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1.
Rev. chil. ortop. traumatol ; 63(3): 178-183, dic.2022. tab, graf
Article in Spanish | LILACS | ID: biblio-1437118

ABSTRACT

OBJETIVOS Determinar la prevalencia de déficit de vitamina D, así como evaluar la seguridad y efectividad de un nuevo método de carga con colecalciferol en pacientes adultos con fractura de tibia. MATERIALES Y MÉTODOS Se reclutaron a 56 pacientes consecutivos con edades entre 18 y 65 años con fractura de tibia ingresados en nuestro hospital durante 1 año. Se determinó el nivel de 25-hidroxivitamina D ([25(OH)-D]) al ingreso y tras suplementación con 100.000 UI semanales de colecalciferol, durante 3 o 5 semanas, en casos de insuficiencia ([25(OH)-D] entre 20 ng/mL y 29,9 ng/mL) o deficiencia ([25(OH)-D] < 20 ng/mL), respectivamente. Se determinó la prevalencia de hipovitaminosis D, el porcentaje de normalización de [25(OH)-D], y los efectos adversos. RESULTADOS Se evaluaron 56 pacientes; 98,2% presentó hipovitaminosis D, y 28 (73,7%) y 10 (26,3%) presentaron déficit e insuficiencia, respectivamente. Tras la suplementación, 92,1% alcanzaron niveles [25(OH)-D] normales. Ningún paciente presentó efectos adversos. DISCUSIÓN La prevalencia de deficiencia de vitamina D en nuestra población fue mayor a la reportada en la literatura. Comprobamos que un esquema de suplementación en altas dosis de vitamina D es seguro, y más efectivo que los previamente recomendados. Este esquema de suplementación puede ser implementado en futuros estudios randomizados. CONCLUSIÓN La prevalencia de hipovitaminosis D en pacientes adultos chilenos con fractura de tibia fue alta (98,2%). El esquema de suplementación con vitamina D propuesto fue efectivo y seguro.


OBJETIVOS Determinar la prevalencia de déficit de vitamina D, así como evaluar la seguridad y efectividad de un nuevo método de carga con colecalciferol en pacientes adultos con fractura de tibia. MATERIALES Y MÉTODOS Se reclutaron a 56 pacientes consecutivos con edades entre 18 y 65 años con fractura de tibia ingresados en nuestro hospital durante 1 año. Se determinó el nivel de 25-hidroxivitamina D ([25(OH)-D]) al ingreso y tras suplementación con 100.000 UI semanales de colecalciferol, durante 3 o 5 semanas, en casos de insuficiencia ([25(OH)-D] entre 20 ng/mL y 29,9 ng/mL) o deficiencia ([25(OH)-D] < 20 ng/mL), respectivamente. Se determinó la prevalencia de hipovitaminosis D, el porcentaje de normalización de [25(OH)-D], y los efectos adversos. RESULTADOS Se evaluaron 56 pacientes; 98,2% presentó hipovitaminosis D, y 28 (73,7%) y 10 (26,3%) presentaron déficit e insuficiencia, respectivamente. Tras la suplementación, 92,1% alcanzaron niveles [25(OH)-D] normales. Ningún paciente presentó efectos adversos. DISCUSIÓN La prevalencia de deficiencia de vitamina D en nuestra población fue mayor a la reportada en la literatura. Comprobamos que un esquema de suplementación en altas dosis de vitamina D es seguro, y más efectivo que los previamente recomendados. Este esquema de suplementación puede ser implementado en futuros estudios randomizados. CONCLUSIÓN La prevalencia de hipovitaminosis D en pacientes adultos chilenos con fractura de tibia fue alta (98,2%). El esquema de suplementación con vitamina D propuesto fue efectivo y seguro.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Tibial Fractures/drug therapy , Vitamin D Deficiency/epidemiology , Cholecalciferol/therapeutic use , Calcium-Regulating Hormones and Agents , Chile/epidemiology , Incidence , Prevalence
2.
Ci. Anim. ; 31(02): 192-201, 2021. ilus
Article in Portuguese | VETINDEX | ID: vti-764682

