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1.
J Orthop Traumatol ; 22(1): 40, 2021 Oct 13.
Artigo em Inglês | MEDLINE | ID: mdl-34647237

RESUMO

INTRODUCTION: Sciatic nerve injury is an uncommon but potentially devastating complication in hip and pelvis surgery. Intraoperative nerve monitoring (IONM) was applied since the seventies in neurosurgery and spine surgery. Nowadays, IONM has gained popularity in other surgical specialities including orthopaedic and trauma surgery. Aim of this systematic review is to resume the literature evidences about the effectiveness of intraoperative monitoring of sciatic nerve during pelvic and hip surgery. METHODS: Two reviewers (GC and MD) independently identified studies by a systematic search of PubMed and Google Scholar from inception of database to 10 January 2021. Inclusion criteria were: (a) English written papers, (b) use of any type of intraoperative nerve monitoring during traumatic or elective pelvic and hip surgery, (c) comparison of the outcomes between patients who underwent nerve monitoring and patient who underwent standard procedures, (d) all study types including case reports. The present review was conducted in accordance with the 2009 PRISMA statement. RESULTS: The literature search produced 224 papers from PubMed and 594 from Google Scholar, with a total amount of 818 papers. The two reviewer excluded 683 papers by title or duplicates. Of the 135 remaining, 72 were excluded after reading the abstract, and 31 by reading the full text. Thus, 32 papers were finally included in the review. CONCLUSIONS: The use of IONM during hip and pelvis surgery is debated. The review results are insufficient to support the routine use of IONM in hip and pelvis surgery. The different IONM techniques have peculiar advantages and disadvantages and differences in sensitivity and specificity without clear evidence of superiority for any. Results from different studies and different interventions are often in contrast. However, there is general agreement in recognizing a role for IONM to define the critical maneuvers, positions or pathologies that could lead to sciatic nerve intraoperative damage. LEVEL OF EVIDENCE: Level 2.


Assuntos
Ortopedia , Humanos , Monitorização Intraoperatória , Procedimentos Neurocirúrgicos , Pelve/cirurgia , Estudos Retrospectivos
2.
J Med Syst ; 45(11): 99, 2021 Oct 09.
Artigo em Inglês | MEDLINE | ID: mdl-34628540

RESUMO

The use of smartphone apps is an essential part of everyday life. Mobile applications offer enormous opportunities for dealing with challenges in public health, and their number increases every day. This paper aims to review the existing literature on mobile applications in orthopaedic oncology and to summarize the current mobile applications for musculoskeletal tumors. A systematic literature review was conducted regarding articles on mobile applications in orthopaedic and trauma surgery. The focus was on identifying mobile applications that can be used in the treatment of patients with musculoskeletal tumors. Two reviewers independently assessed study eligibility, extracted data, and appraised methodological quality. In addition, the Apple App Store and Google Play Store were searched for suitable mobile applications. Ninety-one articles describing a mobile application in orthopaedic and trauma surgery were identified. Three articles focused on a mobile application for musculoskeletal tumors. Additionally, seven mobile applications were available in the App/Play Stores dealing with bone or soft tissue tumors in orthopaedic oncology without corresponding scientific articles. Increasing numbers of mobile applications are being developed in orthopaedic and trauma surgery. Currently, only three scientific articles on mobile applications in orthopaedic oncology are present, yet several more applications are available without scientific medical evaluation. Since mobile applications can facilitate the everyday life of orthopaedic and trauma surgeons, it is worthwhile to be aware of new developments in this field. A regular scientific evaluation of the subject is important in order to classify the significance of these applications.


Assuntos
Aplicativos Móveis , Neoplasias , Ortopedia , Telemedicina , Humanos , Oncologia , Neoplasias/diagnóstico , Neoplasias/terapia
3.
Artigo em Inglês | MEDLINE | ID: mdl-34637404

RESUMO

BACKGROUND: The COVID-19 pandemic has interrupted orthopaedic training structures for both surgeons and trainees. The concept of skill decay must be considered during inactivity of elective practice. The purpose of this study was to provide an evidence-based curriculum in association with immersive virtual reality (iVR) to prevent skill decay during periods of training cessation and beyond. METHODS: A review of pertinent literature for orthopaedic surgical skill decay was performed. Early experience by faculty instructors and residency and fellowship program directors was gathered from multiple institutions with experience in virtual training methods including iVR. A proposed curriculum for cognitive and manual skill acquisition during COVID-19 was produced from qualitative narrative group opinion. RESULTS: Skill decay can occur on the order of days to months and is dependent on the initial skill level. A novel curriculum for structured continuing medical education during and after periods of surgical disruption including e-learning, virtual meetings, and iVR simulators was produced from expert opinion and based on competency-based curriculum standards. CONCLUSION: Skill decay mitigation strategies should use best available evidence technologies and course structures that satisfy advanced learning concepts. The virtual curriculum including iVR simulators may provide cost-effective solutions to training.


