No abstract

No abstract

No abstract

No abstract

This study provides evidence suggesting that patient-related known factors such as higher ASA score predisposes to shoulder arthroplasty-associated infection. Furthermore, unusual pathogens associated with PSI were identified.

Objective: To assess the clinical results obtained of patients who underwent arthroscopic surgical treatment following a first episode of traumatic anterior shoulder dislocation. Methods: Between August 2000 and October 2008, 14 shoulders of 14 patients were treated by the Shoulder and Elbow Group of Santa Casa Hospital, São Paulo. Thirteen patients (93%) were male and one (7%) was female; their ages ranged from 17 to 41 years, with a mean of 28 years. All of the patients evaluated were regularly practicing a sports activity (which required physical vigor of the upper limbs). The time that had elapsed between the trauma and the surgical treatment ranged from seven to 60 days, with a mean of 20 days. The surgical procedure was performed with arthroscopic viewing, with the patient positioned in lateral decubitus. Fixation of the labral-ligamentous complex was achieved using bioabsorbable anchors. The postoperative clinical assessment was made using Rowe and UCLA criteria. Joint mobility was measured according to the guidance from ASES (American Shoulder and Elbow Surgeons). The length of postoperative follow-up ranged from 24 to 120 months, with a mean of 45 months. Results: All the patients achieved satisfactory results, (85% excellent and 15% good), as shown by UCLA, while 100% of the results were excellent according Rowe. The “grip test” was negative for all the patients. Conclusion: Surgical treatment after a first episode of traumatic anterior shoulder dislocation seems to be a good therapeutic option for young active patients who practice sports activities.

Objective: To evaluate the clinical results from patients with traumatic anterior shoulder instability that was treated surgically through arthroscopic viewing, using bioabsorbable anchors and a technique for remove the cartilage of the anterior glenoid rim for repairing a Bankart lesion. Method: Between March 2006 and October 2008, 27 shoulders in 27 patients with a diagnosis of traumatic anterior shoulder instability were operated. The patients’ mean age was 28 years and they had had between two and 25 previous episodes of dislocation. The patients were predominantly male (24; 89%). The minimum length of follow-up was 24 months and the mean was 36 months. None of the patients had previously undergone surgery on the affected shoulder or had any significant bone lesion at the glenoid margin. The postoperative clinical assessment was done using the Rowe scale. To measure the preoperative and postoperative joint range of motion, we used the method described by the American Academy of Orthopaedic Surgeons (AAOS). Results: According to the Rowe criteria, 25 patients (93%) achieved excellent results and two (7%) had poor results. None of the patients presented good or fair results. Twenty-three patients were satisfied with the results obtained (85%), and returned to their activities without limitations, while four patients (15%) had some degree of limitation. There was recurrence of instability in two patients (7%). Conclusion: Treatment of traumatic anterior shoulder instability through arthroscopic viewing using a technique for remove the cartilage of the anterior glenoid rim for repairing a Bankart lesion provided excellent results for 93% of the patients operated.

O trauma é um importante problema de saúde pública mundial devido às altas taxas de morbidade e mortalidade. O trabalho em questão considerou os traumas em pacientes com idade inferior a 18 anos e exclusivamente músculo-esqueléticos, atendidos num serviço de emergência ortopédica de um hospital metropolitano, no período de outubro de 2000 a junho de 2001, totalizando 340 protocolos. O objetivo foi permitir melhor conhecimento das características do trauma, proporcionando um planejamento adequado do atendimento, redução dos custos e estabelecimento de medidas preventivas. As lesões encontradas foram diferenciadas em leves ou graves. A faixa etária de escolares foi a mais acometida, totalizando 40% dos atendimentos realizados, destacando-se a queda como o principal mecanismo de trauma encontrado. O ambiente mais propício a acidentes foi o domiciliar e as extremidades foram a parte do corpo mais acometidas, tanto nas lesões leves quanto graves. Cerca de 64% dos casos foram leves. Os tipos de trauma mais freqüentes foram a contusão, seguida de fratura e entorse. Já os lactentes apresentam como importantes mecanismos de trauma a tração, pressão e a agressão, em sua maioria pelos familiares. Foi constatado que o fato da criança estar acompanhada de algum adulto não impede a ocorrência de acidentes, nem interfere na gravidade.