ABSTRACT

O macaco-prego-preto é endêmico em áreas de mata atlântica, porém pode ser encontrado nas demais regiões, como na cidade de Maringá, Paraná, em áreas de reserva ambiental. É uma espécie quase em extinção. Acidentes envolvendo animais selvagens são comuns, principalmente em áreas de reservas próximas a ruas e avenidas. Objetiva-se relatar o caso de um Sapajus nigritus nigritus fêmea, adulta, 3,1kg, que foi resgatada e atendida após atropelamento. Após exame radiográfico no membro pélvico direito, foi constatada fratura exposta grau I, oblíqua curta, da tíbia e fíbula. Após limpeza e imobilização temporária do membro com tala, o animal foi submetido à cirurgia de osteossíntese tibial. O protocolo de medicação pré-anestésica incluiu dexmedetomidina associado à morfina. A indução anestésica foi realizada com propofol e cetamina por via intravenosa. Foi realizado ainda bloqueio epidural com lidocaína. Durante o procedimento cirúrgico foi aplicada placa bloqueada na função de apoio e cinco parafusos bloqueados. Os cuidados pós-operatórios farmacológicos envolveram administração de antibióticos, anti-inflamatórios e analgésicos opioides. Após três dias, o membro retornou à sua funcionalidade. O paciente permaneceu internado 45 dias pós-operatórios para recuperação com os cuidados veterinários. Concluiu-se que o método de fixação da fratura, bem como os protocolos sedativos e anestésicos empregados, são aplicáveis para a espécie citada.(AU)


The black capuchin monkey is endemic in areas of Atlantic Forest, but can be found in other regions, such as the city of Maringá, Paraná, in areas of environmental reserve. It is an almost endangered species. Accidents involving wild animals are common, especially in reserve areas close to streets and avenues. The objective is to report the case of a female, adult, 3.1 kg Sapajus nigritus nigritus, which was rescued and treated after being run over. After radiographic examination of the right pelvic limb, a short degree I, open oblique fracture of the tibia and fibula was found. After cleaning and temporary immobilization of the limb with a splint, the animal was submitted to tibial osteosynthesis surgery. The pre-anesthetic medication protocol included dexmedetomidine associated with morphine. Anesthetic induction was performed with propofol and ketamine intravenously. Epidural blocking was performed with lidocaine. During the surgical procedure, a blocked plate was applied to the support function and five blocked screws. Postoperative pharmacological care involved administration of antibiotics, anti-inflammatory drugs and opioid analgesics. After three days, the limb returned to functionality. The patient remained hospitalized 45 days postoperatively for recovery under veterinary care. It was concluded that the fracture fixation method, as well as the sedative and anesthetic protocols used, are applicable for the mentioned species.(AU)


Subject(s)
Animals , Female , Cebus/surgery , Tibial Fractures/diagnostic imaging , Tibial Fractures/drug therapy , Tibial Fractures/surgery , Tibial Fractures/veterinary
3.
Ciênc. Anim. (Impr.) ; 31(02): 192-201, 2021. ilus
Article in Portuguese | VETINDEX | ID: biblio-1472714

ABSTRACT

O macaco-prego-preto é endêmico em áreas de mata atlântica, porém pode ser encontrado nas demais regiões, como na cidade de Maringá, Paraná, em áreas de reserva ambiental. É uma espécie quase em extinção. Acidentes envolvendo animais selvagens são comuns, principalmente em áreas de reservas próximas a ruas e avenidas. Objetiva-se relatar o caso de um Sapajus nigritus nigritus fêmea, adulta, 3,1kg, que foi resgatada e atendida após atropelamento. Após exame radiográfico no membro pélvico direito, foi constatada fratura exposta grau I, oblíqua curta, da tíbia e fíbula. Após limpeza e imobilização temporária do membro com tala, o animal foi submetido à cirurgia de osteossíntese tibial. O protocolo de medicação pré-anestésica incluiu dexmedetomidina associado à morfina. A indução anestésica foi realizada com propofol e cetamina por via intravenosa. Foi realizado ainda bloqueio epidural com lidocaína. Durante o procedimento cirúrgico foi aplicada placa bloqueada na função de apoio e cinco parafusos bloqueados. Os cuidados pós-operatórios farmacológicos envolveram administração de antibióticos, anti-inflamatórios e analgésicos opioides. Após três dias, o membro retornou à sua funcionalidade. O paciente permaneceu internado 45 dias pós-operatórios para recuperação com os cuidados veterinários. Concluiu-se que o método de fixação da fratura, bem como os protocolos sedativos e anestésicos empregados, são aplicáveis para a espécie citada.


