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A single shot arthroscopic reduction and screw fixation of posterior wall acetabular fracture 关节镜下一次性复位螺钉固定治疗髋臼后壁骨折
IF 0.3 Q4 ORTHOPEDICS Pub Date : 2023-08-10 DOI: 10.1097/bco.0000000000001232
Eran Keltz, Noam Reshef, B. Peskin, Farouk J. Khury, I. Botser
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引用次数: 0
Cross-platform social media analysis regarding ACL injury and surgery 关于前交叉韧带损伤和手术的跨平台社交媒体分析
IF 0.3 Q4 ORTHOPEDICS Pub Date : 2023-08-03 DOI: 10.1097/bco.0000000000001229
Hunter L. Hasley, Lainey Bukowiec, Jay M. Zaifman, Martin Malik, Brian D. Batko, Y. Kissin, Michael Kelly
Anterior cruciate ligament (ACL) injury affects a broad patient population, but there is limited knowledge on how ACL injury is discussed across social media platforms. This study aims to develop an extensive snapshot of the social media milieu for understanding who uses social media platforms, what topics users discuss, and how these platforms vary regarding ACL injury and surgery. We utilized a qualitative, descriptive design with quantitative statistical analysis including Kruskal-Wallis tests and Fisher’s Exact tests with post hoc analyses to examine new posts across Facebook, Instagram, Twitter, and TikTok using ACL-specific search terms from August 2021 to January 2022. Posts were analyzed by authorship, content characterization, and engagement. Across social media sites, 760 posts were examined involving ACL surgery and injury. There was statistically significant difference among the platforms when comparing categories of authorship (P<0.001). There were statistically significant differences where physicians (P<0.001) and patients (P<0.001) posted, with physicians representing 20.6% and 19.5% of posts on Facebook and Twitter, respectively. TikTok displayed the highest patient authorship (83.5%) and greatest content engagement. There were also significant differences among platforms regarding content characterization (P<0.001). This study breaks down a snapshot of social media revolving around ACL injury and surgery demonstrating differences in authorship, content, and engagement of posts across platforms. These findings demonstrate the frequent use of social media by patients to address unmet clinical needs and can help surgeons and patients connect on the same platforms. Level IV.
前交叉韧带(ACL)损伤影响着广泛的患者群体,但关于如何在社交媒体平台上讨论ACL损伤的知识有限。这项研究旨在开发社交媒体环境的广泛快照,以了解谁使用社交媒体平台,用户讨论什么话题,以及这些平台在ACL损伤和手术方面的差异。我们利用定性、描述性设计和定量统计分析,包括Kruskal-Wallis检验和Fisher精确检验和事后分析,从2021年8月到2022年1月,使用ACL特定的搜索词,检查了Facebook、Instagram、Twitter和TikTok上的新帖子。文章根据作者、内容特征和参与度进行了分析。在社交媒体网站上,760条涉及ACL手术和损伤的帖子被检查。在比较作者类别时,两个平台之间存在统计学上的显著差异(P<0.001)。医生(P<0.001。TikTok显示出最高的患者署名率(83.5%)和最高的内容参与度。不同平台在内容表征方面也存在显著差异(P<0.001)。这项研究对围绕ACL损伤和手术的社交媒体快照进行了分解,表明不同平台在作者、内容和帖子参与度方面存在差异。这些发现表明,患者经常使用社交媒体来满足未满足的临床需求,并可以帮助外科医生和患者在同一平台上建立联系。四级。
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引用次数: 0
A prospective study on total hip arthroplasty outcome in hip fracture compared with matched elective cohort 髋部骨折全髋关节置换术与匹配的选择性队列比较的前瞻性研究
IF 0.3 Q4 ORTHOPEDICS Pub Date : 2023-08-01 DOI: 10.1097/BCO.0000000000001230
J. W. Lim, Tze Khiang Tan, N. Alkandari, D. Ridley, S. Sripada, A. Jariwala
