal biceps tendon submitted to reinsertion via a single, anterior and transverse approach using two anchors. They were submitted to a rehabilitation protocol and, within six months, to an evaluation of the range of motion and strength intensity during flexion and supination of the operated elbow. Methods The data were collected prospectively, and were analyzed through the Mann-Whitney test and the mixed-model test to evaluate the force between the operated and non-operated elbows. Results A total of 80% of the patients were men, 60% were injured on the dominant side, 46% were manual workers, and 73% led sedentary lifestyles. The use of anabolic steroids was reported by two patients. After the treatment, the patients recovered supination strength by 98% and flexion by 94%. According to the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire, 73% of the patients presented the score expected of a normal population. Conclusion The single, anterior and transverse approach associated with tendon repair using anchors was esthetically satisfactory, with good strength recovery during flexion and supination, and no occurrence of heterotopic ossification.

Comparative study on three surgical techniques for intra-articular calcaneal fractures: open reduction with internal fixation using a plate, external fixation and minimally invasive surgery.

OBJECTIVE: To evaluate, compare and identify the surgical technique with best results for treating intra-articular calcaneal fractures, taking into account postoperative outcomes, complications and scoring in the Aofas questionnaire. METHODS: This was a retrospective study on 54 patients with fractures of the calcaneus who underwent surgery between 2002 and 2012 by means of the following techniques: (1) open reduction with extended L-shaped lateral incision and fixation with double-H plate of 3.5 mm; (2) open reduction with minimal incision lateral approach and percutaneous fixation with wires and screws; and (3) open reduction with minimal incision lateral approach and fixation with adjustable monoplanar external fixator. RESULTS: Patients treated using a lateral approach, with fixation using a plate had a mean Aofas score of 76 points; those treated through a minimal incision lateral approach with screw and wire fixation had a mean score of 71 points; and those treated through a minimal incision lateral approach with an external fixator had a mean score of 75 points. The three surgical techniques were shown to be effective for treating intra-articular calcaneal fractures, without any evidence that any of the techniques being superior. CONCLUSION: Intra-articular calcaneal fractures are complex and their treatment should be individualized based on patient characteristics, type of fracture and the surgeon's experience with the surgical technique chosen.

OBJETIVO: Avaliar, comparar e identificar a técnica cirúrgica com melhor resultado para o tratamento de fraturas intra-articulares do calcâneo, levando em consideração evolução pós-operatória, complicações e pontuação no questionário Aofas. MÉTODOS: Estudo retrospectivo de 54 pacientes com fraturas de calcâneo operados entre e 2002 e 2012 com as técnicas 1) redução aberta com incisão lateral alargada em "L" e fixação com placa duplo "H" de 3,5 mm, 2) redução aberta por incisão lateral econômica e fixação percutânea com fios e parafusos e 3) redução aberta por incisão lateral econômica e fixação com fixador externo monoplanar regulável. RESULTADOS: Pacientes tratados pela via de acesso lateral e fixação com placa tiveram média de 76 pontos na escala Aofas, em pacientes tratados pela via de acesso lateral econômica e fixação com fios e parafuso a média foi de 71 e nos pacientes tratados com via de acesso lateral e fixador externo foi de 75 pontos. As três técnicas cirúrgicas demostraram-se efetivas no tratamento da fratura intra-articular do calcâneo, sem evidência de superioridade de uma técnica sobre as demais. CONCLUSÃO: : A fratura intra-articular do calcâneo é uma fratura complexa e seu tratamento deve ser individualizado, baseado nas características do paciente, no tipo de fratura e na experiência do cirurgião com a técnica operatória escolhida.

Use of superficial peroneal nerve graft for treating peripheral nerve injuries.

OBJECTIVE: To evaluate the clinical results from treating chronic peripheral nerve injuries using the superficial peroneal nerve as a graft donor source. METHODS: This was a study on eleven patients with peripheral nerve injuries in the upper limbs that were treated with grafts from the sensitive branch of the superficial peroneal nerve. The mean time interval between the dates of the injury and surgery was 93 days. The ulnar nerve was injured in eight cases and the median nerve in six. There were three cases of injury to both nerves. In the surgery, a longitudinal incision was made on the anterolateral face of the ankle, thus viewing the superficial peroneal nerve, which was located anteriorly to the extensor digitorum longus muscle. Proximally, the deep fascia between the extensor digitorum longus and the peroneal longus muscles was dissected. Next, the motor branch of the short peroneal muscle (one of the branches of the superficial peroneal nerve) was identified. The proximal limit of the sensitive branch was found at this point. RESULTS: The average space between the nerve stumps was 3.8 cm. The average length of the grafts was 16.44 cm. The number of segments used was two to four cables. In evaluating the recovery of sensitivity, 27.2% evolved to S2+, 54.5% to S3 and 18.1% to S3+. Regarding motor recovery, 72.7% presented grade 4 and 27.2% grade 3. There was no motor deficit in the donor area. A sensitive deficit in the lateral dorsal region of the ankle and the dorsal region of the foot was observed. None of the patients presented complaints in relation to walking. CONCLUSIONS: Use of the superficial peroneal nerve as a graft source for treating peripheral nerve injuries is safe and provides good clinical results similar to those from other nerve graft sources.

