Os autores avaliam os resultados de 35 procedimentos de descompressão cirúrgica do nervo ulnar realizados em 28 pacientes hansênicos. Os parâmetros utilizados incluíram a escala analógica visual, a escala comportamental, a avaliação da força muscular, a estesiometria e a avaliação do efeito do procedimento no que tange à diminuição da corticoterapia no pós-operatório. Observou-se resolução imediata da dor após a realização da cirurgia, melhora da força muscular em metade dos pacientes, melhora da sensibilidade em metade dos pacientes. A diminuição da dosagem da prednisona após a cirurgia foi constante e significativa após a operação.

To evaluate the efficacy of viscosupplementation in patients with osteoarthritis of the ankle. A systematic review to evaluate the evidence in the literature on the use of viscosupplementation for osteoarthritis of the ankle. For this review, we considered blind randomized prospective studies involving the use of viscosupplementation for osteoarthritis of the ankle. A total of 1,961 articles were identified in various databases. After examining each of the articles, five articles were included in this review. Treatment with intraarticular hyaluronic acid is a safe treatment modality that significantly improves functional scores of patients, with no evidence of superiority in relation to other conservative treatments. Further clinical trials with larger numbers of patients are needed so that we can recommend its use and address unanswered questions. Systematic Review of Randomized Clinical Trials.

Introduction: Hallux valgus (HV) is characterized by the lateral deviation of the first finger, associated with pain and medial exostosis of the first metatarsus. The cause is usually multifactorial. The treatment varies with the degree of deformity and can be conservative or surgical. Percutaneous techniques have gained interest, offering less surgical trauma, fewer complications and faster recovery. The present study aims to evaluate the results of the surgical treatment of hallux valgus through percutaneous surgery.  Methods: A search was performed in PubMed / Medline and BVS, from 2013 to 2018, using as descriptors "hallux valgus" and "percutaneous surgery". Original articles in English, Portuguese and Spanish were included. We excluded systematic reviews, descriptions of surgical technique and publications older than 5 years. The quality of the methodology was evaluated with the help of the STROBE tool, with an emphasis on hallux valgus (HVA), intermetatarsal angle (IMA) and the AOFAS score.  Results: We found 185 references. After applying the inclusion and exclusion criteria, and STROBE tool, 5 articles were eligible, comprising a total of 290 percutaneous procedures. The follow-up time ranged from 6 months to 10 years. We found a reduction of IMA between 3.9º and 9.5º and a reduction of HVA between 12.5º and 26.8º. The AOFAS score ranged from 85 to 97.1 points in the evaluated works.  Discussion: In general, we found a good correction of HV deformity with improvement of HVA, IMA, DMAA and clinical improvement by the postoperative AOFAS score, with low complication rates. However, the heterogeneity of the studies, with variation of techniques and samples did not allow us to generalize the findings. Conclusion: It was possible to note that percutaneous surgery for HV treatment produces good outcomes with low complication rates, but few studies had a high level of evidence demonstrating the efficacy of these techniques, despite encouraging preliminary results.

Introduction: Primary osteoarthritis, post-traumatic lesions, Charcot arthropathy and rheumatoid arthritis are some of the causes of ankle and hind foot osteoarthritis that result in pain and sometimes functional limitations in patients affected by such pathology. The therapeutic options vary from conservative treatment (painkillers, bracing and nonsteroidal anti-inflammatory drugs) and surgical treatment. The objective of this present study is to report three cases of patients with ankle osteoarthritis who had undergone minimally invasive surgery (MIS) for tibio-talocalcaneal arthrodesis with an intramedullary nail, with the use of a retrograde blocked intramedullary nail and screws as fixation. Methods: Clinical and radiographic evaluations were conducted of three cases treated using this technique at our institution in 2017, who were allowed full weight bearing postoperatively The AOFAS questionnaire and radiographic evaluation were employed in two orthogonal incidences of the ankle, evaluated after one year postoperatively. Results: We obtained AOFAS scores between 68 and 86 after one year postoperatively with this study technique, and the radiographic consolidation index was observed in 100% of cases (between 6 and 12 weeks) postoperatively. There were no complications. Conclusion: We obtained good results with minimally invasive surgery (MIS) for tibio-talocalcaneal arthrodesis, with satisfactory consolidation presenting no complications. However, there are an insufficient number of studies in the literature demonstrating superiority of the percutaneous tibio-talocalcaneal arthrodesis technique over the open technique. We believe that the percutaneous technique is a recent method fir study that may be added to the therapeutic arsenal.

Objective: Evaluate the treatment of hallux valgus through percutaneous surgery. Methods: This is a systematic review, and the search was conducted on PubMed/Medline and Virtual Health Library (VHL) databases. The search included studies that addressed percutaneous surgery and analyzed the American Orthopaedic Foot & Ankle Society (AOFAS) score, published between 2013 and 2018, as original studies, in English, Portuguese and Spanish. Results: One-hundred and eighty-five articles were identified in the databases, 19 were selected for STrengthening the Reporting of OBservational studies in Epidemiology (STROBE) application, and five were included in the systematic review. The majority of the studies were European; the age of the patient was from 17 to 78 years, who suffered from mild to severe deformities, which were evaluated radiographically and through the AOFAS scale, then submitted to minimally invasive surgeries. Postoperative follow-up was from six months to ten years. Conclusion: The percutaneous technique for hallux valgus correction has shown good results, little surgical trauma, few complications, rapid recovery, return to activities and high satisfaction with the result. Level of Evidence I; Systematic Review of Level I Studies.