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Rio de Janeiro, Brazil

The sprain of the ankle, pure or associated with distortion results in a period of incapacity or longer and if not properly treated generates significant loss of muscle mass in partion of the quadriceps femoris muscle and the triceps surae, as well as the ability to articulate the ankle. In the delicate phase of clinical recovery post-injury or post-surgery, they play a vital role physiotherapy and proper nutrition, which includes the intensive use of sup- plements, foods and integrated functional foods. The aim of this observational study was to investigate a sample of 100 patients treated for a compound fracture of the lateral malleolus if nutritional intervention associated with physical therapy and nutritional supplementation can reduce atrophy of the muscles of the lower limb affected by the fracture itself and optimize an adequate muscle recovery during rehabilitation after cast removal. The study duration was 2 months. The patients were divided into two groups: one treated with diet, physiotherapy and nutritional supplementation (Group A) and one with diet and physiotherapy (Group B). The patients were subjected to three visits: beginning the study (T1), 30 days (T2) and 60 days (T3) during which were measured the capacity of the range of movement (ROM) of the ankle and the size of the triceps muscle of the sura. From the data collected is observed a significant difference in the recovery of the size of the triceps surae in group A compared to group B already after 30 days of treatment (T2). In particular it is observed a better maintenance of the tropism in patients of group A, and particularly a recovery of the most important dimensions of the muscle in the same group. Patients in group B instead claimed a major difficulty in functional recovery and especially the trophic muscle was reduced compared with group A; also in the last visit (T3) the volume of the calf is significantly lower than that of both group A compared to the average values of population. Regarding the ROM of the ankle functional recovery was comparable in both group A than in group B at the first visit (T2), while it is observed a statistically significant difference between the two groups in the second visit (T3) where the ROM of the ankle are almost identical to the average population in group A than in group B. © Mattioli 1885.

Falez F.,Ortopedia e Traumatologia | Favetti F.,Orthopaedics and Traumatology | Casella F.,Orthopaedics and Traumatology | Papalia M.,Orthopaedics and Traumatology | Panegrossi G.,Orthopaedics and Traumatology
International Orthopaedics | Year: 2011

Background: The renewed popularity of resurfacing hip arthroplasty in the last 10 years has generated a remarkable quantity of scientific contributions based on mid- and shortterm follow-up. More than one paper has reported a consistent early revision rate as a consequence of biological or biomechanical failure. Two major complications are commonly described with resurfacing implants: avascular necrosis and femoral-neck fracture. A close relationship between these two events has been suggested, but not firmly demonstrated, whereas cementing technique seems to be better understood as potential cause of failure. Methods: We performed an in vitro study in which four different resurfacing implants were evaluated with a simulated femoral head, two types of cement, (low and high viscosity) and two cementing techniques: direct (cement apposition directly on the femoral head) and indirect (cement poured into the femoral component). Results: High-viscosity cement showed homogeneous distribution over the entire femoral head. Low-viscosity cement showed a massive polar concentration with insufficient, if not absent, distribution in the equatorial zone. Conclusion: Polar cement concentration could be a risk factor for early implant failure due to two effects on the femoral head: biological (excessive local exothermic reaction could cause osteocyte necrosis) and biomechanical (which could lead to uneven load distribution on the femoral head). © Springer-Verlag 2011.

De Paula Mozella A.,Instituto Nacional Of Traumatologia E Ortopedia Into | Da Palma I.M.,Instituto Nacional Of Traumatologia E Ortopedia Into | De Souza A.F.,Ortopedia e Traumatologia | Gouget G.O.,Ortopedia e Traumatologia | De Araujo Barros Cobra H.A.,Instituto Nacional Of Traumatologia E Ortopedia Into
Revista Brasileira de Ortopedia | Year: 2013

Objective Identify the etiology and incidence, as well to assess functional outcomes of patients, undergoing lower limb amputation after failure or complication of total knee arthroplasty. These patients were treated at the Center for Knee Surgery at the National Institute of Traumatology and Orthopedics (INTO), during the period of January 2001 to December 2010. Methods The patients were interviewed and their charts were retrospectively analyzed to evaluate their functional outcome. Results The incidence of amputation due to failure or complication of total knee arthroplasty was 0,41% in 2409 cases. Recurrent deep infection was the cause of amputation in 81% of cases, being Staphylococcus aureus and Pseudomonas aeruginosa the most frequent germs. Vascular complications and periprosthetic fracture associated to metaphyseal bone loss were also causes of amputation. In our study, 44% of amputees patients were using orthesis and 62.5% have had the ability to walk. Conclusion Incidence of 0.41%, being the main cause recurrent infection. The functional outcome is limited, and the fitting achieved in 44% of patients and only 62.5% are ambulatory. © 2013 Sociedade Brasileira de Ortopedia e Traumatologia. Published by Elsevier Editora Ltda. All rights reserved.

Rigotti S.,Ortopedia e Traumatologia | Boriani L.,Rizzoli Orthopaedic Institute | Luzi C.A.,Ortopedia e Traumatologia | Marocco S.,Malattie Tropicali | And 3 more authors.
Journal of Orthopaedics and Traumatology | Year: 2013

We describe a case of dorsal-lumbar vertebral tuberculosis (Pott's disease) first treated with antibiotic therapy, bed rest, and cast. After 2 months of treatment patient's symptoms worsened. Minimally invasive posterior vertebral stabilization was carried out, with excellent clinic and radiographic results. © 2012 The Author(s).

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