Femoral neurapraxia due to the use of tourniquet: case report

Os autores descrevem caso de paciente do sexo feminino, com 23 anos de idade, submetida à cirurgia do joelho para realinhamento patelar com uso de garrote pneumático e que desenvolveu neurapraxia femoral. Faz-se breve revisão da literatura sobre as vantagens e desvantagens do uso do garrote em cirurgias do joelho e discute-se a necessidade da sua indicação, considerando-se as complicações acarretadas por seu uso incorreto.The authors describe the case of a 27 year-old female patient submitted to knee surgery for patellar realignment with the use of a pneumatic tourniquet, who developed femoral neurapraxia. They make a brief literature review about the advantages and disadvantages of using a tourniquet in knee surgeries, and discuss the need for tourniquet indication considering the complications entailed by the incorrect use of the tourniquet

Structure and ultrastructure of the medial pterygoid muscle myotendinous junction in aging rats.

As características das células musculares e da junção miotendínea do músculo pterigóideo mediai de ratos adultos e com envelhecimento foram estudadas, empregando-se as técnicas de microscopia de luz e eletrônica de varredura e de transmissão. A microscopia de luz mostrou que as fibras musculares inserem-se na superfície óssea mandibular através de tecido colágeno composto por numerosos fibroblastos. Os cortes examinados sob luz polarizada revelaram a presença de fibras colágenas tipo\' e li\' nesta região. Além disso, puderam-se notar os capilares sangüíneos em grande número. Observações ao microscópio eletrônico de varredura ressaltaram as estriações presentes no músculo esquelético. O tecido conjuntivo que constitui o endomísio foi notado quando as amostras foram tratadas com solução de hidróxido de sódio e foi possível observar os diferentes diâmetros apresentados pelas fibras musculares. A microscopia eletrônica de transmissão evidenciou o alinhamento dos sarcômeros e as concentrações de mitocôndrias junto à lâmina basal na terminação da fibra muscular. O estudo da junção miotendínea dos ratos adultos e com envelhecimento identificou as fibras colágenas e os feixes de miofibrilas formando interdigitações que promovem o aumento da superfície de contato nesta região. Os aspectos observados nos músculos de ratos adultos mostraram-se bastante similares aos encontrados nos ratos com envelhecimento.The mediai pterygoid muscle cells and myotendinous junction characteristics of adult and aging rats were studied, using light microscopy and scanning and transmission electron microscopy techniques. The Iight microscopy showed the muscle fibers inserting in the mandible surface through collagen tissue and numerous fibroblasts. The samples examined in polarized light revealed the presence of type I and 11I collagen fibers in this site. Furthermore, the numerous blood capillaries could be noticed. Observations at the scanning electron microscope evidenced strias present in the skeletal muscle. The connective tissue that constitutes the endomysium could be noticed when the samples were treated with sodium hydroxide solution and it was possible to observe the muscle fibers different diameters. The transmission electron microscopy revealed the sarcomeres alignment and the mitochondria concentration by the basal lamina in the muscle fiber termination. The adult and aging rats myotendinous junction study showed the collagen fibers and the myofibrils bundles developing finger-like processes that increases the contact areas in this site. The aspects seen in adult rats pterygoid muscles were very similar to the ones seen in the aging rats

Fratura do escafoide por estresse em ginasta: relato de caso

Apresenta-se o relato de caso de um ginasta de 18 anos de idade, que recebeu o diagnóstico de fratura por estresse do escafoide combinada com epifisiólise distal do rádio, e descreve-se seu tratamento. Após breve revisão da literatura sobre essa rara associação de lesões, os autores pedem atenção para a importância do exame físico e de imagem no correto diagnóstico e na observação de possíveis lesões combinadas

SCAPHOID STRESS FRACTURE IN GYMNASTICS ATHLETE: A CASE REPORT

ABSTRACTWe present a case report of an 18 year-old gymnast who was diagnosed with a scaphoid stress fracture associated with a distal radial epiphysiolysis, reporting the treatment of choice. After a brief literature review about this rare association, the authors ask for attention concerning the importance of physical and image examination in making right diagnosis and finding associated injuries

Reconstrução do ligamento cruzado anterior com a técnica de duplo feixe - avaliação no laboratório de biomecânica Anterior cruciate ligament reconstruction using the double bundle technique - evaluation in the biomechanics laboratory

