EMYGDIO JOSE LEOMIL DE PAULA
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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- Comparison between proximal row carpectomy and four-corner fusion for treating osteoarthrosis following carpal trauma: a prospective randomized study(2011) BISNETO, Edgard Novaes Franca; FREITAS, Maura Cristina; PAULA, Emygdio Jose Leomil de; MATTAR JR., Rames; ZUMIOTTI, Arnaldo ValdirOBJECTIVE: To compare the functional results of carpectomy and four-corner fusion surgical procedures for treating osteoarthrosis following carpal trauma. METHODS: In this prospective randomized study, 20 patients underwent proximal row carpectomy or four-corner fusion to treat wrist arthritis and their functional results were compared. The midcarpal joint was free of lesions in all patients. RESULTS: Both proximal row carpectomy and four-corner fusion reduced the pain. All patients had a decreased range of motion after surgery. The differences between groups were not statistically significant. CONCLUSIONS: Functional results of the two procedures were similar as both reduced pain in patients with scapholunate advanced collapse/scaphoid non-union advanced collapse (SLAC/SNAC) wrist without degenerative changes in the midcarpal joint.
- Wrist Arthroscopy in Athletes(2020) FRANÇA BISNETO, Edgard Novaes; DE PAULA, Emygdio José Leomil; MATTAR JUNIOR, RamesAbstract Arthroscopy is a surgical technique whose indication for wrist injuries has grown in recent years. Athletes are subject to traumatic injury to the wrist due to training overload or the intensity of the activity during competition. The need of a quick return to sports practice makes arthroscopy a very useful minimally invasive technique in these situations. The authors present indications of sports-related injuries to the wrist that can be treated by arthroscopy. A literature review is also presented.
- Atypical Cleft Hand: Surgical Technique for Grasping Improvement(2024) BISNETO, Edgard de Novaes Franca; FERNANDES, Laura Filippini Lorimier; PAULA, Emygdio Jose Leomil de; MATTAR JUNIOR, RamesIntroduction:We present 6 cases of children with atypical cleft hand and discuss a surgical technique. Clinically, participants presented with a lack of pulp-to-pulp pinch due to metacarpophalangeal ligament insufficiency and difficulty grasping large objects because of the narrowed first web.Materials and Methods:Second metacarpal resection and Z-plasty, creating a wide first web. The second extensor digitorum communis tendon was transferred to improve the thumb metacarpophalangeal joint stability.Conclusions:The surgical technique presented in this paper did improve function in oligodactyly or type-IIA atypical cleft hand.
article 1 Citação(ões) na Scopus ARTHROSCOPIC AND MACROSCOPIC EVALUATION OF THE LUNATE MEDIAL FACET(2011) BISNETO, Edgard de Novaes Franca; SOUSA, Bruno de Biase Cabral de; PAULA, Emygdio Jose Leomil de; MATTAR JUNIOR, Rames; ZUMIOTTI, Arnaldo ValdirObjective: To evaluate the correlation between the presence of a lunate medial facet and the incidence of ligament lesions of the wrist and arthrosis of the proximal pole of the hamate. This study was carried out on cadavers. Methods: Arthroscopic evaluation and dissection were performed on cadaver wrists. Results: There was a clear, statistically significant correlation between arthrosis of the proximal pole of the hamate and the presence of a medial facet on the lunate. Conclusion: Arthrosis of the proximal pole of the hamate is correlated with the presence of a type II lunate. Level of Evidence III, Study of nonconsecutive patients; without consistently applied reference ""gold"" standard.- What has changed in brachial plexus surgery?(2013) REZENDE, Marcelo Rosa de; SILVA, Gustavo Bersani; PAULA, Emygdio Jose Leomil de; MATTAR JUNIOR, Rames; CAMARGO, Olavo Pires deBrachial plexus injuries, in all their severity and complexity, have been extensively studied. Although brachial plexus injuries are associated with serious and often definitive sequelae, many concepts have changed since the 1950s, when this pathological condition began to be treated more aggressively. Looking back over the last 20 years, it can be seen that the entire approach, from diagnosis to treatment, has changed significantly. Some concepts have become better established, while others have been introduced; thus, it can be said that currently, something can always be offered in terms of functional recovery, regardless of the degree of injury. Advances in microsurgical techniques have enabled improved results after neurolysis and have made it possible to perform neurotization, which has undoubtedly become the greatest differential in treating brachial plexus injuries. Improvements in imaging devices and electrical studies have allowed quick decisions that are reflected in better surgical outcomes. In this review, we intend to show the many developments in brachial plexus surgery that have significantly changed the results and have provided hope to the victims of this serious injury.