Assuntos
COVID-19 , Ortopedia , Treinamento por Simulação , Competência Clínica , Humanos , Pandemias , SARS-CoV-2
4.
Arthroscopy ; 37(10): 3001-3002, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34602140

RESUMO

At the American Orthopaedic Society for Sports Medicine (AOSSM)-Arthroscopy Association of North America (AANA) 2021 Annual Meeting in Nashville, Tennessee, collaboration was the word of the day. AAOSM and AANA are a great pair, and many of us are long-time members of both associations. The attendance was unprecedented. Face-to-face meetings facilitate great spontaneity, profound exchange, nuanced communication, personal sharing, and efficient and passionate occurrence of new ideas. President Mark Getelman will host next year's AANA Annual Meeting, AANA22, in another fantastic American city with which AANA is very familiar, San Francisco, California. The meeting will be held May 19-21, 2022, and we look forward to seeing many of you in the City by the Bay. It will be AANA's 40th Annual Meeting, and naturally, your editors are planning to attend.


Assuntos
Ortopedia , Medicina Esportiva , Alanina/análogos & derivados , Artroscopia , Humanos , Sociedades Médicas , Estados Unidos
6.
BMC Musculoskelet Disord ; 22(1): 896, 2021 Oct 21.
Artigo em Inglês | MEDLINE | ID: mdl-34674677

RESUMO

BACKGROUND: There is a need to improve consultations between patients with persistent musculoskeletal low back pain and orthopaedic spine clinicians when surgery is not indicated. Poor communication and lack of education about self- management in these consultations have been shown to be associated with increased distress and higher subsequent health care seeking. AIM: To develop a standardised intervention to improve spine care consultations for patients for whom surgery is not beneficial. METHOD: The intervention was developed in six stages. The first three stages included: interviews with patients, an interactive workshop with clinicians from a mix of disciplines, and interviews with spine clinicians about their perspective of the recommendations, their perceived difficulties and potential improvements. Information from these stages was synthesised by an expert panel, creating a draft intervention structure and content. The main features of the intervention and the materials developed were then reviewed by patients and spine clinicians. Finally, the research team incorporated the recommended amendments to produce the intervention. RESULTS: In total, 36 patients and 79 clinicians contributed to the development of the intervention. The final intervention includes three components: a pre-consultation letter with information suggesting that surgery is one possible intervention amongst many, introducing the staff, and alerting patients to bring with them a potted history of interventions tried previously. The intervention includes short online training sessions to improve clinicians' communication skills, during the consultation, in reference to listening skills, validation of patients' pain, and use of appropriate language. Clinicians are also supplied with a list of evidence-based sources for advice and further information to share with patients. Finally, post consultation, a follow up letter includes a short summary of the patients' clinical journey, the results of their examination and tests, and a reminder of recommendations for self-management. CONCLUSION: The intervention includes aspects around patient education and enhanced clinician skills. It was developed with input from a multitude of stakeholders and is based on patients' perceptions of what they would find reassuring and empowering when surgery is excluded. The intervention has the potential to improve the patients care journey and might lead to changes in practice in spine clinicians.


Assuntos
Dor Lombar , Ortopedia , Autogestão , Humanos , Dor Lombar/diagnóstico , Dor Lombar/terapia , Aceitação pelo Paciente de Cuidados de Saúde , Encaminhamento e Consulta
7.
Curr Sports Med Rep ; 20(10): 553-561, 2021 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-34622821

RESUMO

ABSTRACT: The role of orthopedic team physicians has evolved greatly over the past decade having been influenced by advances in sports science and performance, new surgical and biologic technologies, social media, medicolegal liability, marketing, and sexual misconduct cases by some team physicians. The great variety of events and sports that are covered from high school and collegiate to the Olympic and professional levels requires a myriad of skills outside of the traditional medical training curriculum. In the current climate of increasing media scrutiny from a 24-h news cycle it is imperative for orthopedic team physicians, whether operative or nonoperative, to continually adapt to the needs and expectations of athletes who also are patients. This is especially true in the wake of the COVID-19 pandemic. Orthopedic team physicians' responsibilities continue to evolve ensuring their relevance and necessity on the sidelines and in the training room as well as in the operative suite.


