Carstenswheeler8410

The patients should be informed of the possible postoperative complications, which are frequent but usually transient.Objective  To investigate the incidence of infection in patients with gunshot-related fractures, and to correlate this finding with the occurrence of surgical debridement in the emergency room. Methods  A retrospective, observational, descriptive study that included all cases of fractures caused by firearms between January 2010 and December 2014; 245 fractures in 223 patients were included. Results  There was surgical-site infection in 8.5% of the fractures, and the mean number of debridements required to control the infectious process was of 1.273 ± 0.608. A correlation was identified between the surgical treatment chosen and the affected body segment ( p   less then  0.001). The surgical treatment in the emergency room had a correlation with the occurrence of infection ( p   less then  0.001; Chi-squared test). Conclusion  Patients with gunshot injuries treated non-operatively presented less severe and stable lesions; thus, the incidence of complications in this group was found to be lower. On the other hand, those patients with complex lesions underwent debridement and external fixation. Therefore, a greater number of infectious complications in patients submitted to external fixation was found, as expected.Objective  To verify the applicability and agreement of the Ottawa ankle rules applied by medical students and orthopedic residents in a tertiary trauma service thus validating the Ottawa protocol for use on Brazilian soil. Prospective  This was a prospective study, conducted in a tertiary hospital, including all patients with acute torsial trauma of the tibiotarsal joint. The patients underwent ankle and/or foot radiographs, and the questionnaire with the Ottawa ankle rules was applied by academics and, subsequently, by residents. The radiographs were evaluated by on-call orthopedists and specialist in foot and ankle, and the expert opinion was considered the gold standard for analysis. Results  Two hundred and sixty-three patients were evaluated, and, after application of the established inclusion criteria, 226 cases remained for evaluation. The sensitivity to detect lesions and negative predictive value (NPV) was 100%. The most sensitive test with higher NPV for both academics and residents was palpation of the lateral malleolus. The study presented potential for a reduction of 30% in the total number of tests requested. Conclusion  The data showed applicability and agreement between academics and residents, which allows for the validation of the Ottawa protocol in emergency care in Brazil.Objective  The objective of the present study was to evaluate the clinical and radiographic results of our series regarding ulnar shortening osteotomy, as well as to briefly review the pathology, indications and surgical options of ulnocarpal conflict. Methods  We performed a retrospective analysis of consecutive patients who were treated with ulnar shortening osteotomy between January 2012 and June 2017 at our hospital. We clinically evaluated pain, articular range of motion, grip strength and functional outcomes using the quick-DASH questionnaire. We radiographically measured the pre- and postoperative ulnar variance and the shortening performed. Results  We identified eight operated patients, and it was possible to evaluate seven of them. Pain decreased in this population (visual analogue scale [VAS] score changed from 7 to 2.6, p   less then  0.05), there was a decrease in quick-DASH (64 to 28, p   less then  0.05) and we found a decrease in the articular amplitude ∼ 7° for flexion ( p  = 0.2), and of 5.5° for supination ( p  = 0.3), as well as decreasing grip strength to about 86% on the contralateral side ( p  = 0.07). The ulnar variance changed from a mean of + 5.5 mm to - 1.1 mm ( p   less then  0.05). Two out of 8 patients (25%) presented plaque-related symptoms and one of them underwent a new intervention to extract the material. Conclusions  Ulnar shortening osteotomy is an effective surgical procedure both in the treatment of ulnocarpal conflict and in the discharge of the ulna. The results presented agreement with other results published in the literature, with good clinical and radiographic results.Objective  The present paper aims to present results from radiographic evaluations of patients with extra-articular distal radius fractures submitted to percutaneous fixation with a 3.5 mm solid screw. Methods  Analytical, descriptive and retrospective case series of 16 patients with evaluation of the radiographic parameters. RP-6685 Results  The average age of the study population was 46.5 years old (25-60 years old); 81.25% of the sample was female. The average time until surgery was 8.8 days (4-14 days). The mean preprocedural volar tilt was - 7.41° (-23.48°-5.29°, standard deviation [SD] ± 6.59°). The mean volar tilt immediately after surgery was 5.93° (SD ± 6.23°, p   less then  0.001). There was no statistical difference in volar tilt values after 6 months of follow-up. The mean preprocedural radial height was 4.13 mm (-7.8 mm-9.5 mm, SD ± 5.06 mm). There was a statistically significant increase at the immediate postoperative period to 10.04 mm ( p  = 0.002), and a significant reduction at 6 months to 9.55 mm ( p  = 0.012). The consolidation rate was 100% with the technique used, with a minimal complication rate. No patient had infection or required a reoperation. Conclusion  The technique was effective for the treatment of distal radial extra-articular fractures at 6 months, with a low complication rate; radiographic parameters values were acceptable and close to the anatomical ones.Objective  To evaluate radiographic parameters of sagittal and spinopelvic alignment in patients with hip osteoarthritis (OA) undergoing primary total hip arthroplasty (THA) to define the primary surgical approach in individuals with concomitant spinal and hip joint disease. Methods  Longitudinal, prospective, comparative study with 27 patients undergoing THA and 43 subjects without OA. Results  An association between hip and spine degenerative disease in patients with OA was noted. After THA, radiographic parameters of pelvic tilt angle, sagittal vertical axis (EVS) and seventh cervical vertebra/sacrofemoral distance (C7/DSF) ratio were similar to values from volunteers without joint disease. Global coronal alignment (ACG), sagittal alignment, spinopelvic T1 and T9 tilts (IT1EP and IT9EP), sacral tilt (IS), pelvic version (VP), pelvic type and lumbopelvic complex (CLP) did not change after THA. Conclusion  Among the sagittal and spinopelvic alignment parameters evaluated, the pelvic tilt angle, the EVS, and the C7/DSF ratio were corrected after THA and can guide the surgeon in the decision-making process for patients with concomitant spinal and hip joint disease.