{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T11:59:16Z","timestamp":1790769556199,"version":"4.1.0"},"reference-count":30,"publisher":"Georg Thieme Verlag KG","issue":"05","license":[{"start":{"date-parts":[[2022,7,6]],"date-time":"2022-07-06T00:00:00Z","timestamp":1657065600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Rev Bras Ortop (Sao Paulo)"],"published-print":{"date-parts":[[2022,10]]},"abstract":"<jats:title>Resumo<\/jats:title><jats:p>\n          Objetivo\u2003Analisar a incid\u00eancia da necrose avascular da ep\u00edfise no tratamento do escorregamento da ep\u00edfise proximal do f\u00eamur pela t\u00e9cnica de Dunn modificada, correlacionando-a com outras vari\u00e1veis. Como objetivo secund\u00e1rio, descrevemos outras complica\u00e7\u00f5es encontradas.<\/jats:p><jats:p>\n          M\u00e9todos\u2003Estudo retrospectivo com 20 pacientes tratados entre 2009 e 2019, com seguimento de 2 a 12 anos, tratados pela mesma equipe cir\u00fargica. A an\u00e1lise incluiu caracter\u00edsticas gerais, tempo entre apresenta\u00e7\u00e3o e procedimento cir\u00fargico, classifica\u00e7\u00e3o, presen\u00e7a de perfus\u00e3o sangu\u00ednea intraoperat\u00f3ria da ep\u00edfise, avalia\u00e7\u00e3o das complica\u00e7\u00f5es e seus respectivos tratamentos.<\/jats:p><jats:p>\n          Resultados\u2003Todos os casos eram graves, 65% cr\u00f4nicos agudizados e 55% dos escorregamentos eram inst\u00e1veis. Nossa taxa de complica\u00e7\u00f5es foi de 45%, sendo 5 casos de necrose avascular, 2 de infec\u00e7\u00e3o profunda, uma falha do material e uma instabilidade articular. Pacientes operados com maior tempo ap\u00f3s a interna\u00e7\u00e3o e os sem perfus\u00e3o intraoperat\u00f3ria da ep\u00edfise tiveram maior risco de necrose na an\u00e1lise estat\u00edstica. Considerando o tempo do estudo, tivemos 4 casos de necrose nos primeiros 5 anos e 1 caso nos \u00faltimos 5 anos.<\/jats:p><jats:p>\n          Conclus\u00e3o\u2003Nosso estudo demonstrou que a necrose foi a complica\u00e7\u00e3o mais comum e que o atraso para a realiza\u00e7\u00e3o da cirurgia e a aus\u00eancia de perfus\u00e3o da ep\u00edfise no intraoperat\u00f3rio podem predispor \u00e0 necrose avascular. Embora n\u00e3o estatisticamente significante, a instabilidade coxofemoral foi observada na forma de apresenta\u00e7\u00e3o cr\u00f4nica e a fixa\u00e7\u00e3o cir\u00fargica com fios rosqueados se mostrou menos eficaz que a fixa\u00e7\u00e3o com parafuso canulado.<\/jats:p><jats:p>Este procedimento deve ser reservado para casos graves nos quais outras t\u00e9cnicas n\u00e3o sejam poss\u00edveis e realizado por equipe experiente, treinada e capacitada.<\/jats:p>","DOI":"10.1055\/s-0042-1744499","type":"journal-article","created":{"date-parts":[[2022,7,6]],"date-time":"2022-07-06T22:50:55Z","timestamp":1657147855000},"page":"807-814","source":"Crossref","is-referenced-by-count":1,"title":["Necrose avascular p\u00f3s-cirurgia de Dunn modificada no tratamento do escorregamento da ep\u00edfise proximal do f\u00eamur*"],"prefix":"10.1055","volume":"57","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7358-819X","authenticated-orcid":false,"given":"Weverley","family":"Valenza","sequence":"additional","affiliation":[{"name":"Departamento de Ortopedia e Traumatologia do Hospital do Trabalhador, Curitiba, PR, Brasil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9448-7352","authenticated-orcid":false,"given":"Jamil","family":"Soni","sequence":"additional","affiliation":[{"name":"Departamento de Ortopedia e Traumatologia do Hospital do Trabalhador, Curitiba, PR, Brasil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0334-3151","authenticated-orcid":false,"given":"La\u00eds","family":"Przysiada","sequence":"additional","affiliation":[{"name":"Departamento de Ortopedia e Traumatologia do Hospital do Trabalhador, Curitiba, PR, Brasil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8947-236X","authenticated-orcid":false,"given":"Helo\u00edsa","family":"Faggion","sequence":"additional","affiliation":[{"name":"Departamento de Ortopedia e Traumatologia do Hospital do Trabalhador, Curitiba, PR, Brasil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2022,7,6]]},"reference":[{"issue":"03","key":"ref1","doi-asserted-by":"crossref","first-page":"286","DOI":"10.1097\/01.bpo.0000217718.10728.70","article-title":"The epidemiology of slipped capital femoral epiphysis: an update","volume":"26","author":"C L Lehmann","year":"2006","journal-title":"J Pediatr Orthop"},{"issue":"12","key":"ref2","doi-asserted-by":"crossref","first-page":"666","DOI":"10.5435\/00124635-200611000-00010","article-title":"Slipped capital femoral epiphysis: current concepts","volume":"14","author":"D D Aronsson","year":"2006","journal-title":"J 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