MARCELO TADEU CAIERO
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
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- Intramedullary Steinmann pin nailing of the ulna: an option for the damage control orthopedics treatment of forearm fractures in open injuries in polytraumatized patients - A description of the technique and presentation of a case series(2021) KOLLNBERGER, Karin Veronica; SILVA, Fernando Brandao de Andrade e; CAIERO, Marcelo Tadeu; LEONHARDT, Marcos de Camargo; REIS, Paulo Roberto dos; SILVA, Jorge dos Santos; KOJIMA, Kodi EdsonIntroduction: Forearm shaft fracture is common in young adult patients and associated with soft tissue and organ injuries. In open fractures in polytrauma patients, damage control orthopaedics (DCO) is well indicated. The aim of this study is to describe intramedullary Steinmann pin fixation of the ulna as a DCO procedure for the forearm and present a case series. Description of the technique: A 3.0 mm Steinmann pin is inserted retrograde in the ulna proximal fragment through the fracture site using the open wound as the approach. With direct visualization of the reduction, the pin is advanced into the distal fragment. The reduction of the longitudinal axis and shortening is thus achieved. Patients and methods: This method was used for all open fractures of forearm both-bone fractures in polytrauma patients undergoing DCO from 2014 to 2019. The alignment and length of the ulna were evaluated radiographically after pin fixation and before and after definitive fixation. Differences in the need for secondary procedures and infection rate between DCO and definitive fixation were also evaluated. Results: There were 30 males (85.7%) with an average age of 32.9 +/- 12.0 years and a mean ISS (Injury Severity Score) of 29.4 (range, 18.0-41.0). The most common associated injuries were thoracic trauma (62.8%) and head trauma (45.7%). In the radius and ulna, 51.4% and 60.0% of fractures, respectively, were multifragmentary (types B and C). Gustilo type IIIA represented 77.1% of the injuries. Pin fixation achieved good alignment and length in all cases. The mean time between DCO and definitive fixation was 12.0 days, and no secondary procedure was needed, nor any case developed either superficial or deep infection. The conversion from DCO to definitive fixation was considered easy in all cases. Conclusion: Intramedullary Steinmann pin fixation of the ulna is a viable option for DCO for forearm both-bone fractures in open fractures in polytrauma patients. (C) 2021 Published by Elsevier Ltd.
- Orthopedics: Musculoskeletal Tumors(2022) BAPTISTA, A. M.; REBOLLEDO, D. C. S.; JUNIOR, M. C. M. T.; CORREIA, L. F. M.; CAIERO, M. T.; TEIXEIRA, W. J.; NARAZAKI, D. K.; CAMARGO, A. F. de França; CAMARGO, O. P. deAmputation has historically been the first choice of treatment for patients with bone or soft tissue sarcomas of the extremities involving major blood vessels. However, recent advances in surgical technique have allowed limb-salvage surgery in a significant number of cases. Nowadays, most patients with malignant bone tumors can be treated with limb-salvage procedures whenever wide margins are possible. Surgical resection of bone and soft tissue tumors, with or without adjuvant radiation therapy, is effective in achieving local control, and limb-salvage procedures have been accepted because they achieve survival rates comparable to those of amputation allowing better quality of life. Along with other reconstructive techniques, vascular reconstruction might allow limb-sparing surgery and avoid amputation in patients with malignant tumors involving major vessels. Intraarterial embolization may as well serve as adjuvant therapy for major resection surgeries or therapeutic in some types of irresectable tumors. © Springer Nature Switzerland AG 2022.