Crossed versus lateral K-wire fixation of supracondylar fractures of the humerus in children: a meta-analysis of randomized controlled trials.

Background: Supracondylar fractures of the humerus are common in children. Whether fixation should be performed with crossed or lateral wires remains controversial. We performed a meta-analysis of randomized controlled trials to evaluate both techniques in terms of the function of the elbow and the risk of neurologic injury and loss of reduction.

Superficial Acral Fibromyxoma: Literature Review.

Superficial acral fibromyxoma is a benign and rare tumor of the soft tissues. It usually manifests itself through a painless mass of slow growth that affects mainly males in the fifth decade of life. It usually affects the distal region, with a polypoid or dome-shaped appearance.

Surgical versus conservative interventions for treating acromioclavicular dislocation of the shoulder in adults.

Background: Dislocation of the acromioclavicular joint is one of the most common shoulder injuries in a sport-active population. The question of whether surgery should be used remains controversial. This is an update of a Cochrane Review first published in 2010.

Sensitivity and specificity of ultrasonography in diagnosing supraspinatus lesions: a prospective accuracy diagnostic study.

Background: This study was designed to define the accuracy of shoulder ultrasonography for diagnosing supraspinatus tendon tears. This examination is routinely used by orthopedists and may do away with the need for other examinations for diagnosing these tendon injuries. The aim of this study was to evaluate the sensitivity and specificity of shoulder ultrasonography for diagnosing supraspinatus tendon injuries, using magnetic resonance imaging as the reference.

Surgical Interventions for the Treatment of Supracondylar Humerus Fractures in Children: Protocol of a Systematic Review.

Background: The treatment of supracondylar humerus fracture in children (SHFC) is associated with complications such as functional deficit, residual deformity, and iatrogenic neurological damage. The standard treatment is closed reduction and percutaneous Kirschner wire fixation with different configurations. Despite this fact, there is still no consensus on the most effective technique for the treatment of these fractures.

Treatment of Displaced Midshaft Clavicle Fractures: Figure-of-Eight Harness Versus Anterior Plate Osteosynthesis: A Randomized Controlled Trial.

Background: Most midshaft clavicle fractures affect the economically active population, which is negatively impacted by transient limb impairment during the treatment. There is still debate about the advantages and disadvantages of surgical treatment for these fractures.

Methods: In this prospective randomized controlled trial, 117 patients were allocated to 1 of 2 groups: nonsurgical treatment with a figure-of-eight harness or surgical treatment with anteroinferior plate osteosynthesis.

Minimally Invasive Osteosynthesis with a Bridge Plate Versus a Functional Brace for Humeral Shaft Fractures: A Randomized Controlled Trial.

Background: Nonoperative treatment has historically been considered the standard for fractures of the shaft of the humerus. Minimally invasive bridge-plate osteosynthesis for isolated humeral shaft fractures has been proven to be a safe technique, with good and reproducible results. This study was designed to compare clinical and radiographic outcomes between patients who had been treated with bridge plate osteosynthesis and those who had been managed nonoperatively with a functional brace.

Arthrotomy versus arthroscopy in the treatment of septic arthritis of the knee in adults: a randomized clinical trial.

Purpose: To evaluate the efficacy of treatment and functional recovery of patients diagnosed with septic arthritis of the knee submitted to two surgical techniques: conventional arthrotomy and arthroscopic approach for debridement.

Method: In this prospective clinical study, all adult patients diagnosed with knee pyoarthritis in a 15-month period at a philanthropic hospital in Brazil were randomized into two groups: one group submitted to arthrotomy and the other to arthroscopy. The protocols of antibiotic therapy, physical therapy and postoperative assessment were standardized in both groups.

Evaluation of the reproducibility of the AO/ASIF classification for humeral shaft fractures.

Objective: To evaluate the reproducibility of the AO/Asif classification for humeral shaft fractures.

Methods: Consecutive radiographs of the arm in both anteroposterior and lateral view from 60 patients with humeral shaft fractures were analyzed. Six observers who were familiar with the AO/Asif classification (three shoulder and elbow surgery specialists and three general orthopedists) were selected to make the analysis, which was done at three different times.

Result from surgical treatment on the terrible triad of the elbow.

Objective: To evaluate the results from surgical treatment of the terrible triad of the elbow, with a minimum of six months of follow-up, taking elbow function into consideration.

Methods: The analyzed aspects of 20 patients, who underwent surgical treatment of the terrible triad of the elbow, were given as follows: Dash score (Disabilities of the Arm, Shoulder and Hand), Meps (Mayo Elbow Performance Score), pain according to VAS (visual analog scale), ROM (range of motion), patient satisfaction, degree of energy of the trauma, complications and radiographs.

Results: The mean length of follow-up among the patients was 38 months.

Open fractures and the incidence of infection in the surgical debridement 6 hours after trauma.

Objectives: To determine whether a time delay greater than 6h from injury to surgical debridement influences the infection rate in open fractures.

Methods: During a period of 18 months, from October 2010 to March 2012, 151 open fractures were available for study in 142 patients in our hospital. The data were collected prospectively and the patients were followed up for 6 weeks.

Correlation of the degree of clavicle shortening after non-surgical treatment of midshaft fractures with upper limb function.

Background: Despite the use of non-surgical methods to treat for the majority of midshaft fractures of the clavicle, it is remains controversial whether shortening of this bone following non-surgical treatment of a middle third fracture affects upper limb function.

Methods: We conducted a cohort study by sequentially recruiting 59 patients with a fracture of the middle third of the clavicle. All patients were treated nonsurgically with a figure-of-eight bandage until clinical and radiological findings indicated healing of the fracture.

