HUGO ALBERTO NAKAMOTO
Projetos de Pesquisa
Unidades Organizacionais
Instituto de Ortopedia e Traumatologia, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/41 - Laboratório de Investigação Médica do Sistema Músculoesquelético, Hospital das Clínicas, Faculdade de Medicina
LIM/04 - Laboratório de Microcirurgia, Hospital das Clínicas, Faculdade de Medicina
LIM/41 - Laboratório de Investigação Médica do Sistema Músculoesquelético, Hospital das Clínicas, Faculdade de Medicina
LIM/04 - Laboratório de Microcirurgia, Hospital das Clínicas, Faculdade de Medicina
9 resultados
Resultados de Busca
Agora exibindo 1 - 9 de 9
- Comparative analysis of scaphoid nonunion treatment with screw fixation and angular stable plate(2023) NAKAMOTO, Joao Carlos; XAVIER, Renato Martins; BURGOS, Felipe Hellmeister; WATAYA, Erick Yoshio; IWASE, Fernanda do Carmo; NAKAMOTO, Hugo Alberto; MATTAR JUNIOR, RamesIntroduction Scaphoid fractures represent 5-10% of nonunion rate and the treatment options consist of an open reduction with correction of deformity, restoration of the scaphoid length with autologous wedge grafting and fixation. However, there is still no consensus in the literature on the best fixation method. Therefore, the purpose of the study is to compare plate fixation and screw fixation in treating scaphoid nonunion with humpback deformity and carpal instability. Methods Prospective, non-randomised study comparing the treatment of two groups of patients with scaphoid nonunion. A total of 19 patients were included in the study, the first ten patients were included in group 1 (plate fixation), subsequently nine patients were included in group 2 (screw fixation). The nonunion duration was longer than 6 months and patients did not present type III Scaphoid Nonunion Advanced Collapse (SNAC). Clinical evaluations included pain intensity, range of motion, grip strength, pinch test and functional scales Disabilities of the Arm, Shoulder and Hand (DASH) and Mayo Wrist Score. Radiographic evaluations consisted of radiographs of both wrists in AP, AP with ulnar deviation, lateral and oblique views. Patients further underwent a tomography of the affected wrist for bone deformity, carpal collapse and later consolidation evaluation. Results According to post-operative measurements, group 1 showed a significant improvement in the scapholunate angle (p = 0.011) and in the intrascaphoid angle (p = 0.002). Group 2 only showed an improvement in the scapholunate angle (p = 0.011). All patients in group 1 achieved consolidation in 8 weeks, while group 2 patients had a slower consolidation, with a mean of 14 weeks and standard deviation (SD) of 4.2, with statistical significance (p = 0.006). Conclusion Our prospective study, despite the limitations, contributes to the literature for demonstrating a better fixation using plate, with a better correction of humpback deformity and Dorsal Intercalated Segment Instability (DISI) and a faster consolidation.
- Estudo prospectivo da sensibilidade tátil em mãos de uma população brasileira usando pressure-specified sensory device(2012) TUSTUMI, Francisco; NAKAMOTO, Hugo Alberto; TUMA JUNIOR, Paulo; MILCHESKI, Dimas André; FERREIRA, Marcus CastroOBJECTIVE: To evaluate the pressure perception thresholds on the pulp of two fingers (index and little fingers), among a Brazilian population with no nerve injury or neuropathy. METHODS: We used the Pressure-Specified Sensory Device (a computerized device) to derive static and dynamic normal pressure perception thresholds and two-point discrimination distances. RESULTS: We tested finger sensitivity on 30 volunteers. Significance analyses were performed using the Student t test. The mean values (g/mm²) for static one and two-point pressure thresholds (s1PD, s2PD) and dynamic one and two-point discrimination (m1PD, m2PD) in the dominant index finger were: s1PD = 0.4, m1PD = 0.4, s2PD = 0.48, m2PD = 0.51. CONCLUSION: There was no significant difference in sensitivity between the dominant and nondominant hands.
