The long-bone fractures occur most frequently in the tibial shaft. Adequate treatment of such fractures avoids consolidation failure, skewed consolidation and reoperation. To classify these fractures, the AO/OTA classification method is still used, but it is worthwhile getting to know the Ellis classification method, which also includes assessment of soft-tissue injuries. There is often an association with compartmental syndrome, and early diagnosis can be achieved through evaluating clinical parameters and constant clinical monitoring. Once the diagnosis has been made, fasciotomy should be performed. It is always difficult to assess consolidation, but the RUST method may help in this. Radiography is assessed in two projections, and points are scored for the presence of the fracture line and a visible bone callus. Today, the dogma of six hours for cleaning the exposed fracture is under discussion. It is considered that an early start to intravenous antibiotic therapy and the lesion severity are very important. The question of early or late closure of the lesion in an exposed fracture has gone through several phases: sometimes early closure has been indicated and sometimes late closure. Currently, whenever possible, early closure of the lesion is recommended, since this diminishes the risk of infection. Milling of the canal when the intramedullary nail is introduced is still a controversial subject. Despite strong personal positions in favor of milling, studies have shown that there may be some advantage in relation to closed fractures, but not in exposed fractures.
REsUMOObjetivo: Avaliar o resultado da reconstrução do ligamento cruzado anterior (LCA) com o autoenxerto dos tendões flexores da coxa. Serão analisados os dados com relação ao sexo, ao índice de massa corporal (IMC) e a associação com fratura no membro inferior (MI). Métodos: Foi analisado um grupo de 265 pacientes submetidos à artroscopia do joelho para fins de reconstrução do LCA com enxerto ipsilateral dos tendões flexores da coxa no período de 6 de julho de 2000 a 19 de novembro de 2007. Resultados: 176 pacientes foram avaliados com média de 34,95 ± 18,8 meses (mediana 31 meses) (IIQ: 20-48 meses). A avaliação mínima foi aos 12 meses e a máxima aos 87 meses. Obtivemos 138 (78,4%) pacientes com resultado excelente, 22 (12,5%) com resultado bom, oito (4,5%) com resultado regular e oito (4,5%) pacientes apresentaram resultado ruim. Não foi considerada significativa a maior incidência de bons e excelentes resultados para o sexo masculino (p = 0,128), para os pacientes com IMC < 25 (p = 0,848) e para os pacientes sem a lesão do LCA relacionada a episódio inicial traumático com fratura no MI (p = 0,656). Conclusões: A técnica de reconstrução do LCA com o autoenxerto dos tendões flexores da coxa demonstrou bons e excelentes resultados em 91,4% da amostra. O sexo masculino parece apresentar tendência maior a bons e excelentes resultados. Não observou-se diferença estatisticamente significativa quando foram analisados os resultados com relação ao IMC e a associação com episódio inicial traumático de fratura no MI. descritores -
Objetivo: avaliar a influência do período de abstinência sexual sobre os parâmetros espermáticos em homens inférteis, assim como determinar a melhora na qualidade seminal após mistura dos ejaculados. Métodos: estudo retrospectivo no qual se avaliou um grupo de 88 homens com oligozoospermia (n=25), astenozoospermia (n=43) ou oligoastenozoospermia (n=20), cujas parceiras foram submetidas à inseminação intra-uterina entre setembro de 2002 e dezembro de 2004. Foram excluídos da análise casais nos quais os homens apresentavam análise seminal normal ou mulheres com alterações sugestivas de infertilidade. Cada homem produziu duas amostras seminais em período curto de tempo (30 minutos a 1 hora). Foram avaliados o volume seminal, a concentração total de espermatozóides móveis e o percentual de motilidade espermática. Para todos os parâmetros avaliados foram comparadas a primeira e a segunda amostra seminal coletadas. Além disso, a concentração total de espermatozóides móveis foi comparada entre a primeira amostra coletada e a união das amostras. A avaliação estatística foi realizada usando o teste t e o teste χ 2 . Resultados: em homens oligozoospérmicos não houve diferença nas características seminais entre a primeira e a segunda amostra seminal (p>0,05). A concentração total de espermatozóides móveis aumentou significativamente na segunda amostra em comparação à primeira amostra em homens astenozoospérmicos (42,4±6,8 vs 51,5±7,2x10 6 espermatozóides/mL) e oligoastenozoospérmicos (11,1±7,4 vs 14,35±7,2x10 6 espermatozóides/mL (p<0,05). A união dos dois ejaculados aumentou a concentração total de espermatozóides móveis em comparação à primeira