Intra-focal reduction and percutaneous fixation of neck fractures of the fifth metacarpal: description of surgical technique / Redução intrafocal e fixação percutânea das fraturas do colo do quinto metacarpo - Descrição de técnica cirúrgica

OBJECTIVE: to demonstrate a surgical technique for treating neck fractures of the fifth metacarpal, by means of reduction through intra-focal manipulation and percutaneous fixation using Kirschner wires, with the aims of making it easier to achieve and maintain the reduction during the operation and enabling reduction of these fractures even if a fibrous callus has formed. METHODS: a series of ten patients with neck fractures of the fifth metacarpal presenting palmar angles greater than 30◦ underwent the surgical technique described, as examples, and their results were evaluated through postoperative radiographs and clinical examinations. RESULTS: all the patients achieved reductions that were close to anatomical and evolved to consolidation of the fracture in the position obtained. CONCLUSION: the surgical technique described is effective, easy to carry out, minimally invasive and low-cost, thereby enabling adequate clinical and radiographic reduction, even in subacute fractures already presenting a fibrous callus...

OBJETIVO: demonstrar uma técnica cirúrgica para o tratamento das fraturas do colo do quinto metacarpo por meio de redução por manipulação intrafocal e fixação percutânea com fios de Kirschner, visando a facilitar a obtenção e manutenção da redução no intraoperatório e possibilitar a redução dessas fraturas, ainda que com calo fibroso formado. MÉTODOS: dez pacientes portadores de fratura do colo do quinto metacarpo com angulação palmar superior a 30◦ foram submetidos, como exemplos, à técnica cirúrgica descrita. Os resultados foram avaliados por meio de radiografias e exame clínico pós-operatório. RESULTADOS: todos os pacientes obtiveram redução próxima da anatômica e evoluíram para consolidação da fratura na posição obtida. CONCLUSÃO: a técnica cirúrgica descrita é eficaz, de simples execução, minimamente invasiva, de baixo custo e permite redução clínica e radiográfica adequadas, mesmo em fraturas subagudas com calo fibroso formado...

Intra-focal reduction and percutaneous fixation of neck fractures of the fifth metacarpal: description of surgical technique.

OBJECTIVE: to demonstrate a surgical technique for treating neck fractures of the fifth metacarpal, by means of reduction through intra-focal manipulation and percutaneous fixation using Kirschner wires, with the aims of making it easier to achieve and maintain the reduction during the operation and enabling reduction of these fractures even if a fibrous callus has formed. METHODS: a series of ten patients with neck fractures of the fifth metacarpal presenting palmar angles greater than 30° underwent the surgical technique described, as examples, and their results were evaluated through postoperative radiographs and clinical examinations. RESULTS: all the patients achieved reductions that were close to anatomical and evolved to consolidation of the fracture in the position obtained. CONCLUSION: the surgical technique described is effective, easy to carry out, minimally invasive and low-cost, thereby enabling adequate clinical and radiographic reduction, even in subacute fractures already presenting a fibrous callus.

OBJETIVO: demonstrar uma técnica cirúrgica para o tratamento das fraturas do colo do quinto metacarpo por meio de redução por manipulação intrafocal e fixação percutânea com fios de Kirschner, visando a facilitar a obtenção e manutenção da redução no intraoperatório e possibilitar a redução dessas fraturas, ainda que com calo fibroso formado. MÉTODOS: dez pacientes portadores de fratura do colo do quinto metacarpo com angulação palmar superior a 30° foram submetidos, como exemplos, à técnica cirúrgica descrita. Os resultados foram avaliados por meio de radiografias e exame clínico pós-operatório. RESULTADOS: todos os pacientes obtiveram redução próxima da anatômica e evoluíram para consolidação da fratura na posição obtida. CONCLUSÃO: a técnica cirúrgica descrita é eficaz, de simples execução, minimamente invasiva, de baixo custo e permite redução clínica e radiográfica adequadas, mesmo em fraturas subagudas com calo fibroso formado.

DISTAL FEMORAL VARUSING FOR OSTEOARTHRITIS OF VALGUS KNEE: A LONG-TERM FOLLOW-UP.

