Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 236
Filtrar
1.
Pan Afr Med J ; 32: 151, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31303922

RESUMO

Ankylosis of the temporomandibular joint (TMJ) is a joint stiffness with an oral aperture of less than 30 mm measured between the incisors, occurring because of a bony, fibrous or fibro-osseous fusion. Arthrosis is a rare cause of the ankylosis of the temporomandibular joint. We report a case of ankylosis of the TMJ due to osteoarthrosis, in order to highlight the diagnostic and therapeutic features of this quite uncommon disease.


Assuntos
Anquilose/diagnóstico , Osteoartrite/diagnóstico , Transtornos da Articulação Temporomandibular/diagnóstico , Anquilose/patologia , Feminino , Humanos , Pessoa de Meia-Idade , Osteoartrite/patologia , Articulação Temporomandibular/patologia , Transtornos da Articulação Temporomandibular/patologia
2.
J Orthop Surg (Hong Kong) ; 27(2): 2309499019858038, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31262219

RESUMO

PURPOSE: The purpose of this study was to report the long-term results of total hip arthroplasty (THA) for the treatment of ankylosed hip. METHODS: Twenty-nine consecutive THAs were performed in 26 patients. The mean age of the patients at the time of the operation was 43.3 years (range, 19-69 years). We used cementless fixation in all hips and the mean duration of follow-up was 10.1 years (range, 4.5-20 years). Radiological evaluation of components, osteolysis, radiolucent lines and loosening were assessed. The Harris Hip Score (HHS), range of motion (ROM), limb-length discrepancy and walking capacity with or without any support were used preoperatively and at final follow-up for clinical evaluation. Survivorship analysis was conducted using the Kaplan-Meier method using second revision for any reason as the endpoint. RESULTS: The mean HHS was 85.6 (range, 55-98) points and mean ROM was 110.5° for flexion. The mean limb-length discrepancy improved from 4.1 cm to 1.1 cm. Positive Trendelenburg sign was recorded in 31% of the patients and 24% of patients needed any support for walking postoperatively. We observed surgical complications related to abductor arm in 25% of the patients. Radiolucency on the acetabular side was seen on one or more zones in 15 patients (16 hips). One aseptic acetabular component loosening was observed. On the femoral side, 11 patients demonstrated non-progressive radiolucent lines and osteolysis around the stem was seen in four hips but there was no aseptic stem loosening. The Kaplan-Meier survival rate considering revision for any reason as the endpoint was 81.5%, for aseptic loosening 91.3%, for a worst-case scenario of 66.4% at 10 years. CONCLUSION: Cementless fixation showed good to excellent results at 10 years. Preoperative and postoperative abductor status of the patient is critical for patient satisfaction.


Assuntos
Anquilose/cirurgia , Artroplastia de Quadril/métodos , Articulação do Quadril/cirurgia , Prótese de Quadril , Adulto , Idoso , Anquilose/diagnóstico , Feminino , Seguimentos , Articulação do Quadril/diagnóstico por imagem , Articulação do Quadril/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Satisfação do Paciente , Período Pós-Operatório , Amplitude de Movimento Articular , Fatores de Tempo , Resultado do Tratamento , Adulto Jovem
5.
J Craniofac Surg ; 29(6): e567-e568, 2018 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-29742569

RESUMO

Surgical management of temporomandibular joint (TMJ) ankylosis in children is often challenging and may result in various complications such as facial nerve injury and visible scar. In this clinical report, the authors present minimally invasive management of a 9-year-old boy with bilateral post-traumatic TMJ ankylosis. The ankylotic TMJs were addressed and gap arthoplasties were performed by endoscopically assisted transoral approach. The risk of facial nerve injury is minimized and facial scar was prevented by avoiding extraoral incision. Mandibular movements in 3 directions were satisfactory at 3rd postoperative month.


