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1.
Acta Biomed ; 92(1): e2021104, 2021 02 09.
Artículo en Inglés | MEDLINE | ID: mdl-33682805

RESUMEN

INTRODUCTION: Coronavirus disease (CoVID-19) is causing millions of deaths worldwide and the crisis of the global healthcare system.  Aim Of The Study: evaluate the preliminary impact of CoVID-19 in three Italian Orthopedics and Traumatology Departments in the first 10 weeks of the national lockdown. We focused on proximal humerus fractures, analyzing data and results in comparison with the same period of 2019. MATERIALS AND METHODS: From February 22nd to May 3rd 2020, 55 patients were admitted to our departments for promixal humerus fractures. Our cohort of patients is composed by 13 males (23.6%) and 42 females (76.4%), with an average age of 73.8 ± 11.7 years (range 44 - 94). Trauma occurred at home in 43 cases (78.2%), by the roadside in 10 cases (18.2%), in a retirement home in 1 case (1.8%), and at work in 1 case (1.8%). We proposed surgical treatment in 15/55 cases, but 4 patients refused hospitalization, mainly because of the risk of contracting n-CoV19 infection. RESULTS: We noticed a decrease in proximal humerus fractures compared to 2019 (-37.5%). Particularly, we observed a significant drop in traumas occurred on the road and at work respectively 23.9% and 3.4%% in 2019, and 18.2% and 1.8% in 2020, probably due to the consequences of the national lockdown. Sports traumas had a reset during the pandemic (6 cases in 2019, 0 in 2020). As consequence, surgical treatment had a decrease due to the reduction in number of fractures, indications and patient's consent. CONCLUSION: The incidence of proximal humerus fractures had a significant reduction during CoVID-19 spread. We assume that the reasons of this reduction are to be found in the national lockdown (since March 10th, 2020) and Ministerial Decrees that limited the access to the E.R. only in case of severe traumas in order to avoid CoVID-19 spread.


Asunto(s)
/epidemiología , Fracturas del Húmero/cirugía , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Italia/epidemiología , Masculino , Persona de Mediana Edad , Ortopedia , Traumatología
2.
Orthopade ; 50(4): 278-286, 2021 Apr.
Artículo en Alemán | MEDLINE | ID: mdl-33666675

RESUMEN

BACKGROUND: The decision for total hip arthroplasty (THA) is based on pain, loss of function, radiological changes and failed conservative therapy. These criteria are rarely based on systematic research and have not been integrated in generally accepted treatment guidelines. Aim of our study was, therefore, to analyse which decision criteria German orthopaedic and trauma surgeons use in order to recommend THA for patients with hip osteoarthritis. MATERIALS AND METHODS: From 10/2019 to 07/2020 we conducted a nation-wide survey among 218 orthopaedic and trauma surgeons about their criteria for and against THA surgery, as well as their treatment objectives. RESULTS: 147 fully completed questionnaires were analysed. Pain (99%), limitation of movement (99%), as well as impairment of walking distance (97%), and the subjective burden (97%) were the most frequent criteria. 97% and 96% of surgeons consider prescription of analgesics and physical therapy, as well as a lack of their effectiveness, as criteria for THA. 87% see radiological changes grade Kellgren & Lawrence III as threshold. A recommendation against surgery is triggered by obesity (BMI ≥ 40 kg/m2) in 48% and by the presence of an active infection in 96%. CONCLUSIONS: Current surgeons' practice criteria of recommendations for THA in Germany seem to reflect widely nationally and internationally discussed recommendations. Particular attention is given to patient factors like pain, loss of function and subjective burden, as well as previous conservative treatment and contraindications, like poorly controlled diabetes or an active infection, whereas morbid obesity is not seen as contraindication by all surgeons.


Asunto(s)
Artroplastia de Reemplazo de Cadera , Ortopedia , Osteoartritis de la Cadera , Cirujanos , Alemania/epidemiología , Humanos , Osteoartritis de la Cadera/cirugía
3.
BMC Musculoskelet Disord ; 22(1): 245, 2021 Mar 05.
Artículo en Inglés | MEDLINE | ID: mdl-33673844