OBJECTIVE: Assess the long-term results of distal femoral varusing osteotomy and try to establish predictive criteria that could help on selecting patients to be submitted to this technique. METHODS: Fifteen patients with lateral compartment osteoarthritis and valgus deformity of the knee were submitted to distal femoral "V" varusing osteotomy fixated with lateral plate, pursuing knee alignment at 0° on the anatomical axis. The mean follow-up period was 81.4 months, ranging from 43 to 132 months. The Knee Society Rating System protocol was employed. Additional assessed variables were the following: patient age, follow-up time, and postoperative anatomical angle. RESULTS: 11 results were regarded as excellent or good (73%) and four as fair or poor (27%). CONCLUSION: Distal femoral "V" varusing osteotomy constitutes a good treatment alternative for patients with lateral compartment osteoarthritis and valgus knee. The following variables have not been confirmed: patient age at the time of surgery, follow-up time, and postoperative anatomical angle as predictive factors for the results.

Osteotomia femoral distal de varização para osteoartrose no joelho valgo: seguimento em longo prazo / Distal femoral varusing osteotomy for osteoarthritis of the valgus knee: a long-term follow-up

OBJETIVO: Avaliar os resultados em longo prazo da osteotomia femoral distal de varização e procurar estabelecer critérios preditivos que possam auxiliar na seleção dos pacientes a serem submetidos a essa técnica. MÉTODOS: Quinze pacientes portadores de osteoartrose do compartimento lateral e deformidade em valgo do joelho foram submetidos à osteotomia femoral distal de varização em "V" e fixação com placa-lâmina lateral, procurando-se alinhar o joelho a 0º no eixo anatômico. O seguimento médio foi de 81,4 meses, variando de 43 a 132 meses. Utilizou-se o protocolo da Knee Society Rating System. Foram consideradas ainda as variáveis: idade do paciente, tempo de seguimento e ângulo anatômico pós-operatórios. RESULTADOS: Foram obtidos 11 resultados excelentes e bons (73 por cento) e quatro regulares e ruins (27 por cento). CONCLUSÃO: A osteotomia femoral distal de varização em "V" constitui boa opção para o tratamento de pacientes com osteoartrose do compartimento lateral e valgismo do joelho. Não se confirmaram as variáveis idade do paciente na data de cirurgia, tempo de seguimento e ângulo anatômico pós-operatórios como fatores preditivos dos resultados.

OBJECTIVE: Assess the long-term results of distal femoral varusing osteotomy and try to establish predictive criteria that could help on selecting patients to be submitted to this technique. METHODS: Fifteen patients with lateral compartment osteoarthritis and valgus deformity of the knee were submitted to distal femoral "V" varusing osteotomy fixated with lateral plate, pursuing knee alignment at 0º on the anatomical axis. The mean follow-up period was 81.4 months, ranging from 43 to 132 months. The Knee Society Rating System protocol was employed. Additional assessed variables were the following: patient age, follow-up time, and postoperative anatomical angle. RESULTS: 11 results were regarded as excellent or good (73 percent) and four as fair or poor (27 percent). CONCLUSION: Distal femoral "V" varusing osteotomy constitutes a good treatment alternative for patients with lateral compartment osteoarthritis and valgus knee. The following variables have not been confirmed: patient age at the time of surgery, follow-up time, and postoperative anatomical angle as predictive factors for the results.

Scorpion venom increases mRNA expression of lung cytokines.

Previous studies have demonstrated that scorpion toxins increase the serum levels of IL-1, IL-6, INF-gamma, and GM-CSF in patients with severe shock and pulmonary edema. Moreover, it has been shown that experimental models of scorpion envenomation presented an increase in serum levels of IL-1, IL-6, IFN-gamma and nitric oxide. Thus, it is possible that the cytokine release may contribute to the onset and maintenance of the pulmonary edema induced by scorpion venom. This study was designed to investigate whether inflammatory and non-inflammatory cytokines, contribute to the pulmonary injury induced by infusion of Tityus serrulatus scorpion toxin in rats. We show that scorpion venom not only increases the expression of mRNA pulmonary inflammatory cytokines but also non-inflammatory cytokines as well. Moreover, the expression of IL-1alpha, IL-1beta and IL-6 mRNA was shown to be higher among the remaining detectable cytokines. The findings of this study provide additional insight towards the understanding of the pathophysiology of the pulmonary edema induced by scorpion venom. The increased level of pulmonary cytokines observed during the pulmonary edema may be responsible for the exacerbation and maintenance of the inflammatory response to scorpion venom in the lungs.