Background: We conducted a prospective study to compare the outcomes of THA for hip fractures with a best-matched elective cohort. Method: We prospectively reviewed patients underwent THA for hip fractures from 2017 to 2019. The modified Harris Hip Score (mHHS) and complications were recorded. Our control group was elective THA cases matched for the month of operation, age, gender, implants, side of operation and surgeon’s grade. Unmatched cases were excluded. Results: Forty-one THA for hip fractures and forty-one matched elective THA were compared. The total modified Harris Hip Score [mHHS (total)] was significantly lower preoperatively in elective cohort (trauma vs. elective: 60.3 vs. 41.4, P<0.001) and achieved significantly higher score than trauma cohort one-year postoperatively (82.6 vs. 88.2, P= 0.029). The trauma cohort had similar mHHS (function) pre- and postoperatively, and no significant difference was witnessed between both cohorts postoperatively (35.1 vs. 37.6, P= 0.142). The mHHS (pain) was significantly higher in trauma cohort preoperatively (19.8 vs. 12.7, P=0.034), but the elective cohort achieved significantly higher mHHS (pain) than trauma cohort at one-year postoperative (40.1 vs. 42.7, P=0.027). Both cohorts had similar complication rates. Conclusions: This is the first matched prospective study on hip fracture patients that underwent THA, with one year follow up results and the involvement of preoperative and postoperative functional outcomes. With careful patient selection, trauma THA patients can return to their pre-injured function within a year and had comparable function scores with elective THA patients, without increased complication rates.
背景:我们进行了一项前瞻性研究,将THA治疗髋部骨折的结果与最佳匹配的选择性队列进行比较。方法:我们前瞻性回顾了2017年至2019年接受THA治疗的髋部骨折患者。记录改良Harris髋关节评分(mHHS)和并发症。我们的对照组是根据手术月份、年龄、性别、植入物、手术侧和外科医生级别匹配的选择性THA病例。排除了不匹配的病例。结果:对41例髋关节骨折的THA和41例匹配的选择性THA进行了比较。在选择性队列中,改良Harris髋关节总分[mHHS(总分)]在术前显著降低(创伤组与选择性组:60.3 vs.41.4,P<0.001),并在术后一年显著高于创伤组(82.6 vs.88.2,P=0.029)。创伤组在术前和术后具有相似的mHHS(功能),两组患者术后均无显著差异(35.1 vs.37.6,P=0.012)。创伤组患者术前mHHS(疼痛)显著高于创伤组(19.8 vs.12.7,P=0.034),但择期患者术后一年mHHS明显高于创伤组患者(40.1 vs.42.7,P=0.027)。两组患者的并发症发生率相似。结论:这是第一个对接受THA的髋部骨折患者进行匹配的前瞻性研究,有一年的随访结果,并涉及术前和术后的功能结果。经过仔细的患者选择,创伤THA患者可以在一年内恢复到受伤前的功能,并且与选择性THA患者的功能评分相当,不会增加并发症发生率。
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引用次数: 0
Proximal tibiofibular joint reconstruction with biceps femoris and iliotibial band autografts with suture tape augmentation 股二头肌和髂胫束自体植骨缝合带增强重建近端胫腓关节
IF 0.3 Q4 ORTHOPEDICS Pub Date : 2023-07-07 DOI: 10.1097/bco.0000000000001228
Nikolas J Sarac, C. Curatolo, T. Miller
INTRODUCTION I nstability of the proximal tibiofibular joint (PTFJ) is a likely under-recognized condition. The true incidence is unknown, but it is likely under-reported in the literature due to spontaneous reductions in acute cases and misdiagnosis in chronic instability. Three types of instability exist: acute traumatic dislocations, chronic or recurrent dislocations, and atraumatic subluxations. Instability may be multidirectional, however most cases of PTFJ instability occur anterolaterally, owing to the weaker posterior stabilizing ligamentous complex. Chronic instability may be misdiagnosed as lateral meniscal pathology, and