Assuntos
Ortopedia , Papel do Médico , Medicina Esportiva , Humanos , Motivação , Ortopedia/tendências , Medicina Esportiva/tendências
8.
BMJ Open Qual ; 10(4)2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34645613

RESUMO

AIMS: Adoption of virtual clinics has been accelerated by the COVID-19 pandemic and they will continue to form an integral part of healthcare delivery. Our objective was to evaluate virtual clinics in orthopaedic practice and determine how to use them effectively and sustainably. METHODS: We surveyed 100 consecutive patients participating in orthopaedic virtual phone clinic (VPC) at an academic hospital to evaluate patient satisfaction against face-to-face (F2F) consultations and obtain suggestions for improving patient experience, and we surveyed 23 clinicians who conducted orthopaedic VPCs in 2020. Data were correlated with clinic outcomes, reason for consultation, diagnosis, patient age and clinician grade. Consultation duration, clinician-associated costs and reimbursement were analysed. Significance was tested using two-tailed Student's t-test and Fisher's exact test. RESULTS: Patient satisfaction (out of 5) for VPC was significantly lower than F2F (4.1 vs 4.5, p=0.0003), and a larger proportion of VPC scored <3 compared with F2F (11% vs 2%). Higher VPC scores were associated with appointments for delivering results and where patients felt clinical examination was not needed. Patients suggested introducing video capability, adhering to appointment time and offering the choice of VPC or F2F. Mean clinician satisfaction scores for VPC were 4.3/5 and suggested indications for VPC included: routine surveillance, communication of results, discussing/consenting for surgery and vulnerable patients. Integrating video, providing private rooms and offering patients time intervals for VPC were recommended. Current National Health Service VPC structures uses greater clinician resources and generates lower reimbursement than F2F consultations, resulting in 11.5% reduction in reimbursement. CONCLUSION: VPC plays a valuable role when clinical evaluation has been performed or considered not necessary. Offering the choice of VPC or F2F, adding video capability and providing a time interval for VPC may reduce resource use and increase satisfaction. We recommend renegotiating VPC tariffs and cost-neutral modifications of clinic structure.


Assuntos
COVID-19 , Ortopedia , Humanos , Pandemias , Satisfação do Paciente , SARS-CoV-2 , Medicina Estatal
9.
Enferm. foco (Brasília) ; 12(7, supl 1): 115-120, out. 2021. tab
Artigo em Português | LILACS, BDENF - enfermagem (Brasil) | ID: biblio-1337862

RESUMO

Objetivo: relatar a experiência acerca da estruturação de ações para a inserção da cultura de segurança no cuidado pediátrico ortopédico. Método: estudo descritivo, tipo relato de experiência, fundamentado no Programa Nacional de Segurança do Paciente através da aplicação das Metas de Segurança do Paciente no cuidado diário de enfermagem no período de janeiro/2019 a dezembro/2019 na enfermaria pediátrica de um instituto referência em traumatologia e ortopedia no Rio de Janeiro. Resultados: a incorporação das práticas seguras ocorreu por meio de indicadores de segurança baseados nas Metas de Segurança, que demonstraram avanços crescentes nos índices percentuais e estratégias de adesão que favoreceram ao reconhecimento e satisfação profissional, liderança e o trabalho em equipe. Conclusões: as ações adotadas para a inserção da cultura de segurança na pediatria permitiram que a segurança e qualidade assistencial, preconizadas pelo Ministério da Saúde, fossem incorporadas como uma nova prática no cuidado pediátrico ortopédico. promovendo a visibilidade e valorização da enfermagem, com destaque à replicabilidade como proposta futura de disseminação de boas práticas no cuidado à saúde. (AU)


