Instituto de Ortopedia e Traumatologia - HC/IOT

URI Permanente desta comunidade

http://opifrontend.fm.usp.br/handle/OPI/92
O Instituto de Ortopedia e Traumatologia (IOT) da Faculdade de Medicina da Universidade de São Paulo - Hospital das Clínicas (FMUSP-HC), inaugurado em 1953, presta atendimento direcionado a pacientes com afecções ortopédicas e traumatológicas, tratando-se de um centro de referência para reimplante de membros.

Em modernas instalações, seu Pronto-socorro recebe pacientes para tratamento do trauma ortopédico de alta complexidade; além de possuir equipes atuantes em diversas subespecialidades (joelho, quadril, pé, mão, fisiatria, coluna, paralisia cerebral, tumores ósseos e reimplantes de membros e próteses), voltadas para o tratamento das diversas enfermidades do aparelho locomotor.

O IOT também se dedica a campanhas na imprensa relacionadas com a conscientização sobre os perigos no trânsito e a prevenção de acidentes.

Site oficial: http://www.iothcfmusp.com.br/

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article 1 Citação(ões) na Scopus
Patient demographic and magnetic resonance imaging evaluation of isolated posterolateral corner knee injuries
(2023) COSTA, Joao Pedro de Guimaraes Fernandes; NETO, Jair Antunes Eleterio; RODRIGUES, Marcelo Bordalo; HELITO, Camilo Partezani; HELITO, Paulo Victor Partezani
Background: Posterolateral stability of the knee is maintained by capsular, ligamentous and tendinous structures, which collectively are known as the posterolateral corner (PLC). Injuries to the PLC of the knee rarely occur without associated anterior (ACL) or posterior cruciate (PCL) ligament tears. The main objectives of our study were to report patient demographics and magnetic resonance imaging (MRI) findings of patients with isolated PLC injuries. Methods: This study consists of a retrospective analysis of knee MRI from January 2011 to June 2016, in two hospitals in Sao Paulo, Brazil, where PLC injuries without associated ACL and PCL injuries were identified in MRI by two radiologists specialized in musculoskeletal injuries. Relative and absolute frequencies were used to describe the injuries of each of the PLC structures in the study cases. Results: A total of 23 cases of PLC injuries without associated cruciate ligament injuries were identified. The mean age of patients was 32.0 +/- 8.1 years and 91% patients were male. The main sport associated with isolated PLC injury was Brazilian Jiu-Jitsu (48%), followed by soccer (35%). MRI evaluations of the knees showed lateral collateral ligament (LCL) injuries in 70% of cases, popliteus tendon injuries in 26% of cases and distal biceps tendon injuries in 30% of cases. The popliteofibular ligament (PFL) was damaged in 83% of cases. An associated ALL injury was observed in 43% of cases. Conclusions: Isolated PLC injuries occurred mainly in young men when practicing Brazilian Jiu-Jitsu and soccer. The LCL was the most frequently injured larger structure in association, and the capsuloligamentous structures (PFL) were the most frequently injured structures overall. ALL injuries occurred in approximately half of the cases, most often concomitantly with LCL injuries.
article 0 Citação(ões) na Scopus
Anterolateral Ligament and Kaplan Fiber Injury Both Occur Frequently in Acute Anterior Cruciate Ligament-Injured Knees
(2024) LEAO, Renata Vidal; HELITO, Paulo Victor Partezani; SAITHNA, Adnan; CORREA, Marcos Felippe de Paula; HELITO, Camilo Partezani
Background and objectives: The association of ALL and KF injuries in anterior cruciate ligament (ACL)-deficient knees remain topics of conflicting research despite improved magnetic resonance imaging (MRI). We aimed to evaluate the rate of the anterolateral ligament (ALL) and Kaplan fibers (KF) injuries in adults with acute ACL injuries using MRI. Methods: We retrospectively reviewed 64 patients with clinical and MRI diagnoses of acute ACL tears. Two radiologists analyzed and categorized the status of the ALL and KF in all patients as intact, partially injured, or completely injured. Interobserver agreement was assessed. Injuries to the collateral ligaments, ITB and posterior cruciate ligament (PCL) were also evaluated. Results: The mean age of the patients was 33 years. ALL injuries were observed in 46 (71%) patients, among whom 33 (71%) had partial and 13 (28%) had complete injuries. KF injuries were identified in 32 (50%) patients, with 28 (87.5%) of them having partial and 4 (12.5%) having complete injuries. Combined injuries of both ALL and KF were found in 25 (32.4%) patients (p-value of 0.266). The agreement between the examiners ranged from moderate to substantial (Kappa between 0.55 and 0.75), with the highest agreement observed in cases of KF injuries (Kappa = 0.75). Conclusions: ALL and KF injuries were prevalent in acute ACL-injured knees with rates of injury of 71% and 50%, respectively. ALL injuries were more frequent and more frequently severe compared to KF injuries.
article 0 Citação(ões) na Scopus
Histological Compatibility in Distal Neurotizations: A Systematic Review
(2023) CAVALHEIRO, Cristina Schmitt; NAKAMOTO, Joao Carlos; WEI, Teng Hsiang; SORRENTI, Luiz; WATAYA, Erick Yoshio
Considering the importance of defining the minimum number of axons between recipient and donor branches, that is, the definition of histological compatibility in distal neurotizations for the success of the procedure and the surgeon's freedom to choose individualized strategies for each patient, this systematic review was conducted to find out the most recent studies on the subject. The objective of this systematic review was to determine the importance of the number of axons and the relationship between axon counts in the donor and recipient nerves in the success of nerve transfer. A literature review was performed on five international databases: Web of Science, Scopus, Wiley (Cochrane Database), Embase, and PubMed. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed (2020 version), a guide designed to guide the elaboration of systematic literature reviews. One hundred and fifty-seven studies were found, and 23 were selected based on the eligibility criteria. The articles presented were conclusive in determining the importance of the number of axons in the success of nerve transfer. Still, the relationship between the number of axons in the donor and recipient nerves seems more relevant in the success of transfers and is not always explored by the authors. The review of the articles has provided compelling evidence that the number of axons is a critical determinant of the success of nerve transfer procedures. However, the relationship between the number of axons in the donor nerve and that in the recipient nerve appears to be even more crucial for successful transfers, a factor that is not always adequately explored by authors in the existing literature.
article 0 Citação(ões) na Scopus
Comparative study of patients with midshaft clavicle fracture fixed with a locked plate via an open versus percutaneous approach
(2023) AMARAL, Felipe Machado do; MALAVOLTA, Eduardo Angeli; SILVA, Fernando Brandao Andrade e; GARCIA JR., Jose Carlos; MOURA, Jakson da Silva; ASSUNCAO, Jorge Henrique; PECORA, Jose Ricardo
Objective: To compare the results of surgical treatment of midshaft clavicle fractures, treated with the technique of minimally invasive plate osteosynthesis (MIPO) with locking compression plate versus open reduction and internal fixation (ORIF) with locked plate. Methods: Quasi-randomized comparative study, evaluating displaced midshaft clavicle fractures treated with MIPO versus ORIF, with procedures performed by a single surgeon. We evaluated patients at 12 months using the University of California at Los Angeles (UCLA) scale and radiographically at 8, 12, 26 and 52 weeks, in addition to describing complications. Results: We evaluated 44 patients; 22 submitted to MIPO and 22 to ORIF. The median UCLA scores at 12 months were 35 in the ORIF group and 35 in the MIPO group (p = 0.712). All patients had fracture healing at 3 months (p > 0.999). The mean surgery time was 87.5 min in the ORIF group and 47.5 in the MIPO (p < 0.001) group. As complications, 1 suture dehiscence (4.5%), 2 protruding plates (9.1%) and 1 change in sensitivity around the surgical wound (4.5%) were observed in the MIPO group, while in the ORIF group, 15 changes in sensitivity (68.2%) and 3 hypertrophic scars (13.6%) were observed. The only complication that showed a difference between the groups was the change in sensitivity (p < 0.001). No cases of pseudarthrosis or failure of osteosynthesis were identified in either technique. Conclusion: This study demonstrated that the two treatments, ORIF and MIPO, are equally effective in the treatment of displaced middle third clavicle fractures. However, MIPO is superior to ORIF in regard to reduced surgical time and preservation of supraclavicular nerve sensitivity.
article 0 Citação(ões) na Scopus
Clinical data or scoring system for predicting mortality in elderly patients with hip fracture: A prospective study
(2023) SOUZA, Ricardo Machado Castanheira de; FRASSEI, Renan Dias; SILVA, Luiza de Campos Moreira da; RAHAL, Miguel Antonio; SILVA, Jorge dos Santos; KOJIMA, Kodi Edson
Introduction: Hip fracture in elderly individuals is frequent and is related to a high rate of mortality. Finding the best predictor of death will help to develop better patient care. Aim - To analyze the reliability of the clinical data and assessment scores to predict mortality in acute hip fracture in elderly patients. Patient and Methods: Prospective data were collected from all patients > 65 years with acute hip fracture from May to October 2020. The clinical data collected were age, sex, comorbidities, medication, type of fracture and presence of delirium. The assessment scores were ASA, Lee, ACP and Charlson. Results: The statistically significant results were age > 80 years (OR 1.121 IC95% [1.028-1.221] p = 0.0101) and number of medications (OR5.991 95% CI [2.422-14.823] p <0.001). Three scores showed a correlation with mortality: ASA score (p = 0.017), Lee score (p = 0.024) and ACP score (p = 0.013). The Charlson Comorbidity Index did not correlate with mortality (p = 0.172). Conclusion: To stratify the risk of death, both clinical data and scores should be used. The best clinical indicators are age and number of medications, and the scores are ASA, Lee and ACP.
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