19,6%). Quanto à localização, os tumores encontravam-se preferencialmente nos membros inferiores (72%), seguidos dos membros superiores (22,4%) e pelve (5,6%). Foi proposta conjuntamente uma classificação para categorizar as bióp-sias conforme o seu resultado em excelente, bom, regular e mau. Resultados: A análise dos dados gerais demonstrou resultados excelentes em 80,4% das biópsias, bons em 8,4%, regulares em 2,8% e ruins em 8,4%. Somando-se os resultados excelentes e bons, encontram-se 88,8% dos casos. Nos casos avaliados, encontraram-se 3,7% de complicações; em nenhum caso a biópsia contra-indicou a cirurgia conservadora -com preservação do membro. Conclusão: As biópsias com agulha de Jamshidi representam método bastante eficiente de diagnóstico das lesões músculo-esqueléticas, com baixo índice de complicações e bons resultados compará-veis aos das biópsias abertas.Descritores -Osteossarcoma; Oncologia / classificação; Biópsia por agulha; Estudos retrospectivos
RESUMOObjetivo: O propósito deste estudo foi aquilatar a precisão das biópsias por trefina de Jamshidi, realizadas no Serviço de Ortopedia Oncológica da UNIFESP / EPM, em tumores músculo-esqueléticos, em distintas topografias, tendo como objetivo propor uma classificação para categorizar as biópsias
Objective: To report on the management of five cases of pyomyositis in athletes after the use of anabolic steroids. Method: Over the past 10 years, five cases of athletes who developed pyomyositis after using anabolic steroids were attended at the Sports Trauma Center (CETE), EPM-UNIFESP. Results: All the patients were diagnosed clinically and through laboratory and imaging tests. Surgical treatment was carried out (with collection of material for culturing) and antibiotic therapy was administered. In four cases, the injection sites were in the upper limbs and in one case, in the gluteus muscles bilaterally as well as in the upper limbs. In all five cases, occurrences of leukocytosis and neutrophilia were observed in the hemogram. After debridement, the germs of normal skin (S. aureus and S. viridans) were found in cultures on the secretions. Demarcation of the abscess and examination of the muscle plane in which the abscess was located were performed using ultrasound and magnetic resonance imaging. All the patients responded to broad-spectrum antibiotic therapy. Two cases required more than one surgical procedure because of the appearance of more than one abscess site with different evolution times. Conclusion: The use of anabolic steroids by some athletes may have grave consequences. Rapid, energetic and multidisciplinary intervention is necessary in such cases in order to avoid undesirable results. The right treatment healed the athletes completely, and they returned to their sports at the same level.
Background Unidirectional traumatic posterior shoulder instability is a specific diagnosis that differs from the more common posteroinferior or multidirectional instabilities. The treatment usually requires a surgical procedure.
MethodsWe treated 21 shoulders in 20 patients. The average age was 29.38 years (range 20 years to 53 years). All patients were involved in recreational sports. The mean follow-up was 28 months (range 12 months to 70 months).
ResultsThe postoperative clinical evaluation was based on the Rowe score. Twenty patients were considered to demonstrate excellent results and one patient was considered to show a regular result. Twenty patients were able to return to recreational sports at the same level. One patient returned to sport at a lower level and required playing adaptations.
ConclusionIn our series of 21 shoulders, pain was the major symptom in 15 patients with posterior labral detachment after a traumatic event. By contrast to classic Bankart lesion, which usually results in instability, the posterior labral detachment produced pain as the major symptom in this series of patients.
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