amostra (p<0,05) nos homens oligozoospérmicos, astenozoospérmicos e oligoastenozoospérmicos em 110,5, 110,3 e 136,03%, respectivamente. Conclusões: menor período de abstinência está associado a melhora da motilidade em homens inférteis. A união das amostras seminais constitue alternativa para aumentar a concentração total de espermatozóides móveis neste grupo de pacientes que desejam participar de inseminação intra-uterina ao invés da fertilização in vitro. PALAVRAS-CHAVE:Abstinência sexual; Infertilidade masculina; Sêmen; Oligoespermia; Espermatozóides ABSTRACT Purpose: to evaluate the influence of abstinence period on seminal characteristics in infertile men and to establish a better seminal quality after pooling the samples. Methods: a retrospective study was performed on 88 oligozoospermic (n=25), asthenozoospermic (n=43), and oligoasthenozoospermic (n=20) men whose partners underwent intrauterine insemination between September 2002 and December 2004. We excluded men with a normal semen analysis or women with abnormalities suggestive of infertility. Each man produced two semen samples in a short period of time (30 min to 1 h). We evaluated semen volume, total motile sperm count and percentage sperm motility. Comparisons were made between the first and second semen samples. After pooling the samples, we compared the total motile sperm count between the first sample and the po...
Objective The therapeutic decision in cases of adult spinal deformity takes numerous factors into account with a consequent variability in treatment options. The objective is to compare the impact of the MISDEF (minimally invasive spine deformity) algorithm on therapeutic decisions in cases of adult spinal deformity. Methods Prospective radiographic analysis of 40 cases of adult deformity. The cases were sent, in two steps, to 20 Latin American surgeons who had to choose among six treatment options with and without the use of the MISDEF. Results For the conducts of decompression, decompression and short fusion, decompression and fusion with interbody device, and osteotomy with extension of fusion to the thoracic spine, no significant differences were found when comparing decisions made with and without MISDEF. For osteotomy, we observed a tendency for the number of surgeons choosing this conduct to increase when the decision is made with MISDEF. We observed that the number of surgeons who decided on conservative treatment decreased with the use of MISDEF (p <0.001). In cases with sagittal vertical axis <6 cm or pelvic tilt <25 ° or PI-LL (pelvic incidence minus lumbar lordosis) <10 ° or coronal curve <20 °, there was a decrease in the conservative treatment option and an increase in osteotomy with proximal extension of the fusion with the use of MISDEF. Conclusions There is a tendency to increase indications of osteotomy and decrease the conservative treatment option when making a decision with MISDEF. The use of the algorithm showed no significant impact on the therapeutic decision in severe cases of adult deformity. Level of Evidence II; Prospective comparative radiographic analysis.
Objective: To evaluate the results from reconstruction of the anterior cruciate ligament (ACL) using with flexor tendon autografts from the thigh, with analysis on data relating to sex, body mass index (BMI) and associations with lower limb fracture. Methods: A group of 265 patients who underwent knee arthroscopy for the purposes of ACL reconstruction using an ipsilateral graft from the flexor tendon of the thigh between July 6, 2000, and November 19, 2007, were evaluated. Results: One hundred and seventy-six patients were evaluated over a mean period of 34.95 ± 18.8 months (median: 31 months) (IQR: 20-48 months). The minimum evaluation period was 12 months and the maximum was 87 months. One hundred and thirty-eight patients (78.4%) had excellent results, 22 (12.5%) had good results, eight (4.5%) had fair results and eight (4.5%) had poor results. Higher incidence of good and excellent results for the following categories was not considered to be significant: males (p = 0.128), patients with BMI < 25 (p = 0.848), or patients with ACL injuries unrelated to an initial traumatic episode of lower-limb fracture (p = 0.656). Conclusion: The ACL reconstruction technique using tendon autografts from the thigh showed good and excellent results for 91.4% of the sample. Male patients seemed to present a greater tendency towards good and excellent results. No statistically significant difference was found when the results were analyzed in relation to BMI or associations with initial traumatic fracture episodes in the lower limbs.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
customersupport@researchsolutions.com
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.