Assuntos
Anquilose/cirurgia , Artroplastia/métodos , Mandíbula/cirurgia , Cirurgia Endoscópica por Orifício Natural/métodos , Transtornos da Articulação Temporomandibular/cirurgia , Articulação Temporomandibular/cirurgia , Anquilose/diagnóstico , Criança , Humanos , Masculino , Mandíbula/diagnóstico por imagem , Boca , Articulação Temporomandibular/diagnóstico por imagem , Transtornos da Articulação Temporomandibular/diagnóstico , Tomografia Computadorizada por Raios X
6.
Medicine (Baltimore) ; 97(15): e0278, 2018 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-29642148

RESUMO

RATIONALE: Progressive restriction of the spinal bio-mechanics is not-uncommon deformity encountered in spine clinics. Congenital spinal fusion as seen in Klippel-Feil-anomaly, progressive non-infectious anterior vertebral fusion, and progressive spinal hyperostosis secondary to ossification of the anterior longitudinal spinal ligament are well delineated and recognized. PATIENT CONCERNS: A 24-year-old girl has history of osteoporosis since her early childhood, associated with multiple axial and appendicular fractures and scoliosis. Recently she presented with episodes of severe back pain, spinal rigidity/stiffness with total loss of spine biomechanics. DIAGNOSES: She was provisionally diagnosed as having osteogenesis imperfecta and was investigated for COL1A1/A2 mutations which have been proven to be negative. Autosomal recessive type of osteogenesis imperfecta was proposed as well, no mutations have been encountered. A homozygous for CTSA gene mutation, the gene associated with Galactosialidosis was identified via whole exome sequencing (Next-Generation Sequencing projects) has been identified. INTERVENTIONS: Early in her life she had a history of frequent fractures of the long bones since she was 4 years which was followed by vertebral fractures at the age of 12 years. She manifested lower serum 25OH-D levels and were associated with lower LS-aBMD Z-scores with higher urinary bone turnover indexes (urinary NTX/Cr). OUTCOMES: Lysosomal storage diseases (LSD) have a strong correlation with the development of osteoporosis. LSD causes skeletal abnormalities results from a lack of skeletal remodeling and ossification abnormalities owing to abnormal deposition of GAGs (impaired degradation of glycosaminoglycans ) in bone and cartilage. 3D reconstruction CT scan of the spine showed diffuse hyperostosis of almost the entire spine (begins at the level of T4- extending downwards to involve the whole thoraco-lumbar and upper part of the sacrum) with total diffuse fusion of the pedicles, the transverse and articular processes, the laminae and the spinous processes. LESSONS: This is the first clinical report of adult patient with a history of osteoporosis and fractures with the late diagnosis of Galactosialidosis. Osteogenesis imperfecta (autosomal dominant and recessive) were the first given diagnoses which proven negative. The pathophysiology of the spine ankylosis in our current patient and its correlation with LSD, antiresorptive medications, vitamin D3 and supplemental calcium is not fully understood. Therefore, further studies are needed to elucidate this sort of correlation.


Assuntos
Anquilose , Catepsina A/genética , Doenças por Armazenamento dos Lisossomos , Osteogênese Imperfeita/diagnóstico , Doenças da Coluna Vertebral , Anquilose/diagnóstico , Anquilose/etiologia , Anquilose/fisiopatologia , Remodelação Óssea , Diagnóstico Diferencial , Gerenciamento Clínico , Feminino , Fraturas Ósseas/diagnóstico , Fraturas Ósseas/etiologia , Humanos , Imageamento Tridimensional/métodos , Doenças por Armazenamento dos Lisossomos/complicações , Doenças por Armazenamento dos Lisossomos/diagnóstico , Doenças por Armazenamento dos Lisossomos/genética , Doenças por Armazenamento dos Lisossomos/fisiopatologia , Mutação , Osteoporose/diagnóstico , Osteoporose/etiologia , Escoliose/diagnóstico , Escoliose/etiologia , Doenças da Coluna Vertebral/diagnóstico , Doenças da Coluna Vertebral/etiologia , Doenças da Coluna Vertebral/fisiopatologia , Tomografia Computadorizada por Raios X/métodos , Adulto Jovem
7.
Rev Esp Cir Ortop Traumatol ; 62(6): 458-466, 2018.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-29477350