Objective: To report the experience regarding the structuring of actions for the insertion of a culture of safety in pediatric orthopedic care. Methods: Descriptive study, experience report type, based on the National Patient Safety Program through the application of the Patient Safety Goals in daily nursing care from January/2019 to December/2019 in the pediatric ward of a reference institute in traumatology and orthopedics in Rio de Janeiro. Results: The incorporation of safe practices occurred through safety indicators based on the Safety Goals, which showed increasing advances in percentage indices and adherence strategies that favored professional recognition and satisfaction, leadership and teamwork. Conclusion: The actions taken to insert a culture of safety in pediatrics allowed the safety and quality of care, recommended by the Ministry of Health, to be incorporated as a new practice in pediatric orthopedic care. promoting the visibility and appreciation of nursing, with emphasis on replicability as a future proposal for the dissemination of good practices in health care. (AU)


Objetivo: Reportar la experiencia en la estructuración de acciones para la inserción de una cultura de seguridad en la atención ortopédica pediátrica. Método: Estudio descriptivo, tipo relato de experiencia, basado en el Programa Nacional de Seguridad del Paciente mediante la aplicación de las Metas de Seguridad del Paciente en la atención diaria de enfermería de enero/2019 a diciembre/2019 en la sala de pediatría de un instituto de referencia en traumatología y ortopedia en Rio de Janeiro. Resultados: La incorporación de prácticas seguras se dio a través de indicadores de seguridad basados en las Metas de Seguridad, que mostraron avances crecientes en índices porcentuales y estrategias de adherencia que favorecieron el reconocimiento y satisfacción profesional, el liderazgo y el trabajo en equipo. Conclusion: Las acciones emprendidas para insertar la cultura de la seguridad en la pediatría permitieron incorporar la seguridad y calidad de la atención, recomendada por el Ministerio de Salud, como una nueva práctica en la atención ortopédica pediátrica. Afirmando la visibilidad y valoración de la enfermería, con énfasis en la replicabilidad como propuesta de futuro para la difusión de buenas prácticas en salud. (AU)


Assuntos
Segurança do Paciente , Ortopedia , Enfermagem Pediátrica
10.
PLoS One ; 16(9): e0257289, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34559826

RESUMO

The Coronovirus Disease 2019 -(COVID-19) pandemic had a significant impact on the health care system and medical staff around the world. The orthopedic units were also subject to new restrictions and regulations. Therefore, the aim of our research was to assess how the COVID-19 pandemic affected orthopedic wards in the last year in Poland. We created an online survey, which was sent to 273 members of the Polish Society of Orthopedics and Traumatology. The survey contained 51 questions and was divided into main sections: Preparedness, Training, Stress, Reduction, Awareness. A total of 80 responses to the survey were obtained. In Preparedness section the vast majority of respondents (90%) replied, that they used personal protective equipment during the pandemic, however only 50% of the respondents indicated that their facility received a sufficient amount of personal protective equipment. Most of the respondents indicated that the pandemic negatively affected the quality of training of future orthopedists (69.4%) and that pandemic has had a negative impact on their operating skills (66,7%). In Reduction section most of the doctors indicated that the number of patients hospitalized in their departments decreased by 20-60% (61,2% respondents), while the number of operations performed decreased by 60-100% (60% respondents). The negative impact of pandemic on education was noticeable especially in the group of young orthopedic surgeons: 0-5 years of work experience (p = 0,029). Among the respondents, the level of stress increased over the last year from 4.8 to 6.9 (p <0.001). The greatest increase in the level of stress was observed among orthopedists working in country hospitals (p = 0,03). In section Awareness 36,3% of respondents feel well or very well informed about the latest Covid-19 regulations. In addition, most doctors (82.6%) believe that the Polish health care system was not well prepared to fight the pandemic and that the regulations applied so far are not sufficient to effectively fight the pandemic (66.2%). The COVID-19 pandemic has impact on orthopedics departments in Poland and negatively affected the quality of training of orthopedic surgeons and the level of stress.


Assuntos
COVID-19 , Procedimentos Ortopédicos , Cirurgiões Ortopédicos/psicologia , Pandemias , Equipamento de Proteção Individual , SARS-CoV-2 , Estresse Psicológico , Adulto , Idoso , COVID-19/epidemiologia , COVID-19/prevenção & controle , COVID-19/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Ortopedia , Polônia , Estresse Psicológico/epidemiologia , Estresse Psicológico/psicologia
11.
Orthopedics ; 44(5): 264-272, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34590941

RESUMO

The Hippocratic oath is traditionally taken by medical school graduates at the time of their graduation, either in its original form or in a modern variation. It is considered the earliest expression of medical ethics, establishing principles of ethics that remain of paramount significance today. However, it was written in antiquity, whereas medicine has been constantly evolving. This article reviews, analyzes, and interprets each section of the oath to determine to what extent it remains relevant to contemporary medicine. [Orthopedics. 2021;44(5):264-272.].