The black capuchin monkey is endemic in areas of Atlantic Forest, but can be found in other regions, such as the city of Maringá, Paraná, in areas of environmental reserve. It is an almost endangered species. Accidents involving wild animals are common, especially in reserve areas close to streets and avenues. The objective is to report the case of a female, adult, 3.1 kg Sapajus nigritus nigritus, which was rescued and treated after being run over. After radiographic examination of the right pelvic limb, a short degree I, open oblique fracture of the tibia and fibula was found. After cleaning and temporary immobilization of the limb with a splint, the animal was submitted to tibial osteosynthesis surgery. The pre-anesthetic medication protocol included dexmedetomidine associated with morphine. Anesthetic induction was performed with propofol and ketamine intravenously. Epidural blocking was performed with lidocaine. During the surgical procedure, a blocked plate was applied to the support function and five blocked screws. Postoperative pharmacological care involved administration of antibiotics, anti-inflammatory drugs and opioid analgesics. After three days, the limb returned to functionality. The patient remained hospitalized 45 days postoperatively for recovery under veterinary care. It was concluded that the fracture fixation method, as well as the sedative and anesthetic protocols used, are applicable for the mentioned species.


Subject(s)
Female , Animals , Cebus/surgery , Tibial Fractures/surgery , Tibial Fractures/diagnostic imaging , Tibial Fractures/drug therapy , Tibial Fractures/veterinary
4.
Int. j. morphol ; 34(2): 763-769, June 2016. ilus
Article in English | LILACS | ID: lil-787066

ABSTRACT

The aim of this study was to evaluate the effects of melatonin healing in a tibial bone defect model in rats by means of histopathological and immunohistochemistry analysis. Twenty one male Wistar albino rats were used in this study. In each animal, bone defects (6 mm length ) were created in the tibias. The animals were divided into three groups. In group 1 control group (rats which tibial defects). Group 2 melatonin (10 mg/kg) + 14 days in the tibial defect group) was administered intraperitoneally to rats. Group 3 melatonin (10 mg/kg) + 28 days in the tibial defect group) was administered intraperitoneally to rats. Histopathological analysis of samples was performed to evaluate the process of osteoblastic activity, matrix formation, trabecular bone formation and myeloid tissue in bone defects. Immunohistochemical and immunoblot analysis demonstrated non-collagenous proteins (osteopontin and osteonectin) differences in tibial bone defects. The expression of osteopontin on tibia was increased by 14 days melatonin treatment. The expression of osteonectin on tibia was dramatically increased by 14 days melatonin treatment.


El objetivo fue evaluar por medio de análisis histopatológico e inmunohistoquímico los efectos cicatrizantes de la melatonina en un modelo de defecto óseo tibial en ratas. Se utilizaron 21 ratas albinas Wistar macho. En cada animal, se crearon defectos óseos en las tibias de 6 mm de longitud. Los animales se dividieron en tres grupos. El Grupo 1 correspondió al grupo control (defectos tibiales sin tratamiento). Al Grupo 2 se administró melatonina por vía intraperitoneal (10 mg/kg) 14 días posteriores al defecto tibial. Al Grupo 3 se administró melatonina por vía intraperitoneal (10 mg/kg) 28 días posteriores al defecto tibial. Se realizó un análisis histopatológico para evaluar los procesos de actividad osteoblástica, formación de matriz, formación de hueso trabecular y tejido mieloide en los defectos óseos. Los análisis inmunohistoquímicos y de inmunotransferencia mostraron diferencias de proteínas no colágenas (osteopontina y osteonectina). La expresión de osteopontina en defectos óseos tibiales se incrementó en el Grupo 2. La expresión de osteonectina en la tibia se incrementó fuertemente bajo el tratamiento con melatonina por 14 días.


Subject(s)
Animals , Rats , Melatonin/pharmacology , Tibial Fractures/drug therapy , Tibia/drug effects , Disease Models, Animal , Melatonin/administration & dosage , Osteonectin/drug effects , Osteonectin/metabolism , Osteopontin/drug effects , Osteopontin/metabolism , Rats, Sprague-Dawley , Tibial Fractures/pathology , Tibia/pathology , Wound Healing/drug effects
5.
Genet Mol Res ; 14(2): 5076-84, 2015 May 12.
Article in English | MEDLINE | ID: mdl-26125699