RESUMEN

OBJECTIVE: To explore orthopaedic and musculoskeletal clinicians' views and experiences of legal, safety, safeguarding and security issues regarding the use of virtual consultations (VC) during the COVID-19 pandemic. A secondary objective was to suggest ways to overcome these issues. METHODS: A mixed method cross-sectional survey was conducted, seeking the views and experiences of orthopaedic and musculoskeletal medically qualified and Allied Health Professionals in the United Kingdom. Descriptive statistical analysis was employed for quantitative data and a qualitative content analysis undertaken for qualitative data. Findings were presented in accordance with the four key issues. RESULTS: Two hundred and ninety professionals (206 physiotherapists, 78 medically qualified professionals, 6 'other' therapists) participated in the survey. Of the 290 participants, 260 (90%) were not using VC prior to the COVID-19 pandemic, 248 respondents (86%) were unsure whether their professional indemnity insurance covered VC, 136 (47%) had considered how they would handle an issue of safeguarding whilst the remainder had not, 126 (43%) had considered what they would do if, during a virtual consultation, a patient suffered an injury (e.g. bang on their head) or a fall (e.g. mechanical or a medical event like syncope) and 158 (54%) reported they felt the current technological solutions are secure in terms of patient data. Qualitative data provided additional context to support the quantitative findings such as validity of indemnification, accuracy of diagnosis and consent using VC, safeguarding issues; and security and sharing of data. Potential changes to practice have been proposed to address these issues. CONCLUSIONS: VC have been rapidly deployed since the onset of the COVID-19 pandemic often without clear guidance or consensus on many important issues. This study identified legal, safeguarding, safety and security issues. There is an urgent need to address these and develop local and national guidance and frameworks to facilitate ongoing safe virtual orthopaedic practice beyond the COVID-19 pandemic.


Asunto(s)
/epidemiología , Encuestas de Atención de la Salud , Pandemias , Seguridad del Paciente , Telemedicina/legislación & jurisprudencia , Telemedicina/normas , Técnicos Medios en Salud , Seguridad Computacional , Confidencialidad , Estudios Transversales , Femenino , Humanos , Masculino , Ortopedia
4.
Artículo en Inglés | MEDLINE | ID: mdl-33672294

RESUMEN

The COVID-19 pandemic has put an enormous burden on healthcare systems. As a direct consequence, many elective procedures were cancelled and available resources were relocated to emergencies and COVID-19 patients. We aimed to analyze the impact on orthopedic surgery in Romania. We performed a retrospective analysis of orthopedics and trauma cases admitted over the first six months of 2019 and 2020 in three representative clinics. In total, there were 1900 patients: 1241 from Timisoara, 216 from Cluj-Napoca, and 443 from Bucharest. In April, activity for all cases in the regional trauma center dropped to 23.8% and stopped in the other two. No arthroscopies or elective joint replacements were performed in April. By June, hospital admissions resumed for trauma cases while arthroscopies and joint replacements still lagged behind.


Asunto(s)
Procedimientos Ortopédicos/estadística & datos numéricos , Ortopedia , Humanos , Pandemias , Estudios Retrospectivos , Rumanía/epidemiología
5.
Ann R Coll Surg Engl ; 103(3): 155-159, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33645272

RESUMEN

INTRODUCTION: The COVID-19 pandemic has had a huge impact on all our lives, both personally and professionally, and in many ways has been a catalyst for change. Limitations on social gathering have called the wisdom of a conventional trauma meeting into question. We have initiated our virtual trauma meeting and report our early results. MATERIALS AND METHODS: Daily morning trauma meetings are now conducted online. Following instigation, we collated the results of a feedback form completed online to assess the relative merits of a virtual trauma meeting. RESULTS: There were 27 responses received to the electronically administered virtual trauma meeting evaluation survey, from a range of trauma and orthopaedic department personnel. There were no concerns regarding patient safety or decision making and, apart from the quality of the audio (63% dissatisfied or very dissatisfied) positive feedback outweighed negative feedback in every category. At 74%, the majority of respondents were satisfied or very satisfied overall with the virtual trauma meeting. CONCLUSION: Trauma meetings can be safely conducted in a virtual environment with high standards of patient care maintained. Virtual trauma meeting offers service enhancements such as early subspecialty input and enhanced cross-site communication and rapid solution development to logistical difficulties. Adapting to conference call etiquette will enhance user experience and opportunity for training opportunities, but adequate investment in high-quality equipment is essential.


