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001), forward elevation ( p  = 0.020), internal rotation ( p  = 0.001) and external rotation ( p  = 0.003) when comparing the group of healed tuberosities with the group of non-healed tuberosities. check details No differences were found regarding the VAS score. Conclusion  Tuberosity healing results in an improvement of the functional outcomes of patients submitted to reverse shoulder arthroplasty as a treatment for complex proximal humeral fractures in the elderly.Objective  To evaluate the influence of the supraspinal tear pattern on the pre- and postoperative functional evaluations. Methods  A retrospective cohort study comparing patients with supraspinatus crescent-shaped tears versus L- or U-shaped tears. We included patients undergoing complete supraspinatus arthroscopic repair. We did not include patients with subscapularis or infraspinatus repair, those submitted to open surgery, or those in whom only partial repair was achieved. The clinical scales used were the American Shoulder and Elbow Surgeons Standardized Shoulder Assessment (ASES) and the Modified-University of California at Los Angeles Shoulder Rating Scale (UCLA), which were applied 1 week before and 24 months after the procedure. Results  We analyzed 167 shoulders (from 163 patients). In the preoperative period, the ASES scale was significantly higher in the crescent-shaped pattern (43.5 ± 17.6 versus 37.7 ± 13.8; p  = 0.034). The UCLA scale followed the same pattern (15.2 ± 4.6 versus 13.5 ± 3.6; p  = 0.028). In the postoperative period, however, there was no significant difference. According to the ASES scale, crescent-shaped tears scored 83.7 ± 18.7 points, and L- or U-shaped tears scored 82.9 ± 20.1 ( p  = 0.887). The values were 30.9 ± 4.9 and 30.5 ± 5.6 ( p  = 0.773) respectively, by the UCLA scale. Conclusion  Crescent-shaped and L- or U-shaped supraspinatus tears have similar postoperative functional results. In the preoperative period, the functional results are superior in crescent-shaped tears.Objective  To describe and demonstrate the outcomes of the modified Monteiro (1991) technique for lower limb reconstruction with a fasciocutaneous flap of the distal pedicle in a series of 15 cases. Method  We present the technique and outcomes from a series of 15 cases of the modified technique using a fasciocutaneous flap of the distal pedicle to repair the lower third of the leg and the foot. Results  Outcomes were satisfactory since these flaps provided good cutaneous and subcutaneous tissue coverage in cases with bone exposure and skin loss. The donor area was closed 3 days after surgery with a partial skin graft to provide better graft viability. Conclusion  The fasciocutaneous flap of the distal pedicle proved to be a good option for reconstruction of the middle and lower thirds of the leg, offering good bone coverage.Objective  To investigate the incidence, mechanisms, types of injury, most affected anatomical regions, and factors leading to injuries in trail bikers. Methods  This was an observational, retrospective study analyzing 47 trail bikers. Data were collected through application of a referenced morbidity survey (RMS), which included information on injuries and their mechanisms. Results  The lesions with the highest incidence were abrasion and bruise. The most affected anatomical regions were the shoulders and knees. The most common injury mechanism was skidding or loss of traction. Conclusion  Trail bikers are exposed to risk factors and, consequently, to falls; it is important to develop more protective equipment, especially for the shoulders and knees.Objective  To evaluate the clinical and radiographic results as well as complications related to patients undergoing arthroscopic treatment of subspine hip impingement. Methods  We retrospectively evaluated 25 patients (28 hips) who underwent arthroscopic treatment of subspine impingement between January 2012 and June 2018. The mean follow-up was 29.5 months, and the patients were evaluated clinically by using the Harris hip score modified by Byrd (MHHS), the non-arthritic hip score (NAHS), and in terms of internal rotation and hip flexion. In addition, the following items were evaluated by imaging exams the center-edge (CE) acetabular angle, the Alpha angle, the presence of a sign of the posterior wall, the degree of arthrosis, the presence of heterotopic hip ossification, and the Hetsroni classification for subspine impingement. Results  There was an average postoperative increase of 26.9 points for the MHHS, 25.4 for the NAHS ( p   less then  0.0001), 10.5° in internal rotation ( p   less then  0.0024), and 7.9° for hip flexion ( p   less then  0.0001). As for the radiographic evaluation, an average reduction of 3.3° in the CE angle and of 31.6° for the Alpha angle ( p   less then  0.0001). Eighteen cases (64.3%) were classified as grade 0 osteoarthritis of Tönnis, and 10 (35.7%) were classified as Tönnis grade 1. Two cases (7.1%) presented grade 1 ossification of Brooker. Most hips ( n  = 15, 53.6%) were classified as type II of Hetsroni et al. Conclusion  In the present study, patients undergoing arthroscopic treatment with subspine impingement showed improvement in clinical aspects and radiographic patterns measured postoperatively, with an average follow-up of 29.5 months.Objective  To evaluate the functional outcomes of patients diagnosed with femoroacetabular impingement (FAI) older than 60 years, compared with those of patients of age 40 years or younger. Methods  This was a retrospective review of patients with FAI who underwent hip arthroscopy between 2010 and 2015. The patients were adults aged over 60 years with Tönnis ≤ 1 matched in a 11 ratio with adults aged 40 years or younger, according to the type of deformity (cam, pincer, or mixed), sex, and the date when the surgery was performed. Results  Thirty-four patients were included in each group. The mean age was 30.6 ± 6.9 years and 65.6 ± 4.6 years in the control and case groups, respectively. There were no significant differences between the groups at 1-year follow-up ( p  > 0.05). In the group with older patients (case group), we observed a change in the total Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score from 46.3 to 22.0 in the 1 st postoperative year, while the control cases improved in the WOMAC score from 38.