ABSTRACT

The expression of transforming growth factor-beta 1 (TGF-ß1) inside the callus cells of diabetic rats and the impact of insulin therapy on its expression and biomechanics was investigated. The rats were randomly divided as follows: an insulin therapy group (IT), a diabetic model group (DM), and a non-diabetic control group (NC). Bone specimens from each group were extracted at different times for immunohistochemical observation of the expression of TGF-ß1. Concurrently, the destruction torque and torsional stiffness were detected at different times. One to four weeks after fracture, TGF-ß1 was widely expressed in fractured callus cells and periosteal proliferating cells, while the expression inside diabetic cells was significantly reduced. The expression of TGF-ß1 decreased over the first 68 weeks, and the mature bone cells never expressed TGF-ß1. The destruction torque (Nm) detected in the 6th week revealed that there was a statistically significant difference between the DM, NC, and IT groups (P < 0.01). In conclusion, TGF-ß1 expression was significantly reduced inside the callus cells of diabetic rats. Insulin therapy increased TGF-ß1 expression inside the callus cells of diabetic rats and improved the biomechanical characteristics of the callus.


Subject(s)
Bony Callus/drug effects , Diabetes Mellitus, Experimental/drug therapy , Hypoglycemic Agents/pharmacology , Insulin/pharmacology , Tibial Fractures/drug therapy , Transforming Growth Factor beta1/genetics , Animals , Bony Callus/metabolism , Bony Callus/pathology , Cell Proliferation , Diabetes Mellitus, Experimental/complications , Diabetes Mellitus, Experimental/genetics , Diabetes Mellitus, Experimental/pathology , Fracture Healing/drug effects , Gene Expression/drug effects , Hardness , Male , Periosteum/drug effects , Periosteum/metabolism , Periosteum/pathology , Rats , Rats, Wistar , Tibial Fractures/complications , Tibial Fractures/genetics , Tibial Fractures/pathology , Torque , Transforming Growth Factor beta1/metabolism
6.
Clinics (Sao Paulo) ; 70(6): 419-22, 2015 Jun.
Article in English | MEDLINE | ID: mdl-26106960

ABSTRACT

OBJECTIVES: Pilon fracture is a complex injury that is often associated with severe soft tissue damage and high rates of surgical site infection. The goal of this study was to analyze and identify independent risk factors for surgical site infection among patients undergoing surgical fixation of a pilon fracture. METHODS: The medical records of all pilon fracture patients who underwent surgical fixation from January 2010 to October 2012 were reviewed to identify those who developed a surgical site infection. Then, we constructed univariate and multivariate logistic regressions to evaluate the independent associations of potential risk factors with surgical site infection in patients undergoing surgical fixation of a pilon fracture. RESULTS: A total of 519 patients were enrolled in the study from January 2010 to October 2012. A total of 12 of the 519 patients developed a surgical site infection, for an incidence of 2.3%. These patients were followed for 12 to 29 months, with an average follow-up period of 19.1 months. In the final regression model, open fracture, elevated postoperative glucose levels (≥125 mg/dL), and a surgery duration of more than 150 minutes were significant risk factors for surgical site infection following surgical fixation of a pilon fracture. CONCLUSIONS: Open fractures, elevated postoperative glucose levels (≥125 mg/dL), and a surgery duration of more than 150 minutes were related to an increased risk for surgical site infection following surgical fixation of a pilon fracture. Patients exhibiting the risk factors identified in this study should be counseled regarding the possible surgical site infection that may develop after surgical fixation.


Subject(s)
Fracture Fixation, Internal/adverse effects , Fractures, Open/surgery , Surgical Wound Infection/etiology , Tibial Fractures/surgery , Antibiotic Prophylaxis , Cefazolin/therapeutic use , Follow-Up Studies , Fractures, Open/complications , Humans , Hyperglycemia/complications , Medical Records , Multivariate Analysis , Operative Time , Postoperative Care , Retrospective Studies , Risk Factors , Smoking/adverse effects , Tibial Fractures/complications , Tibial Fractures/drug therapy , Young Adult
7.
Clinics ; Clinics;70(6): 419-422, 06/2015. tab
Article in English | LILACS | ID: lil-749786

