SUMMARY OBJECTIVE: To evaluate the epidemiological data and available treatments for fractures secondary to radiotherapy treatment. METHODS: Identification of publications on pathological skeletal fractures previously exposed to ionizing radiation. RESULTS: The incidence of fractures after irradiation varies from 1.2% to 25% with a consolidation rate of 33% to 75%, being more frequent in the ribs, pelvis, and femur. The time elapsed between irradiation and fracture occurs years after radiotherapy. Risk factors include age above 50 years, female gender, extensive periosteal detachment, circumferential irradiation, tumor size, and anterior thigh location. The etiology is still uncertain, but cellular disappearance, reduction of bone turnover and activity were observed hematopoietic as possible causes of failure of consolidation. CONCLUSION: There is no consensus in the literature on the factors related to the development of fractures, with radiation dose, previous tumor size and periosteal detachment being suggested as potential factors.
Purpose: To evaluate the use of platelet-rich plasma in the early stages of healing of traumatic injury of the medial collateral ligament in the knee of rabbits. Methods: Thirty rabbits were subjected to surgical lesion of the medial collateral ligament. Of these, 16 were treated with platelet-rich plasma and 14 with saline (control). After 3 and 6 weeks of treatment, 50% of the animals from each group were sacrificed, and biomechanical tests were performed on the injured ligament to compare the tensile strength between the two groups. Results: Platelet-rich plasma significantly increased the tensile strength of the ligament in the groups treated after3 and 6 weeks. In the group treated with platelet-rich plasma vs. saline, the tensile strength values were 3192.5 ± 189.7 g/f vs. 2851.1 ± 193.1 g/f at3 weeks (p = 0.005) and 5915.6 ± 832.0 g/f vs. 4187.6 ± 512.9 g/f at 6 weeks (p = 0.0001).
Conclusion:The use of platelet-rich plasma at the injury site accelerated ligament healing in an animal model, demonstrated by an increase in the tensile strength of the medial collateral ligament.
Resumo
Objetivo Comparar as rotações medial e lateral dos ombros e as distâncias entre o processo coracoide e a fossa cubital de indivíduos não atletas e de jogadores profissionais de squash.
Método O estudo transversal foi realizado entre março e agosto de 2017. Não atletas do sexo feminino e masculino (n = 628) foram selecionados no Serviço de Emergência Ortopédica da nossa instituição. Os critérios de inclusão foram: idade entre 18 e 60 anos, ausência de deficiências físicas ou cognitivas e ausência de dor nos membros superiores. Jogadores profissionais de squash (n = 30) de várias nacionalidades foram selecionados em um evento realizado em nossa cidade. Todos os atletas praticavam seu esporte em alto nível há > 10 anos e/ou 10.000 horas, e todos eram assintomáticos. Os dados demográficos e clínicos foram coletados por entrevista, enquanto os exames físicos e de ombro foram realizados por um único consultor ortopédico.
Resultados Em comparação com os não atletas, os jogadores profissionais de squash apresentaram perdas médias significativas (p < 0,001) de 23°34' na rotação interna e significativos (p < 0,003) ganhos médios de 10°23' na rotação externa dos ombros dominantes. Houve diferença significativa (p < 0,008) entre não atletas e atletas quanto à distância entre o processo coracoide e a fossa cubital no braço dominante.
Conclusão A participação intensiva no squash provoca alterações adaptativas que dão origem ao déficit de rotação interna glenoumeral, acompanhadas de significativo ganho de rotação externa, e podem gerar alterações patogênicas no ombro.
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