OBJETIVO: O objetivo deste estudo é descrever a metodologia da análise da rotação do joelho utilizando instrumentos do laboratório de biomecânica e apresentar os resultados preliminares de um estudo comparativo com pacientes submetidos à reconstrução do ligamento cruzado anterior com a técnica de duplo feixe. MÉTODOS: Descreveu-se o protocolo atualmente utilizado em nosso laboratório e realizou-se a análise cinemática tridimensional e medida da amplitude de rotação do joelho de oito pacientes normais (grupo controle) e 12 pacientes operados com a técnica de duplo feixe em três tarefas no laboratório de biomecânica. RESULTADOS: Não indicam diferenças significativas entre os lados operados e não operados em relação às amplitudes médias da marcha, da marcha com mudança de direção ou da marcha com mudança de direção ao descer a escada (p > 0,13). CONCLUSÕES: Os resultados preliminares não demonstraram diferença da técnica de reconstrução de LCA em duplo feixe em relação ao lado contralateral e ao grupo controle.<br>OBJECTIVE: The objective of this study was to describe the methodology of knee rotation analysis using biomechanics laboratory instruments and to present the preliminary results from a comparative study on patients who underwent anterior cruciate ligament (ACL) reconstruction using the double-bundle technique. METHODS: The protocol currently used in our laboratory was described. Three-dimensional kinematic analysis was performed and knee rotation amplitude was measured on eight normal patients (control group) and 12 patients who were operated using the double-bundle technique, by means of three tasks in the biomechanics laboratory. RESULTS: No significant differences between operated and non-operated sides were shown in relation to the mean amplitudes of gait, gait with change in direction or gait with change in direction when going down stairs (p > 0.13). CONCLUSION: The preliminary results did not show any difference in the double-bundle ACL reconstruction technique in relation to the contralateral side and the control group

Endoscopic treatment of the posterior ankle impingement syndrome on amateur and professional athletes

To determine whether professional and amateur athletes showed differences in ankle function when treated with endoscopic technique for posterior ankle impingement syndrome, to verify the impact of the presence of associated lesions in clinical evolution and to assess time to return to sport (we hypothesize that time will be the only difference between groups). Thirty-two athletes with a diagnosis of posterior impingement syndrome underwent surgery endoscopically. The American Orthopaedics Foot and Ankle Society (AOFAS) scale was used to compare functional results between amateur (15) and professional athletes (17). The satisfaction, time to return to sport, operative time, intraoperative findings and complications were evaluated, and the presence of associated injuries interfering in these results was verified. The preoperative AOFAS score range for the professional group was 62.9 +/- A 14 preoperatively and 92.3 +/- A 7.7 postoperatively, and for the amateur group was 67.9 +/- A 19.7 and 94 +/- A 9.3. The satisfaction was excellent or good in 94 % of all cases and fair in 6 %. The average time of surgery was 48.3 + 25 min. Bone involvement was present in 100 % of cases and complications in three cases. Time to return to sports was similar (n.s.) in both groups, and the mean time was 15.6 +/- A 13.7 and 16.3 +/- A 9 weeks, respectively. No significant difference regarding functional results and time to return to sports between professionals and amateur athletes operated was found. Athletes showed mainly good and excellent results and low complication rate. The presence of associated injuries did not significantly influence the results. With these results, the high-level athlete can better programme their surgeries so they can fully recover and perform better in the most important competitions. Level III2441396140

Endoscopic Treatment Of The Posterior Ankle Impingement Syndrome On Amateur And Professional Athletes.

To determine whether professional and amateur athletes showed differences in ankle function when treated with endoscopic technique for posterior ankle impingement syndrome, to verify the impact of the presence of associated lesions in clinical evolution and to assess time to return to sport (we hypothesize that time will be the only difference between groups). Thirty-two athletes with a diagnosis of posterior impingement syndrome underwent surgery endoscopically. The American Orthopaedics Foot and Ankle Society (AOFAS) scale was used to compare functional results between amateur (15) and professional athletes (17). The satisfaction, time to return to sport, operative time, intraoperative findings and complications were evaluated, and the presence of associated injuries interfering in these results was verified. The preoperative AOFAS score range for the professional group was 62.9 ± 14 preoperatively and 92.3 ± 7.7 postoperatively, and for the amateur group was 67.9 ± 19.7 and 94 ± 9.3. The satisfaction was excellent or good in 94 % of all cases and fair in 6 %. The average time of surgery was 48.3 + 25 min. Bone involvement was present in 100 % of cases and complications in three cases. Time to return to sports was similar (n.s.) in both groups, and the mean time was 15.6 ± 13.7 and 16.3 ± 9 weeks, respectively.  CONCLUSION: No significant difference regarding functional results and time to return to sports between professionals and amateur athletes operated was found. Athletes showed mainly good and excellent results and low complication rate. The presence of associated injuries did not significantly influence the results. With these results, the high-level athlete can better programme their surgeries so they can fully recover and perform better in the most important competitions. Level III.2