Assuntos
Juramento Hipocrático , Ortopedia , Ética Médica , Humanos
12.
Orthopedics ; 44(5): e661-e667, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34590944

RESUMO

Patient activation, the propensity for patients to engage in adaptive health behaviors, is a modifiable factor associated with health outcomes and treatment compliance. The authors evaluated the effect of a question-building intervention (QBI) on patient activation among patients with musculoskeletal symptoms and a low baseline level of activation. Patients seeking treatment for musculoskeletal pain were recruited at the beginning of their outpatient clinic appointment, and they completed the Patient Activation Measure 10-item version (PAM-10) and a demographic questionnaire. Those identified as low activating, based on the initial PAM-10 scores, completed a QBI protocol before their consultation with their provider. A follow-up PAM-10 survey was administered at the end of the visit. A paired sample Student's t test was used to evaluate preintervention and postintervention PAM-10 scores. Fisher's exact test and an unpaired t test were used to assess the association between demographic variables and achievement of minimal clinically important difference (MCID) for PAM-10. Of 194 patients who consented to participate, 60 were identified as low activating and completed the QBI. A paired Student's t test showed a statistically significant increase in mean PAM-10 scores from preintervention (47.3±7.4) to postintervention (54.8±16.8; P<.001). No statistically significant differences were shown in the likelihood of achieving MCID for PAM-10 scores for the sociodemographic variables that were tested. Low-activating patients may benefit from a simple question-formulating intervention before consultation with an orthopedic provider. [Orthopedics. 2021;44(5):e661-e667.].


Assuntos
Dor Musculoesquelética , Procedimentos Ortopédicos , Ortopedia , Humanos , Participação do Paciente , Inquéritos e Questionários
13.
Orthopedics ; 44(5): 289-292, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34590954

RESUMO

Women represent only 15.3% of all residents and fellows in the field of orthopedic surgery. The rate of increase of women in the field of orthopedics continues to lag behind all other surgical specialties. The purpose of this study was 2-fold: (1) to evaluate male/female representation in orthopedic specialty societies and (2) to examine the involvement of male/female orthopedic surgeons on committees, in leadership roles, at annual meetings, and in receipt of monetary awards. A 12-question, anonymous survey was distributed to the executive directors of all 23 orthopedic specialty societies. The survey included questions about the breakdown of male/female membership as well as male/female orthopedic surgeon participation in various functions of the society. Fourteen (60.9%) of 23 executive directors from orthopedic specialty societies responded to the survey. Seven (50.0%) of 14 survey respondents reported society membership of more than 1000. Six (42.9%) of 14 survey respondents reported male membership of more than 1000, while only the Ruth Jackson Orthopaedic Society reported female membership of more than 1000. Eleven (78.6%) of 14 survey respondents (eg, American Association of Hip and Knee Surgeons, American Orthopaedic Foot and Ankle Society, American Orthopaedic Society for Sports Medicine) reported having more than 10 men in leadership positions, whereas 13 (92.9%) of 14 respondents reported 10 or fewer women in leadership positions. Most orthopedic specialty societies have lower female than male membership, fewer women in leadership positions, and fewer monetary awards granted to women compared with men. This disparity was more evident in anatomic societies (eg, American Association of Hip & Knee Surgeons, American Orthopaedic Foot and Ankle Society) compared with general orthopedic societies (eg, Ruth Jackson Orthopaedic Society, Orthopaedic Research Society). Female orthopedic surgeons remain underrepresented in orthopedic specialty societies. [Orthopedics. 2021;44(5):289-292.].


