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Introduction: our aim was to evaluate the clinical outcomes and complications of anterior tibialis tendon transfer (ATTT) in children with dynamic supination after clubfoot treatment., Material and Methods: children with dynamic supination after initial treatment with Ponseti method or surgery who underwent ATTT between 2008 and 2020 were included for evaluation. Demographic data, previous treatment, associated procedures and fixation method were analyzed. Functional results were evaluated with the grading system described by Thompson. Complications and their treatment were analyzed., Results: a total of 39 patients (57 feet) were analyzed. 70% received previous treatment with Ponseti method, 19.3% underwent surgical posteromedial release, and 10.7% another type of surgical treatment. 88% of cases required associated procedures including Achilles tendon lengthening or tenotomy, plantar fasciotomy, tibial osteotomy, lateral column shortening, posterior release. The predominant type of fixation was the pull-out button method (96.5%). The average follow-up was 31.5 months. According to the Thompson grading system, 52 patients presented good results, two fair and three poor. 98.2% of the feet showed active contraction of the transferred tibialis anterior tendon. There were four complications: plantar irritation, synovial cyst in the dorsum of the foot and deep infection. Two feet required unplanned surgery., Conclusion: anterior tibialis tendon transfer is an effective technique to correct residual dynamic supination in patients with clubfoot.

OBJETIVO: o manejo das fraturas toracolombares estáveis é controverso, especialmente em pacientes sem déficit funcional. Este estudo questiona o motivo de ser realizada uma avaliação das imagens apenas na posição supina, uma vez que, paradoxalmente, o tratamento conservador inclui o ortostatismo precoce. O propósito deste estudo é determinar se a realização de radiografias em posição ortostática influencia na definição do tratamento dos pacientes com fraturas torácicas e lombares classificadas como tipo "A" da AO-ASIF. MÉTODOS: de janeiro de 2007 a novembro de 2008, foram avaliados pacientes portadores de fraturas torácicas e lombares por meio de radiografias em decúbito e tomografia computadorizada, visando identificar sinais de instabilidade. As fraturas classificadas radiograficamente como tipo "A" da AO-ASIF, inicialmente por tratamento conservador, foram submetidas à realização de radiografias em ortostatismo sem o colete ortótico na fase aguda e seus parâmetros radiológicos foram reavaliados. RESULTADOS: foram incluídos neste estudo 59 pacientes com fraturas toracolombares estáveis (T11 a L4), e todos toleraram o exame. A cifose vertebral aumentou 46,8%. O colapso anterior aumentou 15,52%. Três destes pacientes (5,1%) receberam a indicação cirúrgica após radiografias em ortostatismo por apresentarem critérios de instabilidade. CONCLUSÕES: a realização das radiografias em ortostatismo mostrou-se eficiente na identificação de pacientes com instabilidade ainda não manifesta e capaz de predizer a evolução satisfatória durante o tratamento conservador, além de ser um exame diagnóstico seguro, de fácil aplicabilidade e com baixo custo. Neste estudo, um total de 5,1% dos pacientes tiveram seu tratamento conservador alterado para o cirúrgico.OBJETIVO: el manejo de las fracturas toraco-lumbares estables es controvertido, especialmente en pacientes sin déficit funcional. Este estudio cuestiona el motivo por realizarse una evaluación de las imágenes apenas en la posición supina, una vez que paradoxalmente el tratamiento conservador incluye el ortatismo precoz. El propósito de este estudio es determinar si la realización de radiografías en posición ortostática influye en la definición del tratamiento de los pacientes con fracturas torácicas y lumbares, clasificadas como tipo "A" de la AO-ASIF. MÉTODOS: de enero de 2007 a noviembre de 2008 fueron evaluados pacientes portadores de fracturas torácicas y lumbares, por medio de radiografías en decúbito y tomografía computarizada, visando identificar señales de inestabilidad. Las fracturas clasificadas radiográficamente como tipo "A" de la AO-ASIF, inicialmente de tratamiento conservador, fueron sometidas a la realización de radiografías en ortostatismo sin chaleco ortótico, en la fase aguda, y sus parámetros radiológicos fueron reevaluados. RESULTADOS: fueron incluidos en este estudio 59 pacientes con fracturas torácicas y lumbares estables (T11 a L4). Todos los pacientes toleraron el examen. La cifosis vertebral aumentó 46.8%. El colapso anterior aumentó 15.56%. Tres de estos pacientes (5.1%) recibieron la indicación quirúrgica después de las radiografías en ortostatismo, ya que criterios de inestabilidad fueron reconocidos. CONCLUSIONES: la realización de las radiografías en ortostatismo mostró eficiencia en la identificación de pacientes con inestabilidad, aun no manifiesta, y capaz de predecir la evolución satisfactoria durante el tratamiento conservador, además de ser un examen de diagnóstico seguro, fácil aplicabilidad y bajo costo. En este estudio, un total de 5.1% tuvo un tratamiento conservador alterado para el quirúrgico.OBJECTIVE: the management of stable thoracolumbar fractures is controversial, especially in patients without functional deficits. This study questions the reason of doing images study only in supine position since, paradoxically, nonoperative treatment includes early orthostatism. The purpose of this study is to determine the influence of weight-bearing radiographs on defining the treatment of patients with thoracolumbar fractures classified as type "A" of AO-ASIF. METHODS: from January 2007 to November 2008, patients with thoracolumbar fractures were evaluated by radiographs in supine position and computed tomography to identify signs of instability. Fractures classified radiographically as type "A" of AO-ASIF, initially treated with nonoperative care, were submitted to weight-bearing radiographs without bracing in acute phase and their radiographic parameters were re-evaluated. RESULTS: 59 patients with stable thoracolumbar fractures (T11 to L4) were included in this study,and all of them tolerated the weight-bearing radiographs. The vertebral kyphosis increased 46.8%. The anterior collapse increased 15.52%. Three of these patients (5.1%) were submitted to surgical treatment after weight-bearing radiographs due to instability criteria. CONCLUSIONS: weight-bearing radiographs were efficient in identifying patients with instability not established yet. This exam is able to predict the satisfactory evolution during the nonoperative treatment and it is a safe and low cost diagnostic examination with easy applicability. In this study, a total of 5.1% of the patients had their treatment changed from conservative to surgical.