article 4 Citação(ões) na Scopus Avaliação do ganho funcional do cotovelo com a cirurgia de Steindler na lesão do plexo braquial(2011) REZENDE, Marcelo Rosa de; MASSA, Bruno Sergio Ferreira; FURLAN, Fernando Cesar; MATTAR JUNIOR, Rames; PAULA, Emygdio Jose Leomil de; SANTOS, Simone Silva e; FREITAS, Maura CristinaObjective: To evaluate the gain in strength and range of motion after modified Steindler surgery of the elbow in patients with lesions of the upper trunk of the brachial plexus. Method: From 1998 to 2007, eleven patients with traumatic closed upper trunk lesion of the brachial plexus were studied. All the patients had development of at least 1 year of injury and degree of strength of elbow flexion ranging from M1 to M3. The patients underwent Steindler surgery with at least 6 months of follow-up. Pre- and post-operative assessments were carried out to determine gain in muscle strength, range of motion of the elbow, and DASH scale score. Results: Of the eleven patients studied, nine (82%) achieved a level of strength equal to or greater than M3 (MRC) with good functional recovery. Two (18%) reached strength level M2 (MRC). We observed that the patients had an average postoperative gain in range of motion of the elbow of 43.45 degrees. The average elbow flexion after surgery was 88 degrees. There was an improvement in elbow function, as demonstrated in the DASH Scale, in 81% of the patients studied. Conclusion: Modified Steindler surgery was effective in the treatment of patients with injuries of the upper trunk of the brachial plexus, with statistically significant gains in range of motion. In all the cases studied, there was some degree of gain in strength and range of elbow flexion, the gain being correlated with the initial muscle strength. Level of Evidence: Level II, prospective clinical trial.- RADIOCARPAL FRACTURE DISLOCATIONS: A NEW CLASSIFICATION AND TREATMENT PROPOSAL(2022) PAULA, Emygdio Jose Leomil De; BISNETO, Edgard De Novaes Franca; PAULOS, Renata Gregorio; MATTAR JUNIOR, RamesIntroduction: The radiographic and surgical findings, and treatment of radiocarpal fracture dislocations, were analyzed retrospectively in 40 patients. Materials and Methods: All patients were classified according to Dumontier's radiological classification and compared with the surgical findings. Based on this analysis, a new classification and treatment are proposed. Results: From 1995 to 2018, 40 patients with radiocarpal fracture dislocation underwent surgery. Thirty-six were males and four were females. The mean age was twenty-four years (range: 18-45). Three dislocations were volar dislocations and 37 were displaced dorsally. Initially, 8 (20%) patients were classified as group I, 29 (72.5%) as group II, and 3 (7.5%) remained unclassified. The main variations occurred in group II. Seven fractures were stable after radial styloid fixation and 6 remained unstable. Sixteen fractures presented articular fragments or an interposed capsule, which prevented anatomical reduction using conservative maneuvers. Conclusion: Based in our intraoperative observations and surgical results, we believe that a more detailed classification should be adopted.
- Results of ulnar nerve neurotization to biceps brachii muscle in branchial plexus injury(2012) REZENDE, Marcelo Rosa de; RABELO, Neylor Teofilo Araujo; SILVEIRA JUNIOR, Clovis Castanho; PETERSEN, Pedro Araujo; PAULA, Emygdio Jose Leomil De; MATTAR JUNIOR, RamesObjective: To evaluate the factors influencing the results of ulnar nerve neurotization at the motor branch of the brachii biceps muscle, aiming at the restoration of elbow flexion in patients with brachial plexus injury. Methods: 19 patients, with 18 men and 1 woman, mean age 28.7 years. Eight patients had injury to roots C5-C6 and 11, to roots C5-C6-C7. The average time interval between injury and surgery was 7.5 months. Four patients had cervical fractures associated with brachial plexus injury. The postoperative follow-up was 15.7 months. Results: Eight patients recovered elbow flexion strength MRC grade 4; two, MRC grade 3 and nine, MRC <3. There was no impairment of the previous ulnar nerve function. Conclusion: The surgical results of ulnar nerve neurotization at the motor branch of brachii biceps muscle are dependent on the interval between brachial plexus injury and surgical treatment, the presence of associated fractures of the cervical spine and occipital condyle, residual function of the C8-T1 roots after the injury and the involvement of the C7 root. Signs of reinnervation manifested up to 3 months after surgery showed better results in the long term. Level of Evidence: IV, Case Series.
bookPart Instabilidade cárpica(2021) PAULA, Emygdio José Leomil de; BISNETO, Edgard de Novaes FrançabookPart Pseudoartrose do escafoide(2021) PAULA, Emygdio José Leomil de