- POSTOPERATIVE RETROSPECTIVE ANALYSIS OF THE TREATMENT OF DUPLICATED THUMB(2018) NAKAMOTO, Hugo Alberto; RAMOS, Frederico Faleiro; GONCALVES, Reinaldo Borges; GOLDENBERG, Dov Charles; GEMPERLI, RolfObjective: To evaluate postoperative epidemiological and functional factors in patients operated to treat duplicate thumb. Methods: This retrospective case series evaluated 20 patients (23 thumbs) treated from January 2012 to December 2016 at our service. Epidemiological and clinical factors were studied, including Tada score. Results: Of the 34 children who were treated surgically, only 20 appeared for the functional evaluation and were included in the study. Of the operated cases, 60% were Wassel type 4. All evaluated cases had good functional results (Tada score >= 5, mean score: 6.65). The most frequently used surgical technique was resection of the radial thumb with reconstruction of the radial collateral ligament (47.8% of cases). Conclusion: Surgical correction of duplicated thumb yields good results, as long as attention is paid to abnormalities in bones, ligaments, and tendons.
- TREATMENT OF SCHAPHOID NONUNION WITH VOLAR LOCKED PLATE(2019) BURGOS, Felipe Hellmeister; NAKAMOTO, Joao Carlos; NAKAMOTO, Hugo Alberto; IWASE, Fernanda do Carmo; MATTAR JUNIOR, RamesObjective: To assess and compare radiographic, tomographic and functional pre and postoperative parameters of patients submitted to treatment of nonunion of the scaphoid waist with locked plate for scaphoid. Methods: This is a case series of scaphoid waist nonunion, operated from March 2017 to March 2018 at the Institute of Orthopedics and Traumatology of HCFMUSP, using the technique of Fisk-Fernandez and osteosynthesis with locked plate for scaphoid APTUS (R) Hand from Medartis. The patients were submitted to radiographs, computed tomography and functional evaluation by the occupational therapy team in the pre and postoperative periods. Results: There was consolidation of the scaphoid waist nonunion in all cases, improvement in the parameters of carpal alignment in the imaging examinations, but functionally we observed reduction of the range of motion and grip strength in relation to the contralateral limb. Conclusions: The treatment of the scaphoid waist nonunion with locked plate was effective, with a high index of consolidation and improvement of the carpal alignment in the imaging tests, although with a reduction in the range of motion and grip strength in relation to the contralateral limb when evaluated with 12 weeks postoperatively.
- ROLE OF ARTERIOVENOUS VASCULAR LOOPS IN MICROSURGICAL RECONSTRUCTION OF THE EXTREMITIES(2018) SILVA, Gustavo Bersani; VERONESI, Bruno Azevedo; TORRES, Luciano Ruiz; IMAGUCHI, Raquel Bernardelli; CHO, Alvaro Baik; NAKAMOTO, Hugo AlbertoObjective: To analyze 10 consecutive cases of microsurgical arteriovenous loops created to reconstruct complex injuries from March 2011 to May 2012. Methods: This observational cohort-type study conducted by the Hand and Microsurgery Group at the HC-FMUSP included patients who were candidates for microsurgical reconstruction as a last alternative to amputation of the limb with proven absence of adequate recipient vessels for primary microsurgical anastomosis, in a prospective and consecutive manner. We analyzed 14 variables (epidemiological, clinical, procedure-related, and outcome) in patients who underwent reconstruction using an arteriovenous loop utilizing a single-stage or two-stage procedure. Results: The injuries were mostly traumatic (80%). The success rate of the single-stage procedure was 75%, and 17% for the two-stage procedure. The rate of preservation for the injured limb was 44%. Conclusion: This study reinforces the more recent understanding that the indication for single-stage or two-stage reconstruction should be individualized; our findings favor the single-stage reconstruction. This technique should be used in selected cases, as a last reconstructive alternative before amputation, and further studies are necessary to confirm its safety and efficacy in our practice.
- EPIDEMIOLOGICAL ASPECTS OF DUPUYTREN'S DISEASE IN BRAZIL(2022) NAKAMOTO, Hugo Alberto; GONCALVES, Reinaldo Borges; OLIVEIRA, Lucas Torres; MACEDO, Lucas Sousa; SAMBUY, Marina Tommasini Carrara de; RODRIGUES, Mauricio Pinto; MATTAR, RamesObjectives: The purpose of this study is to describe associated factors and epidemiological aspects of Dupuytren's Disease in patients followed up in a Brazilian tertiary public hospital, at the Hand Surgery service. Methods: A cross-sectional study was performed from 2014 to 2019. Data collected included: age, gen-der, ancestry, associated comorbidity presence, phenobarbital, tobacco, and alcohol use, family history of Dupuytren's Disease and associated fibrotic diseases. Then, the patients underwent a clinical examination to identify and characterize the involvement of the fingers. The patients were also assessed in regard to whether they presented Dupuytren's Disease severity factors. Results: 140 patients were included, 70.7% men and 29.3% women. Only 42.3% reported being of European ancestry; 20% had first-degree relatives with the disease; 59.3% presented comorbidities, includ-ing hypertension, diabetes, chronic heart disease, dyslipidemia, epilepsy, and HIV infection; 15.8% had Ledderhose disease, 7.1% had Peyronie's disease. 31% were smokers, 16.6% were alcoholic, and 37.1% were phenobarbital users; 40% presented with a severe form of DD. Conclusion: The population studied was composed of Brazilians, most of whom did not report European ancestry; still, they presented several characteristics similar to those described in literature worldwide. Level of Evidence II; Prognostic Stud-ies; Investigating the effect of a patient characteristic on the outcome of a disease.
