A comparative, prospective, and randomized study of two conservative treatment protocols for first-episode lateral ankle ligament injuries.

BACKGROUND: The objective of this study was to investigate functional results, the amount of time that patients missed from regular working activities, and the incidence of residual mechanical ankle instability following conservative treatment of a first episode of severe lateral ankle ligament sprain (with articular instability). METHODS: This prospective and randomized study included 186 patients with severe lateral ankle ligament injuries, who were randomly assigned into 2 conservative treatment groups. In group A, participants were treated with a walking boot with weight-bearing allowed, pain management, ice, and elevation with restricted joint mobilization for 3 weeks. In group B, patients were treated with a functional brace for 3 weeks. After this period, patients from both groups were placed in a short, functional brace for an additional 3 weeks, during which they also started a rehabilitation program. RESULTS: No statistically significant difference was found in pain intensity score between the 2 groups; however, functional evaluations based on the AOFAS ankle and hindfoot score system showed a statistically significant improvement in the group treated with the functional brace. In addition, the average recovery period necessary for patients of group B to resume their duties was shorter than that for patients in group A. No significant difference was detected in residual mechanical ankle instability between the 2 groups. CONCLUSION: Patients with severe lateral ankle ligament lesions treated with a functional brace were shown to exhibit somewhat better results than those treated with a walking boot, and both methods presented a very low incidence of residual chronic instability. We found adequate conservative treatment was sufficient to reestablish ankle stability and that functional treatment had a marginally better clinical short-term outcome with a shorter average recovery period. LEVEL OF EVIDENCE: Level I, prospective randomized study.

Estudo comparativo prospectivo e randomizado entre o tratamento cirúrgico das fraturas diafisárias do úmero com placa em ponte e haste intramedular bloqueada (análise preliminar) / Comparative, prospective and randomized study of humeral shaft fractures requiring surgical treatment: bridging plate versus locked intramedullary nail (preliminary analysys)

A grande maioria das fraturas de diáfise de úmero são de tratamento conservador. As indicações absolutas(ie lesão vascular) e relativas(ie paralisia nervosa primária) para tratamento cirúrgico estão bem estabelecidas na literatura. Os dois principais métodos utilizados para tal, a placa de auto-compressão e a haste intramedular travada possuem estudos comparando-os.No entanto não existem trabalhos comparando a haste intramedular com a placa em ponte e é a este fim que o presente estudo destina-se.

The treatment of the great majority of humeral shaft fractures is conservative. Absolute indications (i.e., vascular injury) and relative indications (i.e., primary nervous palsy) for surgical treatment are well established by literature. The two most used methods for that purpose - the self - compression plate and the locked intramedullary nail - have already been comparatively studied. However, there are no studies comparing intramedullary nails to the bridging plate, therefore, this is the objective of the present study.

Estudo anatomico do Filus terminalis: disseccao de 31 cadaveres / Anatomical and topographical study of the Filum terminale in 31 human cadavers

Descrever a anatomia intradural do Filum terminalis (FT) e relacionar sua origem, comprimento e insercao com a coluna lombar e sacral em 31 cadaveres de adultos sem...