Objective: Eighty-three soccer players aged between 14 and 19 years, in the basic category of a professional soccer club in the city of Belo Horizonte, were followed up during the 2009 season. Methods: A prospective observational cohort study was conducted, in which these soccer players were divided randomly into two groups. The first consisted of individuals with joint hypermobility syndrome (JHS), totaling 22 players, and the second was a control group with 61 players without this syndrome, determined through a physical examinati. Results: Both groups were studied with regard to incidence of ankle sprains. At the end of this period, the data were compiled and statistical analysis was performed. A total of 43 cases of ankle injury due to sprains were recorded, of which nine episodes were in players with JHS, thus making p = 0.106. The significance level was 5%. Conclusion: We were able to conclude that in our study there was insufficient evidence to assert that there is an association with increased incidence of ankle sprains among patients with JHS.
This case report presents a 15-year-old football player who was diagnosed with a pubis stress fracture and underwent conservative treatment with satisfactory results. After a review of the literature, the clinical picture, diagnosis and treatment are described. The importance of this paper comes from the rarity of finding reports about this kind of injury in the literature.
Objective: To present the clinical and functional results of surgical treatment of patients with chronic instability of the ankle using the arthroscopic Brostrom technique. Methods: This is a case series of patients who underwent surgical treatment for chronic instability of the lateral ligament of the ankle using the arthroscopic Brostrom technique. Clinical assessments of ankle stability were performed preoperatively and at the last follow-up using the American Orthopedic Foot and Ankle Score (AOFAS), a visual analog scale (VAS) for pain, and the anterior drawer and talar inversion tilt tests. Surgical complications and patient satisfaction ratings were also analyzed. Results: A total of 16 patients were analyzed, with a mean follow-up of 14 months. There was a statistically significant (p<0.001) improvement in mean AOFAS, which increased from 67.2 to 90.8 points and the mean VAS for pain score reduced from 6.5 to 1.5 points. All ankles were stable and had normal results for the anterior drawer test and the talar inversion tilt test. Three patients (19%) reported that resumption of sporting activities provoked subjective pain in the ankle, which improved progressively during follow-up. Two patients (12.5%) exhibited neurapraxia of the superficial peroneal nerve. A majority of the patients (81%) rated treatment as good or excellent. Conclusion: Treatment of chronic instability of the ankle ligament using the arthroscopic Brostrom technique restored ankle stability and achieved good clinical results. There was a high rate of early complications, but the majority were transitory and underwent complete remission during follow-up. Level of Evidence IV; Therapeutic Studies; Case Series.
This case report presents a 15-year-old football player who was diagnosed with a pubis stress fracture and underwent conservative treatment with satisfactory results. After a review of the literature, the clinical picture, diagnosis and
Objective: Eighty-three soccer players aged between 14 and 19 years, in the basic category of a professional soccer club in the city of Belo Horizonte, were followed up during the 2009 season. Methods: A prospective observational cohort study was conducted, in which these soccer players were divided randomly into two groups. The first consisted of individuals with joint hypermobility syndrome (JHS), totaling 22 players, and the second was a control group with 61 players without this syndrome, determined through
RESUMOObjetivo: Série de casos com o objetivo de avaliar os resultados do tratamento cirúrgico do pé cavo varo sutil com osteotomia de extensão do primeiro metatarso e liberação da fáscia plantar. Métodos: Foram avaliados 11 pacientes e 12 pés, com média de idade de 40 anos, acompanhamento mínimo de 12 meses, sendo cinco do sexo masculino e seis do sexo feminino. Todos apresentavam diagnóstico de pé cavo varo sutil, com patologias associadas que não melhoraram com o tratamento conservador e foram submetidos à correção cirúrgica. Os pacientes foram avaliados através do exame clínico, do questionário da American Orthopaedic Foot and Ankle Society Score (AOFAS), da escala visual analógica (EVA) da dor no pré e pós-operatório, da avaliação do grau de satisfação e da correção clínica da deformidade. Resultados: O AOFAS médio passou de 44,4 