Objective: To analyze the treatment results from 20 patients who underwent an alternative osteosynthesis method as definitive treatment for pelvic ring fractures.
Methods: A retrospective analysis was conducted on a series of 20 patients with pelvic ring fractures (Tile type C) and a high risk of postoperative infection, who were treated at Santa Casa de Misericórdia de São Paulo between August 2004 and December 2012. The patients underwent percutaneous supra-acetabular external fixation in association with cannulated 7.
Objective: This was an epidemiological study on fractures of the proximal third of the femur in elderly patients who were treated at a teaching hospital in the central region of São Paulo.
Methods: The subjects were patients over the age of 60 years who were attended over a 1-year period. A questionnaire seeking basic sociodemographic data and information on comorbidities presented and medications used was drawn up.
The pelvic ring fractures comprise 2-8% of all skeletal injuries. As the incidence rises to 25% in polytrauma and represents a negative prognostic factor with regard to morbidity and mortality of patients, we sought with this work to establish the profile of these, compared to an alteration in the profile of patients with pelvic ring fractures in recent decades. To this end, we evaluated the epidemiological profile, mechanism of injury and types of fractures.
View Article and Find Full Text PDFFemale patient, 42 years old with a history of low back pain on the left for seventeen years in which the definitive diagnosis of the etiology of pain was evident after the completion of neurography magnetic resonance imaging of the sciatic nerve. In this test it was identified the presence of an anatomical variation in the relationship between the piriformis muscle and sciatic nerve. We discuss details of this imaging technique and its importance in the frames of refractory low back pain.
View Article and Find Full Text PDFBackground: While many authors have recommended surgery for patients with persistent symptoms of external snapping hip, it is unclear which one best relieves symptoms. Concerns with iliotibial band (ITB)-modifying techniques include altering the shape of the lateral thigh and overload of the contralateral abduction mechanism. We describe a new endoscopic technique that decreases the tension of the ITB complex by releasing the femoral insertion of the gluteus maximus tendon (GMT).
View Article and Find Full Text PDFObjective: Describe the results from arthroscopic surgical treatment on a group of patients who developed symptoms after repetitive physical activity of moving their hips in a position of hyperflexion, as in leg presses and squats.
Methods: The study group comprised 47 individuals (48 hips) who developed the onset of painful symptoms associated with hip hyperflexion exercises (leg presses or squats) and underwent arthroscopic treatment. The patients were evaluated radiographically and clinically according to the "Harris Hip Score", as modified by Byrd (MHHS), pre and postoperatively, and were asked about their return to sports activities and the surgical findings.
Objective: To assess the inter-evaluator reproducibility of the Modified Merle d'Aubigné and Postel Method.
Method: Forty-five patients took part in the study, with a mean age of 57.93 (±13.
Objective: iHOT12/33 is an outcome tool designed for young patients with hip problems. The objective of this study is to translate and establish a cross-cultural adaptation of this questionnaire to Portuguese.
Method: The Guillemin guidelines were followed for the translation and cross-cultural adaptation consisting on: translation, back-translation, prefinal version, administration of the Questionnaire, and editing of the final version.
Objective: To evaluate the effectiveness of the method of radiographic interpretation of acetabular fractures, according to the classification of Judet and Letournel, used by a group of residents of Orthopedics at a university hospital.
Methods: We selected ten orthopedic residents, who were divided into two groups; one group received training in a methodology for the classification of acetabular fractures, which involves transposing the radiographic images to a graphic two-dimensional representation. We classified fifty cases of acetabular fracture on two separate occasions, and determined the intraobserver and interobserver agreement.
Diagnoses of hip and pelvis disorders are based on the detailed medical history, physical examination and laboratory tests, as appropriate for each condition. Plain radiography is still the initial examination of choice and, because of its importance, there is a need to standardize radiographic studies, both in relation to execution and in radiographic series, according to the different pathological conditions. The aim of this paper was to propose standardization for the main radiographic views of the hip and pelvis, and with regard to performing specific series for different pathological conditions, and to provide technical guidance for achieving these aims.
View Article and Find Full Text PDFPurpose: The aim of this study was to evaluate the type and incidence of complications during the development of hip arthroscopic techniques.
Methods: A retrospective series of 194 files of patients treated with hip arthroscopy in a tertiary hospital from December 1999 to March 2008 was reviewed for complications. The incidence of complications was recorded consecutively for each group of 30 patients and in intervals of 2 years.
Objective: To epidemiologically and clinically evaluate patients with displaced femoral neck fractures that were surgically treatment with cemented hip hemiarthroplasty.
Methods: All patients with displaced femoral neck fractures (Garden III and IV) who underwent cemented hip hemiarthroplasty using a unipolar prosthesis (Thompson), by means of a posterolateral access between June 2005 and September 2008 were retrospectively evaluated.
Results: Seventy patients were initially evaluated.
Objective: To establish guidelines for the treatment of femoral head fractures and to determine the best form of access in cases treated surgically.
Methods: We evaluated the clinical and radiological results from 13 patients (13 fractures) treated surgically, between May 1986 and July 1996, at the Department of Orthopedics and Traumatology, Santa Casa de Misericórdia de Sao Paulo (SCMSP), Fernandinho Simonsen Wing.
Results: Out of six cases of Pipkin 1 fractures, five underwent resection of the fragment, resulting in four excellent and one good result.
Objective: The objective of this study is to show the results achieved in the treatment of hip osteochondromatosis by arthroscopy.
Methods: Six patients submitted to hip arthroscopy for synovial osteochondromatosis have been assessed for pre- and postoperative function and pain. The time of preoperative complaint ranged from nine to 48 months, in an average of 28.
Objective: The purpose of this study is to evaluate the short-term follow-up results of arthroscopic treatment of femoroacetabular impingement. Our hypothesis is that arthroscopic treatment results are favorable.
Methods: Between August 2003 and August 2007, 28 hips had femoroacetabular impingement treated by hip arthroscopy.
Subchondral fracture of the femoral head is an uncommon and underdiagnosed affection. The abrupt or gradual onset of groin pain with functional disability on weight-bearing that improves with a resting period should alert the orthopedic surgeon to the possibility of this diagnosis. The differential diagnosis from osteonecrosis of the femoral head can be provided by assessing the different patterns of bone edema on MRI studies of the hip, thus avoiding unnecessary invasive operations on the hip.
View Article and Find Full Text PDFFrom May 1990 to November 1997, 24 cases of severe slipped capital femoral epiphysis were treated by an osteotomy that is a modification of the Hungria-Kramer intertrochanteric osteotomy proposed by Sugioka (Hungria-Kramer-Sugioka osteotomy or HKS osteotomy). The degree of displacement as seen on the frog-leg lateral radiograph of the proximal femur was measured according to the deviation of the longitudinal axis of the epiphysis from the center line of the neck (Fish classification). All hips were considered as grade III and underwent HKS osteotomy.
View Article and Find Full Text PDF