Assuntos
Cirurgiões Ortopédicos , Ortopedia , Médicas , Cirurgiões , Feminino , Humanos , Liderança , Masculino , Sociedades Médicas , Estados Unidos
14.
Orthopedics ; 44(5): e682-e686, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34590959

RESUMO

The orthopedic surgical specialty is strongly tied to partnerships with industry that have fostered innovation and greatly enhanced patient care. A substantial number of orthopedic surgeons currently receive some form of industry support. These relationships are highly scrutinized because they present the possibility of both personal and financial conflicts of interest (COI). The authors examined orthopedic patients' awareness of existing regulation and perceptions of financial COI by performing a prospective survey-based study of patients seen in an academic orthopedic department. Data were collected during 1 year, in a cross-section of hospital-based and community clinical settings. The authors collected 513 surveys during a 1-year period between 4 clinical locations. Of all respondents, 55% were unconcerned regarding gifts or direct compensation their physicians received from industry, and only 16% were very or extremely concerned regarding these benefits. Patients' opinions regarding possible influence of benefits were similarly ambivalent, with 54% of patients minimally or not at all concerned regarding the potential influence of industry gifts or compensation. Seventy-six percent of patients had never heard of the Sunshine Act, and only 3% indicated that they were aware of the legislation and its intention. The income of the respondents and their level of education were positively correlated with increased concern about handling of COI, as well as knowledge regarding the Sunshine Act. These data suggest that orthopedic surgery patients are widely unconcerned regarding physician COI, but specific subsets of patients may be more likely to have concerns regarding these relationships. [Orthopedics. 2021;44(5):e682-e686.].


Assuntos
Procedimentos Ortopédicos , Ortopedia , Conflito de Interesses , Humanos , Percepção , Estudos Prospectivos
15.
J Mech Behav Biomed Mater ; 123: 104727, 2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-34492615

RESUMO

Bone drilling is an indispensable and demanding operation among many orthopaedic operations. A dedicated drill bit that can achieve low-trauma and self-centring drilling is in urgent need. In this study, a three-step orthopaedic low-traumatic drill bit design was proposed. In order to evaluate the drilling performance of the proposed drill, comprehensive comparison tests were carried out with various commercial medical drills in terms of skiving force, thrust force, temperature rise, and surface quality. The experimental results show that the proposed three-step drill design with the optimal point angle, a small chisel edge, transition arc and web thinning can obtain lower and more stable thrust force, slighter bending force, smaller temperature rise, and higher hole quality compared with the commercial drill bits. The proposed drill shows satisfactory drilling performance and has great application potential in clinical surgery.


Assuntos
Procedimentos Ortopédicos , Ortopedia , Osso e Ossos , Fenômenos Mecânicos , Temperatura
16.
BMC Med Educ ; 21(1): 515, 2021 Sep 29.
Artigo em Inglês | MEDLINE | ID: mdl-34587963

RESUMO

BACKGROUND: In COVID 19 era, the literature on e-learning, or particularly m-learning, has considerably increased focusing on the subject of medical knowledge transfer. Considering the importance of orthopedic knowledge for general practitioners and the inadequacy of the orthopedics internship duration in Mashhad University of Medical Sciences (MUMS), we have developed and investigated a smartphone orthopedic educational application named "Orthobox". METHODS: In a quasi-clinical before-after trial study, we investigated the benefits of Orthobox application for medical interns attending MUMS orthopedic departments. A total of 120 students (64 and 56 students in control and case groups respectively) were recruited. The application consists of five main parts of medication, common order samples, common prescriptions, cast and splint types, and educational movies. Students who passed the course without getting access to the application (control group) and students who were also using application during the course (case group) were defined, and comparison was done between them objectively through final exam score comparison and subjectively through Visual Analogue Scale (VAS) questionnaire score comparison. Besides, using case group students' activity report provided by the application panel, correlational analysis was done on their amount of activity on each of the main parts of the application and the corresponding question exam and VAS score separately. RESULTS: The case group of the study generally achieved higher final exam scores, mainly on Order question score (P value<0.001). Total VAS scores were also greater in case group (P value =0.001). It has also been identified that there is a notable positive trend between student's amount of usage of the application and their final exam scores through correlational analysis. This correlation was not significant about students' application visit numbers and VAS scores. CONCLUSION: These results suggest that m-learning has got the potential to improve students' medical knowledge and skills by organizing must-to-learn content specified for intern students of orthopedics on one hand, and cause more satisfaction in students about their education on the other hand. TRIAL REGISTRATION: This study was not registered because it is a quasi-clinical trial study. LEVEL OF EVIDENCE: Level III (Evidence obtained from well-designed controlled trials without randomization (i.e. quasi-experimental).