Asunto(s)
Actitud del Personal de Salud , Ortopedia/organización & administración , Centros Traumatológicos , Comunicación por Videocoferencia , Comunicación , Humanos , Encuestas y Cuestionarios , Reino Unido
6.
Ann R Coll Surg Engl ; 103(3): 167-172, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33645286

RESUMEN

INTRODUCTION: We describe a new service model, the Orthopaedic Assessment Unit (OAU), designed to provide care for trauma patients during the COVID-19 pandemic. Patients without COVID-19 symptoms and isolated musculoskeletal injuries were redirected to the OAU. METHODS: We prospectively reviewed patients throughput during the peak of the global pandemic (7 May 2020 to 7 June 2020) and compared with our historic service provision (7 May 2019 to 7 June 2019). The Mann-Whitney and Fisher Exact tests were used to test the statistical significance of data. RESULTS: A total of 1,147 patients were seen, with peak attendances between 11am and 2pm; 96% of all referrals were seen within 4h. The majority of patients were seen by orthopaedic registrars (52%) and nurse practitioners (44%). The majority of patients suffered from sprains and strains (39%), followed by fractures (22%) and wounds (20%); 73% of patients were discharged on the same day, 15% given follow up, 8% underwent surgery and 3% were admitted but did not undergo surgery. Our volume of trauma admissions and theatre cases decreased by 22% and 17%, respectively (p=0.058; 0.139). There was a significant reduction of virtual fracture clinic referrals after reconfiguration of services (p<0.001). CONCLUSIONS: Rapid implementation of a specialist OAU during a pandemic can provide early definitive trauma care while exceeding national waiting time standards. The fall in trauma attendances was lower than anticipated. The retention of orthopaedic staff in the department to staff the unit and maintain a high standard of care is imperative.


Asunto(s)
Prestación de Atención de Salud/organización & administración , Fracturas Óseas/terapia , Ortopedia/organización & administración , Esguinces y Distensiones/terapia , Adulto , Anciano , Atención Ambulatoria/estadística & datos numéricos , Servicio de Urgencia en Hospital , Planificación Ambiental , Femenino , Fracturas Óseas/diagnóstico , Fracturas Óseas/epidemiología , Hospitalización/estadística & datos numéricos , Humanos , Masculino , Persona de Mediana Edad , Enfermeras Practicantes , Procedimientos Ortopédicos , Cirujanos Ortopédicos , Escocia/epidemiología , Esguinces y Distensiones/diagnóstico , Esguinces y Distensiones/epidemiología , Centros Traumatológicos , Triaje , Heridas y Traumatismos/diagnóstico , Heridas y Traumatismos/epidemiología , Heridas y Traumatismos/terapia
7.
Orthop Clin North Am ; 52(2): 177-180, 2021 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-33752839

RESUMEN

As the scope of podiatric surgery expands, the relative roles and outcomes of orthopedic surgeons and podiatrists need to be defined. With growing demand for foot and ankle services, the roles of podiatrists and orthopedic surgeons are increasingly overlapping. Few studies have examined the overlapping scope of practice of each of the groups or compared the relative costs and outcomes associated with each.


Asunto(s)
Articulación del Tobillo/cirugía , Articulaciones del Pie/cirugía , Procedimientos Ortopédicos/métodos , Ortopedia , Podiatría , Humanos , Procedimientos Ortopédicos/economía , Resultado del Tratamiento
10.
Am J Orthod Dentofacial Orthop ; 159(4): e343-e362, 2021 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-33653640

RESUMEN

INTRODUCTION: Research on clear aligner treatment (CAT) has increased in recent years. In this study, we aimed to perform a bibliometric and visualized analysis to identify and critically assess the 50 most highly cited articles on CAT. METHODS: Web of Science was selected as a data source and consulted until March 2020 to identify all articles potentially relevant to the analysis. All the eligible articles were collected until 50 manuscripts were listed. Article-based parameters, journal-based parameters, and author-based parameters were registered to perform the bibliometric analysis. Keywords were automatically harvested from the selected articles to implement the visualized analysis. RESULTS: The search identified a total of 378 articles; the total number of citations of the selected articles varied from 15 to 112. The average number of citations per year varied from 1.15 to 13.83. The predominant study design was clinical (31.7%). Over the 15 journals in which the most cited articles were published, the American Journal of Orthodontics and Dentofacial Orthopedics published the majority of those included in the list (14) and also received the greatest number of citations (671). A total of 195 authors contributed to the 50 most cited articles; a significant portion of them (26) were unaffiliated with academic institutions. A total of 184 keywords were gathered from the article list. CONCLUSIONS: The number of citations on CAT is expected to grow steadily in parallel with the rising number of research projects. The present work identifies the most influential articles on CAT and their characteristics, placing emphasis on the journals, the authors, and the topics addressed.


