Objective: To conduct an epidemiological study on brachial plexus injuries, through data collection of patients treated in the Hospital São Paulo, which is the referral center for high complexity in this region. Methods: We conducted a retrospective study with a review of the electronic medical records of the Hospital, from August 2008 to June 2013. Results: We estimated an 1.88/100,000 annual incidence, considering that the Hospital is the only referral center for brachial plexus injuries. The mean time between injury and the first visit to the reference hospital was 8.25 months. The mean time interval between injury and surgery was 11.25 months. The percentage of total injuries was 33%, while the upper and middle trunk injuries were 33% and 28%, respectively. Conclusion: We observed many aspects in common with those reported by other centers of excellence in Brazil such as: sex, age and mechanism of injury. However, some findings were different from most other epidemiological studies, namely: level of injury, time between the accident and the first appointment and the time between injury and surgery. Level of evidence IV, case series.

Objectivesthe purpose of this study was to compare the postoperative radiological and clinical outcomes with minimally invasive percutaneous osteosynthesis using three implants: volar locking plate, intramedullary nail system and nonbridging external fixator for distal radius fractures.Methodsforty-eight patients (A group, 16; B group 16; C group 16) underwent minimally invasive percutaneous osteosynthesis of reductible and unstable displaced (Type IIB by Rayhack Classification) distal radius fractures. In B group intramedullary nail system was used, in A group the patients were treated with volar locking plate and in C group the patients were treated by nonbridging external fixator from January 2011 to December 2012. The mean follow-up period was 12 months. Radiologic parameters, range of motion, grip strength, and disability of the arm, shoulder, and hand score were evaluated at each examination (3rd and 6th week, and 12th months). The visual analog scale of wrist pain and complications were assessed at the final follow-up.Resultsthe groups did not differ significantly in radiological outcomes after 12 months, but the clinical results, VAS scale and dash score in group A (volar locking plate) and B (nail intramedullary) were statistically significantly better than that of C group (nonbridging external fixator). One patient underwent an osteosynthesis with nail intramedullary and another with external fixator (C group) developed persistent pain near the site of the superficial radial nerve because of the distal's screw and pins, respectively.Conclusionin clinical parameters, significant differences in outcomes were found between groups A and B after six weeks versus C group.

ObjectiveTo present the clinical and functional results, including measurement of quality of life, of patients undergoing trapeziometacarpal arthroplasty.MethodThis was a prospective evaluation on 45 patients (53 thumbs) with a diagnosis of idiopathic rhizarthrosis who underwent resection arthroplasty and interposition of an uncemented Ascension® implant, made of pyrocarbon. The clinical and functional results were analyzed through radiography, range of motion (ROM) in degrees (°), visual analog scale (VAS) for pain and the disability of arm, shoulder and hand (DASH) questionnaire for quality of life. In the group analyzed, 38 were women and seven were men, and their mean age was 63.17 years (range: 50–78). Eight patients were treated bilaterally.ResultsAfter 42.08 months of follow-up (range: 8–73), the subjective pain evaluation (VAS) score was 1.37 (range: 1–4). The complete ROM of the thumb increased to 95.75% (range: 75–100%) in relation to the contralateral side. The mean DASH questionnaire score was 9.98 (range: 1–18). The complication rate (negative events) was 11.32%. Five patients presented dislocation of the thumb prosthesis. All of them were reoperated by means of dorsal capsuloplasty using a portion of the retinaculum of the extensors as a graft, and good clinical evolution was achieved in these cases. One patient presented fracturing of the metacarpal and was treated by means of osteosynthesis using Kirschner wires.ConclusionThis method is effective for treating rhizarthrosis, according to the measurements made on the clinical and functional results, even after taking the complication rate into consideration. Moreover, it provides an improvement of quality of life for these patients.

The present study provides a record of the bat fauna captured in Guarulhos, state of São Paulo, Brazil, between February and November 2011. The capture sessions were carried out using mist nets set on trails, around and above streams and lakes, near built areas and around livestock. After a total effort of 26,208 m2.h, we recorded 17 bat species belonging to Phyllostomidae (13 species), Vespertilionidae (3) and Molossidae (1). Sturnira lilium (73 captures), Artibeus fimbriatus (69), and A. lituratus (59) were the most abundant species, corresponding to 57.8% of all captures. Some information about shelters was also commented. This paper is the first to report Molossops neglectus for Guarulhos.

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