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ABSTRACT BACKGROUND AND OBJECTIVES: Identifying and treating psychosocial, intrapsychic, relational, psychiatric and psychobehavioral factors which influence neuropathic pain nature, severity and persistence are object of scientific concern and a lot has been done in this area; however it is clear the need for further emphasis and disclosure of contents for better professional knowledge. This study aimed at outlining the psychobehavioral and psychosocial scenario by means of literature review, through some theories about pain regulation, via cognitive functioning and stress theories, although it is known that the universe of this study is too broad but the idea is to outline a panoramic view of the field. CONTENTS: Incapacity, distress, painful and unhealthy behaviors and of gains are challenging factors for the treatment of neuropathic pain patients. Notions about thinking distortion, especially caused by pain perception leading to catastrophic thoughts and decreasing the efficacy of other non-addressed interventions, as well as aspects of the psychosocial impact influencing the development of chronicity and maintenance of unhealthy patterns. CONCLUSION: Psychological interventions aiming at changing beliefs and dysfunctional behaviors, incapacities and distress, at changing neuropathic pain perception, treatment of mental decompensations such as depression and anxiety and of recurrences, are critical to manage neuropathic pain patients. It is confirmed that knowledge about adaptations in the rewarding circuits is fundamental for psychological, psychotherapeutic and psychosocial interventions to be more effective, thus preventing problems related to pathological maintenance in cases of neuropathic etiology.

ABSTRACT The aim of this study was to evaluate the biomechanical role of both a non-locking two-hole small fragment dynamic compression plate with 3.5-mm screws and a 4.5-mm cortical screw with a washer applied to a Schatzker type-I tibial plateau fracture. Sixteen right synthetic tibiae were used to create an anterolateral shear tibial plateau fracture (Schatzker type-I fracture). Eight models were fixed with a small fragment non-locked straight dynamic compression plate with one 3.5-mm bicortical screw (plate-screw construction) and eight models were fixed with a 4.5-mm cortical screw and a washer (screw-washer construction), both inserted at 1.0 mm distal to the apex of the fracture. Specimens were tested up to the onset of yielding at a constant strain rate of 5.0-mm/min. Stiffness ranged from 311.83 N/mm to 199.54 N/mm, with a mean + SD of 260.32 + 33.8 N/mm in the plate-screw construction, and from 290.34 N/mm to 99.16 N/mm, with a mean + SD of 220.46 + 63.12 N/mm in screw-washer construction. There was no significant difference (p=0.172). Use of a two-hole small-fragment non-locked plate with one 3.5-mm cortical screw or a 4.5-mm cortical screw with a washer applied at 1.0 mm distal to the apex of the fracture as buttressing present similar stiffness in terms of preventing axial displacement in synthetic tibiae models tested up to the onset of yielding.