Asunto(s)
Aparatos Ortodóncicos Removibles , Ortopedia , Bibliometría
11.
Physiother Theory Pract ; 37(3): 432-446, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33715579

RESUMEN

Enhancing and facilitating change or optimization of body awareness and movement behaviors have been sustained throughout history as central objectives in physiotherapy. Focus will be on the thoughts and practice of orthopedist Gunder Nielsen Kjølstad (1794-1860). He is, in a Norwegian context, one of the forefathers of physiotherapy. Kjølstad was unique for his time in the sense that he did not limit himself to medicine, but drew on vast array of disciplines, among them philosophy, geometry, physics, and dance. Fundamental to his treatment method was a pedagogy that rested on the active participation of the patient; an approach that stood in stark contrast to the established clinical practices. Through this approach, he developed a treatment for 'crooked backs' which constituted a historic break with the common treatment regimens of the nineteenth century.


Asunto(s)
Ortopedia/historia , Modalidades de Fisioterapia/historia , Fisioterapia/historia , Escoliosis/terapia , Historia del Siglo XVIII , Historia del Siglo XIX , Humanos , Noruega
12.
Rev. esp. cir. ortop. traumatol. (Ed. impr.) ; 65(1): 54-62, ene.-feb. 2021. tab, graf
Artículo en Español | IBECS | ID: ibc-196568

RESUMEN

La pandemia COVID ha hecho de las consultas telemáticas una herramienta básica en la práctica diaria. El objetivo principal del estudio es valorar los resultados de la aplicación de consultas telemáticas para limitar la movilidad de los pacientes. Son objetivos operativos: proponer un plan de consultas, conocer cómo limita la asistencia a las consultas, definir qué patologías se benefician más con este plan. MATERIAL Y MÉTODOS: Se propone un esquema con la creación de consultas previas a las agendadas para valorar idoneidad y posibilidad de realizarla en acto único no presencial. RESULTADOS: Se han realizado 5.619 consultas con una falta de respuesta telefónica del 19%. El 74% de los pacientes fueron resueltos de forma virtual. Existe diferencia entre unidades, siendo más probable la respuesta telefónica para las consultas de unidad, OR = 0,60 o de traumatología general, OR = 0,67 y menos para los derivados desde urgencias. El 20% de las consultas no se acompañaban de pruebas complementarias. Las consultas de traumatología general, OR = 0,34, control postoperatorio, OR = 0,49, y unidades, OR = 0,40, cumplieron mejor este requisito. De los pacientes restantes, las consultas de traumatología general, OR = 0,50, y las derivadas a unidades, OR = 0,54 fueron las que más se resolvieron sin acudir presencialmente. CONCLUSIONES: Se han resuelto de forma no presencial el 74% de los pacientes que atendieron a la llamada telefónica. El 20% de los pacientes acuden a la visita sin pruebas complementarias. Las consultas de seguimiento de osteosíntesis y postoperatorio de cirugía artroscópica son las que más precisan de ser realizadas de forma presencial


The COVID pandemic has made telematic consultations a basic tool in daily practice. AIMS: The main objective of the study is to assess the results of the application of telematic consultations to limit the mobility of patients. The operational objectives are; to propose a consultation plan, to know how attendance limits consultations and to define which pathologies benefit the most from this plan. METHODS: A scheme is proposed with the creation of pre-scheduled clinic to assess suitability and the possibility of carrying them out in a single non face-to-face act. RESULTS: Phone call to 5,619 patients were made with a lack of response of 19%. The cases of 74% of the patients that answered were resolved virtually. There is a difference between units, obtaining a higher answering rate from patients appointed to specific clinic units, OR = 0.60, or to general trauma ones, OR = 0.67. The lowest answering rate was obtained from those derived from the emergency department. Twenty per cent of the consultations were not accompanied by complementary tests that would have favored the resolution in a single act. The general trauma consultations, OR = 0.34, postoperative control, OR = 0.49, and specific unit ones, OR = 0.40, were the ones that better met this requirement. Out of the remaining patients, the general trauma consultations, OR = 0.50, and those referred to units, OR = 0.54, were the ones that had a higher resolution rate without in- person consultation. CONCLUSIONS: The cases of 74% of the patients who answered the phone call were resolved virtually. Cases of 20% of the patients cannot be solved in a single act because they are derived without complementary tests. Osteosynthesis and postoperative arthroscopic follow-up consultations are the ones that need to be carried out in person the most


