Herein, we report an electrochemical oxidative C(sp2)–H selenylation of activated arenes. The reaction proceeds in an undivided electrochemical cell at Pt‐electrodes in the presence of KI as the supporting electrolyte, which could suffer oxidation at the anode. Using this benign, atom‐economic protocol, the desired selenylated products were obtained regioselectively in good to excellent yields by using a half molar equiv. of the diselenides.

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Category: Trauma; Ankle Introduction/Purpose: Ankle fractures are one of the most operated injuries in orthopedic practice. The decision upon the best management is based on the displacement of the bone fragments and the presence of associated lesions (osseous and/or soft tissues). The therapeutic decision is classically established upon plain radiographs, which might be temerarious due to the usual difficulty in analyzing those exams. In recent years, some authors have advocated that computed tomography could be used as an assistant instrument on the decision-making. Our study aims to demonstrate the superiority of the association between both methods on diagnosis, therapeutic decision, and surgical plan for these injuries. Methods: Patients diagnosed with an ankle fracture, between 2011 and 2016, and assessed with CT and X-ray were included in our investigation. Seven examiners with different degrees of experience analyzed the exams, determined the injuries, chose how they would treat, and the defined surgical strategy when applicable. This was done, at first, only with radiographs and after with the combination of CT and radiographs. The data were statistically compared. Results: Fifty-three patients were included. The medial malleolus fractures characteristics (posteromedial fragment and anterior colliculus), the presence of posterior malleolus fracture and its characteristics (displacement, bone fragment greater than 25%, posteromedial or posterolateral segment), syndesmosis injury, and the absence of deltoid ligament lesion were more noticeable from the combination of CT and radiography. Concerning surgical treatment, the prone position, the posterolateral surgical approach (rather than anterolateral) on lateral malleolus osteosynthesis, the decision to surgically treat the posterior malleolus fracture (through posterolateral approach with posterolateral plate), the option to include the syndesmosis approach in the treatment, and not to include deltoid ligament repair were more noticeable from the combination of CT and radiography, among all groups of expertise, with high inter-observer reliability. Conclusion: The usual radiographs may fail to demonstrate subtle lesions, as posterior malleolus fractures and syndesmotic injuries. The tomographic evaluation increases the precision of diagnosis and improves the quality of information that the surgeon receives, providing data that can positively affect patient care.

The Cover Feature shows a city skyline which represents the modernization of the synthetic methods, while the cyclic voltammogram represents the redox activity of the species involved in the reaction. We propose a new electrochemical oxidative assessment for C(sp2)–H selenylation using Pt electrodes, and two mechanistic pathways. Path A: Activated arenes in the presence of KI as electrolyte can provide iodinated aromatic derivatives as intermediaries. Path B: Diselenides in the presence of KI may provide PhSeI as an electrophilic species. Selenylated products were obtained with good to excellent yields. Artwork by Vinicius F. Pereira, coauthor of this paper. More information can be found in the Communication by A. L. Braga, S. R. Mendes et al.

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Category: Ankle Arthritis; Arthroscopy; Trauma Introduction/Purpose: One of the options for the surgical treatment of tibial pilon fracture is the circular external fixator. Similar results are found in the literature, with good outcomes in relation to a low incidence of infection, osteomyelitis and soft tissue injuries compared to open reduction and internal fixation. Even so, evolution to a probable arthrodesis occurs in 3-27% of cases, showing that the prognosis for this type of fracture is dismal. Options for performing joint fusion include open arthrotomy with joint decortication and internal fixation (plates and/or screws), in addition to arthroscopic joint preparation, a method that has been gaining popularity since 1983, in its first description. Fusion through circular external fixation is an excellent option that has shown good results in the literature. Methods: Patient with left tibial pilon fracture. Uniplanar external fixation was performed in the emergency room, with subsequent conversion to transarticular circular external fixation. After 4 months of review, the patient has evidence of tibiotarsal arthrosis. It was decided to perform arthrodesis using the arthroscopic technique, performing joint compression with circular external fixation, already installed in the patient. Spinal anesthesia was performed on the patient and the Smarch tourniquet was used. First, access to the anteromedial portal, trocar and optic passage was obtained, and the intermediate dorsal cutaneous branch of the superficial peroneal nerve was identified laterally, and the anterolateral portal was constructed. Through these portals, a 4.5mm Shaver blade was used to perform curettage and joint debridement, in addition to curettes and osteotomes. In addition to arthroscopic control, fluoroscopic observation was also performed for adequate joint preparation.Finally, joint compression was performed with the device already installed. Results: The patient presented complete consolidation of the tibio-tarsal arthrodesis. At the moment (2 years and 10 months postoperatively) the patient does not use crutches/gait accessories, does not limit his daily activities due to foot problems, does not have difficulty going down and up stairs, has good ankle alignment, plantigrade foot, has no joint pain and can walk long distances. Conclusion: This work showed a technique rarely reported or cited in the orthopedic literature, not presenting any article as an original description. Supported by the description of the procedure by the robust final functional results of the patient in question, this report establishes the basis for the widespread method and new works to emerge to enrich the debate and study around arthroscopic ankle arthrodesis using the Ilizarov method.

Category: Ankle; Hindfoot Introduction/Purpose: Diagnosis of Achilles insertional tendinopathies (AIT) is based on pain by tendon palpation. However, there is no consensus or standard regarding the amount of force to be used during the evaluation. The algometry is a method of measuring the pressure applied in a specific region and can be a method for determining diagnosis values. Goal: To determine a cut-off value for Pain Threshold (PT) in the assessment of AIT. Methods: Design: This is a prospective case-control study of diagnostic accuracy, to develop a diagnostic criterion. Methods: Forty asymptomatic individuals and forty patients with insertional Achilles tendinopathy, matched by age and sex, were evaluated, and submitted to algometry for PT and for Visual Analogical Scale (VAS) levels with 3kg/f at the insertion of the calcaneal tendon by two different evaluators. Inter-observer reproducibility was accessed through the interclass correlation index (ICC). Sensitivity and specificity calculation of PT and of VAS were calculated and plotted on a ROC (Receiver Operator Characteristic) curve. Results: The lowest ICC found was 0.788. Regarding the diagnosis through TP, the 4.08 kg/f mark showed the best relation between sensitivity and specificity (92.5% and 92.5%, respectively). Algometry values lower than 4.08 were considered positive for disease. For the diagnosis of TIA through VAS with 3kg/f, the value of 2.98 was determined (sensitivity of 92.5% and specificity of 97.5%). Conclusion: This study showed that algometry is a reliable method in the assessment of Achilles insertional tendinopathies, having a high intra-observer reproducibility. The painful threshold for establishing the diagnosis of Achilles insertional tendinopathies was 4.08 kg/, with values below this number considered altered.

This paper aims to present the use of a chatbot as an alternative for teachers using an Intelli-gent Tutoring System and also verify MAZK's chatbot acceptance among the instructors, as this functionality was developed in MAZK's system exclusively for this purpose. A ques-tionnaire was carried out with 32 teachers, most of them beginners on MAZK. These in-structors should set up a class with the chatbot's help and it was noticeable that this re-source's use in their training was well accepted due to the practicality of an online tool. Still, some of the instructors had questions if they could learn all the aspects of the system only through the chatbot's help. Teachers who had previously used MAZK considered the chat-bot's development a necessary improvement as a supporting tool.