ABSTRACT

OBJECTIVES: Pilon fracture is a complex injury that is often associated with severe soft tissue damage and high rates of surgical site infection. The goal of this study was to analyze and identify independent risk factors for surgical site infection among patients undergoing surgical fixation of a pilon fracture. METHODS: The medical records of all pilon fracture patients who underwent surgical fixation from January 2010 to October 2012 were reviewed to identify those who developed a surgical site infection. Then, we constructed univariate and multivariate logistic regressions to evaluate the independent associations of potential risk factors with surgical site infection in patients undergoing surgical fixation of a pilon fracture. RESULTS: A total of 519 patients were enrolled in the study from January 2010 to October 2012. A total of 12 of the 519 patients developed a surgical site infection, for an incidence of 2.3%. These patients were followed for 12 to 29 months, with an average follow-up period of 19.1 months. In the final regression model, open fracture, elevated postoperative glucose levels (≥125 mg/dL), and a surgery duration of more than 150 minutes were significant risk factors for surgical site infection following surgical fixation of a pilon fracture. CONCLUSIONS: Open fractures, elevated postoperative glucose levels (≥125 mg/dL), and a surgery duration of more than 150 minutes were related to an increased risk for surgical site infection following surgical fixation of a pilon fracture. Patients exhibiting the risk factors identified in this study should be counseled regarding the possible surgical site infection that may develop after surgical fixation. .


Subject(s)
Humans , Young Adult , Fracture Fixation, Internal/adverse effects , Fractures, Open/surgery , Surgical Wound Infection/etiology , Tibial Fractures/surgery , Antibiotic Prophylaxis , Cefazolin/therapeutic use , Follow-Up Studies , Fractures, Open/complications , Hyperglycemia/complications , Medical Records , Multivariate Analysis , Operative Time , Postoperative Care , Retrospective Studies , Risk Factors , Smoking/adverse effects , Tibial Fractures/complications , Tibial Fractures/drug therapy
8.
Acta Cir Bras ; 29(12): 794-800, 2014 Dec.
Article in English | MEDLINE | ID: mdl-25517492

ABSTRACT

PURPOSE: To evaluate the performance of composites consisting of fragmented cortical bone heteroimplant in association with methylmethacrylate preserved in 98% glycerin, in segmental bone defect of rabbit tibia medial metaphysis. METHODS: In this study were used twelve adult New Zealand rabbits, divided into three groups of four animals each: G30 (30 days), G60 (60 days) and G90 (90 days). The bone defects previously created in the tibia were filled with composites and both were evaluated by cone-beam computed tomography, immediately after surgery and after 30, 60, and 90 days. RESULTS: The composites fulfilled and remained in the sites of bone defects in all cases and were not registered signals of infection, migration or rejection. CONCLUSIONS: The implanted composites promoted the bone defects repair without signals of infection and/or rejection. The composites are one more option for bone defects repair.


Subject(s)
Biocompatible Materials/therapeutic use , Bone Substitutes/therapeutic use , Fracture Healing/physiology , Methylmethacrylates , Tibia/surgery , Animals , Models, Animal , Postoperative Period , Rabbits , Tibia/diagnostic imaging , Tibial Fractures/drug therapy , Tomography, X-Ray Computed
9.
Acta cir. bras ; Acta cir. bras;29(12): 794-800, 12/2014. graf
Article in English | LILACS | ID: lil-731029

ABSTRACT

PURPOSE: To evaluate the performance of composites consisting of fragmented cortical bone heteroimplant in association with methylmethacrylate preserved in 98% glycerin, in segmental bone defect of rabbit tibia medial metaphysis. METHODS: In this study were used twelve adult New Zealand rabbits, divided into three groups of four animals each: G30 (30 days), G60 (60 days) and G90 (90 days). The bone defects previously created in the tibia were filled with composites and both were evaluated by cone-beam computed tomography, immediately after surgery and after 30, 60, and 90 days. RESULTS: The composites fulfilled and remained in the sites of bone defects in all cases and were not registered signals of infection, migration or rejection. CONCLUSIONS: The implanted composites promoted the bone defects repair without signals of infection and/or rejection. The composites are one more option for bone defects repair. .


Subject(s)
Animals , Rabbits , Biocompatible Materials/therapeutic use , Bone Substitutes/therapeutic use , Fracture Healing/physiology , Methylmethacrylates , Tibia/surgery , Models, Animal , Postoperative Period , Tomography, X-Ray Computed , Tibia , Tibial Fractures/drug therapy
10.
J Biomed Mater Res A ; 94(4): 1257-63, 2010 Sep 15.
Article in English | MEDLINE | ID: mdl-20694993

