Efeitos da terapia de fotobiomodulação na consolidação de fraturas atípicas do fêmur em mulheres idosas
Autor(a) principal: | |
---|---|
Data de Publicação: | 2020 |
Tipo de documento: | Tese |
Idioma: | por |
Título da fonte: | Biblioteca Digital de Teses e Dissertações da Uninove |
Texto Completo: | http://bibliotecatede.uninove.br/handle/tede/2753 |
Resumo: | Atypical Femoral Fractures (AFFs) are described as caused by minimal trauma, in the subtrochanteric or diaphyseal region of the femur, often associated with prolonged use of Bisphosphonates. Orthopedic surgery for bone fixation is the most recommended, however, complications, such as the high rates of delayed or failed bone consolidation, or even failure of the synthesis with implant failure, are more frequent than in typical fractures. The present study aims at the application of Transoperative Intramedullary Bone Photobiomodulation Therapy (PBMT), using Long Sterile Fiber Optics. It is a pilot, clinical-surgical, comparative study with control cases, longitudinal, with eleven female patients, between 60 and 90 years old, diagnosed with FFAs, distributed in two groups: Group treated with intraoperative intramedullary; and Control Group, individuals submitted to surgery only. Prototype Therapy Laser Plus equipment (DMC, São Carlos / SP - Brazil) was used. The application of PBMT through sterile polymer long fiber, with emission by laser diode (continuous mode), wavelength λ of 638 ± 10 nm, power of 200 mW, energy of 3.2 J red, for 16 seconds, in 2 points of the fracture ends. The irradiance is 25.47 W / cm², with energy density or fluency of 407.64 J / cm2, in direct contact with the fracture. In this study, we did not observe differences between the groups regarding the evolution of healing, skin complications, beginning of partial and total load, use of analgesics, length of stay, time and objective criteria for bone healing (modified RUST score) and laboratory tests . Although we did not observe statistically significant differences between the groups, in relation to the RUSTm score, we noticed that there was a tendency to increase the score in the second assessment of the group treated with PBMT. However, the small sample size was insufficient to confirm any inferences in this regard. From these results, it appears that the use of PBMT in this pilot study did not have an additive effect to surgery in the treatment of AFFs. Future studies should be conducted for new assessments of the relationship between PBMT and bone repair. |
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Chavantes, Maria Cristinahttp://lattes.cnpq.br/9684711829191051Dalboni, Maria Aparecidahttp://lattes.cnpq.br/9818040147487320Chavantes, Maria Cristinahttp://lattes.cnpq.br/9684711829191051Silva Junior, Jose Antoniohttp://lattes.cnpq.br/1990427833073161Zamuner, Stella Reginahttp://lattes.cnpq.br/1935805744318404Deana, Alessandro Melohttp://lattes.cnpq.br/3678668865183045Plapler, Héliohttp://lattes.cnpq.br/2871630525937037http://lattes.cnpq.br/1982223599453169Oksman, Daniel2021-11-18T14:32:31Z2020-12-07Oksman, Daniel. Efeitos da terapia de fotobiomodulação na consolidação de fraturas atípicas do fêmur em mulheres idosas. 2020. 119 f. Tese( Programa de Mestrado em Medicina) - Universidade Nove de Julho, São Paulo.http://bibliotecatede.uninove.br/handle/tede/2753Atypical Femoral Fractures (AFFs) are described as caused by minimal trauma, in the subtrochanteric or diaphyseal region of the femur, often associated with prolonged use of Bisphosphonates. Orthopedic surgery for bone fixation is the most recommended, however, complications, such as the high rates of delayed or failed bone consolidation, or even failure of the synthesis with implant failure, are more frequent than in typical fractures. The present study aims at the application of Transoperative Intramedullary Bone Photobiomodulation Therapy (PBMT), using Long Sterile Fiber Optics. It is a pilot, clinical-surgical, comparative study with control cases, longitudinal, with eleven female patients, between 60 