Objective: To evaluate pain and mobility in patients with transtrochanteric fractures subjected to osteosynthesis with pericapsular nerve group (PENG) block and compare with patients who did not receive the block. Methods: The medical records of 49 patients were analyzed and data were collected regarding: age, gender, anesthetic evaluation, cause of trauma, locomotion, fracture classification, type of anesthesia used, anesthetic technique, pain, opioid administration and mobility with partial load. Results: Out of 49 patients, 17 (34.7 %) received PENG block. After surgery, most patients complained of pain and opioids were administered (67.3 %), with greatest frequency in the group without PENG block (93.3 %). Most patients who received PENG block walked within 6 h after surgery (52.9 %) and all recovered the ability to walk until hospital discharge (48 h), different from the group that did not receive PENG block (p = 0.012). The groups showed a significant difference between them regarding the frequency of reports of moderate to severe pain (p = 0.003). Conclusion: The use of PENG block in patients with transtrochanteric fractures subjected to osteosynthesis can help to reduce postoperative pain, early mobility with partial load and less use of opioids. Level of Evidence III, Retrospective Comparative Study.

The authors present the case of a patient with a giant cell tumor of the left femoral neck, with adjacent progressive invasion of bone tissue. Initial treatment was done with local curettage and autologous bone graft from fibula, electrocauterization and filling with methyl methacrylate. A local tumoral relapse was present after one year; therefore a new surgical procedure was necessary, with proximal femoral wide resection and unconventional endoprosthesis fixation. The article discusses the clinical aspects and surgical treatment. This report aimed to demonstrate the necessity to perform wide resection for giant cell tumor of the femoral neck, prioritizing total resection of the tumor and its local extension, preserving limb integrity and demonstrating the complete failure of preserving surgery in cases of femoral neck involvement.

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Para avaliar a mortalidade precoce de idosos que apresentaram fraturas do quadril tratadas cirurgicamente neste hospital, no período de 11 de dezembro de 2020 a 30 de abril de 2021, foram realizados interrogatórios em busca de fatores que poderiam estar relacionados a esse desfecho, como sexo, idade, tipo de fratura, cirurgia realizada, comorbidades, tempo de internação até a cirurgia, tempo de internação total e complicações, incluindo óbito. Com uma amostra final de 74 (setenta e quatro) pacientes, 16 (dezesseis), 21,5%, evoluíram com morte nos primeiros 90 (noventa) dias. Este estudo demonstrou que elevados risco cirúrgico, tempo de internação hospitalar e tempo entre a data do trauma e o procedimento cirúrgico contribuíram para o aumento da morbimortalidade nesses pacientes. Além disso, a maioria desses pacientes eram mulheres e receberam transfusão sanguínea. Assim, é importante reduzir o tempo total de hospitalização e evitar transfusão sanguínea em pacientes sem sintomas de anemia ou com níveis de Hb ≥ de 8 g/dl.

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