- RANDOMIZED CONTROLLED TRIAL OF LIMITED FASCIOTOMY WITH INJECTION OF ADIPOSE GRAFT FOR DUPUYTREN'S DISEASE(2020) SAMBUY, Marina Tommasini C.; NAKAMOTO, Hugo A.; BOLLIGER NETO, Raul; JR, Rames Mattar; REZENDE, Marcelo R.; WEI, Teng HsiangObjective: Dupuytren's disease is a genetic disorder related to the proliferation of myofibroblasts. The pluripotent property of stem cells present in adipose tissue inhibits myofibroblast proliferation. Our study sought to evaluate the effect of stem cell-rich fat grafts in patients that underwent limited fasciotomy. Methods: We studied 45 patients, in a single-blind, prospective, randomized clinical trial. All patients underwent limited fasciotomy. In one group, fat graft was injected. Results: The total passive extension deficit results did not exhibit a significant difference. Fat group exhibited worse functional score at 6 months and 1 year postoperatively, such as higher complication rates (43%), when compared with control group (8%), and more pain at 6 weeks follow-up. Conclusion: Fat grafting associated with limited fasciotomy promotes worse functional results compared to conventional limited fasciotomy in the short term. However, long-term results and recurrence rates should be further assessed.
- PROGNOSTIC FACTORS ON SURVIVAL RATE OF FINGERS REPLANTATION(2015) NETO, Jose Queiroz Lima; CARLI, Alberto De; NAKAMOTO, Hugo Alberto; BERSANI, Gustavo; CREPALDI, Bruno Eiras; REZENDE, Marcelo Rosa deObjective: To evaluate the factors that influence the survival rate of replantation and revascularization of the thumb and/or fingers. Methods: We included fifty cases treated in our department from May 2012 to October 2013 with total or partial finger amputations, which had blood perfusion deficit and underwent vascular anastomosis. The parameters evaluated were: age, gender, comorbidities, trauma, time and type of ischemia, mechanism, the injured area, number of anastomosed vessels and use of vein grafts. The results were statistically analyzed and type I error value was set at p < 0.05. Results: Fifty four percent of the 50 performed replantation survived. Of 15 revascularizations performed, the survival rate was 93.3%. The only factor that affected the survival of the amputated limb was the necessity of venous anastomosis. Conclusion: We could not establish contraindications or absolute indications for the replantation and revascularization of finger amputations in this study.
article 1 Citação(ões) na Scopus AVALIAÇÃO DA SENSIBILIDADE CUTÂNEA EM PACIENTES COM SÍNDROME DO TÚNEL DO CARPO RELACIONADA À HEMODIÁLISE(2011) NAKAMOTO, Hugo Alberto; TUMA JUNIOR, Paulo; MILCHESKI, Dimas Andre; FERREIRA, Marcus CastroObjective: The aim of this study is to describe the use of the PSSD (Pressure specified sensory Device) for the diagnosis of carpal tunnel syndrome. Methods: The PSSD is a tool that incorporates a pressure transducer with two prongs, linked to a computer capable of measuring the cutaneous pressure thresholds. The patients were divided in two groups: Group 1- patients neither with superior limb neuropathy nor renal insufficiency. Group 2- patients with carpal tunnel syndrome related to hemodialysis. Group 2 - patients with carpal tunnel syndrome but no renal insufficiency. Results: The results showed, for two of the four parameters measured, that the group 2 had more benefits for the diagnosis of carpal tunnel syndrome than group 3. Conclusion: The PSSD is useful as a diagnostic tool in hemodialysis-related carpal tunnel syndrome Level of Evidence: Level II, development of diagnostic.