RESUMO

OBJECTIVES: To expose our experience in the diagnostic and surgical treatment of neurogenic heterotopic ossification of the hip. MATERIAL AND METHODS: We designed an observational retrospective descriptive study including 20 patients (30 hips) with neurogenic heterotopic ossification of the hip secondary to spinal cord injury attended in our institution in the last 10 years, with a minimum of one year follow-up. Medical files and imaging studies were reviewed. The study variables analyzed were: type and localization of neurogenic heterotopic ossification, pre-post excision range of motion, level and aetiology of spinal cord injury, ASIA score, smoking history, surgical approach and complications associated with surgery. RESULTS: A total of 20 patients were treated with resection of heterotopic ossification in 30 hips. 16 patients presented ASIA A spinal cord injury and 4 ASIA B spinal cord injury. Preoperatively all the patients had severe ankylosis in the hip that made sitting in a wheel chair and activities such as repositioning and hygiene difficult. The average postoperative motion at the follow-up evaluation was 90° in flexion, 20° of internal rotation and 40° of external rotation. Immediately after surgery all the patients followed a specific intensive physiotherapy regime for the hip and celecoxib 200 mg was administrated daily orally for a month to prevent recurrence of heterotopic bone formation. None of the patients reviewed suffered a recurrence of heterotopic bone formation. CONCLUSIONS: Surgical excision of hip ossification in order to achieve functional ROM of the hip is the best treatment for patients with neurogenic heterotopic ossification of the hip.


Assuntos
Anquilose/cirurgia , Articulação do Quadril/cirurgia , Procedimentos Ortopédicos/métodos , Ossificação Heterotópica/complicações , Traumatismos da Medula Espinal/complicações , Adulto , Idoso , Anquilose/diagnóstico , Anquilose/etiologia , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Ossificação Heterotópica/diagnóstico , Ossificação Heterotópica/cirurgia , Estudos Retrospectivos , Resultado do Tratamento
8.
Sultan Qaboos Univ Med J ; 18(3): e379-e382, 2018 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-30607282

RESUMO

The surgical management of paediatric patients with temporomandibular joint (TMJ) ankylosis, mandibular retrognathia and obstructive sleep apnoea (OSA) is challenging. We report a nine-year-old boy who presented to the Department of Oral Health, Sultan Qaboos University Hospital, Muscat, Oman, in 2016 with complaints of limited mouth opening, loud snoring and excessive daytime sleepiness. He was diagnosed with TMJ ankylosis, mandibular retrognathia and severe OSA. The patient initially underwent mandibular distraction and, subsequently, release of the TMJ ankylosis and rib graft reconstruction. The overall patient outcome was successful, with improvement in OSA-related symptoms, good facial symmetry and adequate mouth opening.


Assuntos
Anquilose/diagnóstico , Retrognatismo/diagnóstico , Apneia Obstrutiva do Sono/diagnóstico , Transtornos da Articulação Temporomandibular/diagnóstico , Anquilose/fisiopatologia , Anquilose/cirurgia , Criança , Humanos , Masculino , Mandíbula/cirurgia , Omã , Procedimentos Cirúrgicos Bucais/métodos , Retrognatismo/fisiopatologia , Apneia Obstrutiva do Sono/fisiopatologia , Transtornos da Articulação Temporomandibular/fisiopatologia , Transtornos da Articulação Temporomandibular/cirurgia
9.
Acta Med Port ; 30(10): 713-718, 2017 Oct 31.
Artigo em Português | MEDLINE | ID: mdl-29268065

RESUMO

INTRODUCTION: Otosclerosis is a common form of conductive hearing loss characterized by abnormal bone remodeling exclusively in the otic capsule. The prevalence of otosclerosis varies in racial populations and is described as being rare in black African populations. In this paper we aim to report five cases of clinical, and surgically confirmed, otosclerosis in black individuals, in São Tomé and Príncipe. MATERIAL AND METHODS: Since February 2011, Ear, Nose and Throat consultations and surgeries specialty have been carried out at Dr. Ayres de Menezes Hospital in cooperation with the project 'Health for all'. A retrospective analysis was undertaken of the records of all patients subjected either to stapedectomy or partial stapedectomy until February 2014. Information regarding clinical presentation, audiometric data and surgery reports was recorded. RESULTS: Five adult patients underwent stapedectomy or partial stapedectomy. All of them presented with normal otoscopy, conductive or mixed hearing loss on audiogram and normal tympanometry with absent stapedial reflexes. None of the patients had signs of infection or history of head trauma. Three cases showed improvement in the air-bone gap after surgery. The other two were lost to follow-up. DISCUSSION: We documented and surgically confirmed five cases of clinical otosclerosis in this population. A thematic review was carried out and concluded that, despite being described as a rare event in this race, available literature on this topic is not enough to state that there is lower prevalence of otosclerosis amongst the African population. CONCLUSION: Even if not common, otosclerosis cannot be disregarded as a possible cause for conductive hearing loss among the population of São Tomé and Principe.