and 90 years old, diagnosed with FFAs, distributed in two groups: Group treated with intraoperative intramedullary; and Control Group, individuals submitted to surgery only. Prototype Therapy Laser Plus equipment (DMC, São Carlos / SP - Brazil) was used. The application of PBMT through sterile polymer long fiber, with emission by laser diode (continuous mode), wavelength λ of 638 ± 10 nm, power of 200 mW, energy of 3.2 J red, for 16 seconds, in 2 points of the fracture ends. The irradiance is 25.47 W / cm², with energy density or fluency of 407.64 J / cm2, in direct contact with the fracture. In this study, we did not observe differences between the groups regarding the evolution of healing, skin complications, beginning of partial and total load, use of analgesics, length of stay, time and objective criteria for bone healing (modified RUST score) and laboratory tests . Although we did not observe statistically significant differences between the groups, in relation to the RUSTm score, we noticed that there was a tendency to increase the score in the second assessment of the group treated with PBMT. However, the small sample size was insufficient to confirm any inferences in this regard. From these results, it appears that the use of PBMT in this pilot study did not have an additive effect to surgery in the treatment of AFFs. Future studies should be conducted for new assessments of the relationship between PBMT and bone repair.Fraturas Femorais Atípicas (FFAs) são descritas como decorridas por trauma mínimo, na região subtrocantérica ou diafisária do fêmur, frequentemente associadas ao uso prolongado de Bisfosfonatos. A cirurgia ortopédica para fixação óssea é o mais recomendado, contudo, complicações, como as altas taxas encontradas de atrasos ou falha na consolidação óssea, ou mesmo falência da síntese com quebra do implante, são mais frequentes que em fraturas habituais. O presente estudo tem como objetivo a aplicação da Terapia de Fotobiomodulação (TFBM) Óssea Intramedular Transoperatória, com uso de Fibra Ótica Longa Estéril. É um estudo piloto, clínico-cirúrgico, comparativo com casos controles, longitudinal, com onze pacientes do sexo feminino, entre 60 e 90 anos, diagnosticadas com FFAs, distribuídas em dois grupos: Grupo tratado com TFBM intramedular transoperatória; e Grupo Controle, indivíduos submetidos apenas à cirurgia. Utilizado equipamento protótipo Therapy Laser Plus (DMC, São Carlos/SP - Brasil). A aplicação da TFBM através de fibra longa estéril de polímero, com emissão por diodo laser (modo contínuo), comprimento de onda λ de 638 ± 10 nm, potência de 200 mW, energia de 3,2 J vermelho, por 16 segundos, em 2 pontos das extremidades da fratura. A irradiância é de 25,47 W/cm², com densidade de energia ou fluência de 407,64 J/cm2, em contato direto com a fratura. Neste estudo não observamos diferenças entre os grupos em relação à evolução da cicatrização, complicações de pele, início da carga parcial e total, uso de analgésicos, tempo de internação, tempo e critérios objetivos de consolidação óssea (escore de RUST modificado) e exames laboratoriais. Embora não tenhamos observado diferenças estatisticamente significantes entre os grupos, em relação ao escore de RUSTm, notamos que houve uma tendência de aumento do escore na segunda avaliação do grupo tratado com TFBM. Contudo, o reduzido tamanho amostral foi insuficiente para afirmar quaisquer inferências neste aspecto. A partir destes resultados, verifica-se que o uso da TFBM neste estudo piloto não apresentou efeito aditivo à cirurgia no tratamento das FFAs. Estudos futuros devem ser conduzidos para novas avaliações da relação da TFBM com o reparo ósseo.Submitted by Nadir Basilio (nadirsb@uninove.br) on 2021-11-18T14:32:31Z No. of bitstreams: 1 Daniel Oksman.pdf: 3552418 bytes, checksum: 1dfe112c2f89cf6b5d56bb4dabe3b795 (MD5)Made available in DSpace on 2021-11-18T14:32:31Z (GMT). No. of bitstreams: 1 Daniel Oksman.pdf: 3552418 bytes, checksum: 1dfe112c2f89cf6b5d56bb4dabe3b795 (MD5) Previous issue date: 2020-12-07application/pdfporUniversidade