Assuntos
COVID-19 , Educação de Graduação em Medicina , Ortopedia , Estudantes de Medicina , Humanos , Aprendizagem , Ortopedia/educação , SARS-CoV-2
18.
J Surg Orthop Adv ; 30(3): 140-143, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34591001

RESUMO

The purpose of this study was to review our protocol of sliding hip screws for stable and cephallomedullary devices for unstable peritrochanteric fractures to evaluate the correctness of the decisions made based on complication rates and on shortening of the fractures as well as financial implications. Over a five-year period, two orthopaedic traumatologists followed a protocol utilizing a sliding hip screw (SHS) for all fractures that were deemed stable and a cephallomedullary nail for unstable fractures. Injury radiographs were then re-reviewed by a blinded observer to classify each fracture pattern as stable or unstable based on the Evans classification. Of 121 patients, 62 were classified as stable and 59 unstable. The tip apex distance averaged 16 mm with 2/61 (3.3%) > 25mm for plates and 22 mm with 6/60 (10%) > 25mm for intermedullary (IM) nails. Two partial cutouts occurred, both in the SHS group. Minimal shortening and deformity were noted for each group. A stability-based protocol utilizing sliding hip screws for stable and IM nails for unstable peritrochanteric hip fractures based on the judgment of experienced surgeons is valid and reasonable, resulting in significant savings compared to using IM nails for all cases ($104,898 in this series). (Journal of Surgical Orthopaedic Advances 30(3):140-143, 2021).


Assuntos
Fixação Intramedular de Fraturas , Fraturas do Quadril , Ortopedia , Pinos Ortopédicos , Fixação Interna de Fraturas , Fraturas do Quadril/diagnóstico por imagem , Fraturas do Quadril/cirurgia , Humanos
19.
J Surg Orthop Adv ; 30(3): 150-155, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34591003

RESUMO

Orthopaedic surgery is one of the most competitive surgical specialties in the United States. No investigation has focused on the impact of research productivity and reputation on matching in this applicant pool. A retrospective investigation evaluating publications was conducted on residency applicants to the department of orthopaedic surgery of a single institution in 2019. Predictors of successful matching in orthopaedic surgery were analyzed. Of 519 candidates, 314 (60.5%) reported publications on their applications at the time of submission. The mean impact factor of reported publications was 3.6 (95% CI 0-11.8) and did not differ between candidates who did (3.4 [95% confidence interval [CI] 0-12.2]) and did not (3.4 [95%CI 0-8.0]) match, (p = 0.90). An applicant's participation in research, number of publications, publications in higher impact journals, or misrepresentation of their publications had no effect on successful orthopaedic residency match. (Journal of Surgical Orthopaedic Advances 30(3):150-155, 2021).


Assuntos
Internato e Residência , Procedimentos Ortopédicos , Ortopedia , Bibliometria , Humanos , Ortopedia/educação , Estudos Retrospectivos , Estados Unidos
20.
J Surg Orthop Adv ; 30(3): 161-165, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34591005

RESUMO

The purpose of this study is to examine differences in pediatric anterior cruciate ligament reconstruction (ACLR) between surgeons with either pediatric or sports medicine fellowship training. Patients were divided into two groups, those performed by either a pediatric or sports medicine fellowship-trained surgeon. One hundred and forty-one patients were identified: 91 (64.5%) by pediatric trained surgeons and 50 (35.4%) by sports medicine trained surgeons. Patients that had ACLR by a pediatric trained surgeon were younger (p = 0.02), had larger body mass index (BMI) (p = 0.027), and more likely to have government assisted insurance (p = 0.006). Pediatric trained surgeons had longer procedure time (p < 0.001), used smaller graft sizes (p = 0.016), used soft tissue grafts (p < 0.001) and used button fixation at both the femur and tibia (p < 0.001). There were no differences regarding meniscus surgery, surgical technique (transphyseal versus physeal sparing), arthrofibrosis, graft failure, and intraoperative complications (p > 0.05). This study shows favorable and comparable results after ACLRs with either pediatric or sports medicine fellowship training. (Journal of Surgical Orthopaedic Advances 30(3):161-165, 2021).


Assuntos
Lesões do Ligamento Cruzado Anterior , Reconstrução do Ligamento Cruzado Anterior , Ortopedia , Lesões do Ligamento Cruzado Anterior/cirurgia , Criança , Bolsas de Estudo , Fêmur , Humanos , Tíbia
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