patients reporting lateral sided pain, instability with or without visible and audible popping sensations. Physical examination may reveal pain, apprehension, or translation of the fibula when the proximal fibula is translated or “shucked”, particularly anteriorly, with the knee flexed. Radiographs are unlikely to aid in diagnosis other than in cases of acute dislocations, although comparison radiographs to the contralateral knee may help detect subtle differences. Magnetic resonance imaging often demonstrates high T2 signal from fluid in the PTFJ or bone contusion of the fibular head or proximal tibia, but may also demonstrate subluxation of the PTFJ. Initial conservative management consists of activity modification, particularly avoiding knee hyperflexion, use of supportive straps, and undergoing physical therapy. If non-operative management fails, surgical intervention can be considered. A plethora of procedures have been described, which includes but is not limited to fibular head resection, fusion, stabilization with the use of suture buttons, and soft tissue reconstructions. Stabilization with autograft reconstruction may include biceps femoris tendon (BFT) and/or iliotibial band (ITB) rerouting. No “gold standard” has been recognized due to infrequency of the condition, and the literature on patient outcomes following stabilization being limited to case reports and small series. In an attempt to maximize patient outcomes, the authors elected to modify a previously described reconstruction technique which utilized ITB and BFT autografts for stabilizing the joint. The described modification is a hybrid technique which still utilizes the ITB and BFT but with added reinforcement of suture tape augmentation (Arthrex Internal Brace, Naples FL) for added stability. The authors feel this allows for a safer, less invasive procedure than previously described. The procedure was performed in an active 26-year-old female who sustained a left PTFJ dislocation which she manually reduced after a jumping injury. PTFJ pain and snapping persisted despite four months of nonoperative treatment. Physical examination in clinic revealed mild laxity at the PTFJ, andmagnetic resonance imaging demonstrated an effusion of the joint as well as edema of the fibular head. As such she was indicated for the procedure described below.
引言I胫腓骨近端关节(PTFJ)的不稳定性可能是一种公认的状况。真实的发病率尚不清楚,但由于急性病例的自发减少和慢性不稳定的误诊,文献中可能报道不足。存在三种类型的不稳定性:急性创伤性脱位、慢性或复发性脱位和非创伤性半脱位。不稳定可能是多方向的,但大多数PTFJ不稳定发生在前外侧,这是由于后部稳定韧带复合体较弱。慢性不稳定可能被误诊为半月板外侧病变,患者报告外侧疼痛,不稳定伴有或不伴有可见和可听的爆裂感。当腓骨近端移位或“松脱”时,尤其是在膝盖弯曲的情况下,体检可能会发现腓骨疼痛、忧虑或移位。除了在急性脱位的情况下,射线照片不太可能有助于诊断,尽管与对侧膝盖的比较射线照片可以帮助发现细微的差异。磁共振成像通常显示PTFJ中的液体或腓骨头或胫骨近端的骨挫伤产生高T2信号,但也可能显示PTFJ半脱位。最初的保守治疗包括活动调整,特别是避免膝盖过度屈曲,使用支撑带,并接受物理治疗。如果非手术治疗失败,可以考虑手术干预。已经描述了大量的手术,包括但不限于腓骨头部切除、融合、使用缝合扣进行稳定和软组织重建。自体移植物重建的稳定可能包括股二头肌腱(BFT)和/或髂胫束(ITB)改道。由于这种情况的罕见性,没有公认的“金标准”,关于稳定后患者结果的文献仅限于病例报告和小系列。为了最大限度地提高患者的疗效,作者选择修改先前描述的重建技术,该技术利用自体ITB和BFT移植物来稳定关节。所描述的修改是一种混合技术,它仍然使用ITB和BFT,但增加了缝合带增强(Arthrex Internal Brace,Naples FL)的增强,以增加稳定性。作者认为,这可以实现一种比之前描述的更安全、侵入性更小的手术。该手术是在一名活跃的26岁女性身上进行的,她在跳跃受伤后手动复位了左侧PTFJ脱位。尽管进行了四个月的非手术治疗,但PTFJ疼痛和折断仍然存在。临床体格检查显示PTFJ轻度松弛,磁共振成像显示关节积液和腓骨头水肿。因此,她被指示进行下述程序。
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引用次数: 0
