MARCOS HIDEYO SAKAKI
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6
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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- Epidemiological study on calcaneus fractures in a tertiary hospital(2018) LEITE, Chilan Bou Ghosson; MACEDO, Rodrigo Sousa; SAITO, Guilherme Honda; SAKAKI, Marcos Hideyo; KOJIMA, Kodi Edson; FERNANDES, Túlio DinizABSTRACT Objective: To analyze the epidemiology and characteristics of patients with calcaneus fractures. Methods: This is a retrospective revision of patients with calcaneus fractures hospitalized in the Institute of Orthopedics and Traumatology of this institution between 2006 and 2010. Data such as age, gender, laterality, trauma mechanism, type of fracture, associated injuries, compound fractures, and time from injury to surgery were analyzed. Results: The analysis of 52 patients showed that men were more commonly affected than women, at a ratio of 5.5:1. Bilateral fractures were observed in ten cases, resulting in a total of 62 calcaneus fractures. A fall from a height was the most frequent trauma mechanism (75%), followed by motorcycle accidents (11.5%) and automobile accidents (9.6%). The most frequent fractures were intra-articular, with 47 cases. Compound fractures were observed in 15 patients (28.9%). Non-surgical management was adopted for 11 patients while 41 patients underwent surgery. The mean time between trauma and the definitive treatment was 7.8 days (range: 0-21 days), and 58.5% of cases were treated within seven days. Conclusion: Patients with calcaneus fractures, most commonly young men, were admitted to a high complexity care hospital, victims of a fall from a height with associated injuries. The great severity of these fractures is characterized by the high prevalence of bilateral (19.2%) and compound fractures (28.9%) in this population group.
- FLEXOR HALLUX TENDON TRANSFER: COMPARATIVE STUDY THROUGH DOUBLE OR SINGLE APPROACH(2014) SAKAKI, Marcos Hideyo; GODOY-SANTOS, Alexandre Leme; ORTIZ, Rafael Trevisan; ARAUJO, Antonio; FERNANDES, Tulio DinizObjective: To quantify the FHL length difference obtained through a single approach and by a double combined approach. Methods: 16 fresh cadavers, a total of 32 feet, were used to measure the FHL graft length. With the cadaver positioned in ventral decubitus, a posteromedial incision in the ankle and a second incision in the plantar cavus were performed. Results: The average gain of tendon's length (GTL) was of 42.43 mm, the lowest value being 32 mm and the largest 48 mm. The comparative analysis of the GTL on the right and left sides through the paired ""t"" Test does not show statistical differences, with a p-value = 0.463 and a statistical power of 0.1443. The height analysis of the sample and the right and left GTL performed through linear regression do not show statistically significant differences, with a p-value of 0.38311 and 0.82640, respectively. Conclusion: Harvesting the FHL graft using a double combined approach yields a 42.43 mm length gain in comparison to harvesting using the single approach.
- Charcot neuroarthropathy: realignment of diabetic foot by means of osteosynthesis using intramedullary screws – case report,(2014) SANTOS, Alexandre Leme Godoy dos; ALBINO, Rômulo Ballarin; ORTIZ, Rafael Trevisan; SAKAKI, Marcos Hideyo; CORSATO, Marcos de Andrade; FERNANDES, Tulio DinizDiabetes mellitus is a serious disease that affects a large portion of the population. Charcot neuroarthropathy is one of its major complications and can lead to osteoarticular deformities, functional incapacity, ulcers and ankle and foot infections. Realignment of the foot by means of arthrodesis presents a high rate of implant failure due to weight-bearing on an insensitive foot. The aim of this report was to describe successful use of intramedullary osteosynthesis with compression screws to stabilize the deformed foot, in a diabetic patient with neuroarthropathy.
