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Objective  To analyze the impact of the educational actions included in the "Mind the Risk" campaign of Sociedade Brasileira de Traumatologia e Ortopedia (Brazilian Society of Traumatology and Orthopedics, SBOT, in Portuguese), to increase the perception of the risk involved in the surgical activity and the use of the surgical checklist. Methods  A comparative research was performed during the 50th Brazilian Congress on Orthopedics and Traumatology (50° CBOT, in Portuguese) in November 2018, using a questionnaire similar to the one used in previous two versions. Results  The number of participants was 730, corresponding to 18,7% of the total of 3,903 enrolled in the 50° CBOT. Among the participants, 542 orthopedists (74,2%) reported having experienced errors within the surgical units and 218 (29,8%) surgeries in wrong sites. In total, 624 participants (85,5%) reported marking the surgical site and 402 (55%) using the surgical checklist systematically. Conclusion  In the sample studied, it was evidenced that SBOT's efforts to disseminate the World Health Organization (WHO) protocol were effective, reducing the number of orthopedists who were unaware of it from 65.3% (in 2012) to 20.7% (in 2018), and expanding its use. In 2018, 402 participants (55%) reported the systematic use of the protocol, compared with 301 (40,8%) in 2014. These data confirm the need for educational campaigns and systematic training, not only to promote behavioral change, but especially a cultural change.Objective  The present paper aims to evaluate the quality of a mobile phone application (app) designed to guide patients after shoulder surgical procedures. Methods  A free and easily accessible app was developed to help patients at home. Patients were monitored for app use and adaptation before physical therapy started. At the end of 6 weeks, a qualitative questionnaire was employed to determine the usability of the app. Results  In total, 97% of the respondents reported that the app was easy to download, the exercises were readily understood, and they would recommend the app. Ninety-three percent of the participants agreed that the app made them feel a greater degree of participation in the treatment of their illness, while 90% considered the app self-explanatory. Conclusion  The virtual platform helps the patients to understand the treatment, aiding the medical prescription of postoperative exercises to be performed at home.Objective  The open Bristow procedure is a long established and effective method for treating anterior shoulder instability. Following the trends of minimally-invasive surgeries, these procedures were performed arthroscopically, and their outcomes were evaluated. Methods  A total of 43 shoulders of patients submitted to Bristow procedures by arthroscopy, using a graft positioned horizontally and a screw, with at least two years of postoperative follow-up, were evaluated regarding quality of life, de novo dislocation index, and loss of lateral rotation. Results  The mean follow-up time was of 76 months (range 129 to 24 months). The University of California at Los Angeles (UCLA) score varied from 25.56 ± 0.50 (standard deviation [SD] = 3.25) to 33.23 ± 0.44 (SD = 2.91) ( p   less then  0.0001). Two or more years after surgery, the mean Rowe score was of 94.25 ± 1.52 (SD = 1.34), whereas the good results standard is 75 ( p   less then  0.0001). The mean value for the simple shoulder test was of 11.35 ± 0.21 (SD = 1.34), while the mean value of the lateral rotation loss was of 10.37° ± 1.36° (SD = 8.58°). There were no de novo dislocations. In total, there were 12 complications, 8 of which had no clinical repercussions. The clinically-significant complications included an infection six months after surgery with a potential hematogenous origin, a coracoid fracture that required an intraoperatively procedure change, and two patients with previous impingement who required synthesis material removal more than six months after surgery. Conclusion  Although the arthroscopic Bristow procedure was effective in treating anterior shoulder instability, it is not a complication-free surgery.Objective  The present study aims to analyze the clinical results of the surgical treatment of metacarpal neck fractures with retrograde intramedullary fixation using cannulated headless screws (Herbert type). Methods  Retrospective study of 21 closed fractures deviated from the metacarpal neck in 21 patients operated between April 2015 and November 2018. Results  The sample included 19 men and 2 women. The mechanisms that caused the trauma were punching, falling to the ground and motor vehicle accident (n = 14, 5 and 2). The affected metacarpals were the 5 th , 3 rd , and 2 nd (n = 19, 1 and 1). Surgical indications were neck-shaft diaphysis of the metacarpal > 30° for the 2 nd and 3 rd metacarpals and > 40° for the 5 th metacarpal, shortening ≥ 5mm, rotational deviation, and the desire of the patient not to use plaster cast. In the immediate postoperative period, patients remained without immobilization and were instructed to mobilize their fingers according to tolerance. All patients had total active mobility > 240° and returned to their former occupations. All fractures consolidated and there were no reinterventions. Discussion  The great advantages of the headless screw technique are its low morbidity, sufficient stability to avoid external immobilization, and reproducibility at low cost. Conclusion  This is an easy, fast technique that has excellent results for the surgical treatment of