Browsing by Author "Sapage, Rita"
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- Difficult diagnosis of a neurogenic thoracic outlet syndrome and review of the current literaturePublication . Rosa, Joao Maia; Sousa, Arnaldo; Fonte, Helder; Campos Pereira, Eva; Sapage, Rita; Trigueiros, MiguelThoracic outlet syndrome (TOS) is an uncommon disorder, without a clear clinical presentation or a fully accepted definition. The patients usually present a set of symptoms arising from compression of the brachial plexus or subclavian vessels during their passage through the thorax, between the base of the cervical region and the axilla. The authors present a case of a 20 year old woman with sporadic paresthesia in the territory of C7-T1 nerve root. At the physical examination she had a positive Wright's test. The imaging studies revealed the presence of a right cervical rib. A partial rib resection was performed with exploration of the braquial plexus and at the current follow up; 24 months after the surgery, the patient is asymptomatic. Our objective is to present a case of TOS and to highlight the clinical-management and treatment challenges of this pathology.
- Free Non-vascularized Toe Phalangeal Transfers in Symbrachydactyly: Outcome AnalysisPublication . Sapage, Rita; Rosa, João; Campos Pereira, Eva; Silva, Marta Santos; Pereira, Alexandre; Silva, CésarFree nonvascularized toe phalangeal transfer is an established surgical option for the reconstruction of hypoplastic digits. The purpose of the present study was to evaluate our experience with this procedure and to assess bone growth and digit function as well foot morbidity. Material and Methods We retrospectively evaluated the clinical records for all children with symbrachydactyly submitted to free nonvascularized toe phalangeal transfer between 2002 and 2017. A total of 8 patients were included. We summoned the patients to na appointment to clinically assess the range ofmotion, the stability, and the alignment of the neo-joint. We radiographically measured the final length and the expected percentage of growth of the transferred phalanx. We also evaluated the foot for comorbidities. Results The mean age at the time of the first surgery was 19 months (range: 8–42 months). A total of 20 phalanges were harvested: 16 total proximal phalanges, 2 middle phalanges, 1 subtotal proximal phalanx, and 1 accessory thumb phalanx. The distal part of one proximal phalanx was trimmed because the skin pocket was too tight. Two patients underwent a secondary procedure to release the syndactyly. One transfer required revision surgery due to distal tip necrosis and exposition of the transferred phalanx. In the present series, the overall clinical and radiographic outcomes were compatible to those reported in other studies. Discussion The main limitation of the nonvascularized toe phalanx transfer is the preexisting soft tissue envelope of the finger and the limited growth potential of the transferred bone. Conclusion Irrespective of the amount of growth achieved in the transferred phalanx, the actual transfer and growth attained should not be viewed as the end result, but rather as a means of providing a stable and functional joint.
- The rare isolated adult Chaput-Tillaux fracture: two case reports and review of the literaturePublication . Campos Pereira, Eva; Rosa, João Maia; Diniz, Sara Elisa; Pereira, Filipa; Sapage, Rita; Soares, Daniel; Costa, LuisThe authors present two isolated chaput-tillaux fractures in an adult skeleton. A high level of suspicion is required to prevent diagnostic failure. Computerized tomography scan detects hidden fractures and enables a more detailed preoperative assessment of each case. Most of the cases reported in the literature are associated with other ankle lesions. This typical juvenile pattern is rare in the adults and ideal treatment is yet to be determined.