Assuntos
Perda Auditiva Condutiva/congênito , Otosclerose , Adulto , Anquilose/diagnóstico , Anquilose/cirurgia , Feminino , Perda Auditiva Condutiva/diagnóstico , Perda Auditiva Condutiva/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Otosclerose/diagnóstico , Otosclerose/cirurgia , Estudos Retrospectivos , São Tomé e Príncipe , Cirurgia do Estribo , Adulto Jovem
10.
Foot Ankle Clin ; 22(2): 425-453, 2017 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-28502356

RESUMO

In patients with a stiff ankle replacement, appropriate resection of scarred capsular structures, hypertrophic bone debridement, and careful release of tendons should be performed to achieve good outcomes. Appropriately sized and correctly implanted components are required to restore ankle function to as normal as possible. Although not proven, the better a total ankle replacement is balanced, the less likely scar and heterotopic bone formation will occur. In patients with a stiff and painful ankle replacement, a preoperative diagnostic workup is mandatory to understand the underlying pathologic process and plan appropriate treatment. All underlying causes should be addressed.


Assuntos
Articulação do Tornozelo , Anquilose/diagnóstico , Anquilose/cirurgia , Artroplastia de Substituição do Tornozelo , Complicações Pós-Operatórias/cirurgia , Tornozelo , Articulação do Tornozelo/diagnóstico por imagem , Anquilose/etiologia , Desbridamento , Diagnóstico Diferencial , Humanos , Período Pré-Operatório
11.
Orthop Traumatol Surg Res ; 103(4): 619-622, 2017 06.
Artigo em Inglês | MEDLINE | ID: mdl-28342819

RESUMO

We present the case of an adolescent male developing an ankylosis of the knee after septic arthritis following anterior cruciate ligament reconstruction (ACLR). The patient was shifted to our institution with postoperative septic arthritis associated with a systemic septic condition. Before, repeated arthroscopic surgery had been conducted without any improvement. MRI showed a concomitant osteomyelitis. The infection (Gächter IV, Staphylococcus aureus) was controlled by an open surgical approach and graft removal. An increasing joint stiffness was documented. X-rays showed an ankylosis at 30° of flexion and early closure of growth plates. Functional knee scores showed significantly worse results. Early diagnosis and a stage-adapted treatment in septic arthritis following ACLR are mandatory. In advanced stages or concomitant osteomyelitis an open approach and graft removal may be appropriate. The antibiotic treatment should be adapted consistently.


Assuntos
Anquilose/diagnóstico , Lesões do Ligamento Cruzado Anterior/cirurgia , Reconstrução do Ligamento Cruzado Anterior/efeitos adversos , Artrite Infecciosa/diagnóstico , Infecções Estafilocócicas/diagnóstico , Adolescente , Anquilose/diagnóstico por imagem , Anquilose/etiologia , Reconstrução do Ligamento Cruzado Anterior/métodos , Artrite Infecciosa/etiologia , Diagnóstico Diferencial , Humanos , Masculino , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/etiologia , Amplitude de Movimento Articular , Infecções Estafilocócicas/etiologia , Staphylococcus aureus/isolamento & purificação
12.
J Orthop Surg (Hong Kong) ; 25(1): 2309499016684095, 2017 01.
Artigo em Inglês | MEDLINE | ID: mdl-28142345

RESUMO

INTRODUCTION: The purpose of this study was to evaluate the results of total knee arthroplasty for patients with ankylosed knees. METHODS: We evaluated seven patients (10 knees) who underwent total knee arthroplasties for ankylosed knees from 1995 to 2008. There were two men and five women, with a mean age of 44.1 years (42-48 years). The mean follow-up period was 10.2 years (1-19.5 years). A rectus snip was performed in all cases, and V-Y quadricepsplasty was used in one case of severe quadriceps contracture. In all cases, we used the PFC Sigma PS fixed model (DePuy Orthopaedics Inc., Warsaw, Indiana, USA). The goal was more than 90° of flexion. Clinical evaluation was performed using range of motion (ROM), Knee Society (KS) Knee Score, KS Function Score, and complications. Radiographs were used to evaluate loosening or osteolysis. RESULTS: The ROF was improved from 9.5° (0-30°) to 78.5° (15-115°), The Knee Score improved from 42.6 (25-70) to 68.6 (41-97), and the Function Score improved from 39 (0-60) to 66 (40-90). A radiolucent line was detected in two cases (one patient) around the tibial component, and one case had a necrosis of skin edge. Only one case had no improvement of motion. CONCLUSION: Total knee arthroplasty conversion for patients with ankylosed knees can achieve good results for motion and function without osteotomy of the tibial tuberosity when there is good quality soft tissue of the thigh.


