No abstract

The effect of allopurinol, superoxide-dismutase, and hyperbaric oxygen was compared on axial pattern skin flap survival. An abdominal flap based on the inferior epigastric pedicle was raised in rats for this purpose. Three experimental groups were studied. In the first group, adult male Wistar rats received 50 mg/kg I.P. of allopurinol. The second received 20,000 I.U./kg of superoxide-dismutase. The third group was submitted to hyperbaric oxygen therapy. The flaps were exposed to 8-h warm ischemia. Flap survival was evaluated on postoperative day 7. All flaps survived, and the mean survival areas were 63.53%, 83.03%, and 55.98%, respectively, in the allopurinol, superoxide-dismutase, and hyperbaric groups. The percentage of flap necrosis was significantly smaller in all experimental groups when compared to controls (P < 0.05). It was clear that the superoxide-dismutase group had better results on axial pattern ischemic skin flap survival, under the tested conditions. The tested methods improved flap survival to ischemic injury, and the flap designed is a reliable model for further investigations.

To justify and describe the humeral head centering osteotomy---an original surgical technique---associated with anterior soft tissue elongation (Sever procedure) for the prevention and treatment of shoulder osteoarticular deformities in children with sequelae of obstetric palsy.

OBJECTIVE:To evaluate the functional and radiographic results in patients undergoing shoulder anterior soft tissue stretching in association with open reduction and internal rotation osteotomy to centralize the humeral head as a treatment for Erb-Duchenne obstetric palsy sequelae.METHOD:A total of 35 patients underwent this surgical treatment, and the mean follow-up was 4.6 years. The Mallet scale was applied before and after the surgical procedure. A total of 20 patients underwent computed tomography to assess the glenoid version and humeral head subluxation.RESULTS:Functional improvement was achieved, as evidenced by an increase in the Mallet scale score from 12.14 to 16.46 (p<0.001). The correction of retroversion was achieved once the glenoid version ranged from -21.4 to -12 degrees (p<0.001). The humeral head subluxation improved from 6.5 to 35.2% (p<0.001). Patients older than 6 years of age did not achieve glenohumeral joint improvement with respect to dysplastic abnormalities.CONCLUSION:Internal rotation osteotomy in association with the stretching of anterior soft tissues of the shoulder in patients under the age of 7 years provided improvements in the function, retroversion, and subluxation of the glenohumeral joint.