ObjectiveTo evaluate the prevalence of rotator cuff tears and describe the profile of reoperated patients, causes of repeated tendon tears, tear evolution and range of times between surgical procedures.MethodThis was a cross-sectional study involving 604 surgical procedures performed at two regional referral hospitals between January 2006 and December 2012. After approval by the ethics committee, data describing the patients’ epidemiological profile were gathered at a single time, using Cofield's classification to measure the extent of the tears, all of which underwent arthroscopic surgery. The data were entered into Epi Info 3.5.3 and were analyzed using SPSS version 18.0.ResultsAmong the 604 surgical procedures, females were affected in more cases (351; 58.1%). When the dominant limb was the right limb, it was affected in 90% of the cases (p < 0.05). The supraspinatus tendon was affected in 574 cases (95%) and the tears were of medium size in 300 cases (49.7%). Eighteen reoperations were performed (2.98%) and the upper right limb was the most affected (66.6%). The cause was non-traumatic in 12 patients. The repeated tears were mostly smaller (44%), and the length of time between the two surgical procedures ranged from 6 to 298 weeks.ConclusionFemale gender, smaller extent in the second procedure and non-traumatic cause were found in most of the cases analyzed.
ObjectivesThe aim of this study was to evaluate the results from arthroscopic tenodesis of the long head of the biceps brachii (LHBB) on the tendon of the subscapularis muscle, with regard to the presence of pain, subscapularis lesion, presence of Popeye's sign and patient satisfaction.MethodsA prospective cohort study was conducted on 32 patients with LHBB lesions, through preoperative interviews and physical examinations, which were repeated six months after the operation. The main variables studied were the belly press, bear hug and lift-off tests, Popeye's sign, anterior pain and satisfaction. The data were entered into Epi Info 3.5.4 and SPSS 18.0. In order to investigate the variables of interest, the chi-square, Student t and Kruskal–Wallis tests were used. The confidence interval was 95% and p values less than 0.05 were taken to be statistically significant.Results32 patients of median age 57.5 years were evaluated. Anterior pain was reported by one interviewee after the operation. The tests for evaluating subscapularis lesions did not show any damage to this musculature after the surgery. Popeye's sign was negative in all the patients. The patient satisfaction rate reached 90.6% of the interviewees.ConclusionThis study showed that the new surgical technique described here presented excellent performance, without any subscapularis lesion and without identifying Popeye's sign. Only 3.1% of the patients had complaints of residual pain. The high level of satisfaction among the patients after the surgery confirms the results presented.
Resumo Objetivo Avaliar o perfil laboratorial de idosos com fratura de fêmur proximal e verificar a relação dos dados com o desfecho da própria fratura e com o desfecho óbito. Métodos Estudo transversal de pacientes admitidos na emergência ortopédica de um hospital referência, entre os meses de fevereiro e abril de 2017, com fratura de fêmur proximal, por mecanismo de baixa energia, sendo coletados exames laboratoriais e de imagem. Foram excluídos do estudo pacientes com suspeita ou confirmação de fratura patológica. Resultados Foram avaliados 66 indivíduos, sendo 44 mulheres, todos com idade superior a 60 anos. A fratura transtrocantérica apresentou maior incidência no estudo (36). Alterações do hormônio da paratireoide (PTH) e da albumina foram significativos para óbito (p ≤ 0,05). O tempo de internação não foi fator significativo para óbito. Conclusões Alterações laboratoriais não estavam relacionadas ao desfecho de óbito. A albumina pode estar relacionada ao risco de óbito. Nenhum resultado laboratorial foi apontado como facilitador na geração de fraturas de fêmur proximal. Mais estudos são necessários para poder entender melhor a influência do quadro laboratorial do paciente na ocorrência de fraturas e suas consequências.
Objectives: Femoroacetabular impingement (FAI) has been recently related to several pathologies, besides chondral injury and hip arthritis. We aim to investigate the prevalence of FAI morphology in an elderly cohort hospitalized due to a proximal femur fracture and compare these findings to a control group. We hypothesize that limited medial rotation due to FAI’s morphology could increase stresses to the proximal femur, acting as a facilitating mechanism for fractures in this region. Therefore, a higher prevalence of FAI morphology would be present in the study group. Methods: A retrospective cross-sectional study was performed based on the analysis of radiographic images in AP and lateral views of the fractured hip. Firstly, we have set to measure FAI prevalence in an elderly cohort victimized by fractures of the proximal by measures of the alpha, Tönnis, and lateral center edge angles of a hundred consecutive patients hospitalized for proximal femur fractures. Secondly, we have analyzed the possible relationship between the FAI subtypes and the type of fracture. Finally, we have compared this sample’s data with that of a similar control cohort not affected by fracture. Results: The cohort in this study displayed a higher prevalence of pathological changes in the Tönnis, center-edge, and alpha angles with odds ratios of 3.41, 2.56, and 4.80, respectively (with statistical significance). There was also a significant relationship between cam-type FAI and intertrochanteric fractures, corroborating our initial hypotheses. Conclusions: This study demonstrated that a cohort of older patients affected by fractures of the proximal femur had an increased prevalence of radiographic signs of femoroacetabular impingement. Furthermore, this is the first study demonstrating a statistically significant relationship of cam-type FAI with intertrochanteric fractures, suggesting a possible cause and effect relationship.
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