ABSTRACT

Fractures have different etiology and treatment and may be associated or not to bone losses. Laser light has been shown to improve bone healing. We aimed to assess, through Raman spectroscopy, the level of CHA (approximately 958 cm(-1)) on complete fractures animals treated with IRF treated or not with Low Level Laser Therapy-LLLT and associated or not to BMPs and GBR. Complete tibial fractures were created on 15 animals that were divided into five groups. LLLT (Laser Unit, Kondortech, São Carlos, SP, Brazil, lambda790 nm, 4 J/cm(2)/point, 40 mW, phi approximately 0.5 cm(2), 16 J/cm(2) session) started immediately after surgery and repeated at 48 h interval (2 weeks). Animal death occurred after 30 days. Raman spectroscopy was performed at the surface of the fracture. Our results showed significant differences between the groups IRF + BL /IRF_NBL (p = 0.05); between all experimental groups and untreated bone; bone/IRF + BL; IRF + BL + Bio + GBR; IRF + BL + LLLT; IRF + BL + Bio + GBR + LLLT; IRF_NBL (p < 0.001, all); IRF_NBL/IRF + BL + LLLT (p = 0.03); IRF_NBL/IRF + BL + Bio + GBR + LLLT (p = 0.02); IRF + BL/IRF + BL + LLLT (p = 0.04); IRF + BL/IRF + BL + Bio + GBR + LLLT (p = 0.002); IRF + BL + Bio + GBR/IRF + BL + Bio + GBR + LLLT (p = 0.05). It is concluded that the use of NIR LLLT associated to BMPs and GBR was effective in improving bone healing on fractured bones due to increased levels of CHA.


Subject(s)
Bone Morphogenetic Proteins/therapeutic use , Bone Regeneration/physiology , Fracture Fixation, Internal/methods , Guided Tissue Regeneration/methods , Laser Therapy , Spectrum Analysis, Raman , Tibial Fractures/drug therapy , Animals , Bone Morphogenetic Proteins/pharmacology , Bone Regeneration/drug effects , Cattle , Infrared Rays , Male , Rabbits , Surface Properties/drug effects , Tibial Fractures/surgery
11.
Rev. cuba. med. mil ; 37(4)oct.-dic. 2008.
Article in Spanish | CUMED | ID: cum-40794

ABSTRACT

Se realizó una revisión bibliográfica y actualización sobre los tratamientos de los pacientes que sufren facturas abiertas de la diáfisis tibial, con el objetivo de facilitar el estudio en este polémico tema a los residentes y especialistas en Traumatología para su manejo. Se profundizó en los conocimientos de aspectos importantes como las clasificaciones y específicamente los factores que las modifican, importancia de la irrigación sanguínea y el desbridamiento quirúrgico. Especial hincapié se realizó en el uso de los antibióticos tanto sistémicos como locales, y estos últimos en combinación con el cemento óseo. Se analizaron los criterios de amputaciones, por ser tan frecuentes en esta entidad, y los métodos de estabilización ósea (fijación externa o interna), por la controversia en sus indicaciones precisas. Se exponen aspectos importantes en el manejo definitivo de las heridas, según el tiempo y tipos de cierres aplicados en las fracturas abiertas por ser muy contaminadas. Todo esto debe incidir en un mejor tratamiento en los pacientes con estas lesiones traumáticas(AU)


A bibliographic review and updating of the treatments of patients with open fractures of the tibial diaphysis was made aimed at making easier the study of this polemic topic for residents and specialists in Traumatology.Wçe went deep into the knowledge of important aspects such as the classifications and, specifically, the factors modifying them, the significance of blood irrigation, and surgical debridement. Special emphasis was given to the use of systemic and local antibiotics and to the combination of the latter with bone cement. The amputation criteria, which are very frequent in this entity were analyzed, as well as the methods of bone stabilization (external or internal fixation), due the controversy on its precise indications. Important aspects on the definite management of wounds are exposed, according to time and to the types of closing applied to open fractures, taking into account their high level of contamination. All this should lead to a better treatment of patients with traumatic lesions(AU)


Subject(s)
Humans , Fractures, Open/classification , Fractures, Open/drug therapy , Tibial Fractures/drug therapy , Anti-Bacterial Agents/therapeutic use , Tibial Fractures/diagnosis
12.
Rev. cuba. med. mil ; 37(4)oct.-dic. 2008.
Article in Spanish | LILACS | ID: lil-547126

ABSTRACT

Se realizó una revisión bibliográfica y actualización sobre los tratamientos de los pacientes que sufren facturas abiertas de la diáfisis tibial, con el objetivo de facilitar el estudio en este polémico tema a los residentes y especialistas en Traumatología para su manejo. Se profundizó en los conocimientos de aspectos importantes como las clasificaciones y específicamente los factores que las modifican, importancia de la irrigación sanguínea y el desbridamiento quirúrgico. Especial hincapié se realizó en el uso de los antibióticos tanto sistémicos como locales, y estos últimos en combinación con el cemento óseo. Se analizaron los criterios de amputaciones, por ser tan frecuentes en esta entidad, y los métodos de estabilización ósea (fijación externa o interna), por la controversia en sus indicaciones precisas. Se exponen aspectos importantes en el manejo definitivo de las heridas, según el tiempo y tipos de cierres aplicados en las fracturas abiertas por ser muy contaminadas. Todo esto debe incidir en un mejor tratamiento en los pacientes con estas lesiones traumáticas.


