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- Uso de protetor solar nos adolescentes Portugueses: conceitos e preconceitosPublication . Pinheiro-Torres, J; Macedo, J; Abreu, N; Moura, DL
- Why are Diverticula of the Rectum Uncommon? Angiomorphological HypothesisPublication . Bernardes, A; Melo, C; Moura, DL; Pinheiro, S
- Sinovite vilonodular pigmentada do joelho. Tratamento da recidivaPublication . Farinha-Martins, P; Moura, DL; Freitas, JP; Casanova, JOs autores apresentam um raro caso de Sinovite Vilonodular Pigmentada do joelho, difusa, recidivada numa paciente jovem, com grave repercussão nas suas atividades diárias. Houve a necessidade de efetuar um tratamento localmente agressivo, com substituição total da articulação do joelho utilizando componentes de revisão. O tratamento revelou-se eficaz sob ponto de vista clínico e funcional
- Subacute L5 Paresis Following a Capoeira PresentationPublication . Marques, JP; Moura, DL; Cordeiro, A; Páscoa-Pinheiro, JA young female suffered minor low back trauma during a capoeira presentation. She was initially diagnosed with an acute episode of uncomplicated low back and radicular pain. She kept training and competing until developing paresthesia and weakness of the right leg six weeks later. Physical examination revealed sensory and motor deficits compatible with L5 nerve root compression. The MRI revealed an L5-S1 disc extrusion compressing the right L5 nerve root. Nerve root decompression and partial discectomy were performed, and seven months later she was competing without restrictions. We present our approach and discuss possible pathological mechanisms that may explain this unusual presentation.
- Treatment of Pathological Humerus-Shaft Tumoral Fractures with Rigid Static Interlocking Intramedullary Nail-22 Years of ExperiencePublication . Moura, DL; Alves, F; Fonseca, R; Freitas, J; Casanova, JObjective This was a retrospective observational study in patients submitted to intramedullary nail fixation after established or impeding pathological humerus-shaft tumoral fracture in the context of disseminated tumoral disease along 22 years of experience at the same institution. Methods Sample with 82 patients and 86 humeral fixations with unreamed rigid interlocking static intramedullary nail by the antegrade or retrograde approaches. Results The most prevalent primary tumors were breast carcinoma (30.49%), multiple myeloma (24.39%), lung adenocarcinoma (8.54%), and renal cell carcinoma (6.10%). The average surgical time was 90.16 ± 42.98 minutes (40-135 minutes). All of the patients reported improvement in arm pain and the mean Musculoskeletal Tumor Society (MSTS) score rose from 26% in the preoperative period to 72.6% in the evaluation performed in patients still alive 3 months after the surgery. The overall survival was 69.50% 3 months after the surgery, 56.10% at 6 months, 26.70% at 1 year, and 11.90% at 2 years. No death was related to the surgery or its complications. There were only 4 surgery-related complications, 1 intraoperative and 3 late, corresponding to a 4.65% complication risk. Conclusion Closed unreamed static interlocking intramedullary nailing (both in the antegrade or retrograde approaches) of the humerus is a fast, safe, effective, and low morbidity procedure to treat pathological fractures of the humerus shaft, assuring a stable arm fixation and consequently improving function and quality of life in these patients during their short life expectation.
- Síndrome do osso trígonoPublication . Moura, DLThe most frequent cause of posterior ankle impingement syndrome involves the os trigonum and the talar process, being called os trigonum syndrome to the symptomatic soft tissue and bone compression at the tibiocalcaneal interval. It is a controversial entity, currently with limited evidence at scientific literature. Os trigonum syndrome is frequently misdiagnosed or tardily diagnosed. A high suspicion level is needed for its early diagnosis, which is essential not only to quickly begin the proper treatment for symptoms relief, but also for prognostic terms.
- Traumatologia da Articulação de LisfrancPublication . Moura, DL; Gaspar, AR; Fonseca, FAs lesões do complexo articular de Lisfranc são frequentes e muitas vezes subdiagnosticadas em desportistas. São lesões com tempo prolongado de recuperação e que muitas vezes colocam a carreira desportiva em risco, na medida em que a maioria evolui rapidamente para osteoartrose sintomática. Um nível elevado de suspeita de reconhecimento dos sinais clínicos de lesão e uso dos exames de imagem adequados são críticos para um diagnóstico correto e precoce, de modo a se conseguir um tratamento adequado e garantir rápido regresso à atividade desportiva. Os tratamentos ideais para as lesões de Lisfranc são controversos e devem ser adequados ao tipo de lesão, estadio e características do atleta. Este artigo apresenta uma revisão da atual evidência científica em relação aos princípios de diagnóstico e tratamento das lesões do complexo articular de Lisfranc na população praticante de desporto.
- Sports activity and hip, knee, shoulder and intervertebral disc arthroplastiesPublication . Moura, DL; Fonseca, FThe success of joint replacement surgery has been responsible for raising patients' expectations regarding the procedure. Many of these procedures are currently designed not only to relive the pain caused by arthrosis, but also to enable patients to achieve functional recovery and to engage in some degree of physical activity and sports. However, as physical exercise causes an increase in forces exercised through the articular prosthesis, it can be an important risk factor for its early failure. Scientific literature on sports after arthroplasty is limited to small-scale retrospective studies with short-term follow-up, which are mostly insufficient to evaluate articular prosthesis durability. This article presents a review of the literature on sports in the context of hip, knee, shoulder and intervertebral disc arthroplasty, and puts forward general recommendations based on the current scientific evidence. Systematic Review, Level of Evidence III.