OSTEOSYNTHESIS OF A SCAPHOID NECK FRACTURE WITH A CANNULATED COMPRESSION SCREW: EVALUATION OF 52 PATIENTS.

OBJECTIVE: To evaluate the effectiveness of the dorsal fixation technique with a cannulated compression screw (CCS) for transverse scaphoid neck fractures. METHODS: A case series study was carried out with patients treated with a CSS between April 2014 and May 2021. The main outcome was the healing of the fracture, verified by radiographic evaluation that used images of the wrist in anteroposterior, lateral, radial deviation, ulnar deviation and oblique views, obtained in the postoperative period. RESULTS: Fifty-two patients aged between 15 and 65 years were analyzed, of which 43 (83%) were male. Of the 52 patients, 19 (36.53%) had a right-hand injury and 33 (63.46%) had a left-hand injury. Results were excellent in 47 patients (90.38%); good in 4 patients (7.69%), with reduced mobility compared to contralateral and poor in 1 patient (1.92%), with failure of consolidation and breakage of the synthesis material. In 51 cases (99%) there was bone consolidation at the end of six months. CONCLUSION: Osteosynthesis with a cannulated compression screw is a safe, effective and promising method for the treatment of scaphoid neck fractures. Level of Evidence IV, Case Series.

OBJETIVO: Avaliar a eficácia da técnica de fixação dorsal com parafuso canulado de compressão (CCS) para fraturas transversas do colo do escafoide. Métodos: Foi realizado um estudo de série de casos com pacientes tratados com CSS entre abril de 2014 e maio de 2021. O desfecho principal foi a consolidação da fratura, verificada por meio da avaliação radiográfica das imagens do punho em anteroposterior, perfil, desvio radial, desvio ulnar e oblíquo obtidas no pós-operatório. RESULTADOS: Foram analisados 52 pacientes com idade entre 15 e 65 anos, sendo 43 (83%) do sexo masculino. Dos 52 pacientes, 19 (36,53%) tinham lesão na mão direita e 33(63,46%) na mão esquerda. Os resultados foram excelentes em 47 dos pacientes (90,38%); bons em quatro (7,69%), com mobilidade reduzida comparada ao membro contralateral; e ruim em um (1,92%), com falha da consolidação e quebra do material de síntese. Em 51 casos (99%) houve consolidação óssea ao final de seis meses. Conclusão: A osteossíntese com parafuso canulado de compressão é um método seguro, eficaz e promissor para o tratamento das fraturas no colo do escafoide. Nível de Evidência IV, Série de Casos.

Osteosynthesis of a scaphoid neck fracture with a cannulated compression screw: evaluation of 52 patients / Osteossíntese de fratura no colo do escafoide com parafuso canulado de compressão: avaliação de 52 pacientes

ABSTRACT Objective: To evaluate the effectiveness of the dorsal fixation technique with a cannulated compression screw (CCS) for transverse scaphoid neck fractures. Methods: A case series study was carried out with patients treated with a CSS between April 2014 and May 2021. The main outcome was the healing of the fracture, verified by radiographic evaluation that used images of the wrist in anteroposterior, lateral, radial deviation, ulnar deviation and oblique views, obtained in the postoperative period. Results: Fifty-two patients aged between 15 and 65 years were analyzed, of which 43 (83%) were male. Of the 52 patients, 19 (36.53%) had a right-hand injury and 33 (63.46%) had a left-hand injury. Results were excellent in 47 patients (90.38%); good in 4 patients (7.69%), with reduced mobility compared to contralateral and poor in 1 patient (1.92%), with failure of consolidation and breakage of the synthesis material. In 51 cases (99%) there was bone consolidation at the end of six months. Conclusion: Osteosynthesis with a cannulated compression screw is a safe, effective and promising method for the treatment of scaphoid neck fractures. Level of Evidence IV, Case Series.

RESUMO Objetivo: Avaliar a eficácia da técnica de fixação dorsal com parafuso canulado de compressão (CCS) para fraturas transversas do colo do escafoide. Métodos: Foi realizado um estudo de série de casos com pacientes tratados com CSS entre abril de 2014 e maio de 2021. O desfecho principal foi a consolidação da fratura, verificada por meio da avaliação radiográfica das imagens do punho em anteroposterior, perfil, desvio radial, desvio ulnar e oblíquo obtidas no pós-operatório. Resultados: Foram analisados 52 pacientes com idade entre 15 e 65 anos, sendo 43 (83%) do sexo masculino. Dos 52 pacientes, 19 (36,53%) tinham lesão na mão direita e 33(63,46%) na mão esquerda. Os resultados foram excelentes em 47 dos pacientes (90,38%); bons em quatro (7,69%), com mobilidade reduzida comparada ao membro contralateral; e ruim em um (1,92%), com falha da consolidação e quebra do material de síntese. Em 51 casos (99%) houve consolidação óssea ao final de seis meses. Conclusão: A osteossíntese com parafuso canulado de compressão é um método seguro, eficaz e promissor para o tratamento das fraturas no colo do escafoide. Nível de Evidência IV, Série de Casos.

Comparative analysis of four morphometric methods for sex estimation: A study conducted on human skulls.

The pelvis and skull are the regions of the human skeleton that most clearly show sexual dimorphism, with the pelvis being superior to the skull for sex estimation owing to reproductive and hormonal factors. However, as many skeletons are found incomplete, it is important to be able to determine sex from analyzing the skull as well as the pelvis. This study was aimed at validating and evaluating the effectiveness of four morphometric methods for sex estimation using the human skull. One hundred human Brazilian skulls belonging to identified but unclaimed skeletons were used after all legal and administrative requirements for exhumation were satisfied. Four dimensions were analyzed: the facial triangle; the bimastoid triangle; the mastoid triangle; and finally, the occipital triangle. These dimensions were used to calculate the triangle areas. Descriptive analysis was used to verify the mean, standard deviation, and confidence interval of all variables and discriminant analysis with cross-validation was used to verify the percentage of correctness of the sex estimation methods. Individual analysis of the areas of the facial, right mastoid, left mastoid, bimastoid, and occipital triangles, and sum of the mastoid triangle areas, produced average accuracies of 63.0%, 81.8%, 77.8%, 71.4%, 64.0%, and 80.8%, respectively. Combinations of triangles resulted in higher mean accuracy percentages, with only 75.6% accuracy recorded when the left and right mastoid triangle areas were removed. All average values of analyzed triangles were higher in males than in females. Analyses of the cranial triangles were useful for sex estimation in the population studied.