Comparison of 3D printed anatomical model qualities in acetabular fracture representation.

Background: Acetabular fractures account for 10% of pelvis injuries, which are especially difficult to treat in developing countries with less access to resources. 3D printing has previously been shown to be a beneficial method of surgical planning, however the steep initial costs associated with purchasing a 3D printer may prevent some facilities form utilizing this technique. The purpose of this study was to develop 3D printed models for acetabular surgery using methodologies of varying cost to determine differences in model accuracy and overall quality. Methods: Five acetabular fracture models were developed from de-identified CT data using (I) proprietary and open-source segmentation software and (II) fused deposition modeling (FDM) and stereolithography (SLA) 3D printing methods. The distance between the posterior inferior iliac spine (PIIS) and the ischial spine as well as a unique fracture fragment for each model was compared between the different printing methodologies. The models were then given to 5 physicians and assessed on their overall accuracy compared to traditional 2D images. Results: Printing methodology did not affect the distance from PIIS to ischial spine (P=0.263). However, fracture fragment representation differed across 3D printed models, with the most accurate model produced by the high-end resin-based printer (P=0.007). The survey analysis showed that the low-cost printing methods produced models that were not as accurate in their representation of the fractured region (P=0.008). Conclusions: The differences between models developed using traditional methods and low-cost methods have slight differences but may still provide useful information when developing a surgical plan.

Duodenal injury in blunt abdominal trauma. Case report and literature review.

There are few reported cases of small bowel injury due to blunt abdominal trauma. We describe the clinical presentation and surgical management of these lesions. This is the clinical case of a polytraumatized male with a duodenal injury IIID3 according to AAST, who underwent resection of the intestinal segment with duodeno-duodenum anastomosis with favorable results. The infrequent presentation of injuries to the small intestine due to blunt trauma may lead the clinician to overlook the need for intentional interrogation about the kinematics of the trauma, while at the same time neglecting the taking of complementary diagnostic imaging studies, this because of a lack of clinical suspicion. It is important to analyze the patient's context, which will allow us to assess the need to delve into diagnostic studies in order to optimize their treatment.

Existen pocos casos notificados de lesión de intestino delgado por traumatismo contuso abdominal. Se describen la presentación clínica y el tratamiento quirúrgico de dichas lesiones, un caso clínico de un paciente masculino politraumatizado con lesión duodenal IIID3 según la AAST, objeto de resección de segmento intestinal con anastomosis duodenoduodenal terminoterminal con resultados favorables. La presentación infrecuente de lesiones de intestino delgado por traumatismo contuso puede llevar al clínico a soslayar la necesidad de un interrogatorio intencionado acerca de la cinemática del traumatismo y también de los estudios de imagen complementarios diagnósticos debido a la falta de sospecha clínica. Es importante analizar el contexto del paciente para valorar la necesidad de profundizar en estudios diagnósticos y optimizar el tratamiento.

Remote fitting procedures for upper limb 3d printed prostheses.

BACKGROUND: The objective of the current investigation was twofold: i) describe a remote fitting procedure for upper limb 3D printed prostheses and ii) assess patient satisfaction and comfort with 3D printed prostheses fitted remotely. METHODS: A qualitative study using content and score analysis to describe patient satisfaction after remote prosthetic fitting. Research participants reported QUEST and OPUS scores that allow for perceived rating of general aspects and functionality of upper limb prostheses. RESULTS: Six children (three girls & boys, 6-16 years of age) and 2 adult males (25 and 59 years of age) with congenital (n = 7) and acquired (n = 1) upper limb loss participated in this study. Highest device satisfaction items of the QUEST include weight (4.50 ± 0.76), safety (4.38 ± 0.52), and ease of use (4.13 ± 0.64). Functional tasks of the OPUS observe that prosthesis donning and doffing (1.5 ± 0.84) and drinking from a paper cup (1.75 ± 0.89) were the easiest functional tasks. CONCLUSION: The presented methodology for remote fitting of 3D printed upper-limb prostheses exhibits significant potential for rapid fabrication of functional prostheses to developing countries due to increased availability of digital devices in rural areas.

Coactivation index of children with congenital upper limb reduction deficiencies before and after using a wrist-driven 3D printed partial hand prosthesis.

BACKGROUND: Co-contraction is the simultaneous activation of agonist and antagonist muscles that produces forces around a joint. It is unknown if the use of a wrist-driven 3D printed transitional prostheses has any influence on the neuromuscular motor control strategies of the affected hand of children with unilateral upper-limb reduction deficiencies. Thus, the purpose of the current investigation was to examine the coactivation index (CI) of children with congenital upper-limb reduction deficiencies before and after 6 months of using a wrist-driven 3D printed partial hand prosthesis. METHODS: Electromyographic activity of wrist flexors and extensors (flexor carpi ulnaris and extensor digitorum) was recorded during maximal voluntary contraction of the affected and non-affected wrists. Co-contraction was calculated using the coactivation index and was expressed as percent activation of antagonist over agonist. Nine children (two girls and seven boys, 6 to 16 years of age) with congenital upper-limb deficiencies participated in this study and were fitted with a wrist-driven 3D printed prosthetic hand. From the nine children, five (two girls and three boys, 7 to 10 years of age) completed a second visit after using the wrist-driven 3D printed partial hand prosthesis for 6 months. RESULTS: Separate two-way repeated measures ANOVAs were performed to analyze the coactivation index and strength data. There was a significant main effect for hand with the affected hand resulting in a higher coactivation index for flexion and extension than the non-affected hand. For wrist flexion there was a significant main effect for time indicating that the affected and non-affected hand had a significantly lower coactivation index after a period of 6 months. CONCLUSION: The use of a wrist-driven 3D printed hand prosthesis lowered the coactivation index by 70% in children with congenital upper limb reduction deficiencies. This reduction in coactivation and possible improvement in motor control strategies can potentially improve prosthetic rehabilitation outcomes.

Capacidad intelectual y función ejecutiva en niños intelectualmente talentosos y en niños con inteligencia promedio / Intellectual ability and executive function in intellectually gifted children and children with average intelligence

El objetivo del presente estudio fue analizar las relaciones, por comparación y correlación, entre las dimensiones de función ejecutiva (FE) y capacidad intelectual (CI) en niños con talento excepcional (NTE) y niños con inteligencia promedio (NIP), de 7 a 11 años de edad, de la ciudad de Medellín, Colombia. Se seleccionó una muestra no aleatoria de 62 niños y se conformaron dos grupos independientes, de acuerdo con la CI. Se les administraron pruebas de FE. Según los resultados, los NTE tuvieron una ejecución significativamente más alta en la TFV-fonológica (p < 0,05), con un tamaño del efecto medio (0,65). Únicamente, se encontró una correlación estadísticamente significativa pero baja (r = 0,267, p = 0,03) entre TFV-fonológica y el CIV. Se concluyó que la FE parece ser una actividad cognitiva no relacionada con las mediciones de la CI...

Objective: To analyze the relationship, by comparison and correlation, between executive function (EF) and intellectual capacity (IC) in clever children (CC) and Average Intelligence Quotient children (AIQC), aged 7 to 11 years, and living in Medellín - Colombia. Patients and Methods: a non-randomized sample of 62 children was selected. The sample was constituted by two independent groups, according the IC. EF tasks were administered to both groups. Results: CC had statistically significant higher performance on phonological verbal fluency test (PVFT) (p < 0,05), with a modest effect size (0,65). A statistically significant, but low (r = 0,267, p = 0,03), correlation between PVF and verbal IQ was found. Conclusion: EF appeared as a non IQ-related ability...