Asunto(s)
Humanos , Infecciones por Coronavirus/prevención & control , Neumonía Viral/prevención & control , Pandemias , Acceso Efectivo a los Servicios de Salud/estadística & datos numéricos , Consulta Remota/estadística & datos numéricos , Ortopedia/estadística & datos numéricos , Procedimientos Ortopédicos , Centros Traumatológicos , Laparoscopía
15.
West Afr J Med ; 38(2): 166-170, 2021 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-33641153

RESUMEN

BACKGROUND: With expanding indications for operative fracture treatment, removal of orthopaedic implants has become a frequent elective orthopaedic procedure in developing countries. The clinical indications for implant removal are not well established and there are no specific indications despite the morbidity associated with implant removal operations. OBJECTIVE: To determine the frequency, indications and complications of removal of orthopaedic implants with a view to guiding implant removal protocol among surgeons. MATERIALS AND METHODS: Retrospective data was obtained over a 5-year-period in NKST Rehabilitation Hospital, Mkar, Nigeria. One hundred and twenty-eight patients aged 4-88 years met the criteria for inclusion. Patients were followed up for at least 1 year and all complications recorded. Data was analysed using SPSS version 21. RESULTS: A total of 128 patients were studied. There were 84(55%) males and 44(45%) were females. The mean age was 40.0±15.5 years. The commonest indication for implant removal was infected implant in 29(22.6%) patients, followed by patient's demand 22(17.2%). Femoral plate was the commonest [29(22.6%)] implant removed, followed by tibia plate [20(15.6%)] and humeral shaft plate [7(5.5%)]. The mean duration of hospital stay was 21.7±24.1 days. Twenty-five (19.5%) patients had post-operative complications. CONCLUSION: The commonest indication for implant removal was infected implant followed by patients demand. Femoral plate was the commonest implant removed. Post-operative complications included fractures, bleeding, nerve injuries and infection. Findings from this study suggest that implant removal operation may be associated with substantial morbidity. Therefore, not all orthopaedic implants require removal. Strict implant removal policy is advocated to guide the surgeon.


Asunto(s)
Ortopedia , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Placas Óseas , Niño , Preescolar , Femenino , Humanos , Masculino , Persona de Mediana Edad , Nigeria , Estudios Retrospectivos , Centros de Atención Terciaria , Adulto Joven
16.
Artículo en Inglés | MEDLINE | ID: mdl-33570868

RESUMEN

As the world continues to adjust to life with COVID-19, one topic that requires further thought and discussion is whether elective international medical volunteerism can continue, and, if so, what challenges will need to be addressed. During a pandemic, the medical community is attentive to controlling the disease outbreak, and most of the literature regarding physician involvement during a pandemic focuses primarily on physicians traveling to areas of need to help treat the disease. As a result, little has been written about medical volunteerism that focuses on medical treatment unrelated to the disease outbreak. In a world-wide pandemic, many factors are to be considered in determining whether, and when, a physician should travel to another region to provide care and training for medical issues not directly related to the pandemic. Leaders of humanitarian committees of orthopaedic surgery subspecialties engaged with one another and host orthopaedic surgeons and a sponsoring organization to provide thoughtful insight and expert opinion on the challenges faced and possible pathways to provide continued orthopaedic support around the globe. Although this discussion focuses on international orthopaedic care, these suggestions may have a much broader application to the international medical community as a whole.


Asunto(s)
Países en Desarrollo , Misiones Médicas , Ortopedia , Sistemas de Socorro , Voluntarios , Humanos , Internacionalidad
17.
J Orthop Surg (Hong Kong) ; 29(1): 2309499020988176, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33569998

RESUMEN

PURPOSE: In this study we investigated on the personal protective equipment (PPE) usage, recycling, and disposal among spine surgeons in the Asia Pacific region. METHODS: A cross-sectional survey was carried out among spine surgeons in Asia Pacific. The questionnaires were focused on the usage, recycling and disposal of PPE. RESULTS: Two hundred and twenty-two surgeons from 19 countries participated in the survey. When we sub-analysed the differences between countries, the provision of adequate PPE by hospitals ranged from 37.5% to 100%. The usage of PPE was generally high. The most used PPE were surgical face masks (88.7%), followed by surgical caps (88.3%), gowns (85.6%), sterile gloves (83.3%) and face shields (82.0%). The least used PPE were powered air-purifying respirators (PAPR) (23.0%) and shoes/boots (45.0%). The commonly used PPE for surgeries involving COVID-19 positive patients were N95 masks (74.8%), sterile gloves (73.0%), gowns (72.1%), surgical caps (71.6%), face shields (64.4%), goggles (64.0%), shoe covers (58.6%), plastic aprons (45.9%), shoes/boots (45.9%), surgical face masks (36.5%) and PAPRs (21.2%). Most PPE were not recycled. Biohazard bins were the preferred method of disposal for all types of PPE items compared to general waste. CONCLUSIONS: The usage of PPE was generally high among most countries especially for surgeries involving COVID-19 positive patients except for Myanmar and Nepal. Overall, the most used PPE were surgical face masks. For surgeries involving COVID-19 positive patients, the most used PPE were N95 masks. Most PPE were not recycled. Biohazard bins were the preferred method of disposal for all types of PPE.


