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- Ainda Existe Espaço para o Tratamento Conservador nas Fraturas Complexas da Diáfise do Úmero?Publication . Durão, C; Ramos, JAs fraturas da diáfise do úmero representam cerca de 1 a 3% de todas as fraturas, e cerca de 20% das fraturas umerais. A maioria das fraturas da diáfise do úmero, nomeadamente as oblíquas longas e as cominutivas, pode ser tratada conservadoramente, porém a tendência atual vai no sentido do tratamento cirúrgico, mesmo nas fraturas que se obtinham bons resultados com o tratamento não cirúrgico. O presente trabalho descreve o bom resultado diante de um tratamento conservador numa fratura diafisária complexa do úmero, demonstrando ainda existir espaço para o tratamento não cirúrgico, e discute a importância da relação médico-doente diante diversas opções terapêuticas.
- Arthroscopic-Assisted Acromioclavicular Joint Dislocation Repair: A Modified Technique for Horizontal Stabilization Using Suture AnchorsPublication . Teixeira Ramos, Jorge; Silva Gomes, Diogo; Quinaz Neto, Pedro; Sarmento, Marco; Moura, Nuno; Cartucho, AntónioAcromioclavicular (AC) dislocation is a common lesion often resulting from a sports injury. Nowadays, treatment is still controversial mainly in grade III lesions according to the Rockwood classification. For most surgically treated AC acute dislocations, treatment is performed with an arthroscopic procedure that anatomically reconstructs the coracoclavicular ligaments. Increasing knowledge about AC joint biomechanics has underlined the importance of its horizontal stability through the superior and inferior AC ligaments. Moreover, the pattern of lesion tends to repeat itself, with the superior AC ligament being torn most frequently from the clavicular side in a peeling fashion. Therefore, the purpose of this note is to describe the technical aspects of additional horizontal stability through superior AC ligament repair using suture anchors.
- Aspectos forenses das lesões ortopédicas nos atropelamentosPublication . Durão, C; Lucas, FM; Vieira, DN
- "Death by a thread" - Peritonitis due to visceral perforation by a guide wire, during proximal femur osteosynthesis with DHS: A fatal case and legal implications.Publication . Durão, C; Barros, A; Guerreiro, R; Pedrosa, FIatrogenic intestinal perforations in orthopaedic surgery are very rare. Reports of iatrogenic lesions caused by a guide wire during femur fracture osteosynthesis are even scarcer. There are no similar reports in recent literature. As opposed to what is normally described the lesion documented in this case report was not identified on time resulting in death by peritonitis. The forensic autopsy allowed the identification of an intestinal perforation with faecal leakage to peritoneal space in association with a vesical perforation enabling the reproduction of the guide wire path. In view of the increasing number of osteosynthesis it is essential for the surgeon to be aware of possible complications due to guide wire perforations. Cases like this go unnoticed if the forensic pathologist is not familiarized with the surgical technique which may explain the rarity of such descriptions in literature.
- Death by chumbinho: aldicarb intoxication—regarding a corpse in decompositionPublication . Durão, C; Machado, MPChumbinho is the popular name given to carbamate aldicarb (Temik), an insecticide commonly used in agriculture and highly toxic (LD50 = 0.9 mg/kg oral in rats) that has been sold clandestinely in several regions of Brazil. Chumbinho is sold illegally as raticide and is available in a formulation of small black granules which are easily mixed with food for criminal purposes, its use often being attributed to accidents and suicides, hence the importance of its inclusion in the toxicology studies of suspicious deaths. With the corpse putrefaction, many pathological and toxicological anatomical parameters are damaged or lost. This study emphasizes the importance of the gastric content observation, which in this case has, despite the advanced putrefaction, recognized the presence of chumbinho and guide its toxicological confirmation.
- Death in the ‘‘microwave oven’’: A form of execution by carbonizationPublication . Durão, C; Machado, MP; Daruge Júnior, E
- 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.
- Ethical and Legal Dictates in the Doctor's Relationship with Social Networks: How Many "Likes" do I Deserve?Publication . Durão, C; Braz Lamarca, RC
- A fatal case by a suicide kit containing sodium nitrite ordered on the internetPublication . Durão, C; Pedrosa, F; Dinis-Oliveira, RJFatal sodium nitrite poisonings are rare in the forensic context. The present work describes a first fatal case of sodium nitrite contained in a suicide kit that the victim acquired over the internet. The results of the autopsy showed general signs of asphyxia, such as intense cyanosis of the extremities, brown-gray-blue-red livor mortis, and some Tardieu petechiae in addition to intense visceral congestion. It is clear that forensic experts must be aware of the proliferation of this market and the risks of improper selling of these substances through suicide support networks available on the internet. The lack of knowledge of this reality may become unidentifiable, when toxicological analysis contemplates only the most classical and frequent substances involved in poisoning and reinforce the importance of a careful analysis of the death scene.
- Flagrant of a Clavicle Fracture as Bullfight InjuryPublication . Durão, Carlos; Ramos, JorgeThe Vila Franca de Xira Hospital is located in the region with the highest number of festivals and bullfighting activities of Portugal. As a natural consequence, the hospital ends up with a particular experience in the treatment of victims of bullfighting accidents. These are usually common people harvested in street celebrations during the traditional festivals of the region, but also workers such as cattle herders, foremen, ranchers and others who handle the wild cattle and in particular those who deal with the bulls, such as forcados, banderilleros, matadors and cavaleiros. Although we may refer the perforating injuries generated by the horns of bulls, the most frequent injuries are the blunt ones, among them bruises and fractures of the limbs. This work shows the typical striking of a bull horn, showing the violence of the trauma in bullfighting accidents, which in this case resulted only on the fracture of the clavicle from the member hit in the fall.