ObjectiveTo map out the approaches used by Brazilian orthopedists in treating complete tears of the rotator cuff.MethodsA multiple-choice questionnaire was handed out to 232 orthopedists at the 45th Brazilian Congress of Orthopedics and Traumatology. Of these, 207 were returned but five were incomplete and were excluded. Thus, 202 questionnaires were used.ResultsAmong the orthopedists who answered the questionnaires, around 60% were from the southeastern region and 46% were shoulder and elbow surgeons. There was a significant association (p < 0.05) between length of experience and number of rotator cuff repairs performed per year. There was also a significant association (p < 0.05) between shoulder specialty and the following variables: arthroscopic technique, use of anchors in a single-row configuration, mean time taken for an indication for surgery to be made in cases of traumatic and degenerative lesions, use of a specific protocol for postsurgical rehabilitation, return to sport and indication of irreparable injuries.ConclusionsBrazilian shoulder surgeons have well-established approaches toward treating rotator cuff injuries. Most of these approaches differ significantly from those of other specialties. This shows the importance of placing value on training in preparing shoulder specialists in this country.

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Objective: To evaluate the intra- and interobserver reproducibility of radiographic cranial parameters. Method: A study of the reproducibility of the radiographic cranial parameters (cranial incidence, cranial tilt, cranial slope and spinocervical angle) of 40 patients by 4 observers with different levels of experience. Results: Cranial incidence (CI) showed poor intraobserver concordance; for the other cranial parameters, good to excellent concordance was observed. In the assessment of interobserver concordance, all the parameters analyzed showed statistical significance, with good CI concordance. Conclusion: Cranial parameters are easily reproducible by orthopedists with different levels of experience. CI showed good interobserver concordance, but only reasonable intraobserver concordance among more experienced observers. Level of evidence IV; Diagnostic Study.

Objective: To determine the preoperative radiographic method for measuring the Cobb angle that is closest to the postoperative result in patients with scoliotic deformity. Methods: Retrospective cohort study of radiographic spinal evaluation (preoperative posteroanterior (PA), bending, traction, traction under anesthesia and immediate postoperative posteroanterior (PO)) of 26 patients treated surgically for scoliotic deformities during the period from January 2017 to September 2019. The final mean Cobb angle and its decrease in relation to the PA value were evaluated in the three curves in patients with idiopathic (IS) and non-idiopathic scoliosis. Results: All the mean curve values were statistically significant, except for bending in non-idiopathic scoliosis (non-IS). The mean traction under anesthesia values were closer to the PO values. Regarding the delta (decrease) of the maneuvers in relation to the PA, no statistical significance was observed in the non-IS group. The traction under anesthesia maneuver had a greater delta in all curves. Conclusions: The traction under anesthesia maneuver in patients with idiopathic scoliosis is the method with the greatest flexibility and which best predicts the postoperative result. Level of evidence III; Diagnostic study.

Background?The viability of skin flaps is critical and greatly affects patient's quality of life. Effects of anticoagulant use on focal skin flap necrosis were explored, administering clopidogrel or low-molecular-weight heparin (LMWH) singly and in combination. Methods?Adult male rats (N?=?40) were randomly assigned to one of four equally divided groups, raising a random dorsal flap (10???4 cm) on each animal and delivering either no drug (control group) or daily applications of LMWH (4 mg/kg), clopidogrel (20 mg/kg), or both agents (LMWH?Clop) for a 7-day period. Thereafter, area and the percentage of flap necrosis (NP) were individually determined. Results?Average NP values were as follows: controls, 51.61%; LMWH, 49.50%; clopidogrel, 27.70%; and LMWH?Clop, 29.71%. Conclusion?Clopidogrel significantly enhanced the viability of random skin flap in rats, whereas single-agent LMWH or its combined usage conferred no significant benefits in this setting.