- Epidemiological study on talus fractures(2014) SAKAKI, Marcos Hideyo; SAITO, Guilherme Honda; OLIVEIRA, Rafael Garcia de; ORTIZ, Rafael Trevisan; SILVA, Jorge dos Santos; FERNANDES, Túlio Diniz; SANTOS, Alexandre Leme Godoy dosObjective: To analyze the characteristics of patients with talus fractures and the injuries that they present. Methods: Retrospective analysis on patients hospitalized in the Institute of Orthopedics and Traumatology, Hospital das Clínicas, School of Medicine of the University of São Paulo, between 2006 and 2011, with talus fractures. Patient profile parameters, risk factors, fracture characteristics, treatment data and acute complications were analyzed. Results: Analysis on 23 cases showed that men were more affected than women, with a ratio of 4.8:1. The most frequent trauma mechanism was traffic accidents, followed by falls from a height. The most frequent type of fracture was at the neck of the talus, with 17 cases. Among the 23 cases, seven had peritalar dislocation at the time of presentation, four had exposed fractures and 11 presented other associated fractures. The mean length of time between the trauma and the definitive treatment was six days, while the mean length of hospital stay was 11 days. Three patients presented acute postoperative complications. Conclusion: Talus fractures occurred most commonly in the region of the talar neck and most frequently in young males who suffered high-energy trauma. In almost half of the cases, there were other associated fractures. The length of hospital stay was 11 days.
- EPIDEMIOLOGICAL STUDY ON LISFRANC INJURIES(2017) SOBRADO, Marcel Faraco; SAITO, Guilherme Honda; SAKAKI, Marcos Hideyo; PONTIN, Pedro Augusto; SANTOS, Alexandre Leme Godoy dos; FERNANDES, Tulio DinizObjective: To analyze the characteristics of patients with Lisfranc injuries and their associated fractures. Methods: This is a retrospective analysis on 42 patients with Lisfranc injuries hospitalized at Instituto de Ortopedia e Traumatologia do Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo, between 2006 and 2010. Parameters on patient profile, risk factors, fracture characteristics, data on treatment and acute complications were analyzed. Results: Analysis of 42 cases showed that in our sample, men were more affected than women, with a ratio of 4.25:1. The most frequent trauma mechanism was car accident, followed by motorcycle accident. The most frequent type of injury was isolated lesion type B of Quenu and Kuss classification, representing 50% of cases. The most common fracture on the sample was the second metatarsal bone, with 16 cases, followed by cuboid bone fracture. Among the 42 cases, 17% had exposed fractures and 33 patients presented other associated fractures. The mean time elapsed between the trauma and definitive treatment was 6.7 days, while the mean length of hospital stay was 13.8 days. Six patients presented acute postoperative complications. Conclusion: Lisfranc injuries are more common in men undergoing automobile trauma. The prevalence of associated fractures is a frequent finding and the hospital stay may be longstanding.
- SOFT-TISSUE INJURY TO THE FOOT AND ANKLE: LITERATURE REVIEW AND STAGED MANAGEMENT PROTOCOL(2019) GODOY-SANTOS, Alexandre Leme; SCHEPERS, Tim; RAMMELT, Stefan; SAKAKI, Marcos Hideyo; MATELUNA, Cristian Ortiz; SPOSETO, Rafael Barban; SYMEONIDIS, Panagiotis; BITAR, Rogerio; DARWISH, Husam; ZWIPP, HansComplex trauma of the foot and ankle is characterized by fractures with severe soft tissue damage associated with neurovascular injury and joint involvement. These injuries are frequently present in the polytraumatized patient and are a predictor of unfavorable clinical outcome. In the initial approach to a patient with complex foot and ankle trauma, the decision between amputation and reconstruction is crucial. The various existing classification systems are of limited effectiveness and should serve as tools to assist and support a clinical decision rather than as determinants of conduct. In the emergency department, one of two treatment options must be adopted: early complete treatment or staged treatment. The former consists of definitive fixation and immediate skin coverage, using either primary closure (suturing) or flaps, and is usually reserved for less complex cases. Staged treatment is divided into initial and definitive. The objectives in the first phase are: prevention of the progression of ischemia, necrosis and infection. The principles of definitive treatment are: proximal-to-distal bone reconstruction, anatomic foot alignment, fusions in severe cartilage lesions or gross instabilities, stable internal fixation and adequate skin coverage.