A bibliographic review and updating of the treatments of patients with open fractures of the tibial diaphysis was made aimed at making easier the study of this polemic topic for residents and specialists in Traumatology.Wçe went deep into the knowledge of important aspects such as the classifications and, specifically, the factors modifying them, the significance of blood irrigation, and surgical debridement. Special emphasis was given to the use of systemic and local antibiotics and to the combination of the latter with bone cement. The amputation criteria, which are very frequent in this entity were analyzed, as well as the methods of bone stabilization (external or internal fixation), due the controversy on its precise indications. Important aspects on the definite management of wounds are exposed, according to time and to the types of closing applied to open fractures, taking into account their high level of contamination. All this should lead to a better treatment of patients with traumatic lesions.


Subject(s)
Humans , Anti-Bacterial Agents/therapeutic use , Fractures, Open/classification , Fractures, Open/drug therapy , Tibial Fractures/diagnosis , Tibial Fractures/drug therapy
13.
Acta ortop. bras ; Acta ortop. bras;12(4): 197-204, out.-dez. 2004. ilus, tab, graf
Article in English, Portuguese | LILACS | ID: lil-393512

ABSTRACT

Os AINH (Antiinflamatórios não hormonais) são agentes utilizados na prática clínica que interferem no processo inflamatório pela inibicão da síntese de prostaglandinas e tromboxanos. Alguns trabalhos experimentais investigaram sua acão no processo de consolidacão de fraturas, por meio de estudos clínicos e histológicos, sendo escassas as análises biomecânicas. Nesse estudo foram utilizados 20 ratos da linhagem Wistar, divididos aleatoriamente em dois grupos iguais: grupo A (controle) e grupo B (tratado com diclofenaco sódico). Em ambos os grupos foram realizadas fraturas abertas, após perfuracão, na tíbia direita. A administracão da droga foi via intramuscular, dose única diária, por 28 dias. Os animais foram pesados semanalmente. Após o sacrifício as tíbias foram dissecadas, pesadas e submetidas a ensaio biomecânico de flexão analisando-se carga máxima, deformacão e coeficiente de rigidez. Observou-se que no grupo tratado com AINH não houve aumento do peso corpóreo a partir da segunda semana e as tíbias fraturadas foram mais pesadas. Neste grupo o calo ósseo suportou menor carga máxima, apresentando maior deformacão e menor coeficiente de rigidez. Nos animais tratados, o osso não fraturado também se mostrou menos rígido. Concluiu-se, nas condicões estudadas, que o DS alterou o processo de consolidacão e o metabolismo ósseo, levando a retardo na maturacão do calo e menor rigidez do osso intacto, respectivamente.


Subject(s)
Animals , Rats , Diclofenac/adverse effects , Diclofenac/therapeutic use , Tibial Fractures , Anti-Inflammatory Agents , Tibial Fractures/drug therapy
14.
Injury ; 34(2): 85-94, 2003 Feb.
Article in English | MEDLINE | ID: mdl-12565014

