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- Importance of a National arthroplasty register for Identification by medical examinerPublication . Durão, C; Pinto, R; Ribeiro, C; Vieira, D
- Aspectos forenses das lesões ortopédicas nos atropelamentosPublication . Durão, C; Lucas, FM; Vieira, DN
- Knee glomangioma: a rare location for a glomus tumorPublication . Gonçalves, R; Lopes, A; Júlio, C; Durão, C; Andrade de Mello, RGlomus tumor is a rare, benign neoplasm rising from the glomus apparatus of the skin. It occurs most frequently on fingers and toes and accounts for 1.6% of all soft tissue tumors. Clinical diagnosis may prove difficult if the tumor occurs on an extra digital location. We report a case of a vascular-type glomus tumor(glomangioma) found in an atypical location,namely the lateral aspect of the knee joint.
- Lesões típicas e seus epônimos em balística forensePublication . Durão, C; Salles Machado, MPOs epônimos são parte da história da Medicina e representam, sobretudo, uma homenagem aos pioneiros na descrição de um sinal, doença, técnica, manobra ou estrutura anatômica. Este trabalho tem como objetivo revisar a literatura médico-legal clássica e apresentar epônimos referentes aos resultados mais significativos da balística terminal. Os epônimos podem facilitar a comunicação entre os peritos, encurtando a descrição, mas não deve ser utilizado em relatórios que irão ser lido por leigos, uma vez que o seu uso neste caso, poderia conduzir à confusão de termos.
- Homicide, Suicide or Accident? The Importance of Forensic Autopsy in a Case of “Cafe Coronary Syndrome”Publication . Durão, C; Carpinteiro, DDetermining the cause of death and its forensic etiology is crucial in forensic investigation. The autopsy should clarify and elucidate the Court in its decisions. Suicide may be ground for exclusion in insurance and in certain contracts doubles the amount paid in cases of homicide or accidents opposing natural death. This paper presents a case of death by asphyxiation as the result of an accident where an altered state of consciousness of a drunken victim made him choke with a whole steak. “Cafe Brazilian Journal of Forensic Sciences, Medical Law and Bioethics 4(3):332-336 (2015) 333 C. H. Durão & D. Capinteiro coronary” was term coined by Haugen in 1963 for sudden and unexpected death occurring during a meal due to accidental occlusion of the airway by food. It were excluded the possibilities of murder and suicide, which hitherto existed. The case provides good documentation and particular medical legal interest, confirming the importance of the autopsy and the opening of all wells, including observation of the neck organs.
- Primary Total Elbow Arthroplasty in the Treatment of Complex Elbow Fracture: A Case ReportPublication . Campos, PM; Rosa, B; Barros, A; Durão, C; Magalhães, G; Júlio, C; Quinaz-Neto, PIntroduction: Some elbow fractures are very complex with inadequate bone stock, so it is not possible to perform a stable fixation. However, loss of basic elbow function can severely affect daily living activities. There are few alternatives to internal fixation, but arthroplasty can be a reasonable option. The aim of this case report is to evaluate the role of primary total elbow arthroplasty in the treatment of complex elbow fractures. Case study: A 54-year-old male patient presented at our emergency department in the sequence of a motorcycle accident, which caused an open fracture of the left elbow, classified as type IIIB of Gustilo and Anderson. The X-ray showed comminuted fractures of distal humerus and proximal ulna with bone loss from both epiphysis. He started antibiotherapy and was submitted to immediate surgical debridement, provisional fixation with an external fixator and skin closure. The external fixator was removed 2 months after, when the patient presented with great elbow instability. The X-ray and the Computed Tomography showed signals of malunion and bone loss, which prevented any kind of fixation. Therefore, 3 months after, the patient was submitted to elbow joint replacement. A posterior approach was used, in which the triceps was reflected and was applied a linked arthroplasty - Coonrad-Morrey total elbow arthroplasty. On the second week after surgery, passive motion was started and by the fourth week, progressed to active motion. Six months after, he presented without significant pain and with a range of motion of 0° to 135º. Conclusions: Although rarely used, total elbow arthroplasty may be the choice in selected patients with elbow fractures with loss of bone. As shown in this case, this treatment can lead to a satisfactory functional recovery. Despite having some complications, more recent studies encourage its use in the future.