displaced fractures of the neck of the metacarpals.Objective  To evaluate the use of a propeller flap to cover soft-tissue injuries in the lower limb. Materials and Methods  A retrospective study, with review of medical records, and a convenience sample of 14 patients operated between July 2018 and June 2019. The following clinical aspects were evaluated sex; age group; type of injury; cause of the injury; initial diagnosis; affected location; techniques for incision and identification; surgical planning; flap design; postoperative period; result of the propeller flap; and complications. Results  The sample was composed of male patients (100%), with a mean age of 36.4 years, and 92.7% of the injuries resulted from motorcycle accidents, mostly on the right side (71.4%). The surgical planning of the propeller flap followed the same procedure in all cases. Immediate postsurgical complications were present in 35.7% of the cases, and they included excessive bleeding (14.3%), partial necrosis (14.3%), and flap dehiscence (7.1%). In total, 13 patients had excellent coverage, and only 1 had flap loss. Conclusion  The propeller-flap technique to cover lesions in the lower limb proved to be a good alternative in most cases evaluated, with a good surgical result, although complications were observed in some cases.Objective  To evaluate knee alignment in the frontal plane and pelvic balance during the step-down test in female and male soccer players. Methods  Cross-sectional study carried out with male and female soccer players from under-15 and under-17 teams of a professional club in Southern Brazil. The step-down test was performed, filmed with a video camera, and evaluated according to the angular measurements obtained during movement using the Kinovea software (open source), version 0.8.24. selleck chemicals llc Results  The sample consisted of 38 individuals, 19 males and 19 females. Female athletes had a greater varus angle (9.42° ± 1.65°) compared to male athletes (3.91° ± 2.0°; p  = 0.04). There was no difference regarding the unilateral pelvic drop between the groups. In addition, the association between the hip-related pelvic drop and the projection angle on the frontal plane of the knee was weak in both genders. Conclusion  Even though the pelvic drop was observed in both genders, young female athletes had greater varus knee angles on the step-down test, which require greater attention to minimize the risk of injury.Objective  The main objective of the present study was to compare the subjective perception of pain and symptoms of anterior knee pain with the different body mass index (BMI) classifications. The secondary objective was to verify the association between biological and anthropometric variables with the results of subjective questionnaires. Methods  A total of 126 recreational runners from both genders, aged between 20 and 59 years old, were recruited. Data regarding the biological variable (age), anthropometric variables (weight, height), visual analog scale (VAS), and Lysholm and Kujala questionnaires scores were collected. Information was obtained with a digital platform, available through a single link, allowing volunteers to answer these questions using electronic devices. Normality was verified by the Shapiro-Wilk test. T-tests and Wilcoxon tests were used to compare mean values. The association between variables was determined by the Pearson linear correlation. Results  There were significant differences in height between overweight and grade 1 obesity subjects ( p  = 0.029), in weight and BMI comparing normal weight subjects and both overweight and grade 1 obesity subjects ( p   less then  0.001 and p   less then  0.05, respectively). An unclear significant correlation was observed between BMI values and specific questionnaires and subjective scale scores ( p   less then  0.05). Conclusion  Recreational runners who present high BMI values are more likely to experience knee pain than those with normal BMI values.COVID-19 pandemics required substantial reorganization and adaptation of healthcare services all over the world. This study aims to analyze the effect of operational strategies implemented in Brazil to manage the extra strain placed on healthcare services by the COVID-19 pandemic of 2020. In particular, this investigation examines the strategy to convert an institute specialized in elective orthopedic procedures of high complexity into a trauma unit for all musculoskeletal trauma patients of an entire federative unit. A retrospective study was conducted comparing hospital variables at the peak period of the pandemic (from March 16, 2020 to June 30, 2020) with the same period in 2019 as a comparative baseline. The variables analyzed included number of professionals away from work, surgeries performed, outpatient care, transfers, length of stay, number of patients diagnosed with COVID-19 and patient mortality. During the COVID-19 peak period, there was a 48.5% reduction in surgical productivity and 72.4% reduction in outpatient care compared with the same period in 2019. The number of transfers increased substantially (124.5%), while 94 confirmed cases and 77 suspected cases of COVID-19 were reported. The mortality rate increased by 245%. The present study highlighted the effect of COVID-19 on a tertiary orthopedic hospital. Despite the dramatic changes in hospital operations, due to the implementation of protocols to manage the pandemic, the results demonstrated the feasibility and efficiency of such protocols in prioritizing quality and safety for patients and the healthcare workforce.