Assuntos
Anquilose/cirurgia , Artroplastia do Joelho , Articulação do Joelho , Adulto , Anquilose/diagnóstico , Anquilose/etiologia , Estudos de Coortes , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Amplitude de Movimento Articular , Resultado do Tratamento
13.
Mod Rheumatol ; 27(5): 801-805, 2017 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-27919200

RESUMO

OBJECTIVES: The purpose of this study was to clarify the characteristics of bony ankylosis of the facet joint of the cervical spine in rheumatoid arthritis (RA) patients who required cervical spine surgery, and its relationship to the clinical findings. METHODS: Eighty consecutive RA patients with cervical spine disorder who received initial surgery were reviewed. The occurrence of bony ankylosis of the facet joint of the cervical spine was investigated using computed tomography (CT) before surgery. We also evaluated the severity of neurological symptoms and the plain wrist radiographs taken before surgery; furthermore, we evaluated each patient's medical history for total knee arthroplasty (TKA) or hip arthroplasty (THA). RESULTS: The preoperative CT imaging demonstrated bony ankylosis of the facet joint of the cervical spine in 45 facet levels of 19 cases (BA + group). In all patients, responsible instability or stenosis was demonstrated just caudal or on the cranial side of those bony ankylosis. Before surgery, the BA + group included significantly more patients showing severe cervical myelopathy (p < 0.05), and significantly more cases showing progressed ankylosis in the wrist joint bilaterally (p < 0.01). There were also significantly more patients who received two or more TKA or THA before the cervical spine surgery in the BA + group (p < 0.01). CONCLUSIONS: Bony ankylosis of the facet joint of the cervical spine may be a risk factor of instability or stenosis at the adjacent disc level and severe cervical myelopathy. Furthermore, its ankylosis was demonstrated in RA patients with severe destroyed joints.


Assuntos
Anquilose , Artrite Reumatoide , Vértebras Cervicais , Doenças da Coluna Vertebral , Articulação Zigapofisária , Adulto , Idoso , Anquilose/diagnóstico , Anquilose/etiologia , Artrite Reumatoide/complicações , Artrite Reumatoide/diagnóstico , Artrite Reumatoide/fisiopatologia , Vértebras Cervicais/diagnóstico por imagem , Vértebras Cervicais/cirurgia , Feminino , Humanos , Japão , Masculino , Pessoa de Meia-Idade , Exame Neurológico/métodos , Exame Neurológico/estatística & dados numéricos , Assistência Perioperatória/métodos , Assistência Perioperatória/estatística & dados numéricos , Índice de Gravidade de Doença , Doenças da Coluna Vertebral/diagnóstico , Doenças da Coluna Vertebral/etiologia , Doenças da Coluna Vertebral/fisiopatologia , Doenças da Coluna Vertebral/cirurgia , Estatística como Assunto , Tomografia Computadorizada por Raios X/métodos , Articulação Zigapofisária/diagnóstico por imagem , Articulação Zigapofisária/fisiopatologia
14.
J Craniofac Surg ; 28(1): 203-206, 2017 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-27930467

RESUMO

Juvenile idiopathic arthritis (JIA), the most common inflammatory autoimmune rheumatic disease in children, consists of a heterogeneous group of diseases with 7 distinct subtypes. Involvement of the temporomandibular joint (TMJ) in JIA varies from 17% to 87%, and can alter craniofacial growth due to damage to the condylar growth center. This study was a literature review and clinical report of bilateral ankylosis of the TMJ in a 13-year-old patient with polyarticular JIA. Temporomandibular joint reconstruction with a costochondral graft was carried out. The surgery was uneventful and the patient developed a mouth opening of 40 mm during the postoperative period of 24 months. The authors concluded that treatment of TMJ ankylosis should be surgical with removal of the ankylotic mass, and when necessary, joint reconstruction in patients undergoing a growth phase. Costochondral graft is still the gold standard due to its biological similarity and growth potential in patients with JIA. Research and early diagnosis of TMJ diseases should be carried out, because the earlier the identification of the disease, the better the chances of reducing its devastating effects, thus avoiding the worst possible outcome: TMJ ankylosis.