Vascularized pronator quadratus pedicled bone grafting versus iliac crest bone grafting in the treatment of scaphoid nonunion: a retrospective study 带血管旋前方肌带蒂植骨与髂骨植骨治疗舟状骨不连的回顾性研究
IF 0.3 Q4 ORTHOPEDICS Pub Date : 2023-07-06 DOI: 10.1097/BCO.0000000000001225
Farshad Zandrahimi, Maryam Aazami, Alireza Sarhadi Zade, A. Saied
Background: Vascularized pronator quadratus pedicled bone grafting is a viable procedure for the treatment of scaphoid nonunion. However, its superiority over iliac crest bone grafting is unknown. In this study, we compare the union rate and outcomes of these procedures in the treatment of scaphoid nonunion. Methods: The medical profiles of the patients with scaphoid nonunion that were treated with either pronator quadratus pedicled bone grafting (n=23) or iliac crest bone grafting procedure (n=31) were retrospectively reviewed. Patients with avascular necrosis of the scaphoid and those with the involvement of the proximal pole were excluded. The outcome measures were the union rate and time, active wrist range of motion, pinch, and grip strength. Results: The mean age of the patients was 30±8.1 yr. Bony union was achieved in all patients of the study groups. The mean time to union was 9.1±2.8 wk in the pronator quadratus group and 8.7±3.5 wk in the iliac crest groups (P=0.14). The mean active flexion, extension, radial deviation, ulnar deviation, pinch, and grip strength of the involved wrist averaged 87.3%, 86.2%, 80.2%, 89.1%, 84.3%, and 85.6% of the contralateral wrist in the pronator quadratus group and 85.5%, 87%, 77.8%, 85.1%, 88.8%, and 87.8% of the contralateral wrist in the iliac crest group, respectively. These differences were not statistically significant. Conclusion: Pronator quadratus pedicled bone grafting provides a similar union rate and outcomes compared to the iliac crest bone grafting in the treatment of scaphoid nonunion. Level of Evidence: IV
背景:带血管旋前方肌蒂骨移植是治疗舟骨不连的可行方法。然而,它相对于髂骨移植的优越性尚不清楚。在本研究中,我们比较了这些手术治疗舟骨不连的愈合率和结果。方法:回顾性分析采用旋方肌带蒂骨移植(n=23)或髂嵴骨移植术(n=31)治疗腕舟骨不连的临床资料。排除舟骨缺血性坏死患者和累及近端骨的患者。结果指标包括愈合率和时间、活动手腕活动范围、握力和握力。结果:患者的平均年龄为30±8.1岁。研究组的所有患者都实现了骨愈合。旋方组和髂嵴组的平均愈合时间分别为9.1±2.8周和8.7±3.5周(P=0.014)。旋方组对侧手腕的平均主动屈曲、伸展、径向偏移、尺骨偏移、挤压和握力分别为87.3%、86.2%、80.2%、89.1%、84.3%和85.6%和85.5%、87%、77.8%、85.1%、88.8%,髂嵴组分别占对侧手腕的87.8%。这些差异在统计学上并不显著。结论:旋方肌蒂骨移植与髂嵴骨移植治疗舟骨不连具有相似的愈合率和疗效。证据级别:IV
{"title":"Vascularized pronator quadratus pedicled bone grafting versus iliac crest bone grafting in the treatment of scaphoid nonunion: a retrospective study","authors":"Farshad Zandrahimi, Maryam Aazami, Alireza Sarhadi Zade, A. Saied","doi":"10.1097/BCO.0000000000001225","DOIUrl":"https://doi.org/10.1097/BCO.0000000000001225","url":null,"abstract":"Background: Vascularized pronator quadratus pedicled bone grafting is a viable procedure for the treatment of scaphoid nonunion. However, its superiority over iliac crest bone grafting is unknown. In this study, we compare the union rate and outcomes of these procedures in the treatment of scaphoid nonunion. Methods: The medical profiles of the patients with scaphoid nonunion that were treated with either pronator quadratus pedicled bone grafting (n=23) or iliac crest bone grafting procedure (n=31) were retrospectively reviewed. Patients