RESUMO
OBJETIVO: Avaliar os resultados do tratamento cirúrgico de 84 luxações acromioclaviculares agudas com a utilização da via de acesso posterossuperior do ombro. MÉTODOS: Foram avaliados 84 casos de luxações acromioclaviculares agudas grau III da classificação de Allman-Tossy operados de novembro de 2002 a maio de 2010. A média de idade dos pacientes foi de 34 anos. O diagnóstico foi realizado por avaliação clínica e radiográfica. Os pacientes foram operados pela mesma equipe cirúrgica em até três semanas da data do trauma realizando-se a via de acesso posterossuperior do ombro com acesso ao topo da base do processo coracoide para colocação de duas âncoras utilizadas na redução da luxação. O seguimento mínimo foi de 12 meses. A avaliação clínica-radiográfica pós-operatória foi realizada pelos critérios de Karlsson modificados e do escore da Universidade da Califórnia em Los Angeles (UCLA). RESULTADOS: Dos 84 pacientes operados, 92,8% apresentavam resultados bons ou excelentes e 7,2% de resultados regulares ou fracos pelo escore de avaliação da UCLA. Pelos critérios de Karlsson modificados 76,2% foram avaliados como grau A, 17,9% como grau B e 5,9% como grau C. CONCLUSÃO: A VIA de acesso posterossuperior do ombro é uma nova opção para acesso ao processo coracoide e tratamento das luxações acromioclaviculares, com resultados clínicos e radiográficos equivalentes aos da literatura.
OBJECTIVE: To evaluate the results from surgical treatment of 84 cases of acute acromioclavicular dislocation, using a posterosuperior access route. METHODS: Eighty-four cases of acute acromioclavicular dislocation (grade III in the Allman-Tossy classification) operated between November 2002 and May 2010 were evaluated. The patients' mean age was 34 years. The diagnoses were made using clinical and radiographic evaluations. The patients were operated by the same surgical team, within three weeks of the date of the trauma, using a posterosuperior approach to the shoulder to access the top of the base of the coracoid process for placement of two anchors, which were used in reducing the dislocation. The minimum follow-up was 12 months. The postoperative clinical-radiographic evaluation was done using the modified Karlsson criteria and the University of California at Los Angeles (UCLA) score. RESULTS: 92.8% of the 84 patients treated presented good or excellent results, and 7.2% presented fair or poor results, using the UCLA assessment score. According to the modified Karlsson criteria, 76.2% were assessed as grade A, 17.9% as grade B and 5.9% as grade C. CONCLUSION: The posterosuperior access route to the shoulder is a new option for accessing the coracoid process and treating acromioclavicular dislocation, with clinical and radiographic results equivalent to those in the literature.
Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto Jovem , Pessoa de Meia-Idade , Articulação Acromioclavicular/anatomia & histologia , Articulação Acromioclavicular/cirurgia , Articulação Acromioclavicular/lesõesRESUMO
OBJECTIVE: To evaluate the results from surgical treatment of 84 cases of acute acromioclavicular dislocation, using a posterosuperior access route. METHODS: Eighty-four cases of acute acromioclavicular dislocation (grade III in the Allman-Tossy classification) operated between November 2002 and May 2010 were evaluated. The patients' mean age was 34 years. The diagnoses were made using clinical and radiographic evaluations. The patients were operated by the same surgical team, within three weeks of the date of the trauma, using a posterosuperior approach to the shoulder to access the top of the base of the coracoid process for placement of two anchors, which were used in reducing the dislocation. The minimum follow-up was 12 months. The postoperative clinical-radiographic evaluation was done using the modified Karlsson criteria and the University of California at Los Angeles (UCLA) score. RESULTS: 92.8% of the 84 patients treated presented good or excellent results, and 7.2% presented fair or poor results, using the UCLA assessment score. According to the modified Karlsson criteria, 76.2% were assessed as grade A, 17.9% as grade B and 5.9% as grade C. CONCLUSION: The posterosuperior access route to the shoulder is a new option for accessing the coracoid process and treating acromioclavicular dislocation, with clinical and radiographic results equivalent to those in the literature.
RESUMO
OBJECTIVES: To analyze and correlate the clinical and radiographic results from patients with distal radius fractures who underwent surgical treatment with a fixed-angle volar locked plate. METHODS: Sixty-four patients with distal radius fractures were evaluated. They all underwent surgical treatment with a volar locked plate for the distal radius, with a minimum of six months of postoperative follow-up. They underwent a physical examination that measured range of motion and grip strength, answered the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire and underwent radiographic examination. RESULTS: In the physical examination on the patients, all the range-of-motion measurements were reduced. Grip strength measured in kgf was on average 85.8% of the strength on the unaffected side. The mean DASH score was 15.99. A significant relationship was found between lower DASH scores and losses of extension and grip strength. On the radiographs, the mean values in relation to the unfractured side were 84.0% for radial inclination, 85.4% for radial length and 86.8% for volar deviation of the radius. Loss of radial length was correlated with losses of extension and grip strength.
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Assimetrias de comprimento dos MMII são comuns na população, porém apenas quando maiores que 1,5 cm deixam deser um problema estético e podem levar a alterações funcionais. Objetivo: Estabelecer uma correlação entre as medidas clínicas e radiográficasda coxa e da perna em crianças entre 7-12 anos, sendo esta obtida através da escanometria. Material e Método: Avaliaçãoprospectiva do comprimento da coxa e perna de 300 crianças entre 7-12 anos, de ambos os sexos, através da medida clínica com fitamilimetrada e radiográfica pela escanometria. A correlação entre as medidas foi feita através da regressão linear simples. Resultadoe discussão: Através da análise estatística verificou-se que há diferença estatisticamente significativa entre as medidas clínicas e radiográficasde coxa e perna (p<0,05). Por este motivo foi feita a regressão linear simples entre os valores encontrados e verificou-se aexistência de correlação entre elas e definiu-se uma equação de correlação. Com base nesta equação é possível que a medida radiográficaseja pressuposta a partir da medida clínica. Conclusão: As medidas clínicas e radiográficas são estatisticamente diferentes, porém existeuma correlação entre elas, permitindo que seja estabelecida uma fórmula que possibilita a predição das medidas radiográficas a partirdos valores obtidos clinicamente.
Limb length discrepancies are common in the general population, but they only cause functional problems when they areover 1.5 cm. Objective: To make a correlation between clinical and radiological assessments of children´s thigh and leg lengths between7-12 yrs, through slit scanogram measurement. Method: Prospective study of limb length in 300 children between 7-12 yrs, of bothsexes, through clinical measurement using a measuring tape and radiographic assessment using the supine slit scanogram technique. Thecorrelation between the assessments was made by simple linear regression. Results and discussion: The statistical analysis showed thatthere are differences between the clinical and the radiographic assessments (p<0.05). The simple linear regression was used to verifythe correlation and to define the correlation equation. Using this equation, it is possible to define the radiographic values based on theclinical assessment. Conclusion: The clinical and radiographic assessments are statistically different; however, there is