OBJETIVO: Avaliar resultados clínicos do tratamento das lesões crônicas de nervos periféricos com o nervo fibular superficial como fonte doadora de enxerto. MÉTODOS: Estudo de 11 pacientes com lesões de nervos periféricos nos membros superiores tratados com enxerto do ramo sensitivo do nervo fibular superficial, com intervalo médio de 93 dias entre a data de registro da lesão e a cirurgia. Foram observadas lesões do nervo ulnar em oito pacientes e do nervo mediano em seis. Em três ambos os nervos foram lesados. Na cirurgia faz-se incisão longitudinal na face anterolateral no tornozelo, visualiza-se o nervo fibular superficial, situado anteriormente ao músculo extensor longo dos artelhos. Proximalmente disseca-se a fáscia profunda entre os músculos extensor longo dos artelhos e o fibular longo. A seguir, identifica-se o ramo motor do músculo fibular curto, um dos ramos do nervo fibular superficial. O limite proximal do ramo sensitivo encontra-se nesse ponto. RESULTADOS: A média do espaço entre os cotos nervosos foi de 3,8 cm, comprimento médio dos enxertos de 16,44 cm, número de segmentos usados de dois a quatro cabos. Na avaliação da recuperação da sensibilidade, 27,2% evoluíram para S2+, 54,5% para S3 e 18,1% para S3+. Quanto à recuperação motora, 72,7% apresentavam grau 4 e 27,2%, grau 3. Não houve déficit motor da área doadora, observou-se déficit sensitivo na região dorso lateral do tornozelo e dorsal do pé. Nenhum paciente apresentou queixas à deambulação. CONCLUSÕES: O uso do nervo fibular superficial no tratamento das lesões de nervos periféricos como fonte de enxerto é seguro e proporciona resultados clínicos semelhantes a outras fontes de enxerto de nervos.

Injuries among amateur runners.

OBJECTIVES: To determine the frequency and severity of injuries that affect amateur runners. METHODS: This study was conducted by means of a questionnaire applied to 204 amateur runners. Individuals who were under the age of 18 years and those who were unpracticed runners were excluded. The data gathered comprised the number, type, site and degree of severity of the injuries and the individuals' age and sex. RESULTS: It was observed that male athletes predominated. The mean age was 32.6 ± 9.3 years with a range from 18 to 68 years, and the injuries were classified as mild, keeping the athlete away from practicing running for fewer than eight days. Sprains, blisters and abrasions were the most frequent injuries, located most often on the lower limbs and predominantly on the feet. CONCLUSION: In practicing running, sprains, blisters and abrasions occur frequently, but are mild injuries. They mostly affect the lower limbs.

OBJETIVOS: Verificar a frequência e a gravidade das lesões que acometem praticantes amadores de corrida. MÉTODOS: O estudo foi conduzido por meio de questionário aplicado a 204 corredores amadores. Foram excluídos do estudo menores de idade e pessoas sem prática de corrida. Número, tipo, topografia e grau de gravidade das lesões, além de idade e sexo, foram os dados coletados. RESULTADOS: Observou-se predomínio de atletas do sexo masculino, idade média de 32,6 ± 9,3 anos com variação de 18 a 68 anos. As lesões foram classificadas como leves e afastaram o atleta da prática de corrida por menos de oito dias. Entorses, lesões bolhosas e escoriações foram as lesões mais frequentes, localizadas mais frequentemente nos membros inferiores, com predomínio nos pés. CONCLUSÃO: Na prática de corrida, entorses, lesões bolhosas e escoriações são frequentes, porém são leves e acometem mais os membros inferiores.

Surgical treatment of intra-articular calcaneal fractures: description of a technique using an adjustable uniplanar external fixator.

Several surgical techniques are available for the treatment of intra-articular calcaneal fractures. The use of a uniplanar external fixator is an option for the treatment of fractures classified as Sanders types 2 and 3. Satisfactory reduction and stabilisation of the fracture are achieved by means of mini-incisions and fixator adjustment. The advantages of this technique include less soft-tissue damage, avoidance of internal implants and early weight-bearing with the potential to improve postoperative recovery.