with avascular necrosis of the scaphoid and those with the involvement of the proximal pole were excluded. The outcome measures were the union rate and time, active wrist range of motion, pinch, and grip strength. Results: The mean age of the patients was 30±8.1 yr. Bony union was achieved in all patients of the study groups. The mean time to union was 9.1±2.8 wk in the pronator quadratus group and 8.7±3.5 wk in the iliac crest groups (P=0.14). The mean active flexion, extension, radial deviation, ulnar deviation, pinch, and grip strength of the involved wrist averaged 87.3%, 86.2%, 80.2%, 89.1%, 84.3%, and 85.6% of the contralateral wrist in the pronator quadratus group and 85.5%, 87%, 77.8%, 85.1%, 88.8%, and 87.8% of the contralateral wrist in the iliac crest group, respectively. These differences were not statistically significant. Conclusion: Pronator quadratus pedicled bone grafting provides a similar union rate and outcomes compared to the iliac crest bone grafting in the treatment of scaphoid nonunion. Level of Evidence: IV","PeriodicalId":10732,"journal":{"name":"Current Orthopaedic Practice","volume":"34 1","pages":"225 - 228"},"PeriodicalIF":0.3,"publicationDate":"2023-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48579349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Do insurance and socioeconomic status affect outcomes for children who undergo surgery for medial epicondyle fractures? 保险和社会经济地位会影响儿童内上髁骨折手术的结果吗?
IF 0.3 Q4 ORTHOPEDICS Pub Date : 2023-07-06 DOI: 10.1097/BCO.0000000000001227
Jacqueline Ziegman, Molly E Duncan, J. Balch Samora
Background: Low socioeconomic status (SES) and Medicaid insurance have been associated with poorer outcomes. The purpose of this study is to compare outcomes among children with Medicaid vs private insurance, and children with low vs high SES who undergo surgery for medial epicondyle fractures. Methods: This is a retrospective review of patients who underwent surgery for medial epicondyle fractures at a large pediatric hospital between 2015 and 2020. SES was measured using the Opportunity Atlas and the United States Small-Area Life Expectancy Estimate Project. A subset of patients were prospectively administered the PROMIS Pediatric Pain Intensity Numeric Rating Scale and PROMIS Pediatric Upper Extremity Short Form to gather additional information on outcomes as they relate to SES. Results: Of 117 patients, 59 (50.4%) were females, 90 (76.9%) were Caucasian, and average age was 11.1. The average household income was $44,889 (SD=$11,417) and most patients (72.6%) were privately insured. Higher household income was associated with increased number of follow-up appointments (β=0.29, 95% CI=0.08, 0.50) and increased likelihood of using physical therapy (OR=1.67, 95% CI=1.15, 2.42). Patients with private insurance returned to activity 20.5 days sooner than those with public insurance (β=−20.52, 95% CI=−39.5, −1.53). Private insurance tended to be related to less likelihood of complications and more likelihood of use of physical therapy. Conclusions: Insurance and SES may play a role in shaping healthcare outcomes for pediatric patients receiving surgery for medial epicondyle fractures. Level of Evidence: Prognostic Level III.
