Hamstring (HS) muscle injuries are the most common injury in sports. They are correlated to long rehabilitations and have a great tendency to recur. The HS consist of the long head of the biceps femoris, semitendinosus, and semimembranosus. The patient's clinical presentation depends on the characteristics of the lesion, which may vary from strain to avulsions of the proximal insertion. The most recognized risk factor is a previous injury. Magnetic resonance imaging is the method of choice for the injury diagnosis and classification. Many classification systems have been proposed; the current classifications aim to describe the injury and correlate it to the prognosis. The treatment is conservative, with the use of anti-inflammatory drugs in the acute phase followed by a muscle rehabilitation program. Proximal avulsions have shown better results with surgical repair. When the patient is pain free, shows recovery of strength and muscle flexibility, and can perform the sport's movements, he/she is able to return to play. Prevention programs based on eccentric strengthening of the muscles have been indicated both to prevent the initial injury as well as preventing recurrence.
Objective Describe the ligamentous and associated injuries that occur in the traumatic knee dislocation, relating them to the mechanisms of trauma and to identify patterns of injuries. Methods Twenty three knee dislocations were described in the period between March 2010 and March 2011. After the diagnosis of the lesions, the reduction and transarticular external fixation of the dislocated knees were done. At the second moment, the patients were evaluated with physical examination under anesthesia and the surgical exploration of peripheral lesions was perfomed by a surgeon of the knee surgery group of this institution. The patients data with the description of the injuries were found and registered. Results 65% of patients were male, the average age was 35 years and the most common mechanism of trauma was the motorcycle accident (60%). The lesion of the anterior cruciate ligament (ACL) occurred in 75% of the cases, and the lesion of posterior cruciate ligament (PCL) in 95%. The medial peripheral injuries happened in 65% of the dislocations, and the lateral lesions in 40%. The most common dislocations were classified as KDI (25%) and as KDIIIm (25%). The arterial injury was present in 15% of the cases, and the nervous injury where registered in one patient (5%). At the initial radiographic evaluation, 45% of the dislocations presented reduced. Conclusion The characteristics of the knee dislocations described showed a great range of variability demonstrating that an individualized evaluation of each case is mandatory. The surgeon should be able to recognize and choose the correct treatment to these lesions.
OBJETIVO: Apresentar um estudo experimental sobre o efeito da ciprofloxacina na resistência do calo ósseo de fraturas padronizadas de fêmures de ratos. MÉTODOS: Os ratos foram separados em dois grupos de oito animais: o grupo estudo (cipro) e o grupo controle. Os animais foram submetidos à fixação dos fêmures esquerdos com fio metálico intramedular e à confecção de fraturas padronizadas no mesmo osso. O grupo estudo recebeu ciprofloxacina e o grupo controle soro fisiológico durante seis semanas. Após este período, realizou-se estudo radiográfico controle e ensaio biomecânico de três pontos para obtenção da força de flexão mensurada em Newtons. RESULTADOS: As radiografias e a análise macroscópica demonstraram consolidação óssea em todas as fraturas. Foram comparados os resultados encontrados no estudo biomecânico entre os dois grupos, sendo que o grupo cipro apresentou resistência à força de flexão média 71,11 e o grupo controle, força de flexão média 74,78, não apresentando significância estatística (p = 0,601, test t). CONCLUSÃO: Não houve diferença estatística significante na resistência do calo ósseo de fraturas padronizadas de fêmur de ratos após o uso de ciprofloxacina em relação ao grupo controle.
The medial patellofemoral ligament (MPFL) injury has been considered instrumental in lateral patellar instability after patellar dislocation. Consequently, the focus on the study of this ligament reconstruction has increased in recent years. The MPFL femoral anatomical origin point has great importance at the moment of reconstruction surgery, because a graft fixation in a non anatomical position may result in medial overload, medial subluxation of the patella or excessive tensioning of the graft with subsequent failure. In the pediatric population, the location of this point is highlighted by the presence of femoral physis. The literature is still controversial regarding the best placement of the graft. We describe two cases of skeletally immature patients in whom LPFM reconstruction was performed. The femoral fixation was through anchors that were placed above the physis. With the growth and development of the patients, the femoral origin point of the graft moved proximally, resulting in failure in these two cases.
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