Biomedical subjects
Publications and source records attributed to R Mattar Júnior.
Wrist arthroscopy was performed in 12 patients that complained of wrist pain for four months and in whom the diagnosis not established. The instruments and the technique of the procedure is described. In two patients the wrist pain diminished and in eight it disappeared. In other two patients the pain was not relieved. There were no complications.
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The authors review 15 patients with giant cell tumor of the distal part of the radius in the period from 1980 to 1993. Pain was always present. The treatment of stage 2 with marginal resection and methylmethacrylate yielded excellent result. In the treatment of stage 3 the authors emphasize the need of wide resection. In these patients the best functional results were obtained with the use of vascularized proximal epiphyseal fibular graft, preserving some painless mobility of the wrist and forearm.
The reports of transfer of the medial arm flap have been inconsistent, and confusion remains about its anatomy and use. The advantages of this donor site, however, justify new researches about the vascular anatomy of the flap. In this study, the vascular supply to the medial side of the arm was analysed in fifteen fresh cadaver dissections. The methods, the anatomical bases, and the technique of elevation of the flap were detailed. Methylene blue injection studies showed the extent of the medial arm flap. The authors found that, in most cases, the superior ulnar collateral artery was the main vessel of this flap, giving cutaneous branches to medial arm skin. The diameter of the superior ulnar collateral artery was measured and considered adequate for microsurgical transfer. If no major cutaneous branches are noted from superior ulnar collateral artery, then a significant direct cutaneous branch from the brachial artery will be always present. With this in mind, the dissection must initially proceed carefully, preserving all vessels that may contribute to cutaneous perfusion. The authors conclude that with knowledge of its anatomical variations, the medial arm flap is a plausible reconstructive option.