RESUMO
OBJECTIVE: This study aims to assess differences in clinical and surgical outcomes associated with the surgical treatment of midshaft clavicle fractures of different complexities based on fragment number. Additionally, the investigation seeks to present the outcomes of a series of patients who underwent surgery at our institution. MATERIALS AND METHODS: A retrospective analysis was conducted on the medical records of patients aged over 18 who underwent midshaft clavicle fracture surgery at our center from November 2009 to May 2021. Patients were categorized based on the number of fracture fragments into groups of two, three, or more than three fragments. Consolidation, implant removal, complications, surgical duration, and functional outcomes (assessed through VAS, ASES, and Constant-Murley scale) were evaluated for each specific group and for the overall cohort. RESULTS: In total, 260 patients were analyzed. There were no significant differences in any of the parameters between the three groups except for surgical time, which was shorter in simple fractures than in those with more than three fragments (68.2 min vs. 75.3 min; p = 0.01). Pseudoarthrosis rate was 2.69%, implant removal rate was 9.61%, and 4.23% of patients presented with complications other than the previous ones. Functional results were excellent, with averages of 97.3 (72.7-100) for the ASES score, 97.5 (75-100) for the Constant score, and 0.6 (0-8) on the VAS. CONCLUSION: According to our results, there were no differences in postoperative results between simple and multifragmentary midshaft clavicle fractures. Patients across all groups reported satisfactory results.
Assuntos
Clavícula , Fixação Interna de Fraturas , Fraturas Ósseas , Humanos , Clavícula/lesões , Clavícula/cirurgia , Masculino , Feminino , Estudos Retrospectivos , Fraturas Ósseas/cirurgia , Adulto , Pessoa de Meia-Idade , Fixação Interna de Fraturas/efeitos adversos , Fixação Interna de Fraturas/métodos , Resultado do Tratamento , Duração da Cirurgia , Complicações Pós-Operatórias/etiologia , Remoção de Dispositivo/estatística & dados numéricos , Pseudoartrose/cirurgia , Pseudoartrose/etiologia , Consolidação da FraturaRESUMO
The optimal management of anterior shoulder instability continues to be a challenge. The presence of an anterior glenoid rim fracture in the context of a glenohumeral dislocation, also called "bony Bankart lesion," can alter therapeutic behavior. Reduction and fixation of the bone fragment has been shown to greatly reduce the risk of recurrence once bone consolidation is achieved. However, there is no gold standard surgical technique. Stability of fixation and the healing of the bony fragment are still a concern, and there are no clinical studies comparing the different techniques to date. The aim of this report is to describe an arthroscopic double-point fragment fixation technique in lateral decubitus for the treatment of an acute traumatic shoulder dislocation with a bony Bankart lesion.
RESUMO
La luxación de la articulación esternoclavicular (AEC) representa menos del 5% de las luxaciones de la cintura escapular. El tratamiento quirúrgico esta reservado para pacientes con inestabilidad de la articulación EC sintomática y persistente. Se han descrito varias técnicas diferentes para la reconstrucción AEC. El objetivo de nuestro trabajo fue reportar el caso de una paciente con inestabilidad EC anterior recurrente, a la que se le realizó una técnica de reconstrucción en forma de 8, como fue descripto por Spencer y Kuhn,utilizando un aloinjerto de tibial posterior
Sternoclavicular dislocations account for less than 5% of all dislocations of the scapular belt. Chronic instability without response to physical therapy warrants surgical treatment. Several techniques have been described for the reconstruction of the SC joint. The purpose of this work was to report on a case of a patient who developed chronic instability of the SC joint and underwent surgical reconstruction using the "figure of eight" technique as described by Spencer & Kuhn15 using posterior tibial allograft
Assuntos
Adulto , Artroscopia/métodos , Articulação Esternoclavicular/cirurgia , Articulação Esternoclavicular/lesões , Luxações Articulares , AloenxertosRESUMO
PURPOSE: To evaluate functional outcomes and complications in a consecutive group of patients with partial bursal rotator cuff tears (PBRCTs) treated with insitu repair without acromioplasty. METHODS: Seventy-four patients who had undergone an arthroscopic single row in situ repair for bursal-sided rotator cuff tears were evaluated. Clinical assessment consisted of glenohumeral range of motion measurement, the American Shoulder and Elbow Surgeons score, and the University of California at Los Angeles score. Pain was recorded using a visual analog scale. Postoperative complications were also assessed. RESULTS: Mean age was 55.2 years (±6.3) with a minimum of 2-year follow-up. After arthroscopic repair, all active range of motion parameters improved significantly (P < .0001). The American Shoulder and Elbow Surgeons scores improved from 42.5 to 86.1; the University of California at Los Angeles scores improved from 15.8 to 31.4, and the visual analog scale scores improved from 6.6 to 0.7 (P < .0001). Only 3 patients developed a postoperative adhesive capsulitis that responded to physical therapy. CONCLUSIONS: In the midterm follow-up (42 months), arthroscopic in situ repair of PBRCTs without acromioplasty is a reliable procedure that produces significant functional improvements and pain relief. LEVEL OF EVIDENCE: Level IV, therapeutic case series.
Assuntos
Bolsa Sinovial/lesões , Lesões do Manguito Rotador/cirurgia , Acrômio , Adulto , Idoso , Argentina , Artroscopia/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Medição da Dor , Avaliação de Resultados da Assistência ao Paciente , Complicações Pós-Operatórias , Amplitude de Movimento Articular , Estudos Retrospectivos , Lesões do Manguito Rotador/reabilitação , Resultado do TratamentoRESUMO
PURPOSE: To evaluate the clinical outcomes and complications in a series of patients with painful partial articular cuff tears treated with the arthroscopic transtendinous repair with a minimum 2-year follow-up. METHODS: Eighty patients with a mean age of 51 ± 5.4 years who had undergone an arthroscopic transtendon repair for a painful articular-sided rotator cuff tear with a minimum of 2-year follow-up were contacted. Clinical outcomes using a patient-based questionnaire, the University of California at Los Angeles score, the American Shoulder and Elbow Surgeons score, and the visual analog scale were evaluated. Postoperative complications were also assessed. RESULTS: After arthroscopic repair, the University of California at Los Angeles scores improved from 13.6 to 31.5; the American Shoulder and Elbow Surgeons scores improved from 44.4 to 76.1; and the visual analog scale scores improved from 6.3 to 1.3 (P < .0001). A total of 92.5% of patients were satisfied with their results. Only 5 patients developed a postoperative adhesive capsulitis that responded favorably to physical therapy. Eleven patients had concurrent procedures performed at the time of surgery. We found no difference between these patients and those who had an isolated tendon repair. CONCLUSIONS: Arthroscopic transtendon repair of partial-thickness articular-side rotator cuff tears is a reliable procedure that can be expected to produce satisfactory functional improvements and pain relief in most patients with a low rate of complications in the midterm follow-up. Concurrent procedures performed at the time of supraspinatus repair do not change functional outcomes. LEVEL OF EVIDENCE: Level IV, therapeutic case series.