Reproducibility of classifications for olecranon fractures.

Introduction: Fractures of the olecranon are relatively common injuries in adults and are of great clinical importance. Classification systems have been developed as tools to assist surgeons in grouping different types of fractures, to facilitate communication and to standardise treatment, but none of the systems used today is universally accepted for olecranon fractures.

Methods: Fifty-nine olecranon fractures were classified according to the Schatzker, Colton, Mayo and AO/ASIF systems by four observers with different levels of expertise.

Influence of blood coagulability after spinal surgeries.

Objective: To verify whether spinal surgery causes relevant changes in the blood clotting process and define which factors have the greatest influence on changes found.

Method: This is a not randomized, cross-sectional study, Forty seven patients were evaluated between August 2011 and February 2013, whose clinical, surgical, laboratory and image daata were collected. The data obtained were crossed with the epidemiological data of each patient in a moment prior to and another after surgery searching which variables have been directly influenced.

Identification of areas in Brazil that optimize conservation of forest carbon, jaguars, and biodiversity.

A major question in global environmental policy is whether schemes to reduce carbon pollution through forest management, such as Reducing Emissions from Deforestation and Degradation (REDD+), can also benefit biodiversity conservation in tropical countries. We identified municipalities in Brazil that are priorities for reducing rates of deforestation and thus preserving carbon stocks that are also conservation targets for the endangered jaguar (Panthera onca) and biodiversity in general. Preliminary statistical analysis showed that municipalities with high biodiversity were positively associated with high forest carbon stocks.

Treatment of the humeral shaft fractures--minimally invasive osteosynthesis with bridge plate versus conservative treatment with functional brace: study protocol for a randomised controlled trial.

Background: Humeral shaft fractures account for 1 to 3% of all fractures in adults and for 20% of all humeral fractures. Non-operative treatment is still the standard treatment of isolated humeral shaft fractures, although this method can present unsatisfactory results. Surgical treatment is reserved for specific conditions.

Effectiveness of intra-articular lidocaine injection for reduction of anterior shoulder dislocation: randomized clinical trial.

Context And Objective: Shoulder dislocation is the most common dislocation among the large joints. The aim here was to compare the effectiveness of reduction of acute anterior shoulder dislocation with or without articular anesthesia.

Design And Setting: Prospective randomized trial conducted in Escola Paulista de Medicina, Universidade Federal de São Paulo (EPM-Unifesp).

Treatment of Bankart lesions in traumatic anterior instability of the shoulder: a randomized controlled trial comparing arthroscopy and open techniques.

Purpose: The objective of this study was to compare the functional assessments of arthroscopy and open repair for treating Bankart lesion in traumatic anterior shoulder instability.

Methods: Fifty adult patients, aged less than 40 years, with traumatic anterior shoulder instability and the presence of an isolated Bankart lesion confirmed by diagnostic arthroscopy were included in the study. They were randomly assigned to receive open or arthroscopic treatment of an isolated Bankart lesion.

RESULTS FROM BI-CONTACT(®) TOTAL ELBOW ARTHROPLASTY: MULTICENTER STUDY.

Objective: To describe the initial experience of four orthopedic clinics from using Bi-Contact(®) total elbow arthroplasty (TEA), reporting the results and complications of the procedure.

Methods: This was a retrospective study, through analysis on the medical records of patients who underwent primary TEA using a prosthesis model developed in conjunction with IOT-HCFMUSP. Forty-six elbows (45 patients) that were operated at four orthopedic clinics between 2000 and 2009 were evaluated.

PATHOLOGICAL FRACTURE OF LUMBAR VERTEBRA IN CHILDREN WITH ACUTE NEUROLOGICAL DEFICIT: CASE REPORT.

This study reports on a case of lymphoma in a 13-year-old patient who came to a consultation with lumbar pain. The patient had suffered low-intensity trauma in the lumbar region that resulted in persistent pain of progressive nature. In an emergency evaluation, radiographic examination showed a spinal fracture.

EVALUATION OF SURGICAL TREATMENT OF FRACTURES OF THORACOLUMBAR SPINE WITH THIRD-GENERATION MATERIAL FOR INTERNAL FIXATION.

Objective: To evaluate the functional results from patients with surgical fractures in the thoracolumbar spine.

Method: A prospective study including 100 patients with spinal fractures in the thoracic and lumbar segments was conducted. The lesions were classified in accordance with the AO system, and the patients were treated surgically.

PREVALENCE OF LESIONS ASSOCIATED WITH TRAUMATIC RECURRENT SHOULDER DISLOCATION.

Objective: To evaluate the prevalence of lesions associated with traumatic anterior shoulder instability and the relationships between the prevalence of these lesions and the number of episodes and time since symptoms started.

Method: Fifty-seven patients aged 18 to 40 years, with traumatic anterior shoulder instability, more than one episode of shoulder dislocation and at least six months since the first dislocation, who required surgery to treat the instability, were selected. Arthroscopic inspection was performed on all the patients to assess any associated lesions.

Surgical versus conservative interventions for treating acromioclavicular dislocation of the shoulder in adults.

Background: Dislocation of the acromioclavicular joint is one of the most common shoulder problems in general orthopaedic practice. The question of whether surgery should be used remains controversial.

Objectives: To assess the relative effects of surgical versus conservative (non-surgical) interventions for treating acromioclavicular dislocations in adults.

Surgical interventions for treating acute fractures or non-union of the middle third of the clavicle.

Background: This review covers two conditions. These are acute fractures and non-union resulting from failed fracture healing. Clavicle or collarbone fractures account for around 4% of all fractures.