Assuntos
Anquilose/cirurgia , Artrite Juvenil/complicações , Artroplastia/métodos , Ossos Faciais/cirurgia , Transtornos da Articulação Temporomandibular/cirurgia , Adolescente , Anquilose/diagnóstico , Anquilose/etiologia , Artrite Juvenil/diagnóstico , Feminino , Humanos , Articulação Temporomandibular/cirurgia , Transtornos da Articulação Temporomandibular/diagnóstico , Transtornos da Articulação Temporomandibular/etiologia , Tomografia Computadorizada por Raios X
15.
JNMA J Nepal Med Assoc ; 54(202): 63-66, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27935925

RESUMO

INTRODUCTION: Fused or Ankylosed hip is late complication of chronic inflammatory disorder with progressive changes in and around articular as well as periarticular structures with alteration in bio-force line of body which later lead to severe flexion deformity of joint. This not only results decreased movements of hip, it's also increase pain around the hip, back and contralateral hip. METHODS: Retrospectively, all patients aged 18 years or older undergoing THA between June 2006 to June 2012 were reviewed with selection criteria. The five ankylosed hips (three left and two right) with severe flexion deformities which ankylosed spontaneously were successfully converted to THA at time period of 2006 to June 2012. Range of motion, Harris Hip Score and flexion deformity angle at preoperative, postoperative and follow-up periods were used as evaluation. RESULTS: Mean follow up is 42 months. Mean HHS increased from 21.6±4.97 to 81.8±4.02 points with one excellent, two good and two fair cases. The FDA is corrected to mean 8°±10.95 postoperatively and 4°±5.47 at final follow up from 81.6°±4.39 with two hips of 10° residual deformity. Hip ROM is improved as flexion 70° to 100°, adduction 10° to 20°, abduction 10° to 30°, internal rotation 5° to 10° and external rotation 2° to 50° from 0° activity. As complications, one hip had loose prosthesis, two had early postoperative dislocations, one had Deep Vein Thrombosis and one had femoral nerve palsy with quadriceps weakness. CONCLUSIONS: THA is an effective treatment for ankylosed hip with severe flexion deformity although complications are noted more than routine hip arthroplasties.


Assuntos
Anquilose/cirurgia , Artroplastia de Quadril , Articulação do Quadril/cirurgia , Amplitude de Movimento Articular , Adulto , Anquilose/diagnóstico , Anquilose/etiologia , Anquilose/fisiopatologia , Seguimentos , Articulação do Quadril/fisiopatologia , Humanos , Estudos Retrospectivos , Fatores de Tempo , Resultado do Tratamento
16.
J Clin Anesth ; 35: 207-209, 2016 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-27871523

RESUMO

We describe the use of peripheral nerve stimulator for mandibular nerve block intraoperatively in a 4.5year old child with complete temporomandibular joint ankyloses. The block was not possible preoperatively, therefore, it was administered after release of ankyloses. The use of peripheral nerve stimulator increased the chances of a successful block. No intraoperative analgesics and muscle relaxants were required. Postoperative pain relief was excellent. Peripheral nerve stimulator is an easy way of for accurate needle tip placement for mandibular nerve block in patients with distorted anatomy.


Assuntos
Anestésicos Locais/administração & dosagem , Anquilose/cirurgia , Cuidados Intraoperatórios/métodos , Nervo Mandibular/efeitos dos fármacos , Bloqueio Nervoso/métodos , Transtornos da Articulação Temporomandibular/cirurgia , Androstanóis/administração & dosagem , Anestesia Geral , Anestésicos Inalatórios/administração & dosagem , Anestésicos Intravenosos/administração & dosagem , Anquilose/diagnóstico , Artroplastia , Bupivacaína/administração & dosagem , Pré-Escolar , Terapia por Estimulação Elétrica , Feminino , Humanos , Lidocaína/administração & dosagem , Éteres Metílicos/administração & dosagem , Bloqueio Neuromuscular/métodos , Fármacos Neuromusculares não Despolarizantes/administração & dosagem , Propofol/administração & dosagem , Rocurônio , Sevoflurano , Transtornos da Articulação Temporomandibular/diagnóstico , Tomografia Computadorizada por Raios X
17.
Clin Orthop Surg ; 8(3): 339-44, 2016 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-27583120

RESUMO

This case demonstrates a rarely reported bilateral scapulohumeral bony ankylosis. A young woman developed extensive heterotopic ossifications (HOs) in both shoulder joints after being mechanically ventilated for several months at the intensive care unit in a comatose status. She presented with a severe movement restriction of both shoulder joints. Surgical resection of the bony bridges was performed in 2 separate sessions with a significant improvement of shoulder function afterwards. No postoperative complications, pain, or recurrence of HOs were noted at 1-year follow-up. Mechanical ventilation, immobilization, neuromuscular blockage, and prolonged sedation are known risk factors for the development of HOs in the shoulder joints. Relatively early surgical resection of the HOs can be performed safely in contrary to earlier belief. Afterwards, nonsteroidal anti-inflammatory drugs and/or radiation therapy can be possible treatment modalities to prevent recurrence of HOs.


