RESUMEN
INTRODUCTION: Time-efficiency of individually wrapped screws versus screws in a screw rack is not well established. MATERIALS AND METHODS: We performed a prospective single-center clinical study timing the interval between the surgeon asking and receiving a screw during plate and screw osteosynthesis of distal radius fractures. Patients were randomized for individually wrapped screws or screws in a screw rack. The study was conducted in a Level 1 Trauma Center and surgeries were performed between March and June 2023. RESULTS: Average handling time for screws from a screw rack was 9 s (SD 5.5; range 3-28) and 22 s for individually wrapped screws (SD 6.1; range 6-38). This average difference of 13 s is significant (p < 0.0001). CONCLUSION: There is a significant increase in handling time using individually wrapped screws over using a screw rack. LEVEL OF EVIDENCE: Level I (therapeutic, randomized controlled trial).
Asunto(s)
Tornillos Óseos , Fijación Interna de Fracturas , Fracturas del Radio , Humanos , Fracturas del Radio/cirugía , Estudios Prospectivos , Fijación Interna de Fracturas/instrumentación , Fijación Interna de Fracturas/métodos , Masculino , Femenino , Persona de Mediana Edad , Adulto , Anciano , Tempo Operativo , Anciano de 80 o más Años , Fracturas de la MuñecaRESUMEN
OBJECTIVE: To attempt defining differential radiographic diagnostic characteristics for osteonecrotic lesions using 2D as opposed to 3D images. MATERIALS AND METHODS: This was a cross-sectional study. Subjects presenting mandibular osteonecrotic lesions (osteomyelitis, osteoradionecrosis, and medication-related osteonecrosis of the jaws) were selected and compared to a group of age- and gender-matched controls, all having both cone-beam computed tomographic images (CBCT) and panoramic radiographs (PANO). Both imaging modalities (predictor variables) were evaluated by two radiologists that scored lesion presence, eight additional radiological features, and a composite severity index (outcome variables). For each pathologic condition, characteristic features were assessed in PANO and CBCT by the Wilcoxon signed-rank test. Regression tree analysis revealed the predictive value of PANO and CBCT (α = 5%). RESULTS: Overall, the predictive value of PANO reached 74%, while for CBCT it became 90%. Regarding the composite severity index, CBCT enabled to detect more subtle lesions. Also, CBCT imaging allowed showing more distinct radiographic diagnostic features as compared to PANO imaging, more specifically when distinguishing osteomyelitis from both other lesions. CONCLUSIONS: Cone-beam computed tomography enabled showing more differences in radiological features between distinct osteonecrosis disease entities. CBCT imaging might be a better contributor for the detection of early lesions and to monitor further pathological developments in the mandible.