Nove de JulhoPrograma de Mestrado em MedicinaUNINOVEBrasilSaúdecirurgia ortopédicaTerapia de Fotobiomodulação / TFBMlaserterapiafraturas atípicasconsolidaçãodorcicatrizaçãoorthopedic surgeryLow Level Laser Therapy / LLLTlaseratypical fracturesconsolidationpainhealingCIENCIAS DA SAUDEEfeitos da terapia de fotobiomodulação na consolidação de fraturas atípicas do fêmur em mulheres idosasinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/doctoralThesis8765449414823306929600info:eu-repo/semantics/openAccessreponame:Biblioteca Digital de Teses e Dissertações da Uninoveinstname:Universidade Nove de Julho (UNINOVE)instacron:UNINOVEORIGINALDaniel Oksman.pdfDaniel Oksman.pdfapplication/pdf3552418http://localhost:8080/tede/bitstream/tede/2753/2/Daniel+Oksman.pdf1dfe112c2f89cf6b5d56bb4dabe3b795MD52LICENSElicense.txtlicense.txttext/plain; charset=utf-82165http://localhost:8080/tede/bitstream/tede/2753/1/license.txtbd3efa91386c1718a7f26a329fdcb468MD51tede/27532022-06-02 15:00:35.747oai:localhost: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Biblioteca Digital de Teses e Dissertaçõeshttp://bibliotecatede.uninove.br/PRIhttp://bibliotecatede.uninove.br/oai/requestbibliotecatede@uninove.br||bibliotecatede@uninove.bropendoar:2022-06-02T18:00:35Biblioteca Digital de Teses e Dissertações da Uninove - Universidade Nove de Julho (UNINOVE)false |
dc.title.por.fl_str_mv |
Efeitos da terapia de fotobiomodulação na consolidação de fraturas atípicas do fêmur em mulheres idosas |
title |
Efeitos da terapia de fotobiomodulação na consolidação de fraturas atípicas do fêmur em mulheres idosas |
spellingShingle |
Efeitos da terapia de fotobiomodulação na consolidação de fraturas atípicas do fêmur em mulheres idosas Oksman, Daniel cirurgia ortopédica Terapia de Fotobiomodulação / TFBM laserterapia fraturas atípicas consolidação dor cicatrização orthopedic surgery Low Level Laser Therapy / LLLT laser atypical fractures consolidation pain healing CIENCIAS DA SAUDE |
title_short |
Efeitos da terapia de fotobiomodulação na consolidação de fraturas atípicas do fêmur em mulheres idosas |
title_full |
Efeitos da terapia de fotobiomodulação na consolidação de fraturas atípicas do fêmur em mulheres idosas |
title_fullStr |
Efeitos da terapia de fotobiomodulação na consolidação de fraturas atípicas do fêmur em mulheres idosas |
title_full_unstemmed |
Efeitos da terapia de fotobiomodulação na consolidação de fraturas atípicas do fêmur em mulheres idosas |
title_sort |
Efeitos da terapia de fotobiomodulação na consolidação de fraturas atípicas do fêmur em mulheres idosas |
author |
Oksman, Daniel |
author_facet |
Oksman, Daniel |
author_role |
author |
dc.contributor.advisor1.fl_str_mv |
Chavantes, Maria Cristina |
dc.contributor.advisor1Lattes.fl_str_mv |
http://lattes.cnpq.br/9684711829191051 |
dc.contributor.advisor-co1.fl_str_mv |
Dalboni, Maria Aparecida |
dc.contributor.advisor-co1Lattes.fl_str_mv |
http://lattes.cnpq.br/9818040147487320 |
dc.contributor.referee1.fl_str_mv |
Chavantes, Maria Cristina |
dc.contributor.referee1Lattes.fl_str_mv |
http://lattes.cnpq.br/9684711829191051 |
dc.contributor.referee2.fl_str_mv |
Silva Junior, Jose Antonio |
dc.contributor.referee2Lattes.fl_str_mv |
http://lattes.cnpq.br/1990427833073161 |
dc.contributor.referee3.fl_str_mv |
Zamuner, Stella Regina |
dc.contributor.referee3Lattes.fl_str_mv |
http://lattes.cnpq.br/1935805744318404 |
dc.contributor.referee4.fl_str_mv |
Deana, Alessandro Melo |
dc.contributor.referee4Lattes.fl_str_mv |
http://lattes.cnpq.br/3678668865183045 |
dc.contributor.referee5.fl_str_mv |
Plapler, Hélio |
dc.contributor.referee5Lattes.fl_str_mv |
http://lattes.cnpq.br/2871630525937037 |
dc.contributor.authorLattes.fl_str_mv |
http://lattes.cnpq.br/1982223599453169 |
dc.contributor.author.fl_str_mv |
Oksman, Daniel |
contributor_str_mv |
Chavantes, Maria Cristina Dalboni, Maria Aparecida Chavantes, Maria Cristina Silva Junior, Jose Antonio Zamuner, Stella Regina Deana, Alessandro Melo Plapler, Hélio |
dc.subject.por.fl_str_mv |
