Background: This study aims to assess orthopaedic surgeon knowledge in Brazil about ionizing radiation and its health implications on surgical teams and patients. Methods: A 15-question survey on theoretical and practical concepts of ionizing radiation was administered during the 23rd Brazilian Orthopaedic Trauma Association annual meeting. The survey addressed issues within orthopedic surgery, such as radiation safety concepts, protection, exposure, as well as the participant gender. Participants were either orthopedic surgeons or orthopedic surgery residents working at institutions in Brazil. Results: One thousand surveys were distributed at the moment of the meeting registration, and 258 were answered completely (25.8% response rate). Only 5.8% of participants used basic radiation protection equipment; 47.3% used a dosimeter; 2.7% reached the annual maximum permissible radiation dose; 10.5% knew the period of increased risk to fetal gestation; 5.8% knew the maximum permissible radiation dose during pregnancy; 58.5% knew that the hands, eyes, and thyroid are the most exposed areas and at greater risk of radiation-related lesions; 25.2% knew the safe distance from a radiation-emitting tube is 3 m or more; 44.2% knew the safest positioning of the radiation-emitting tube; 25.2% knew that smaller tubes emit greater radiation at the entrance dose to magnify the image; and 55.4% knew that the surgery team receives more scattered radiation in surgical procedures performed on obese patients. Conclusion: This study revealed inadequate theoretical and practical knowledge about radiation exposure among orthopaedic surgeons in Brazil. Only a minority of orthopaedic surgeons used basic radiation protection equipment. No significant differences in knowledge were found when comparing all orthopedic surgery specialties. Our findings indicate an urgent need for education to increase knowledge among orthopaedic surgeons about the hazards of ionizing radiation. Personal protection and implementation of the ALARA (as low as reasonably achievable) protocol in daily practice are important behaviors to prevent the harmful effects of ionizing radiation.

Data here provided may contribute to the interpretation of the results of FERT in different cultural contexts and highlight the common bias that should be corrected in the future tasks to be developed.

Avulsion of the tibial tubercle is an uncommon injury that occurs in the young athlete, resulting from an eccentric contraction of the extensor mechanism with the leg fixed to the ground. Concomitant injuries to the patellar tendon are very rare, with few cases reported in the literature. The authors present a case of a 15-year-old basketball player who suffered an avulsion of the tibial tubercle associated with complete distal rupture of the patellar tendon while training. It was treated with open reduction of the tibial fragment and reconstruction of the patellar tendon with mini-anchors and cannulated screws, as well as hamstring autograft tendon reinforcement. The patient showed excellent results and returned to sports after 12 months of follow-up.

Background: This study aims to assess orthopedic surgeon knowledge in Brazil about ionizing radiation and its health implications on surgical teams and patients. Methods: A 15-question survey on theoretical and practical concepts of ionizing radiation was administered during the 23rd Brazilian Orthopaedic Trauma Association annual meeting. The survey addressed issues within orthopedic surgery, such as radiation safety concepts, protection, exposure, as well as the participant gender.Participants were either orthopedic surgeons or orthopedic surgery residents working at institutions in Brazil. Results: One thousand surveys weredistributed,and 258 were answered completely (25.8% response rate).Only 5.8% of participants used basic radiation protection equipment (apron, thyroid shield, and radiation protection glasses); 47.3% used a dosimeter; 2.7% reached the annual maximum permissible radiation dose; 10.5% knew the period of increased risk to fetal gestation; 5.8% knew the maximum permissible radiation dose during pregnancy; 58.5% knew that the hands, eyes, and thyroid are the most exposed areas and at greater risk of radiation-related lesions; 25.2% knew the safe distance from a radiation-emitting tube is 3 meters or more; 44.2% knew the safest positioning of the radiation-emitting tube; 25.2% knew that smaller tubes emit greater radiation at the entrance dose to magnify the image; and 55.4% knew that the surgery team receives more scattered radiation in surgical procedures performed on obese patients. Conclusion: This study revealed inadequate theoretical and practical knowledge about radiation exposureamong orthopaedic surgeons in Brazil. Only a minority of orthopaedic surgeons used basic radiation protection equipment (apron, thyroid shield, and radiation protection glasses). No significant differences in knowledge were found when comparing all orthopedic surgery specialties. Our findings indicate an urgent need for education to increase knowledge among orthopaedic surgeons about the hazards of ionizing radiation. Personal protection and implementation of the ALARA (as low as reasonably achievable) protocol in daily practice are important behaviors to prevent the harmful effects of ionizing radiation.

Objective: To evaluate the interobserver agreement of the new AOSpine classification for subaxial cervical fractures. Methods: A descriptive study, which11 traumatic lesions of the subaxial cervical spine (through radiographic and tomographic images), were evaluated by 16 observers being: 6 senior surgeons, 4 fellows in spinal surgery and 6 physicians residents in Orthopedics and Traumatology by the new AOSpine classification, with subsequent statistical analysis of the results. An agreement analysis was performed using the Kappa coefficient, both individually and in combination, with an interpretation of the index performed using the standardized model for Landis and Koch. To determine the level of significance of the analyzes, values less than 0.05 were considered statistically significant. Results: In general, the level of agreement among the examiners was considered reasonable. The lesions “A0 (F3)”, “A4 (F3)”, “B1”, “B3”, “B3 (F3)”, “C”, “C (F3)” and “F3”showed a low level of agreement between the examiners. The level of reasonable agreement was obtained between fractures “A0”, “A1”, “A4”, “B2” and “C (F4)”. The only fracture that presented a moderate level of agreement was the “C (F4 BL)” lesion. This result indicates that the referred injury was the fracture of the subaxial column that presented the best level of agreement among the 16 examiners in the present study. Conclusions: The results of the study indicate an intermediate agreement of the new AOSpine classification for subaxial cervical lesion and point to the need to carry out studies that seek to evaluate this new classification in order to better evaluate its strengths and weaknesses, contributing for its improvement. Level of evidence III; Diagnostic study - investigation of a diagnostic test.

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Objective Morphometric study of the positioning of the cortical trajectory pedicle screw in the lumbar spine of Brazilian patients of different sexes and ages, through the use of computed tomography images, in order to obtain more reliable data about cortical screw insertion and the variations observed, providing assistance for a safer, more effective approach with fewer complications. Methods Selection of 100 patients from a database, alternating by sex, measuring the length, diameter, cephalic angulation, and lateral angulation of the vertebrae from L1 to L5. Results Statistically significant measurements were obtained for the four different parameters in relation to sex. The mean age was 56, with a minimum of 20 and a maximum of 87 years. The L4 and L5 screws showed a reduction in relation to the other levels, while the width showed a progressive increase starting at L3. Lateral angulation was the parameter with the least variation among the levels, while there was greater variation and a reduction from L4 to L5 in cephalic angulation. Conclusion Statistically significant results were obtained for length, diameter, lateral and cephalic angulation. Sex was a significant factor in spine surgery instrumentation using the cortical trajectory pedicle screw technique. Level of evidence I; Diagnostic study (investigation of an examination for diagnosis).

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