COVID-19 is a disease that is challenging science, health-care systems, and humanity. An astonishingly wide spectrum of manifestations of multiorgan damage, including musculoskeletal, can be associated with SARS-CoV-2. » In the acute phase of COVID-19, fatigue, myalgia, and arthralgia are the most common musculoskeletal symptoms.» Post-COVID-19 syndrome is a group of signs and symptoms that are present for .12 weeks. The associated musculoskeletal manifestations are fatigue, arthralgia, myalgia, new-onset back pain, muscle weakness, and poor physical performance.» Data on COVID-19 complications are growing due to large absolute numbers of cases and survivors in these 2 years of the pandemic. Additional musculoskeletal manifestations encountered are falls by the elderly, increased mortality after hip fracture, reduced bone mineral density and osteoporosis, acute sarcopenia, rhabdomyolysis, Guillain-Barr é syndrome, muscle denervation atrophy, fibromyalgia, rheumatological disease triggering, septic arthritis, adhesive capsulitis, myositis, critical illness myopathy, onset of latent muscular dystrophy, osteonecrosis, soft-tissue abscess, urticarial vasculitis with musculoskeletal manifestations, and necrotizing autoimmune myositis.
Background There are several studies comparing techniques and different materials, yet the results are not unanimous. We compared three methods of skin closure in total knee arthroplasty (TKA), including suture with single stitches and unabsorbable MonoNylon®, as well as continuous subcuticular suture with Monocryl® or barbed Stratafix® absorbable suture. Methods A prospective, randomized study was conducted with 63 patients undergoing TKA between March 2016 and December 2016. Patients were divided into three groups: traditional suture MonoNylon® (n 22), subcuticular continuous suture with Monocryl® (n 20), and another barbed with Stratafix® (n 21). The closure time, length of wire used, pain intensity, possible complications, and cosmeses were evaluated. Results Subcuticular continuous suture using Monocryl® was superior to traditional suture using MonoNylon® as less thread was used (p 0.01) and a better cosmetic effect was achieved (p < 0.01), which was equal to Stratafix® aspects analyzed (p > 0.05). Complications were observed mostly in patients who used Stratafix®. Conclusions This study concluded that the subcuticular suture with absorbable monofilament Monocryl® proved to be advantageous compared to the others because it presented results equal to the barbed Stratafix®, however with fewer complications. Furthermore, Monocryl® was shown to be equal or superior to traditional MonoNylon® suture regarding in relation pain intensity, aesthetic result, and effective cost. Trial registration WHO ICTRP identifier RBR78dh5d. Retrospectively registered: 07/29/2020.
Determinados padrões de fratura do planalto tibial podem representar um quadro atípico de luxação ou subluxação do joelho, cuja suspeição diagnóstica pode não ser óbvia na avaliação inicial, especialmente se o joelho estiver reduzido nos exames de imagem. A associação entre a fratura pósterolateral do planalto tibial e as lesões do ligamento cruzado anterior, do ligamento colateral medial e do menisco lateral é relativamente frequente. Alguns pacientes podem apresentar um padrão raro de depressão articular na região póstero-lateral do planalto tibial, em associação com a lesão do ligamento cruzado anterior, que se assemelha à mordida de maçã, razão pela qual foi denominado “apple-bite-fracture”. O objetivo do presente estudo é descrever um quadro atípico de luxação de joelho, acompanhado por um padrão ainda mais raro de fratura, onde há destacamento de um fragmento osteocondral por forças de cisalhamento, entendido como uma variação do padrão “apple-bite”, e seu tratamento com a realização da osteotomia do epicôndilo lateral do fêmur.
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