cirurgia ortopédica Terapia de Fotobiomodulação / TFBM laserterapia fraturas atípicas consolidação dor cicatrização |
topic |
cirurgia ortopédica Terapia de Fotobiomodulação / TFBM laserterapia fraturas atípicas consolidação dor cicatrização orthopedic surgery Low Level Laser Therapy / LLLT laser atypical fractures consolidation pain healing CIENCIAS DA SAUDE |
dc.subject.eng.fl_str_mv |
orthopedic surgery Low Level Laser Therapy / LLLT laser atypical fractures consolidation pain healing |
dc.subject.cnpq.fl_str_mv |
CIENCIAS DA SAUDE |
description |
Atypical Femoral Fractures (AFFs) are described as caused by minimal trauma, in the subtrochanteric or diaphyseal region of the femur, often associated with prolonged use of Bisphosphonates. Orthopedic surgery for bone fixation is the most recommended, however, complications, such as the high rates of delayed or failed bone consolidation, or even failure of the synthesis with implant failure, are more frequent than in typical fractures. The present study aims at the application of Transoperative Intramedullary Bone Photobiomodulation Therapy (PBMT), using Long Sterile Fiber Optics. It is a pilot, clinical-surgical, comparative study with control cases, longitudinal, with eleven female patients, between 60 and 90 years old, diagnosed with FFAs, distributed in two groups: Group treated with intraoperative intramedullary; and Control Group, individuals submitted to surgery only. Prototype Therapy Laser Plus equipment (DMC, São Carlos / SP - Brazil) was used. The application of PBMT through sterile polymer long fiber, with emission by laser diode (continuous mode), wavelength λ of 638 ± 10 nm, power of 200 mW, energy of 3.2 J red, for 16 seconds, in 2 points of the fracture ends. The irradiance is 25.47 W / cm², with energy density or fluency of 407.64 J / cm2, in direct contact with the fracture. In this study, we did not observe differences between the groups regarding the evolution of healing, skin complications, beginning of partial and total load, use of analgesics, length of stay, time and objective criteria for bone healing (modified RUST score) and laboratory tests . Although we did not observe statistically significant differences between the groups, in relation to the RUSTm score, we noticed that there was a tendency to increase the score in the second assessment of the group treated with PBMT. However, the small sample size was insufficient to confirm any inferences in this regard. From these results, it appears that the use of PBMT in this pilot study did not have an additive effect to surgery in the treatment of AFFs. Future studies should be conducted for new assessments of the relationship between PBMT and bone repair. |
publishDate |
2020 |
dc.date.issued.fl_str_mv |
2020-12-07 |
dc.date.accessioned.fl_str_mv |
2021-11-18T14:32:31Z |
dc.type.status.fl_str_mv |
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publishedVersion |
dc.identifier.citation.fl_str_mv |
Oksman, Daniel. Efeitos da terapia de fotobiomodulação na consolidação de fraturas atípicas do fêmur em mulheres idosas. 2020. 119 f. Tese( Programa de Mestrado em Medicina) - Universidade Nove de Julho, São Paulo. |
dc.identifier.uri.fl_str_mv |
http://bibliotecatede.uninove.br/handle/tede/2753 |
identifier_str_mv |
Oksman, Daniel. Efeitos da terapia de fotobiomodulação na consolidação de fraturas atípicas do fêmur em mulheres idosas. 2020. 119 f. Tese( Programa de Mestrado em Medicina) - Universidade Nove de Julho, São Paulo. |
url |
http://bibliotecatede.uninove.br/handle/tede/2753 |
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por |
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por |
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Programa de Mestrado em Medicina |
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UNINOVE |
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Brasil |
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Saúde |
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Universidade Nove de Julho |
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