背景:低社会经济地位(SES)和医疗补助保险与较差的结果有关。本研究的目的是比较接受医疗补助与私人保险的儿童,以及接受内侧上髁骨折手术的SES低与高的儿童的结果。方法:这是对2015年至2020年间在一家大型儿科医院接受内侧上髁骨折手术的患者的回顾性回顾。SES是使用机会地图集和美国小面积预期寿命估计项目进行测量的。一部分患者前瞻性地使用PROMIS儿科疼痛强度数值评定量表和PROMIS儿科上肢简表,以收集与SES相关的结果的额外信息。结果:117例患者中,女性59例(50.4%),高加索人90例(76.9%),平均年龄11.1岁。平均家庭收入为44889美元(SD=111417美元),大多数患者(72.6%)都有私人保险。较高的家庭收入与随访次数增加有关(β=0.29,95%CI=0.08,0.50)和使用物理治疗的可能性增加有关(OR=1.67,95%CI=1.15,2.42)。私人保险患者比公共保险患者早20.5天恢复活动(β=−20.52,95%CI=−39.5,−1.53)并发症和更可能使用物理治疗。结论:保险和SES可能在影响接受内侧上髁骨折手术的儿童患者的医疗保健结果方面发挥作用。证据等级:预后等级III。
{"title":"Do insurance and socioeconomic status affect outcomes for children who undergo surgery for medial epicondyle fractures?","authors":"Jacqueline Ziegman, Molly E Duncan, J. Balch Samora","doi":"10.1097/BCO.0000000000001227","DOIUrl":"https://doi.org/10.1097/BCO.0000000000001227","url":null,"abstract":"Background: Low socioeconomic status (SES) and Medicaid insurance have been associated with poorer outcomes. The purpose of this study is to compare outcomes among children with Medicaid vs private insurance, and children with low vs high SES who undergo surgery for medial epicondyle fractures. Methods: This is a retrospective review of patients who underwent surgery for medial epicondyle fractures at a large pediatric hospital between 2015 and 2020. SES was measured using the Opportunity Atlas and the United States Small-Area Life Expectancy Estimate Project. A subset of patients were prospectively administered the PROMIS Pediatric Pain Intensity Numeric Rating Scale and PROMIS Pediatric Upper Extremity Short Form to gather additional information on outcomes as they relate to SES. Results: Of 117 patients, 59 (50.4%) were females, 90 (76.9%) were Caucasian, and average age was 11.1. The average household income was $44,889 (SD=$11,417) and most patients (72.6%) were privately insured. Higher household income was associated with increased number of follow-up appointments (β=0.29, 95% CI=0.08, 0.50) and increased likelihood of using physical therapy (OR=1.67, 95% CI=1.15, 2.42). Patients with private insurance returned to activity 20.5 days sooner than those with public insurance (β=−20.52, 95% CI=−39.5, −1.53). Private insurance tended to be related to less likelihood of complications and more likelihood of use of physical therapy. Conclusions: Insurance and SES may play a role in shaping healthcare outcomes for pediatric patients receiving surgery for medial epicondyle fractures. Level of Evidence: Prognostic Level III.","PeriodicalId":10732,"journal":{"name":"Current Orthopaedic Practice","volume":"34 1","pages":"263 - 268"},"PeriodicalIF":0.3,"publicationDate":"2023-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48780353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Haptic feedback during virtual reality training significantly improves First-Year orthopedic resident performance at tibia drilling: a randomized trial 虚拟现实训练中的触觉反馈显著提高第一年骨科住院医师胫骨钻孔的表现:一项随机试验
IF 0.3 Q4 ORTHOPEDICS Pub Date : 2023-06-12 DOI: 10.1097/BCO.0000000000001223
A. Kanakamedala, John F. Dankert, Rown Parola, K. Egol, V. Aggarwal, Claudette M. Lajam
Background: Few studies have investigated whether haptic feedback improves the effectiveness of virtual reality (VR) simulation. This study aimed to determine whether new orthopedic surgery residents trained on haptic feedback-enabled VR performed basic drilling better than residents who had trained on VR without haptic feedback. Methods: Fourteen first-year orthopedic surgery residents were enrolled and randomized into “haptic” or “non-haptic” groups and blinded to study goals and randomization. Residents participated in a VR tibia drilling simulation with haptic feedback either turned on or off and then performed a plastic resin tibia model drilling session where overdrill depth was measured by two raters blinded to study groups. Questionnaires were completed before and after the hands-on sessions with responses on a five-point Likert scale. Results: There were no significant differences in demographics between groups. Overdrill depth during the first trial was significantly less in the haptic group than the non-haptic group (3.9 mm vs. 6.0 mm, P=0.005). Subsequent trials showed no significant difference in mean overdrill depth between groups (P>0.05). Haptic group participants reported higher confidence in the safe use of surgical tools (4 vs. 3, P<0.01) and more simulation realism (4 vs. 3, P<0.01). Conclusion: VR training with haptic feedback significantly improves initial performance during use of a surgical drill through a tibia model compared to VR training without haptic feedback in first year orthopedic residents. The addition of haptic feedback also increases the perceived value, realism, and enjoyment of VR simulation. Level of Evidence: Level II.