ResumenLos desplazamientos laterales son de gran importancia en el tenis. Sin embargo, no ha sido publicado ningún estudio sobre el efecto del calzado sobre el rendimiento en este tipo de movimientos. En el estudio participaron 5 jugadores habituales de tenis y se analizaron 10 calzados comerciales de tenis. El movimiento estudiado consistió en un desplazamiento lateral con parada y cambio de sentido, registrándose las fuerzas mediante una plataforma dinamométrica Dinascan-IBV y grabándose el movimiento con dos cámaras de vídeo S-VHS Panasonic WV-BL600. Los resultados de los ANOVAs realizados mostraron que algunas de las variables analizadas eran dependientes del calzado (p < 0.05). De éstas, destacan (1) la supinación máxima de la subastragalina y (2) el tiempo de apoyo. Se detectaron varias correlaciones (Pearson) significativas (p < 0.05) de especial relevancia, destacando la correlación positiva entre el tiempo de apoyo con los máximos de supinación. Como el impulso mecánico no se ha visto afectado por el calzado, esto indica que el calzado que limita la supinación permite realizar el movimiento analizado en un menor tiempo.Abstract Sideward cutting movements are very important in tennis. However, no studies on their effect on performance have been published. 5 tennis players (age 21.5 ± 0.8, weight 75.2 ± 2.8 kg, height, 1.78 ± 0.05 m) participated in the study on a voluntary basis and 10 tennis shoes were analysed. Subjects perform a sideward cutting movement. An extensometric force plate (Dinascan-IBV) was used to record the kinetic variables and 2 video cameras (Panasonic-WV-BL600) were utilized for the kinematic variables. ANOVA results showed several variables as shoe-dependent (p < 0.05), among these stands out (1) rearfoot supination movement and (2) contact time. Moreover these variables were positively correlated (p < 0.05). As mechanical impulse was not change, this means that shoes that limit supination allow perform sideward cutting movements faster.

Introduction: Painful pronation (PD), also known as "nursemaid's elbow", is a common injury caused by abrupt longitudinal traction of the hand while the forearm is pronated and the elbow extended., Objective: to describe a sample of patients diagnosed with painful pronation and the different reduction tech niques used for this pathology., Patients and Method: retrospective study of patients who visited the emergency department of a referral hospital, from January 2018 to September 2019. Patients under 7 years of age consulting due to a condition compatible with PD were included. We recorded demogra phic data, sex, and age, number of previous episodes (defining recurrent as three or more episodes), affected extremity, mechanism of injury, diagnostic images, reduction maneuver used, and success obtained measured through the presence of "click" and decrease in pain. Patients who presented any sign of trauma or fractures were excluded from the study., Results: 172 patients were included, 57.6% were female, and a median age of 25.5 months. The most affected side was the left one and the main mechanism was traction of the extremity, followed by a same-level fall. The hyperpronation method was effective in 66% of the cases, and the remaining 34% required a supination maneuver., Conclusions: PD is a frequent reason for consultation in pediatric patients around the age of 2 years. The hyperpronation method was the most commonly used for its management. It is important to be aware of this pathology in the context of emergency care.

Objective: Musculoskeletal disorders, particularly carpal tunnel syndrome, have been one of the most important public health problems during recent years. It is the leading cause of occupational morbidity in Colombia, the flower industry being one of the areas of work having the highest incidence. This study was thus aimed at ascertaining whether flower-cutters' strength of apprehension has been affected by cutting height and arm posture., Method: The study involved 12 operating personnel; a 22 factorial arrangement was used and the effect of cutting height and posture on forearm pronation or supination ans the factors influencing the strength of apprehension., Results: Statistical analysis showed no interaction between the factors; however, it did reveal a significant effect on the strength of apprehension. Varying how the arm bent had a greater effect than changing the position of the forearm (pronation or supination)., Conclusions: Pronation was the ideal flower-cutting posture because it involved less effort to perform such task. Further research should examine the effects of wrist deviation angle in the flower industry.