- EPIDEMIOLOGIC STUDY OF ANKLE FRACTURES IN A TERTIARY HOSPITAL(2014) SAKAKI, Marcos Hideyo; MATSUMURA, Bruno Akio Rodrigues; DOTTA, Thiago De Angelis Guerra; PONTIN, Pedro Augusto; SANTOS, Alexandre Leme Godoy dos; FERNANDES, Tulio DinizObjectives: To evaluate the epidemiology of ankle fractures surgically treated at the Instituto de Ortopedia e Traumatologia do Hospital das Clinicas da Universidade de Sao Paulo. Methods: Medical records of patients admitted with foot and ankle fractures between 2006 and 2011 were revised. Seventy three ankle fractures that underwent surgical treatment were identified. The parameters analyzed included age, gender, injured side, AO and Gustilo & Anderson classification, associated injuries, exposure, need to urgent treatment, time to definitive treatment and early post-operative complications. Study design: retrospective epidemiological study. Results: Male gender was predominant among subjects and the mean age was 27.5 years old. Thirty nine fractures resulted from traffic accidents and type B fracture according to AO classification was the most common. Twenty one were open fractures and 22 patients had associated injuries. The average time to definitive treatment was 6.5 days. Early post-operative complications were found in 21.3% of patients. Conclusions: Ankle fractures treated in a tertiary hospital of a large city in Brazil affect young people victims of high-energy accidents and present significant rates of associated injuries and post-operative complications.
bookPart Prevenção e abordagem cirúrgica das infecções(2013) FERNANDES, Tulio Diniz; SPOSETO, Rafael Barban; ORTIZ, Rafael Trevisan; SANTOS, Alexandre Leme Godoy dos; SAKAKI, Marcos Hideyo; CORSATO, Marcos de Andrade- HALLUX RIGIDUS: PROSPECTIVE STUDY OF JOINT REPLACEMENT WITH HEMIARTHROPLASTY(2013) SANTOS, Alexandre Leme Godoy dos; DUARTE, Fernando Aires; SEITO, Carlos Augusto Itiu; ORTIZ, Rafael Trevisan; SAKAKI, Marcos Hideyo; FERNANDES, Tulio DinizObjective: To report the results of medium-term follow-up after deploying Arthrosurface-HemiCap (R) in patients with diagnosis of Hallux Rigidus (HR). Method: Eleven patients underwent partial Arthroplasty of the first metatarsal-phalangeal joint. Six women and five men with an average age 51.9 years (46 to 58 years) and average postoperative follow-up of 3.73 years (3-4 years); were classified through the Kravitz system and evaluated by the American Orthopaedic Foot and Ankle Society (AOFAS) scales for hallux, Visual Analogical Scale (VAS) - analog functional pain - and range of motion in the first metatarsal joint in preoperative, postoperative after six months and present post-operative. Results: The results show significant improvement of the three analyzed parameters, both for overall analysis and for pre and post-operative comparisons individually. The comparative analysis of each variable in the six months and the current postoperative periods do not show statistically significant differences, indicating maintenance of parameters during this interval. Conclusion: hemiarthroplasty of first metatarsophalangeal joint is a reproducible and safe option for the surgical treatment of hallux rigidus II and III, with significant improvement of the evaluated parameters for the studied population.
- Talar Body Reconstruction for Nonunions and Malunions(2018) SAKAKI, Marcos Hideyo; MACEDO, Rodrigo Sousa; SANTOS, Alexandre Leme Godoy Dos; ORTIZ, Rafael Trevisan; SPOSETO, Rafael Barban; FERNANDES, Tulio DinizBackground: Talar body and neck nonunions and malunions may undergo a reconstructive surgery when joint cartilage is still viable, and no talar collapse or infection has occurred. This is a rare condition and the studies supporting the procedure have small number of cases. The objective of the present study is to report a case series of six patients who underwent talar reconstructions. Materials and Methods: Six patients with talar malunions or nonunions who underwent surgical treatment were reviewed in this retrospective study. There were three nonunions and two malunions of the talar body and one malunion of the talar neck. Clinical evaluation included all the parameters used in the American Orthopaedic Foot and Ankle Society (AOFAS) hindfoot scale. Arthritic degeneration of the ankle joint was assessed according to a modified Bargon scale. Results: The mean followup was 86 months (range 24-282 months). There were no cases of postoperative avascular necrosis of the talus. Four of the six patients in our series required a subtalar fusion as part of the reconstruction procedure. The average preoperative AOFAS hindfoot score was 34, and at the time of the last evaluation, it was 74. The mean preoperative score on the modified Bargon scale for the tibiotalar joint was 1.17. At the last followup, it rose to 1.33. Three different deformities of the talus were identified (a) flattening of the talus (b) extra-articular step and (c) intraarticular step. Conclusion: Reconstruction of talar nonunions and malunions improved function in selected patients with a low risk of complications. Three different anatomical patterns of talar nonunions and malunions were identified.