背景:很少有研究调查触觉反馈是否能提高虚拟现实(VR)模拟的有效性。这项研究旨在确定接受触觉反馈VR训练的新骨科住院医师是否比接受无触觉反馈VR培训的住院医师更好地进行基础训练。方法:14名骨科一年级住院患者被纳入并随机分为“触觉”组或“非触觉”组,对研究目标和随机分组不知情。居民参与了VR胫骨钻孔模拟,打开或关闭触觉反馈,然后进行塑料树脂胫骨模型钻孔,由两名对研究组不知情的评分员测量过钻深度。问卷调查是在实践环节前后完成的,回答采用Likert五分制。结果:两组之间的人口统计学没有显著差异。在第一次试验中,触觉组的过度填充深度明显小于非触觉组(3.9 mm对6.0 mm,P=0.005)。随后的试验显示,各组之间的平均过度填充深度没有显著差异(P>0.05)。触觉组参与者对手术工具的安全使用有更高的信心(4对3,P<0.01),模拟逼真度更高(4对三,P<0.01)。结论:在骨科一年级住院医师中,与没有触觉反馈的VR训练相比,有触觉反馈的虚拟现实训练显著提高了通过胫骨模型使用手术钻头的初始性能。触觉反馈的加入也增加了VR模拟的感知价值、真实感和乐趣。证据级别:二级。
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引用次数: 0
The surgical management of scheurmann’s kyphosis: Efficacy and safety of a low density posterior pedicle screw construct scheurmann后凸畸形的外科治疗:低密度后椎弓根螺钉结构的有效性和安全性
IF 0.3 Q4 ORTHOPEDICS Pub Date : 2023-06-02 DOI: 10.1097/BCO.0000000000001220
M. Khattab, M. Saad, Youssry K. El Hawary
Background: To see if employing a low pedicle screw density in the posterior therapy of Scheuermann kyphosis is safe, radiologically effective, and clinically effective. Methods: Patients with Scheuermann kyphosis underwent posterior surgical correction between 2016 and 2019. Low Screw Density, peri apical Ponte osteotomies and cantilever correction maneuver were our surgical technique for deformity correction. Two observers performed a radiological evaluation of the before and postoperative Spinopelvic parameters. Validated Arabic version of Scoliosis Research Society 22 questionnaire were used to assess the preoperative and postoperative clinical results. Cost saving analysis was performed. Results: This study enlisted the participation of thirty patients. The patients mean age 21.8 ±3.4 years and mean follow up 34.8±7.9 months. The mean surgical time was 165.33 ±17.9 minutes , the mean number of osteotomies was 4.2± 0.8 , and the mean blood loss was 770± 139.3cc.The mean preoperative dorsal kyphosis 87.5°±4.6 °and the mean postoperative dorsal kyphosis 43.1°± 3.7° at final follow up (P<0.001).The mean preoperative scoliosis research society 22 questionnaire 2.8±0.4 and the mean postoperative scoliosis research society 22 questionnaire 4.3±0.8 at final follow up (P<0.001). Conclusions: Posterior Surgical Intervention with low Screw Density construct and periapical Ponte osteotomies is safe , radiologically , clinically and cost effective way in surgical management of Scheuermann kyphosis. Study Design: Prospective Cohort Study. Level of Evidence: Level IV.
