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CC BY-NC-ND 4.0 · Rev Bras Ortop (Sao Paulo) 2020; 55(05): 612-619
DOI: 10.1055/s-0040-1702959
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Osteotomias de encurtamento da ulna: A nossa experiência[*]

Article in several languages: português | English
Afonso Nobre Pinto Cardoso 
1   Departamento de Ortopedia e Traumatologia, Hospital Beatriz Ângelo, Loures, Portugal
,
Rui Viegas
1   Departamento de Ortopedia e Traumatologia, Hospital Beatriz Ângelo, Loures, Portugal
,
Patrícia Gamelas
1   Departamento de Ortopedia e Traumatologia, Hospital Beatriz Ângelo, Loures, Portugal
,
Pedro Falcão
1   Departamento de Ortopedia e Traumatologia, Hospital Beatriz Ângelo, Loures, Portugal
,
Carolina Baptista
1   Departamento de Ortopedia e Traumatologia, Hospital Beatriz Ângelo, Loures, Portugal
,
Filipa Santos Silva
1   Departamento de Ortopedia e Traumatologia, Hospital Beatriz Ângelo, Loures, Portugal
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Resumo

Objetivo O objetivo do presente estudo foi avaliar os resultados clínicos e radiográficos da nossa casuística relativamente a osteotomias de encurtamento da ulna, bem como rever sumariamente a patologia, as indicações e as opções cirúrgicas do conflito ulnocárpico.

Métodos Realizamos uma análise retrospectiva de pacientes consecutivos que foram tratados com osteotomia de encurtamento da ulna entre janeiro de 2012 e junho de 2017 no nosso hospital. Avaliamos clinicamente a dor, amplitude articular, força da garra e resultados funcionais recorrendo ao questionário quick-DASH. Medimos radiograficamente a variância ulnar pré- e pós-operatória e o encurtamento realizado.

Resultados Identificamos oito pacientes operados, tendo sido possível avaliar sete destes. Nesta população, obtivemos uma diminuição da dor (escala analógica visual [VAS, na sigla em inglês] de 7 para 2.6, p < 0,05), uma diminuição do quick-DASH (64 para 28, p < 0,05) e constatamos uma diminuição da amplitude articular ∼ 7° para a flexão (p = 0.2), de 5.5° para a supinação (p = 0,3), bem como diminuição da força da garra para cerca de 86% do lado contralateral (p = 0,07). A variância ulnar foi alterada de uma média de + 5.5 mm para −1.1 mm (p < 0,05). Dois em 8 pacientes (25%) apresentaram sintomatologia relacionada com a placa, sendo que um deles foi submetido a nova intervenção para extração do material.

Conclusões A osteotomia de encurtamento da ulna é um procedimento cirúrgico eficaz, tanto no tratamento do conflito ulnocárpico, como na descarga da ulna. Os resultados apresentados vão ao encontro aos demais publicados na literatura, tendo-se obtido bons resultados clínicos e radiográficos.

Palavras-chave

osteotomia - ulna - articulação do punho - estudos retrospectivos

* Trabalho desenvolvido no Departamento de Ortopedia e Traumatologia, Hospital Beatriz Ângelo, Loures, Portugal.




Publication History

Received: 12 August 2019

Accepted: 29 November 2019

Article published online:
06 April 2020

© 2020. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

Sociedade Brasileira de Ortopedia e Traumatologia. Published by Thieme Revinter Publicações Ltda
Rio de Janeiro, Brazil

 

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