para 80. A EVA da dor média passou de 8,7 para 2,0 pontos. Sete pacientes classificaram o resultado como excelente, dois pacientes como bom e os outros dois como regular. Dois pacientes tiveram deiscência da ferida operatória, um apresentou uma neuropatia no nervo fibular e um outro metatarsalgia de transferência, todos foram tratados clinicamente com resolução dos quadros. Não houve recidiva da deformidade e das patologias associadas. Conclusão: O tratamento cirúrgico do pé cavo varo sutil através da osteotomia do primeiro metatarso em associação à liberação da fáscia plantar mostrou bons resultados clínicos. Nível de Evidência III; Estudo Retrospectivo Comparativo.Descritores: Pé cavo; Deformidades do pé; Diagnóstico; Tratamento. ABSTRACTObjective: To evaluate, using a case series, the results of the surgical treatment of subtle cavovarus foot with extension osteotomy of the first metatarsal and release of the plantar fascia. Methods: Eleven patients and 12 feet, including five males and six females with a mean age of 40 years and minimum follow-up of 12 months. All patients had a diagnosis of subtle cavovarus foot with associated pathologies that did not improve with conservative treatment and were subjected to surgical correction. The patients were evaluated through a clinical examination, the American Orthopedic Foot and Ankle Society (AOFAS) scale, the visual analog scale (VAS) of pain in the pre-and postoperative period, and assessment of the degree of satisfaction and clinical correction of the deformity. Results: The mean AOFAS score increased from 44.4 to 80. The mean pain VAS score decreased from 8.7 to 2.0. Seven patients rated the result as excellent, two patients as good and the other two as regular. Two patients had dehiscence of the surgical wound, one presented a neuropathy in the fibular nerve, and another presented transfer metatarsalgia; all were treated clinically with resolution of the clinical picture. There was no recurrence of deformities or associated pathologies. Conclusion: Surgical treatment of subtle cavovarus foot through first metatarsal osteotomy in combination with plantar fascia release showed good clinical results. Level of Evidence III; Retrospe...
Worldwide, osteoarthritis (OA) is a leading cause of musculoskeletal disease and the second cause of work-related disability among adult men. There are few Brazilian population-based studies on OA, none investigating the national burden. Objective: To investigate the burden of OA among Brazilian people (50+ years old), from 2000 to 2017. Method: Descriptive study on the estimates of OA obtained in collaboration with the study Global Burden of Disease 2017. Since OA is not a cause of death, we described the prevalence and the years lived with disability (YLDs), representing the burden of disease (DALYs). We compare the metrics for Brazil with a developing country in Latin America (Chile) and two developed countries, with or without public health system (England and United States). Results: The number of cases in Brazil almost doubled from 2000 to 2017. All countries showed increasing age-standardized prevalence. Brazil presented the smallest rates and increase (9%) in the period. OA raised from 14th to the 12th cause of disability from 2000 to 2017 in those aged 50 to 69 and in 2017. The YLD rates of 100,000 inhabitants increased more than three times, in men and women, among those aged 50 to 54 years and in individuals over 80 years old. Aging was associated with a clear gradient increase in disability for both sexes and years analyzed. Conclusion: Estimate of the burden of OA in Brazil highlight the importance of this cause of disability to health policymakers and call attention to the need for more research investments.
A ruptura aguda do tendão de Aquiles é uma lesão frequente dos membros inferiores e existe controvérsia em relação ao tratamento ideal. Diversos métodos estão descritos na literatura, dentre eles, tratamento conservador, reparo aberto e cirurgia minimamente invasiva. O reparo aberto está associado a maior índice de complicações no sítio cirúrgico enquanto as técnicas minimamente invasivas apresentam risco aumentado de lesão iatrogênica do nervo sural. Alguns dispositivos foram desenvolvidos para reduzir as complicações das primeiras técnicas percutâneas descritas. Apresentamos uma técnica para reparo das lesões agudas do tendão de Aquiles de maneira percutânea utilizando materiais simples disponíveis na maioria dos centros cirúrgicos, sem necessidade de instrumental especial. Associado a essa técnica, adotamos protocolo de reabilitação funcional precoce, que já provou ser vantajoso na recuperação das funções do paciente.
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