Navegando por Palavras-chave "Shoulder dislocation"
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- ItemAcesso aberto (Open Access)Effectiveness of intra-articular lidocaine injection for reduction of anterior shoulder dislocation: randomized clinical trial(Associação Paulista de Medicina - APM, 2012-01-01) Tamaoki, Marcel Jun Sugawara [UNIFESP]; Faloppa, Flávio [UNIFESP]; Wajnsztejn, André [UNIFESP]; Archetti Netto, Nicola [UNIFESP]; Matsumoto, Marcelo Hide [UNIFESP]; Belloti, Joao Carlos [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)CONTEXT AND OBJECTIVE: Shoulder dislocation is the most common dislocation among the large joints. The aim here was to compare the effectiveness of reduction of acute anterior shoulder dislocation with or without articular anesthesia. DESIGN AND SETTING: Prospective randomized trial conducted in Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP) (EPM-UNIFESP). METHODS: From March 2008 to December 2009, 42 patients with shoulder dislocation were recruited. Reductions using traction-countertraction for acute anterior shoulder dislocation with and without lidocaine articular anesthesia were compared. As the primary outcome, pain was assessed through application of a visual analogue scale before reduction, and one and five minutes after the reduction maneuver was performed. Complications were also assessed. RESULTS: Forty-two patients were included: 20 in the group without analgesia (control group) and 22 in the group that received intra-articular lidocaine injection. The group that received intra-articular lidocaine had a statistically greater decrease in pain over time than shown by the control group, both in the first minute (respectively: mean 2.1 (0 to 5.0), standard deviation, SD 1.3, versus mean 4.9 (2.0 to 7.0, SD 1.5; P < 0.001) and the fifth minute (respectively: mean 1.0; 0 to 3.0; SD = 1.0 versus mean 4.0; 1.0 to 6.0; SD = 1.4; P < 0.001). There was one failure in the control group. There were no other complications in either group. CONCLUSION: Reduction of anterior shoulder dislocation using intra-articular lidocaine injection is effective, since it is safe and diminishes the pain. CLINICAL TRIAL REGISTRATION: ISRCTN27127703.
- ItemAcesso aberto (Open Access)Estimulação elétrica funcional na subluxação crônica do ombro após acidente vascular encefálico: relato de casos(Universidade de São Paulo, 2009-03-01) Corrêa, Juliana Barbosa; Borges, Heloise Cazangi [UNIFESP]; Lucareli, Paulo Roberto Garcia; Liebano, Richard Eloin; Universidade Federal de São Paulo (UNIFESP); Centro Universitário São Camilo; Universidade Cidade de São PauloShoulder subluxation is a common complication among stroke survivors; it may cause pain, brachial plexus injuries, adhesive capsulitis and rotator cuff muscle injuries, leading to rehabilitation delay and interference in patients' quality of life. The purpose of this study was to assess the effects of functional electrical stimulation (FES) in post-stroke hemiplegia shoulder subluxation. Three patients with over one year of stroke onset and shoulder subluxation confirmed by X ray were assessed prior to, and after FES treatment, as to: degree of shoulder subluxation and range of motion (ROM); sensory-motor function by the Fugl-Meyer scale; and pain at rest and at passive movement by means of a visual analog scale. All patients were treated with conventional physical therapy and FES in the hemiplegic member for ten sessions. Results showed improvement in final measures of ROM and sensory-motor assessments, pain relief and shoulder subluxation reduction after treatment. FES associated to conventional physical therapy has thus proved effective in decreasing subluxation, increasing upper limb function and in relieving pain in post-stroke shoulder subluxation patients.
- ItemAcesso aberto (Open Access)Estudo transversal sobre o tratamento das lesões acrômioclaviculares agudas(Sociedade Brasileira de Ortopedia e Traumatologia, 2009-01-01) Tamaoki, Marcel Jun Sugawara [UNIFESP]; Cocco, Luiz Fernando [UNIFESP]; Pereira, Henrique Rodrigues Fernandes [UNIFESP]; Belloti, Joao Carlos [UNIFESP]; Santos, João Baptista Gomes dos [UNIFESP]; Archetti Neto, Nicola [UNIFESP]; Matsumoto, Marcelo Hide [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)The objective of the present transversal study is to check how Brazilian orthopedists treat these injuries, their criteria for choosing the treatment, results and complications. METHODS: During the 6th Brazilian Congress of Shoulder and Elbow Surgery (CBOC) and the 38th Brazilian Congress of Orthopaedics and Traumatology (CBOT) 507 questionnaires were distributed (148 CBOC and 359 CBOT), with 478 being considered for analysis. RESULTS: Regarding type-I and -II ACIs, most of the respondents use traditional non-surgical methods. On the other hand, for type-IV, V and VI injuries, 475 (99.4%) of the respondents indicate surgical methods. Concerning type-III injuries, there is no consensus in the selection between traditional and surgical treatment for 386 (80.7%) respondents, with the most important factor for selecting a given treatment method being the patient's level of sports practice and age. CONCLUSION: There is no consensus regarding type-III ACIs, and the selection of the best treatment method is made according to patient's individual characteristics. However, current literature shows a trend towards non-operative methods.