Assuntos
Anquilose , Respiração Artificial/efeitos adversos , Articulação do Ombro , Adulto , Anquilose/diagnóstico , Anquilose/diagnóstico por imagem , Anquilose/etiologia , Anquilose/fisiopatologia , Feminino , Humanos , Imagem por Ressonância Magnética , Amplitude de Movimento Articular , Articulação do Ombro/diagnóstico por imagem , Articulação do Ombro/fisiopatologia , Tomografia Computadorizada por Raios X
19.
Rev Stomatol Chir Maxillofac Chir Orale ; 117(4): 245-55, 2016 Sep.
Artigo em Francês | MEDLINE | ID: mdl-27481673

RESUMO

Ankylosis of the temporomandibular joint is defined as a permanent constriction of the jaws with less than 30mm mouth opening measured between the incisors, occurring because of bony, fibrous or fibro-osseous fusion. Resulting complications such as speech, chewing, swallowing impediment and deficient oral hygiene may occur. The overall incidence is decreasing but remains significant in some developing countries. The most frequent etiology in developed countries is the post-traumatic ankylosis occurring after condylar fracture. Other causes may be found: infection (decreasing since the advent of antibiotics), inflammation (rheumatoid arthritis and ankylosing spondylitis mainly) and congenital diseases (very rare). Management relies on surgery: resection of the ankylosis block in combination with bilateral coronoidectomy… The block resection may be offset by the interposition temporal fascia flap, a costochondral graft or a TMJ prosthesis according to the loss of height and to the impact on dental occlusion. Postoperative rehabilitation is essential and has to be started early, to be intense and prolonged. Poor rehabilitation is the main cause of ankylosis recurrence.


Assuntos
Anquilose , Transtornos da Articulação Temporomandibular , Anquilose/diagnóstico , Anquilose/epidemiologia , Anquilose/reabilitação , Anquilose/cirurgia , Diagnóstico Diferencial , Humanos , Côndilo Mandibular/cirurgia , Procedimentos Cirúrgicos Reconstrutivos/reabilitação , Articulação Temporomandibular/cirurgia , Transtornos da Articulação Temporomandibular/diagnóstico , Transtornos da Articulação Temporomandibular/epidemiologia , Transtornos da Articulação Temporomandibular/reabilitação , Transtornos da Articulação Temporomandibular/cirurgia
20.
J Oral Maxillofac Surg ; 74(12): 2378.e1-2378.e5, 2016 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-27566458

RESUMO

PURPOSE: Traumatic dislocation of the mandibular condyle into the middle cranial fossa is an extremely rare complication of maxillofacial injury. Management case of the of dislocation of the mandibular condyle complicated by bilateral temporomandibular joint ankylosis is presented. MATERIALS AND METHODS: A 17year old male patient presented to the outpatient clinic complaining of inability to open his mouth following a motor vehicle accident 6 months prior. Examination revealed bilateral TMJ ankylosis following left condylar head fracture and dislocation of the right condylar head into the middle cranial fossa. Bilateral total alloplastic TMJ reconstruction was performed. RESULTS: MIO at a three-year follow-up was 35mm, occlusion was intact and the patient was functioning optimally.


Assuntos
Anquilose/cirurgia , Artroplastia de Substituição/métodos , Fossa Craniana Média , Luxações Articulares/complicações , Côndilo Mandibular/lesões , Fraturas Mandibulares/complicações , Transtornos da Articulação Temporomandibular/cirurgia , Articulação Temporomandibular/lesões , Adolescente , Anquilose/diagnóstico , Anquilose/etiologia , Humanos , Luxações Articulares/diagnóstico , Masculino , Fraturas Mandibulares/diagnóstico , Transtornos da Articulação Temporomandibular/diagnóstico , Transtornos da Articulação Temporomandibular/etiologia
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA