Reducao fechada e fixacao percutanea em fraturas supracondilianas do umero em criancas. Estudo retrospectivo de 32 casos

This retrospective study evaluated 32 cases of supracondylar fractures of the humerus in children, according to percutaneous crossed Kirschner-wire fixation. Follow-up was performed by radiographs of Baumann's angle and clinical evaluation of joint movement and carrying angle. According to Flynn's criteria, results were satisfactory in all cases, indicating that this method is a safe and efficient method in the treatment of such fractures.

Comportamento fractal de tracos de fraturas na borda sul do macico granitico de itu, estado de Sao Paulo

Fractal geometry is relevant to understand and explain many natural complex geometries. Using the fractal set concept (fig. 1) many authors have shown that shorelines, landscapes and fractures follow a fractal behaviour. These authors have developed many methods, including the Cantor's Dust Method (CDM) (VELDE et al., 1992), a linear method of analysis adapted for the determination of two-dimensional phenomena. The Itu Granitic Complex (IGC) is a wide granitic body that that crops out at northwest of Cabreuva City, Sao Paulo State (fig. 2) and was affected in its south border by dextral Itu-Jundiuvira Shear Zone (IJSZ) that produced fractures and alignment of feldspars crystals. The different types of fractures (compression, distension and shear) was discriminated from the relationship between them and medium stress ellipsoid of IJSZ (fig. 3). A modified version of CDM was used to study a possible fractal behaviour of the fracture traces in the south border of IGC. The main modification was the use only one direction of analysis (NE/SW). Four parallel profiles were traced with lengths between 9.75km and 12.75km, each one them was divided into six classes of segments (x) with 375m, 500m, 750m, 1.000m, 1.250m and 1.500m. The parameter (N) is provided by he rate between profile length and choiced segment. For each x the number of intervals is counted with at least one event (fracture intersection) which supplied the parameter(n). The n/N rate provide the parameter (p) that represents the relationship between frequency of events and x. And finally the parameters p and x were plotted in a logarithmic graphics (fig. 4) that provide a line with such a declivity (1) which is related to effective dimension (De). In theory, granitics bodies are isotropics and they would have a same fractal dimension in all segments, but the logarithmic graphics (fig. 4) show that fracture traces of IGC has a fractal behaviour in a restrict interval. This fact probably occurs from the passage of a ductil-brittle deformation condition to a more brittle deformation condition of IGC.

Effect of 2% chlorhexidine on microtensile bond strength of composite to dentin

Purpose: To evaluate the effect of 2% chlorhexidine on the microtensile bond strength of composite resin to dentin treated with three dentin bonding systems. Materials and Methods: Flat dentinal surfaces were prepared in 24 extracted human third molars. Teeth were randomly divided into 8 distinct experimental groups according to the adhesive applied (Prime & Bond NT, Single Bond and Clearfil SE Bond), the application (yes/no) of chlorhexidine, and the time point at which it was applied (before or after acid etching the dentin). Composite resin blocks were built up over treated surfaces, and teeth were then stored in water at 37°C for 24 h. Samples were thermocycled, stored under the same conditions, and then vertically sectioned, thus obtaining specimens with 1.0 ± 0.1 mm2 cross-sectional area. Specimens were stressed in tension at 0.5 mm/min crosshead speed. Bond strength results were evaluated using a one-way ANOVA (p < 0.05). The modes of failures were verified using optical microscopy. Dentin disks were obtained from 3 additional teeth treated in the same manner for observation under SEM. The most representative samples of fractured specimens were also observed under SEM. Results: No statistically significant differences of bond strength values were found between any groups. Failures occurred mainly within the bond; exclusively adhesive fractures (adhesive-dentin) were not observed. Conclusion: The 2% chlorhexidine solution, applied before or after acid etching of the dentin, did not interfere with the microtensile bond strength of composite resin to the dentin treated with Prime & Bond NT, Single Bond, or Clearfil SE Bond bonding systems.

Influência da geometria do martelo na determinação da força durante o ensaio de impacto Charpy-V

The instrumentation applied to the Charpy test machine allows the accompaniment of the specimen answer front the impact load, in form of a sign characteristically dynamic representative of the deformation process and it fractures of material tested. The main advantages of the rehearsal conventional Charpy: low cost, manufacturing sample facilities and simple handle the machine. With the instrumentation, the number of information regarding the process of fracture of the specimen increases. In this work discusses the influence of the hammer geometry in determination of the force during the process of specimen fracture submitted to the instrumented impact test Charpy-V. The purpose is obtaining a hammer, in conformity with Norma ISO 14.556, with great sensibility to register the force during the impact. Two geometries different from hammers were instrumented and rehearsed with material of low tenacity, in this case the steel ABNT 4140 in the condition of having normalized. It could be proven as larger the sensibility of the hammer, adult will be the effects of the shock waves in the strain gages of the transducer.

La última palabra en dosis mínima

In this article we rewiewed the indications of the low-dose hormone replacement therapy in post menopausal women. We evaluate the effects of this therapy on menopausal symptoms bone metabolism, cardiovascular risk and endometrial cancer. The low-dose hormone replacement therapy is satisfactory to relief menopausal symptoms and improves lipid profile preventing atherosclerosis. It does not increase the risk of hyperplasia or endometrial cancer when is associate with progestagens. The low dose hormone replacement therapy is also associate to improve bone mineral density but to have better comprehension about the effective action of the low dose hormone replacement therapy on bone, more studies evaluating the risk of fractures are necessary.

Carta de Aptidão para a implantação de rodovias e avaliação de alternativas de traçado com uso de geotecnologias

This study discuss the use of the geotechnologies to aid the planners on the terrain aptness definition for highways implantation and on the different trace evaluation to the extention of the Governador Carvalho Pinto highway, between Taubaté-SP and Aparecida do Norte-SP. Fratures on the area were mapping using Landsat ETM+, band Pan. In order to elaborate the phisical aptness chart for highway implantation was used the Analitical Hierarchy Process (AHP) operation, in on geographical information system (GIS). Using GIS were realized a ponderate middle with the soils, rocks, relief, slope, fractures and land use/cover maps. Using this physical aptness chart and joinning it with urban and restrict areas (that was inserted by the Boolean operation), were obtained a viability chart for highway implantation. Based on it were proposed three aleatory traces for the Carvalho Pinto highway. This traces were evaluated with the cross tabulation operation. The integration of the restrict areas, land use and phisical aptness in digital media can offer for the planners the cartography of the viability for the highway implantation. The evaliation of these three traces, based on the viability chart, can subsidyse the decision by the planners.

Avaliação de diferentes híbridos suínos submetidos à insensibilização elétrica e gasosa (CO 2). Parte 3 - Mensurações visuais de qualidade

Three pig genetics lineages A, B and C marketed in Brazil, were stunning with the manual electric stunning (Karl Schermer 220-230/250 volts, 45-60 Hz and 1.4 - 1.5 A) and the collective gaseous system (COMBI-BUTINA 90% CO 2). The electric stunning provided higher blood splashed levels in the areas of the inside round (0.477 and 0.26, p ≤ 0.01), shoulder/cranial (0.154 and 0.039, p ≤ 0.005), shoulder/central (0.261 e 0.052, p ≤ 0.001), shoulder/caudal (0.180 and 0.030, p ≤ 0.01), loin/central (0.185 and 0.065, p ≤ 0.01), loin/caudal (0.06 and 0.207, p ≤ 0.01) and loin/lateral external (0.061 and 0.013, p ≤ 0.05), as well as more diffuse blood splashed in the areas of the inside round (0.461 and 0.279, p ≤ 0.05), shoulder/cranial (0.154 and 0.039, p ≤ 0.001), shoulder/central (0.231 and 0.039, p ≤ 0.001) and shoulder/caudal (0.185 and 0.026, p ≤ 0.001). The electric stunning also provided higher skin damage levels in the areas of the shoulder (1.098 and 0.795, p ≤ 0.001), body (1.04 and 0.948, p ≤ 0.05) and ham (0.84 and 0.68, p ≤ 0.001), as well as higher eyelid reflex levels (11.57%) comparatively to the gaseous system (2.86%) of a total of 426 pigs. Small indexes of bone fractures and muscle bruises were found in both systems.

Comparative therapeutic use of Risedronate and Calcarea phosphorica - Allopathy versus homeopathy - In bone repair in castrated rats

Osteoporosis, a disease characterized by progressive bone loss, has been the target of several studies in the past few years. It results in a much higher risk for fractures and might cause slower bone lesion healing. The aim of this work was to study the effects of Risedronate (allopathic medicine) and Calcarea phosphorica 6CH (homeopathic medicine) on the repair of bone lesions in male rats with osteoporosis induced by castration. Eighty-four three-month-old rats were used divided into four groups of twenty-one animals each. Three groups where castrated and one group was submitted to Sham surgery. One month later, cortical lesions were made in all animals' tibiae and, after one day, the different experimental treatments began according to the following groups: CR - castrated/Risedronate (1 mg/kg/day); CCp - castrated/ Calcarea phosphorica 6CH (3 drops/day); CP - castrated/placebo and SP - Sham/placebo. The animals were sacrificed at seven, fourteen and twenty-eight days after the beginning of the treatments and had their tibiae removed. Digital radiographs of the tibiae were taken and analyzed in order to evaluate the optical density of the defect area. Then, they were decalcified and processed for histological and histomorphometrical analysis. The data were submitted to ANOVA, and to the Tukey and Dunnett tests (5%). The allopathic and homeopathic treatments led to different bone formation as regards remodeling and maturation aspects. Further research is necessary to access the resistance and quality of the newly formed bone.

Etiologia e incidência das fraturas faciais em adultos e crianças: Experiência em 513 casos

Facial trauma has presented an increasing occurrence in the last four decades, due especially to the growth of accidents with automobiles as well as to the urban violence. Both of which continue being the main cause of such traumas. Aim: To evaluate the features of the population victim of facial trauma as to gender, age, occupation, origin, type of fracture and its cause. Design study: retrospective clinical with transversal cohort. Material and Method: Retrospective study consulting hospital registers of 513 patients victms of the facial trauma. Results: There was a higher incidence of facial trauma on men (84,9%), white (82,7) and with an average age of 29. Regarding occupation, the trauma was mostly occurred to students (16,6%) and Masons (11,2%). The jaw was the most affected place (35%), followed by zygoma (24%) and by the nose (23%), though most patients presented a single facial fracture (82,5%). Among the causes, accidents with automobiles (28,3%), aggressions (21%) and accidental fall s (19,5%) were the most common. Conclusions: Accidents with automobiles continue being the main cause of facial trauma, especially of multiple factures due to the great transmission of kinetic energy.

Avaliação radiográfica, densitométrica e histológica do uso de perfurações ósseas para o estímulo de consolidação de fraturas do terço distal do rádio de cães

To stimulate the bone callus development process from distal third of radius, 24 adult mongrel dogs used were from both sexes. These dogs were separated in two experimental groups of 12 animals each, named control and treated, divided in 4 moments (M1=15 days; M2=30 days; M3=45 days; M4=60 days), who underwent were performed surgical fractures. In treated group, it was performed bone perforations on proximal and distal edges, craniolateral and mediolateral to the fracture site. At the end of each moment, control and treated animals were evaluated by radiography, histology, and bone mineral densitometry (BMD) was determined on fracture site. According to the radiographic data of treated dogs, it was verified on days 15 and 30 more intense bone regeneration than control group. During M3 and M4, it wasn't detected any difference in bone reparation process betweencontrol and treated groups. In densitometric study, BMD values were greater in treated animals than in control dogs. Histological studies revealed at 15 and 30 days chondrocyte hyperplasia and initial endochondral ossification on drilled limbs; control group showed sustainment connective tissue and initial chondrocyte hiperplasia. At M3 and M4 of the treated group, were verified development and remodeling of periosteal callus in more advanced phases when comparing with limbs from control group. It can be concluded that using perforations enhances blood flow supply and activation of osteogenic cells on fracture site, stimulating the beginning of fracture consolidation process.

Comportamento do implante contendo bone morphogenetic protein (bmp) associado ao plasma rico em plaquetas na reparação de fraturas orbitárias

Purpose: This study intends to evaluate BMP (Bone Morphogenetic Protein) implant and BMP implant plus PRP (Platelet Rich Plasma) in rabbit orbital fractures, searching for tissue reaction, by radiological and morfometrical analysis. Methods:Third six white rabbits were submitted to orbital floor fracture and distributed in three groups: G1, with rabbits receiving a plate containing decalcified bone matrix and BMP; G2, with rabbits receiving the implant with BMP wrapped by PRP; G3, the control group where it was made the fracture only. The animals were evaluated radiologically after surgery and at sacrifice time in 7, 30, 90 and 180th day after surgery. After sacrifice, a block containing the right orbital tissue was extracted and prepared to morphological and morphometrical analysis. Results: An intensive linfomononuclear inflammatory reaction was observed at 7th day in G1 e G2, witch decreased after the 30th day; mesenchimal cells, osteoblasts, new bone and progressive cavitation of the implant were also observed, besides signs of calcium deposition by radiological study. In the control group fibrosis at the site of fracture was identified only. Conclusion: BMP seemed a good orbital implant producing new bone at the implant site and correcting bone defect.There was not observed acceleration of osteoinduction when the implant was associated with PRP.

Comparison between polyurethanes containing castor oil (Soft Segment) and cancellous bone autograft in the treatment of segmental bone defect induced in rabbits

The aim of this study is to compare polyurethanes containing castor oil (soft segment) in granular form compared to cancellous bone autograft applied to a segmental bone defect. Norfolk adult female rabbits - approximately 13 months of age with a mean body weight of 4.5 kg - are used. In both radial diaphyses, 1 cm osteoperiosteal segmental defects are created. The defect in the left radius is filled with the castor-oil-based polyurethane, and the right one, filled with cancellous bone autograft, collected from the left proximal humerus. The rabbits are euthanazed at 15, 30, 60, and 120 days postsurgery (5 animals/ period), for histological analyses. By radiographic analyses, at these time points, the bone regeneration is more evident and accelerated in the bone defects treated with the cancellous bone autograft. At 120 days postsurgery, the segmental bone defects treated with the cancellous bone autograft are totally reconstituted and remodeled, while the bone defects treated with polyurethane polymer have bone formation of 79%. Histological study shows that the polyurethane acts as a space filler, minimizing the local production of fibrous tissue. No granule degradation, resorption or any inflammatory reaction is detected. Thus, it is possible to conclude that the castor-oil-plant-based polyurethane - in the granule presentation - is biocompatible and osteointegrated, but does not show the same bone regeneration capacity as the cancellous bone autograft. © 2007 SAGE Publications.

Bond strength of adhesive systems to human tooth enamel

The purpose of this study was to evaluate in vitro three adhesive systems: a total etching single-component system (G1 Prime & Bond 2.1), a self-etching primer (G2 Clearfil SE Bond), and a self-etching adhesive (G3 One Up Bond F), through shear bond strength to enamel of human teeth, evaluating the type of fracture through stereomicroscopy, following the ISO guidance on adhesive testing. Thirty sound premolars were bisected mesiodistally and the buccal and lingual surfaces were embedded in acrylic resin, polished up to 600-grit sandpapers, and randomly assigned to three experimental groups (n = 20). Composite resin cylinders were added to the tested surfaces. The specimens were kept in distilled water (37°C/24 h), thermocycled for 500 cycles (5°C-55°C) and submitted to shear testing at a crosshead speed of 0.5 mm/min. The type of fracture was analyzed under stereomicroscopy and the data were submitted to Anova, Tukey and Chi-squared (5%) statistical analyses. The mean adhesive strengths were G1: 18.13 ± 6.49 MPa, (55% of resin cohesive fractures); G2: 17.12 ± 5.80 MPa (90% of adhesive fractures); and G3: 10.47 ± 3.14 MPa (85% of adhesive fractures). In terms of bond strength, there were no significant differences between G1 and G2, and G3 was significantly different from the other groups. G1 presented a different type of fracture from that of G2 and G3. In conclusion, although the total etching and self-etching systems presented similar shear bond strength values, the types of fracture presented by them were different, which can have clinical implications.

Prevalence of dental trauma in patients with cerebral palsy

This study presents the findings of a record review that evaluated the prevalence of dental trauma in patients with cerebral palsy and evaluated its possible relationship with age, type of palsy, and epilepsy. The dental records of 2,200 patients with special needs admitted to the special care clinic of the School of Dentistry of Araçatuba/UNESP, Brazil, between 1998 and 2003 were reviewed. Of the records that were analyzed, 500 patients who had cerebral palsy were selected for this study. Information regarding age, gender, type of palsy and dental trauma was collected and statistically analyzed. It was observed that 10.6% of the subjects (n = 53) had sustained dental trauma. The number of traumatized teeth was 84. Enamel or enamel/dentin fractures were the most frequent types of traumatic injury (84.9%). The permanent maxillary central incisors were the most commonly affected teeth (50%). The frequency of traumatic injuries showed no significant correlation (p>.05) with the type of cerebral palsy or gender and they were more frequent in subjects between the ages of 0 and 12 years. Having epilepsy was not a statistically significant risk factor (p>.05) for dental trauma. © 2008 Special Care Dentistry.

BMP implant associated with platelet-rich plasma in orbit fracture repair

Purpose: To evaluate a bone morphogenetic protein (BMP) implant with and without platelet-rich plasma (PRP), which is supposed to accelerate fracture consolidation in the orbit fracture treatment. Methods: Thirty-six white rabbits were subjected to orbital fracture and treated in three groups: BMP implant fracture repair (G1), BMP plus PRP implant fracture repair (G2), and fracture and spontaneous repair (G3). The animals were sacrificed at 7, 30, 90, and 180 days after surgery. A radiology evaluation was carried out on the 7th day after the fracture and at the sacrifice moments. After the animals' death, the orbital content material was removed and prepared for morphological and morphometric analysis. Results: Radiology suggested intramembranous and progressive cavitation and ossification without a reduction in implant size and with signs of calcium deposition; these events were confirmed by histological analysis, which showed a lymphomononuclear inflammatory reaction in G1 and G2, more intense 7 days after surgery and reducing after 30 days. Associating PRP with BMP did not accelerate bone induction. Conclusion: BMP implant promotes bone induction, integration at fracture site, scarce inflammatory reaction, and may be a good alternative in orbit fracture reconstruction. The addition of PRP to the BMP plate did not accelerate the resolution, and its use is not necessary. Copyright © Informa Healthcare USA, Inc.