- ItemAcesso aberto (Open Access)Estudo transversal sobre os diferentes métodos de tratamento das luxações traumáticas glenoumerais: a cross-sectional study(Sociedade Brasileira de Ortopedia e Traumatologia, 2009-10-01) Wajnsztejn, André [UNIFESP]; Tamaoki, Marcel Jun Sugawara [UNIFESP]; Archetti Netto, Nicola [UNIFESP]; Belloti, Joao Carlos [UNIFESP]; Matsumoto, Marcelo Hide [UNIFESP]; Faloppa, Flávio [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)OBJECTIVE: The aim of the present study was to investigate Brazilian orthopedists' opinions regarding the main aspects of the treatment of glenohumeral traumatic dislocation and compare these to literature's current concepts. METHODS: Two hundred questionnaires containing 13 items were randomly distributed to orthopedists who were attending a Brazilian orthopedics congress; 158 were filled in correctly and were considered in this study. RESULTS: The preferred maneuver was traction-countertraction (60.8%). Among the respondents, 68.4% stated that glenohumeral dislocation reduction was achieved in the first attempt in 90% of the cases. The first attempt of reduction occurred mainly in the Emergency room (96.5%). Seventy-nine individuals (50%) reported that they do not use any analgesic prior to reduction. The majority of the participants immobilize their patients after the reduction (98.1%). 75.4% of them keep their patients immobilized from 2 to 3 weeks. CONCLUSION: Generally, Brazilian orthopaedists perform traction-countertraction maneuvers, achieving reduction in the first attempt in more than 90% of the cases in the Emergency room. No previous analgesic agent is used prior to reduction. Immobilization of the patient is made with a Velpeau dressing or a sling for 2 to 3 weeks.
- ItemAcesso aberto (Open Access)Resultados do reparo artroscópico do primeiro episódio de luxação glenoumeral em atletas(Universidade Federal de São Paulo (UNIFESP), 2017-12-08) Terra, Bernardo Barcellos [UNIFESP]; Ejnisman, Benno [UNIFESP]; http://lattes.cnpq.br/1124807952912223; http://lattes.cnpq.br/0612347056064419; Universidade Federal de São Paulo (UNIFESP)Introdução: A articulação glenoumeral é caraterizada pelo amplo grau de movimento e consequentemente é a articulação mais suscetível a luxações. Considerando a alta taxa de recorrência, retorno ao esporte e a artropatia pós instabilidade, diversos autores advogam o tratamento cirúrgico após o primeiro episódio de luxação, obtendo assim um reparo mais anatômico e com um risco menor de recorrência. Há uma escassez de estudos com atletas jovens e primeiro episódio de luxação do ombro. Objetivo: Relatar os resultados do tratamento cirúrgico artroscópico após o primeiro episódio de luxação glenoumeral em atletas jovens. Método: Trata-se de um estudo retrospectivo com dados coletados de forma prospectiva de 53 pacientes (54 ombros) menores que 40 anos operados com um tempo médio entre o primeiro episódio de luxação e o ato cirúrgico de 59 dias (2-360 dias). O seguimento mínimo foi de 2 anos com uma média de 844 dias. A análise estatística foi realizada pelo software SPSS versão 20. O nível de significância utilizado foi de de alfa menor que 0,05. Resultados: A idade média dos atletas foi de 30,8 anos. A média do EROE foi de 93,8, sendo 98% de resultados bons e excelentes. Quanto ao escore de Rowe, 98,2% tiveram resultados bons e excelentes, com uma média de 95. A escala visual analógica de dor teve uma média menor que 1. A taxa de reincidência da luxação foi de 2% (um caso). Não existiu correlação entre o tempo para a cirurgia após a lesão com o resultado cirúrgico [EROE total (p = 0,16), Rowe total (p = 0,13)] e EVA (p = 0.68). Foi observado uma diferença significativa entre retorno ao esporte e resultado cirúrgico, escore EROE (p = 0,001) e Rowe total (p = 0,008). A taxa de retorno ao esporte foi de 83%, sendo que os pacientes com lesão labial superior associada tiveram menores taxas de retorno ao esporte (p = 0,001) e dos escores EROE (p = 0,017) e Rowe (p = 0,019). Conclusão: O presente estudo mostrou resultados favoráveis no tratamento cirúrgico artroscópico após o primeiro episódio de luxação em atletas jovens, sendo uma forma de tratamento eficaz e segura nesta população. O tempo de espera para a cirurgia e idade não mostraram diferença nos resultados dos escores funcionais.