Asunto(s)
/epidemiología , Transmisión de Enfermedad Infecciosa/prevención & control , Ortopedia , Equipo de Protección Personal/estadística & datos numéricos , Sociedades Médicas , Enfermedades de la Columna Vertebral/cirugía , Asia , Comorbilidad , Estudios Transversales , Humanos , Pandemias , Enfermedades de la Columna Vertebral/epidemiología , Encuestas y Cuestionarios
18.
BMC Surg ; 21(1): 75, 2021 Feb 06.
Artículo en Inglés | MEDLINE | ID: mdl-33549063

RESUMEN

BACKGROUND: Knot tying technique is an extremely important basic skill for all surgeons. Clinically, knot slippage or suture breakage will lead to wound complications. Although some previous studies described the knot-tying technique of medical students or trainees, little information had been reported on the knot-tying technique of instructors. The objective of the preset study was to assess surgeons' manual knot tying techniques and to investigate the differences of tensile strength in knot tying technique between surgical instructors and trainees. METHODS: A total of 48 orthopaedic surgeons (postgraduate year: PGY 2-18) participated. Surgeons were requested to tie surgical knots manually using same suture material. They were divided into two groups based on each career; instructors and trainees. Although four open conventional knots with four throws were chosen and done with self-selected methods, knot tying practice to have the appropriate square knots was done as education only for trainees before the actual trial. The knots were placed over a 30 cm long custom made smooth polished surface with two cylindrical rods. All knots were tested for tensile strength using a tensiometer. The surgical loops were loaded until the knot slipped or the suture broke. The tensile strength of each individual knot was defined as the force (N) required to result in knot failure. Simultaneously, knot failure was evaluated based on knot slippage or suture rupture. In terms of tensile strength or knot failure, statistical comparison was performed between groups using two-tailed Mann-Whitney U test or Fisher exact probability test, respectively. RESULTS: Twenty-four instructors (PGY6-PGY18) and 24 trainees (PGY2-PGY5) were enrolled. Tensile strength was significantly greater in trainees (83.0 ± 27.7 N) than in instructors (49.9 ± 34.4 N, P = 0.0246). The ratio of slippage was significantly larger in instructors than in trainees (P < 0.001). Knot slippage (31.8 ± 17.7 N) was significantly worse than suture rupture (89.9 ± 22.2 N, P < 0.001) in tensile strength. CONCLUSIONS: Mean tensile strength of knots done by trainees after practice was judged to be greater than that done by instructors in the present study. Clinically, knot slippage can lead to wound dehiscence, compared to suture rupture.


Asunto(s)
Ortopedia/educación , Estudiantes de Medicina , Cirujanos , Procedimientos Quirúrgicos Operativos/métodos , Técnicas de Sutura , Suturas , Resistencia a la Tracción , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Procedimientos Quirúrgicos Operativos/educación
19.
Rehabilitation (Stuttg) ; 60(1): 45-66, 2021 Feb.
Artículo en Alemán | MEDLINE | ID: mdl-33556979
20.
Biomed Res Int ; 2021: 6653967, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33521128

RESUMEN

3D printing technology is widely used in the field of implantable medical device in recent decades because of its advantages in high precision, complex structure, and high material utilization. Based on the characteristics of 3D printing technology, this paper reviews the manufacturing process, materials, and some typical products of 3D printing implantable medical devices and analyzes and summarizes the development trend of 3D printed implantable medical devices.


Asunto(s)
Impresión Tridimensional , Prótesis e Implantes , Diseño de Prótesis/métodos , Tecnología Farmacéutica/métodos , Materiales Biocompatibles , Prótesis Vascular , Cerámica , Humanos , Prótesis Articulares , Rayos Láser , Ortopedia , Polímeros/química , Stents
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