- Enlarged parietal foramina: a rare forensic autopsy findingPublication . Durão, C; Carpinteiro, D; Pedrosa, F; Machado, MP; Cunha, EEnlarged parietal foramina (EPF) are a quite rare developmental defect of the parietal bone which has to be distinguished from the normal small parietal foramina. We report a forensic case of an individual found in an advanced state of putrefaction in his own house with an undetermined cause of death. No evidence of trauma was observed, and the toxicological exam was negative. The victim was a 40-year-old man with a history of epilepsy. The large biparietal foramina, a rare anatomical variation and unusual autopsy finding, were observed at autopsy. The recognition of anatomical variations is important to avoid false interpretations and conclusions and has a significant potential as an identity factor, thus contributing to positive identification.
- Simulação, dissimulação e exagero: desafios da perícia médica em ortopedia e traumatologiaPublication . Durão, C; Lucas, FA relação médico doente é uma interação que envolve confiança e responsabilidade. É caracterizada por compromissos e deveres dos intervenientes, ambos motivados na sincera busca terapêutica. O médico, enquanto assistencialista, norteia-se nos sinais e sintomas descritos pelo doente no estabelecimento de um diagnóstico para a melhor terapêutica, onde os conflitos de interesse, são a exceção. Já o médico enquanto perito, pauta o seu trabalho na perícia médica, na busca do diagnóstico preciso, na valoração das lesões e sequelas, tendo como norma o conflito de interesse, onde o litígio é a regra. É no exercício médico-legal de qualquer especialidade, que o médico se confronta com a simulação, a dissimulação ou tão simplesmente o exagero. É necessário conhecer muito bem o estado da arte da simulação, para que o médico enquanto perito, a possa reconhecer, não se permitindo influenciar no exercício da sua prática pericial.
- InterInterpretação das lesões ortopédicas dos ocupantes dos veículos na reconstrução forense dos acidentes de viaçãoPublication . Durão, C; Lucas, FMRoad Traffic accidents are the leading cause of violent death and a major cause of death and sequelae in young and economically active population in developed and developing countries. Numbers that can only be compared to wars, which exemplifies the consequences of these lesions in economic and social terms. In 2002, about 1.2 million people died in traffic accidents, and in 2020, it is estimated that this number will double according to the World Health Organization (WHO). Only a small percentage of these are generated by vehicle faults or adverse conditions. The vast majority of accidents are caused by carelessness, negligence or malpractice of drivers or pedestrians, which makes the reconstruction of accidents a key step in the investigation and prevention of further accidents.
- Primary Total Elbow Arthroplasty in the Treatment of Complex Elbow Fracture: A Case ReportPublication . Campos, PM; Rosa, B; Barros, A; Durão, C; Magalhães, G; Júlio, C; Quinaz-Neto, PIntroduction: Some elbow fractures are very complex with inadequate bone stock, so it is not possible to perform a stable fixation. However, loss of basic elbow function can severely affect daily living activities. There are few alternatives to internal fixation, but arthroplasty can be a reasonable option. The aim of this case report is to evaluate the role of primary total elbow arthroplasty in the treatment of complex elbow fractures. Case study: A 54-year-old male patient presented at our emergency department in the sequence of a motorcycle accident, which caused an open fracture of the left elbow, classified as type IIIB of Gustilo and Anderson. The X-ray showed comminuted fractures of distal humerus and proximal ulna with bone loss from both epiphysis. He started antibiotherapy and was submitted to immediate surgical debridement, provisional fixation with an external fixator and skin closure. The external fixator was removed 2 months after, when the patient presented with great elbow instability. The X-ray and the Computed Tomography showed signals of malunion and bone loss, which prevented any kind of fixation. Therefore, 3 months after, the patient was submitted to elbow joint replacement. A posterior approach was used, in which the triceps was reflected and was applied a linked arthroplasty - Coonrad-Morrey total elbow arthroplasty. On the second week after surgery, passive motion was started and by the fourth week, progressed to active motion. Six months after, he presented without significant pain and with a range of motion of 0° to 135º. Conclusions: Although rarely used, total elbow arthroplasty may be the choice in selected patients with elbow fractures with loss of bone. As shown in this case, this treatment can lead to a satisfactory functional recovery. Despite having some complications, more recent studies encourage its use in the future.