RESUMO
OBJECTIVE: The spinal cord-injured patients begin to present a new configuration of forces on the joints. The hip joint is one of the most affected, because these patients generally use a wheelchair as a means of locomotion. Osteoarticular changes, such as heterotopic ossification, can be found in these patients, as evidenced by radiographic studies. This study aims to identify radiographic changes in hips of spinal cord-injured patients. METHODS: 15 patients (30 hips) were evaluated and followed up at the Laboratory of Biomechanical Rehabilitation of the Musculoskeletal System of HC-Unicamp, through the analysis of radiographs of the pelvis in anterior-posterior and Lowenstein lateral positions. RESULTS: Of the total hips, only seven (23%) had no evidence of articular damage. The prevalence of heterotopic ossification found (16.6%) was similar to the literature. CONCLUSION: The radiographic assessment of these patient's hips is justified by the prevalence of joint changes found. Level of Evidence II, Development of diagnostic criteria in consecutive patients (with universally applied reference "gold" standard).
RESUMO
OBJECTIVE: To evaluate the intraobserver and interobserver reproducibility of Hawkins' classification for fractures of the neck of the talus. METHODS: 20 random cases of fracture of the talus were selected, to be defined according to the classification of types by eight orthopedic surgeons, 13 orthopedic residents and 15 radiology residents. RESULTS: Using the statistical test of Landis and Koch, measurements of 0.627 and 0.668 were obtained in the first and second evaluations, respectively. These values define a satisfactory agreement for Hawkins' classification. CONCLUSION: We conclude that this classification is reproducible between observers, with better values for the more experienced observers. Level of Evidence I, Study Diagnostic - Investigating a diagnostic test.
RESUMO
OBJETIVO: Avaliar a reprodutibilidade intra-observador e inter-observador da classificação de Hawkins para fraturas do colo do talus. MÉTODOS: Selecionou-se 20 casos aleatórios de fratura de tálus para serem definidos entre os tipos da classificação por oito cirurgiões ortopédicos, 13 residentes de ortopedia e 15 de radiologia. RESULTADOS: Utilizando o teste estatístico de Landis e Kock foram obtidas médias de 0.627 e 0.668, na primeira e segunda avaliação, respectivamente. Tais valores definem uma concordância satisfatória para a classificação de Hawkins. CONCLUSÃO: Conclui-se que tal classificação é reprodutível entre observadores, possuindo melhores valores conforme maior experiência. Nível de Evidência I, Estudos diagnósticos - Investigação de um exame para diagnóstico.
OBJECTIVE: To evaluate the intraobserver and interobserver reproducibility of Hawkins' classification for fractures of the neck of the talus. METHODS: 20 random cases of fracture of the talus were selected, to be defined according to the classification of types by eight orthopedic surgeons, 13 orthopedic residents and 15 radiology residents. RESULTS: Using the statistical test of Landis and Koch, measurements of 0.627 and 0.668 were obtained in the first and second evaluations, respectively. These values define a satisfactory agreement for Hawkins' classification. CONCLUSION: We conclude that this classification is reproducible between observers, with better values for the more experienced observers. Level of Evidence I, Study Diagnostic - Investigating a diagnostic test.
Assuntos
Humanos , Fraturas Ósseas/classificação , Fraturas Ósseas/complicações , Reprodutibilidade dos Testes , Tálus/lesões , Ortopedia , RadiografiaRESUMO
OBJETIVO: Os pacientes lesado-medulares passam a se submeter a uma nova conformação de forças sobre as articulações. O quadril é uma das mais afetadas, por utilizarem a cadeira de rodas como meio de locomoção. Alterações osteoarticulares, como ossificação heterotópica, podem ser encontradas nesses pacientes, sendo evidenciadas por estudos radiográficos. Este estudo visa identificar a incidência das alterações radiográficas em quadris de paciente lesados medulares. MÉTODOS: Foram avaliados 15 pacientes (30 quadris) acompanhados no Laboratório de Reabilitação Biomecânica do Aparelho Locomotor do HC-Unicamp, analisando-se radiografias da bacia em posições antero-posterior e lowenstein. RESULTADOS: Dos quadris avaliados, apenas sete (23 por cento) não possuíam alguma evidência de dano à superfície articular. A prevalência de ossificação heterotópica encontrada (16,6 por cento) aproximou-se a da literatura. CONCLUSÃO: Devido à prevalência de alterações articulares encontradas, justifica-se o acompanhamento radiográfico dos quadris destes pacientes. Nível de Evidência II. Desenvolvimento de critérios diagnósticos em pacientes consecutivo. (com padrão de referência "ouro" aplicado).
OBJECTIVE: The spinal cord-injured patients begin to present a new configuration of forces on the joints. The hip joint is one of the most affected, because these patients generally use a wheelchair as a means of locomotion. Osteoarticular changes, such as heterotopic ossification, can be found in these patients, as evidenced by radiographic studies. This study aims to identify radiographic changes in hips of spinal cord-injured patients.METHODS: 15 patients (30 hips) were evaluated and followed up at the Laboratory of Biomechanical Rehabilitation of the Musculoskeletal System of HC-Unicamp, through the analysis of radiographs of the pelvis in anterior-posterior and Lowenstein lateral positions.RESULTS: Of the total hips, only seven (23%) had no evidence of articular damage. The prevalence of heterotopic ossification found (16.6%) was similar to the literature.CONCLUSION:The radiographic assessment of these patient's hips is justified by the prevalence of joint changes found. Level of Evidence II, Development of diagnostic criteria in consecutive patients (with universally applied reference "gold" standard).