ABSTRACT

BACKGROUND: Nonsteroidal anti-inflammatory drugs have been implicated in the development of delayed unions and nonunion after fractures in animal models. Previous investigations have identified two important factors as determinants of delayed fracture healing: early drug administration and a dose-dependent effect. OBJECTIVE: The purpose of this investigation was to study the effect of tenoxicam, a nonsteroidal anti-inflammatory drug, on the fracture healing process in rat tibiae. METHODS: Fifty-eight Wistar rats were randomly divided in four groups (I, II, III, and IV). Group I (control group, n=12) was given 0.1ml saline solution per day intramuscularly. Groups II (n=12), III (n=12), and IV (n=12) were administered 10mg per kg per day of tenoxicam intramuscularly. Administration of substances was begun on a week before to 48h after the fracturing procedure and continued during the entire experiment. Callus formation was studied histologically and histomorphologically, using light microscopy. In addition, a histologic grading based on the morphologic stage of fracture healing was carried out at 4 weeks, according to the criteria proposed by Allen et al. RESULTS: There was a significant difference in treatment effect between Group I (saline solution) and Groups II, III, and IV (tenoxicam) (P=0.07). Histologically and histomorphologically, there were qualitative and quantitative delay in callus formation at all tenoxicam groups. This was more pronounced the earlier the nonsteroidal anti-inflammatory drug was started, although no significant difference could be detected between Groups II, III, and IV (P>(alpha=10%)). Four weeks after fracture, Group I (n=3) showed complete osseous union, Groups II (n=3) and III (n=3), complete cartilaginous union, and Group IV (n=3), incomplete osseous union, according to Allen et al. By using this rating scale, the difference between control and drug-treated groups was statistically significant (P<0.1). CONCLUSION: Under studied conditions, this investigation shows that administration of tenoxicam intramuscularly delays fracture healing process in rat tibiae. These results suggest the hypothesis that early drug administration may delay bone healing after experimental fractures in animals, although it could not be detected statistically significant.


Subject(s)
Anti-Inflammatory Agents, Non-Steroidal/therapeutic use , Fracture Healing/drug effects , Piroxicam/analogs & derivatives , Piroxicam/therapeutic use , Tibial Fractures/drug therapy , Animals , Male , Rats , Rats, Wistar , Tibial Fractures/pathology , Tibial Fractures/physiopathology
15.
Rev. bras. ortop ; 34(6): 395-400, jun. 1999. ilus
Article in Portuguese | LILACS | ID: lil-360959

ABSTRACT

O objetivo desta pesquisa foi estudar o efeito do tenoxicam, uma droga antiinflamatória não-esteróide (AINE), no processo de consolidação de fraturas em tíbia de ratos. Os animais foram divididos aleatoriamente em três grupos (I, II, III), um dos quais utilizado como controle. No grupo controle (n = 12 animais) foi administrado soro fisiológico a 0,9 por cento por via intramuscular, enquanto no grupo 11, com 12 animais, administraram-se 10 miligramas/quilograma/dia do AINE por via intramuscular; no grupo III (n = 4 animais) foram administrados 20 miligramas/quilograma/dia da droga. O início da administração das substâncias se deu aproximadamente duas horas após a produção da fratura. A formação do calo ósseo foi avaliada histologicamente por microscopia de luz, corando-se as peças com hematoxilina-eosina, picromallory e alcian blue pH 2,5-safranina. O calo ósseo foi estudado histomorfologicamente ao término da pesquisa, segundo escore qualitativo de maturidade. Os resultados indicaram que o tenoxicam induziu alterações histológicas qualitativas, caracterizadas pelo atraso no processo de consolidação óssea. No grupo III ocorreu acentuado retarde da osteogênese, sugerindo ação de dose-dependência da droga. Nas condições estudadas, observou-se que o tenoxicam administrado por via intramuscular retarda o processo de consolidação de fratura de tíbia de ratos em relação direta com a dose empregada.


Subject(s)
Animals , Rats , Anti-Inflammatory Agents, Non-Steroidal , Fracture Healing , Tibial Fractures/drug therapy , Bony Callus , Histological Techniques , Treatment Outcome
16.
Folha méd ; 107(2): 79-82, ago. 1993. tab
Article in Portuguese | LILACS | ID: lil-170340

ABSTRACT

Foram avaliados 30 pacientes com patologias inflamatórias agudas nåo infecciosas do aparelho locomotor. Houve melhora total ou parcial de todas as principais manifestaçöes da inflamaçåo em todos os pacientes estudados. A tolerabilidade foi excelente, e a maioria dos pacientes obteve resposta clínica em até 1 hora após a ingeståo do nimesulide


Subject(s)
Humans , Anti-Inflammatory Agents, Non-Steroidal/therapeutic use , Inflammation/drug therapy , Low Back Pain/drug therapy , Sulfonamides/therapeutic use , Ankle Injuries/drug therapy , Bursitis/drug therapy , Calcaneus/injuries , Finger Injuries/drug therapy , Tibial Fractures/drug therapy , Fractures, Bone/drug therapy , Leg Injuries/drug therapy , Shoulder Fractures/drug therapy , Synovitis/drug therapy , Tennis Elbow/drug therapy , Arm Injuries/drug therapy
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