ALEXANDRE LEME GODOY DOS SANTOS
Projetos de Pesquisa
Unidades Organizacionais
Instituto de Ortopedia e Traumatologia, Hospital das Clínicas, Faculdade de Medicina
LIM/41 - Laboratório de Investigação Médica do Sistema Músculoesquelético, Hospital das Clínicas, Faculdade de Medicina
LIM/41 - Laboratório de Investigação Médica do Sistema Músculoesquelético, Hospital das Clínicas, Faculdade de Medicina
5 resultados
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- Arthrodesis in the Deformed Charcot Foot(2022) ROSEMBERG, Dov Lagus; SPOSETO, Rafael Barban; GODOY-SANTOS, Alexandre Leme
- Tibiotalocalcaneal Arthrodesis: A Retrospective Comparison Between Nails and Lateral Locking Plate Complications(2023) ROSEMBERG, D. L.; MACEDO, R. S.; SPOSETO, R. B.; SAKAKI, M. H.; GODOY-SANTOS, A. L.; FERNANDES, T. D.Background: Tibiotalocalcaneal arthrodesis is a well-established procedure to treat some hindfoot diseases. Currently, the most used implants are retrograde intramedullary nails and locking plates combined with lag screws, but there are few articles comparing differences regarding the complications. Methods: We have retrospectively analyzed the medical records and the radiographs of patients older than 18 years who underwent this procedure in our service between 2005 and 2019 through retrograde intramedullary nails or lateral locking plates and compression screws with at least 12 months of follow-up and with no history of osteomyelitis in these bones. Results: We evaluated a total of 67 patients; of these, 48 received retrograde intramedullary nail implants and 19 received locking plates and compression screws. The overall mean age was 48 years; the median follow-up time was 64.3 months. The complication rate was 60.4% for the intramedullary nail procedure and 52.6% for the locking plate combined with compression screws procedure. Conclusion: No significant differences were found in the complication rates between the 2 implants. Level of Evidence: Level V, Case series
- ANALYSIS OF 45,507 SURGICAL TREATMENT OF DISTAL TIBIA AND MALLEOLAR FRACTURES OVER 14 YEARS(2023) ROSEMBERG, Dov Lagos; WOLOSKER, Nelson; SILVA, Marcelo Fiorelli Alexandrino; MANN, Tania Szejnfeld; GIORDANO, Vincenzo; GODOY-SANTOS, Alexandre LemeThe distal leg joint fractures are among the most common frac-tures in humans across all age groups, and 50% of them require surgical treatment. Few studies discuss the epidemiology and costs of this fracture in the global and national literature. Objective: To evaluate the annual incidence and reimbursement value of distal leg joint fractures requiring surgical treatment from 2008 to 2021. Methods: A retrospective study was conducted to analyze the complex structured data of high volume and high variability (Big Data), publicly available on the TabNet platform (DATASUS), via software with artificial intelligence. Data from 2008 to 2021 on surgical treatment for malleolar fracture, distal tibia fracture, and isolated fibula fracture were analyzed. Results: From 2008 to 2021, there was an average incidence of 28.8 fractures/105 inhabitants per year, representing 14.62% of all fractures. The total amount paid for hospitalizations due to these fractures was R$ 34,218,014.62 over these 14 years. Conclusion: The incidence of distal leg joint fractures follows the pattern of those recorded in other countries. The adjustment of reimbursement over the years was lower than the accumulated inflation. Level of Evidence II, Economic and Decision Analyses - Developing an Economic or Decision Model.
- Histoarchitecture of the fibrillary matrix of human fetal posterior tibial tendons(2022) MACEDO, Rodrigo Sousa; TEODORO, Walcy Rosolia; CAPELLOZZI, Vera Luiza; ROSEMBERG, Dov Lagus; SPOSETO, Rafael Barban; NETTO, Cesar de Cesar; DELAND, Jonathan T.; MAFFULLI, Nicola; ELLIS, Scott J.; GODOY-SANTOS, Alexandre LemeAdult tendons are highly differentiated. In mature individuals, tendon healing after an injury occurs through fibrotic tissue formation. Understanding the intrinsic reparative properties of fetal tendons would help to understand the maturation tissue process and tendon tissue repair. The present study evaluated the evolution of histoarchitecture, cellularity and the distribution of collagens I, III and V in the posterior tibial tendon in human fetuses at different gestational ages. Morphological profiles were assessed in nine fresh spontaneously aborted fetuses (Group I: five fetuses aged between 22 and 28 weeks of gestation; Group II: four fetuses aged between 32 and 38 weeks of gestation), characterized by a combination of histology, fluorescence and immunohistochemistry. In Group I, the posterior tibial tendon showed statistically significant greater cellularity and presence of collagen III and V than in Group II tendon, which showed a predominance of collagenous I and a better organization of the extracellular matrix compared with Group I tendons. In addition, a statistically significant higher rate of CD90, a marker of mesenchymal cells, was found in Group I tendons. In fetuses with gestational age between 22 and 28 weeks, the posterior tibialis tendons showed a thin and disorganized fibrillar structure, with an increase in collagen III and V fibers and mesenchymal cells. In the posterior tibialis tendons of fetuses with gestational age between 32 and 38 weeks, the fibrillar structure was thicker with a statistically significant increase in type I collagen and decreased cellularity.
- Staged management of Lisfranc complex injury - Case report and literature review(2021) ROSEMBERG, D. L.; SPOSETO, R. B.; MACEDO, R. S.; FERNANDES, T. D.; GODOY-SANTOS, A. L.Background: There is an increase in the numbers of high energy tarsometatarsal / Lisfranc fracture dislocation. In this type of trauma, the specialist in orthopedics and traumatology cannot consider only the fracture as the challenge to be overcome, the injury to the soft tissues of the foot ends up being of equal or greater importance throughout the treatment. Our aim is to demonstrate, through a case report and literature review, that staged multidisciplinary surgical treatment is a good option for the treatment of these complex cases. Case: We report a case of a 28-year-old female victim of a motorcycle collision with a car. She was diagnosed with complex lesion of the right foot (fracture the medial cuneiform, fracture of the lateral cuneiform, cuboid fracture and loss of the intermediate cuneiform, detaching wound of dorsal skin, loss of the extensor hallux longus tendon, anterior tibial artery and deep peroneal nerve). In the emergency setting the patient was submitted to an initial debridement and gross reduction fixation with Kirschner wires. The further course was complicated with local infection and need for staged debridements, modification of the fixation and negative pressure wound dressing. She was later submitted to a flap coverage at the dorsum of the foot and in a last approach, arthrodesis of the medial tarsometatarsal and navicular joints. Conclusions: Lisfranc complex injuries continue to be an important source of pain and disability for patients worldwide. This case description show decision making challenges in a scenario without all resources available. The literature review demonstrates thar 2 phases of treatment principles must be respected: early damage control and definitive treatment. The key factors for improved outcomes are: early soft tissue coverage and restore axial, sagittal, and coronal alignment of the medial and lateral columns of the foot. © 2021