背景:观察在Scheuermann后凸的后路治疗中使用低椎弓根螺钉密度是否安全、放射学有效和临床有效。方法:2016年至2019年间,Scheuermann后凸患者接受了后路手术矫正。低螺钉密度、根尖周桥截骨术和悬臂矫正术是我们矫正畸形的手术技术。两名观察者对术前和术后脊髓瓣参数进行了放射学评估。使用经验证的阿拉伯版脊柱侧弯研究学会22号问卷来评估术前和术后的临床结果。进行了成本节约分析。结果:本研究共有30名患者参与。患者平均年龄21.8±3.4岁,平均随访34.8±7.9个月。平均手术时间165.33±17.9分钟、平均截骨次数4.2±0.8次,平均失血量为770±139.3cc。术前平均后凸87.5°±4.6°,术后平均后凸43.1°±3.7°(P<0.001)。术前脊柱侧弯研究会22份问卷平均2.8±0.4,术后脊柱侧弯调查会22份调查问卷平均4.3±0.8在Scheuermann后凸的外科治疗中,低螺钉密度结构和根尖周桥截骨是一种安全、放射学、临床和成本效益高的方法。研究设计:前瞻性队列研究。证据级别:四级。
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引用次数: 0
An analysis of 32 orthopaedic society costs and benefits 32例骨科社会成本与效益分析
IF 0.3 Q4 ORTHOPEDICS Pub Date : 2023-06-01 DOI: 10.1097/BCO.0000000000001218
Janae Rasmussen, Lisa K. Cannada, J. Balch Samora
Background: Many orthopaedic surgeons belong to specialty groups or societies at the local, state, and national levels. We sought to understand costs and benefits of orthopaedic society memberships. Methods: We collected data on the cost of membership and benefits for 32 different orthopaedic societies in 2020 and 2021 by using website information and contacting the society’s administration. We grouped benefits into distinct categories: annual conference, continuing education, educational resources, leadership opportunities, career job listings, research grants, mentorship program, resident/fellow resources, medical student resources, and journal affiliation. Results: On average, attending surgeons pay $460 and residents/fellows pay $300 for a single annual membership. However, some organizations, such as the American Academy of Orthopaedic Surgeons (AAOS), the American Orthopaedic Association (AOA), and the Hip Society have higher annual dues ($1,115, $1,100, and $1,500, respectfully). Over 20 years, a physician belonging to both the AOA and the AAOS pay $44,300 in fees at the current cost. All 32 societies offer an annual conference, continuing education credit opportunities, other educational resources, leadership opportunities, and journal affiliations. Conclusions: Membership fees vary and benefits are often difficult to assess without becoming a member. The COVID-19 pandemic has moved society activities online, decreasing opportunities for in-person networking and education, with some societies considering reduced fees. The pandemic has also strained hospital budgets resulting in loss of funds for many physicians at academic organizations that would normally be used toward membership fees. Perhaps increased opportunities for resource pooling, with group access to educational opportunities and mentorship, should be considered. Level of Evidence: Level V.
背景:许多整形外科医生属于地方、州和国家级别的专业团体或协会。我们试图了解整形外科学会会员的成本和收益。方法:我们使用网站信息并联系协会管理部门,收集了2020年和2021年32个不同骨科协会的会员成本和福利数据。我们将福利分为不同的类别:年会、继续教育、教育资源、领导机会、职业工作清单、研究资助、导师计划、住院医师/同事资源、医学生资源和期刊附属关系。结果:主治外科医生平均每年支付460美元,住院医师/研究员每年支付300美元。然而,一些组织,如美国骨科医师学会(AAOS)、美国骨科协会(AOA)和髋关节协会的年费更高(分别为1115美元、1100美元和1500美元)。在20多年的时间里,AOA和AAOS的医生按当前成本支付44300美元的费用。所有32个学会都提供年度会议、继续教育学分机会、其他教育资源、领导机会和期刊附属机构。结论:会员费用各不相同,如果不成为会员,往往很难评估福利。新冠肺炎疫情将社会活动转移到了网上,减少了住院人员联网和教育的机会,一些社会考虑降低费用。疫情还使医院预算紧张,导致学术组织的许多医生失去了通常用于会员费的资金。也许应该考虑增加资源共享的机会,让群体获得教育机会和指导。证据级别:五级。
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引用次数: 0
Investigation of the effect of subacromial corticosteroid injections on intraocular pressure 肩峰下皮质类固醇注射对眼压影响的研究
IF 0.3 Q4 ORTHOPEDICS Pub Date : 2023-06-01 DOI: 10.1097/bco.0000000000001219
Onur Engin, Ceren Durmaz Engin, Rumeysa Samanci, K. Teberik, S. Ataoğlu
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引用次数: 0
期刊
Current Orthopaedic Practice
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