Nicola Archetti Neto

Estudo transversal sobre o tratamento das lesões acrômioclaviculares agudas

OBJETIVO: O objetivo do presente estudo transversal e verificar como o ortopedista brasileiro interpreta as lesoes acromioclaviculares quanto aos criterios para a indicacao do tratamento cirurgico ou nao, seus metodos preferidos, as complicacoes mais frequentes e os resultados obtidos. METODOS: Durante o 6o Congresso Brasileiro de Cirurgia do Ombro e Cotovelo (CBOC) e o 38o Congresso Brasileiro de Ortopedia e Traumatologia (CBOT) foram distribuidos 507 questionarios, sendo considerados 478 para analise. RESULTADOS: Em relacao ao tratamento das LAC tipo I e II, a maioria dos entrevistados utilizam metodos nao cirurgicos. Em contraposicao nas LAC IV, V e VI 475 (99,4%) dos entrevistados tratam essas lesoes cirurgicamente. Nas LAC tipo III nao existe uma definicao na escolha do tratamento cirurgico ou nao cirurgico para 386 (80,7%) entrevistados, sendo que o fator mais importante para tomada de decisao para a maioria dos entrevistados e a atividade esportiva do paciente e a idade. CONCLUSAO: Nas LAC tipo III nao ha consenso, sendo o tratamento determinado conforme as caracteristicas do paciente, contudo na literatura atual ha uma tendencia para o tratamento nao cirurgico destas lesoes.

Prevalence of lesions associated with traumatic recurrent shoulder dislocation

Objective: To evaluate the prevalence of lesions associated with traumatic anterior shoulder instability and the relationships between the prevalence of these lesions and the number of episodes and time since symptoms started. Method: Fifty-seven patients aged 18 to 40 years, with traumatic anterior shoulder instability, more than one episode of shoulder dislocation and at least six months since the first dislocation, who required surgery to treat the instability, were selected. Arthroscopic inspection was performed on all the patients to assess any associated lesions. Results: The prevalence of lesions was assessed, and Bankart lesions were the most prevalent, followed by Hill-Sachs lesions, while rotator cuff injuries were the least prevalent. There was no correlation from comparison between the number of episodes of dislocation and the prevalence of associated lesions. On the other hand, in relation to the time since symptoms started, the patients who had had symptoms for longer times had fewer Hill-Sachs lesions. Conclusion: It was not possible to affirm that, in patients with chronic shoulder instability, the numbers of associated lesions increased with the time since symptoms started, or with the number of episodes of dislocation.

Prevalência das lesões associadas na luxação recidivante traumática do ombro

OBJECTIVE: To evaluate the prevalence of lesions associated with traumatic anterior shoulder instability and the relationships between the prevalence of these lesions and the number of episodes and time since symptoms started. METHOD: Fifty-seven patients aged 18 to 40 years, with traumatic anterior shoulder instability, more than one episode of shoulder dislocation and at least six months since the first dislocation, who required surgery to treat the instability, were selected. Arthroscopic inspection was performed on all the patients to assess any associated lesions. RESULTS: The prevalence of lesions was assessed, and Bankert lesions were the most prevalent, followed by Hill-Sachs lesions, while rotator cuff injuries were the least prevalent. There was no correlation from comparison between the number of episodes of dislocation and the prevalence of associated lesions. On the other hand, in relation to the time since symptoms started, the patients who had had symptoms for longer times had fewer Hill-Sachs lesions. CONCLUSION: It was not possible to affirm that, in patients with chronic shoulder instability, the numbers of associated lesions increased with the time since symptoms started, or with the number of episodes of dislocation.