RESUMO
OBJETIVOS: Analisar os resultados do tratamento cirúrgico de pacientes com lesão isolada do tendão do músculo subescapular. PACIENTES E MÉTODOS: Foram avaliados 12 pacientes com lesão isolada do tendão do músculo subescapular submetidos a tratamento cirúrgico entre junho de 1987 a abril de 2005. Em 10 pacientes a lesão era de origem traumática. Oito eram do sexo masculino e quatro do feminino. O tempo de dor no período pré-operatório variou de três dias até 72 meses. Sete pacientes foram submetidos a tratamento artroscópico e cinco por cirurgia aberta. Sete possuíam lesão completa do tendão e cinco lesões parciais. RESULTADOS: A mobilidade no período pós-operatório dos pacientes passou de elevação média de 135º para 150º, a rotação lateral média de 60º para 50º e a rotação medial passou de média de T12 para T9. Os seis pacientes que praticavam esportes, retornaram ao nível de atividade prévio. Pelo método da UCLA, 11 pacientes tiveram resultados excelentes e bons. Houve associação de 33,3 por cento de lesão do tendão da cabeça longa do bíceps braquial. CONCLUSÃO: O tratamento cirúrgico da lesão isolada do tendão subescapular propicia bons resultados e satisfação na parte dos pacientes.
OBJECTIVES: To evaluate the results of surgically treated patients with isolated subscapularis tendon injuries. PATIENTS E METHODS: Twelve patients with isolated tears of the subscapularis muscle tendon surgically treated between June 1987 and April 2005 were evaluated. Ten patients had traumatic injuries. Eight patients were males and four females. The duration of preoperative pain ranged from three days to 72 months. Seven patients were submitted to arthroscopic procedures and five to open surgical ones. Seven had complete tendon ears while five showed partial injuries. RESULTS: The mean range of motion of the patients has improved from pre-operative to final evaluation from 135º to 150º of forward lifting, from 60º to 50º of lateral rotation, and from T12 to T9 for medial rotation. Six patients returned to their pre-injury level of sports activity. Using the UCLA score, 11 patients showed excellent or good results. 33.3 percent of the cases were associated to injuries of the long head of the brachial biceps. CONCLUSION: Isolated tears of the subscapularis tendon addressed with surgery lead to good outcomes and patient satisfaction.
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Articulação do Ombro/lesões , Ombro/cirurgia , Traumatismos dos Tendões/cirurgia , Traumatismos dos Tendões/diagnóstico , Amplitude de Movimento ArticularRESUMO
Southwick's angles measured in the anteroposterior and Lauenstein frog-leg views have been used for planning surgical treatment of deformities caused by slipped capital femoral epiphysis (SCFE). Clinically established epiphysiolysis is associated with a decrease in anteroposterior angles and an increase in Lauenstein angles. Obesity is one of the factors involved in the development of SCFE, but its influence in Southwick's angles has not been previously described. Additionally, few reports describe normal values adjusted for sex and bone age. In this study, we determined Southwick's angles in normal control participants (n=70), in patients with obesity (n=31) and in patients with epiphysiolysis (n=33). The intra-observer variations were 1.7 and 23.3% for the anteroposterior and Lauenstein angles, respectively. No significant differences were detected in the control group when these individuals were compared according to sex or chronological age. Obese patients showed a significant increase in the anterposterior angle when compared with control individuals. The hip with epiphysiolysis presented a significant reduction in the anteroposterior angle and an increase in the Lauenstein angle, when the same was compared with the contralateral hip or with the control values. In patients with unilateral SCFE the Lauenstein angle of the normal hip was detected as increased, which was possibly related to the obesity associated with decreased insulin resistance presented by these patients. We conclude that the detection of risk for developing SCFE should include an expanded clinical and radiological profile characterized by pubertal males who present obesity associated with insulin resistance and an increase in Southwick's anteroposterior angle.