Cirurgia de Bristow - Latarjet: um panorama atual no Brasil.
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Data
2022
Autores
Araujo, Bruno Vierno de [UNIFESP]
Orientadores
Belangero, Paulo Santoro [UNIFESP]
Tipo
Dissertação de mestrado profissional
Título da Revista
ISSN da Revista
Título de Volume
Resumo
Objetivo: Traçar um panorama atual sobre a cirurgia de Bristow – Latarjet no Brasil.
Método: Estudo transversal no qual um questionário eletrônico com 26 perguntas
abordando aspectos de formação acadêmica; técnicas cirúrgicas; complicações e
manejo pós-cirúrgico foi enviado a 845 membros ativos da Sociedade Brasileira de
Cirurgia do Ombro e Cotovelo, no período de 20 de abril a 12 de maio de 2021.
Resultados: Do total de médicos ortopedistas convidados a participar, obtiveram-se
310 instrumentos com respostas completas. Em relação a formação acadêmica
verificou-se uma média de 19,3 anos para graduação em medicina; 15,6 anos para
conclusão de residência médica em ortopedia e traumatologia e 13 anos para
obtenção de título de especialista em ombro e cotovelo. A região Sudeste é a maior
formadora de especialistas sendo o local onde está concentrada a maior parte deles.
Durante o estágio curricular, a maioria dos especialistas participou em mais de 10
procedimentos de Bristow - Latarjet. A complicação mais frequentemente citada foi a
fratura do enxerto e quanto a dificuldade técnica, foi o posicionamento dos parafusos.
Os especialistas relataram que 50,6% dos pacientes já tiveram complicações no
intraoperatório; 73,9% tiveram complicações no pós-operatório. Quanto ao manejo
pós-cirúrgico 57,1% fizeram a sutura do subescapular; 99,7% indicaram a
imobilização no pós-operatório; 61,9% consideraram a consolidação do enxerto como
fundamental. Conclusão: Ressalta-se que embora a maioria dos especialistas
participou em até 10 procedimentos de Bristow – Latarjet durante a especialização,
13,5% deles concluíram sua formação sem ter participado de nenhuma cirurgia. O
maior número de complicações ocorreu com especialistas que obtiveram o título há
11 a 15 anos atrás. A complicação mais frequente foi a fratura do enxerto e a
dificuldade técnica mais frequente foi o posicionamento dos parafusos. Já a
imobilização no pós-operatório é a preferência da maioria dos participantes, assim
como consideraram fundamental a consolidação do enxerto para o retorno ao esporte.
Objective: To outline a current overview of Bristow – Latarjet surgery in Brazil. Method: Cross-sectional study in which an electronic questionnaire with 26 questions addressed aspects of academic training; surgical techniques; complications and post-surgical management was sent to 845 active members of the Brazilian Society of Shoulder and Elbow Surgery, from April 20 to May 12, 2021. Results: Of the total number of orthopedic doctors invited to participate, 310 were obtained. instruments with complete answers. Regarding academic training, there was an average of 19.3 years for graduation in medicine; 15.6 years to complete medical residency in orthopedics and traumatology and 13 years to obtain a specialist title in shoulder and elbow. The Southeast region is the largest producer of specialists, being the place where most of them are concentrated. During the curricular internship, most specialists participated in more than 10 Bristow - Latarjet procedures. The most frequently cited complication was fracture of the graft and as for technical difficulty, it was the positioning of the screws. Specialists reported that 50.6% of patients already had intraoperative complications; 73.9% had postoperative complications. As for the post-surgical management, 57.1% performed the suture of the subscapularis; 99.7% indicated postoperative immobilization; 61.9% considered graft consolidation as essential. Conclusion: It is noteworthy that although most specialists participated in up to 10 Bristow – Latarjet procedures during specialization, 13.5% of them completed their training without having participated in any surgery. The greatest number of complications occurred with specialists who obtained the title 11 to 15 years ago. The most frequent complication was graft fracture and the most frequent technical difficulty was positioning the screws. Immobilization in the postoperative period is the preference of most participants, as well as they considered graft consolidation essential for returning to sports.
Objective: To outline a current overview of Bristow – Latarjet surgery in Brazil. Method: Cross-sectional study in which an electronic questionnaire with 26 questions addressed aspects of academic training; surgical techniques; complications and post-surgical management was sent to 845 active members of the Brazilian Society of Shoulder and Elbow Surgery, from April 20 to May 12, 2021. Results: Of the total number of orthopedic doctors invited to participate, 310 were obtained. instruments with complete answers. Regarding academic training, there was an average of 19.3 years for graduation in medicine; 15.6 years to complete medical residency in orthopedics and traumatology and 13 years to obtain a specialist title in shoulder and elbow. The Southeast region is the largest producer of specialists, being the place where most of them are concentrated. During the curricular internship, most specialists participated in more than 10 Bristow - Latarjet procedures. The most frequently cited complication was fracture of the graft and as for technical difficulty, it was the positioning of the screws. Specialists reported that 50.6% of patients already had intraoperative complications; 73.9% had postoperative complications. As for the post-surgical management, 57.1% performed the suture of the subscapularis; 99.7% indicated postoperative immobilization; 61.9% considered graft consolidation as essential. Conclusion: It is noteworthy that although most specialists participated in up to 10 Bristow – Latarjet procedures during specialization, 13.5% of them completed their training without having participated in any surgery. The greatest number of complications occurred with specialists who obtained the title 11 to 15 years ago. The most frequent complication was graft fracture and the most frequent technical difficulty was positioning the screws. Immobilization in the postoperative period is the preference of most participants, as well as they considered graft consolidation essential for returning to sports.