The purpose of this study is to identify the causes of mechanical complications of osteosynthesis of members to prevent and improve the results of our surgical treatments. Patients and Method: Retrospective study incl...The purpose of this study is to identify the causes of mechanical complications of osteosynthesis of members to prevent and improve the results of our surgical treatments. Patients and Method: Retrospective study including all patients diagnosed with mechanical complications after osteosynthesis of the limbs and who received medical follow-up. 42 patients with an average age of 42.2 years, with a male predominance (36 cases) were selected. These complications predominated in the femur with 26 cases. The implants involved were predominantly screwed plates with 25 cases. We investigated and analyzed the different types of dismantling of material as well as the etiological factors that may be at the origin of these disassembly. Results: After a mean follow-up of 15.47 months, four types of complications were identified: material expulsion (20 cases), migration (3 cases), incurvation (7 cases), fracture of material (12 cases). 4 types of factors causing dismantling have been identified: the factors related to the patient, factors related to fracture, the factors related to the implant and factors related to the surgeon. Conclusion: Disassembly of orthopedic implants is most often of multifactorial origin. These factors may act in isolation but are most often entangled in the patient. Proper preoperative planning can help prevent them. However, unexpected stresses of the implant and certain factors related to the ground remain difficult to control.展开更多
目的探讨基于快速康复外科(enhanced recovery after surgery,ERAS)理念的麻醉苏醒期护理对老年髋部骨折全麻手术患者术后谵妄(postoperative delirium,POD)的影响。方法选取2017年1月—2019年12月在新疆医科大学第一附属医院择期行髋...目的探讨基于快速康复外科(enhanced recovery after surgery,ERAS)理念的麻醉苏醒期护理对老年髋部骨折全麻手术患者术后谵妄(postoperative delirium,POD)的影响。方法选取2017年1月—2019年12月在新疆医科大学第一附属医院择期行髋部骨折手术的老年患者100例,应用随机数字表将患者分为对照组(50例)和观察组(50例),对照组予以常规护理,观察组实施基于ERAS理念的麻醉苏醒期护理;比较2组POD发生情况、POD相关不良事件发生情况、术后恢复情况及护理满意度。结果观察组与对照组POD发生率分别为12.00%和30.00%,POD持续时间分别为(3.42±1.09)h和(4.74±1.31)h,差异均有统计学意义(均P<0.05)。观察组POD相关不良事件包括跌倒/坠床、非计划性拔管、压力性损伤发生率均低于对照组,差异均有统计学意义(均P<0.05)。观察组与对照组术后恢复情况中,拔管时间、麻醉术后恢复室(PACU)停留时间、定向力恢复时间及术后住院时间均短于对照组,差异均有统计学意义(均P<0.05)。观察组护理满意度高于对照组,差异有统计学意义(P<0.05)。结论基于ERAS理念的麻醉苏醒期能够有效预防老年髋部骨折全麻手术患者POD的发生,促进患者术后恢复。展开更多
文摘The purpose of this study is to identify the causes of mechanical complications of osteosynthesis of members to prevent and improve the results of our surgical treatments. Patients and Method: Retrospective study including all patients diagnosed with mechanical complications after osteosynthesis of the limbs and who received medical follow-up. 42 patients with an average age of 42.2 years, with a male predominance (36 cases) were selected. These complications predominated in the femur with 26 cases. The implants involved were predominantly screwed plates with 25 cases. We investigated and analyzed the different types of dismantling of material as well as the etiological factors that may be at the origin of these disassembly. Results: After a mean follow-up of 15.47 months, four types of complications were identified: material expulsion (20 cases), migration (3 cases), incurvation (7 cases), fracture of material (12 cases). 4 types of factors causing dismantling have been identified: the factors related to the patient, factors related to fracture, the factors related to the implant and factors related to the surgeon. Conclusion: Disassembly of orthopedic implants is most often of multifactorial origin. These factors may act in isolation but are most often entangled in the patient. Proper preoperative planning can help prevent them. However, unexpected stresses of the implant and certain factors related to the ground remain difficult to control.
文摘目的探讨基于快速康复外科(enhanced recovery after surgery,ERAS)理念的麻醉苏醒期护理对老年髋部骨折全麻手术患者术后谵妄(postoperative delirium,POD)的影响。方法选取2017年1月—2019年12月在新疆医科大学第一附属医院择期行髋部骨折手术的老年患者100例,应用随机数字表将患者分为对照组(50例)和观察组(50例),对照组予以常规护理,观察组实施基于ERAS理念的麻醉苏醒期护理;比较2组POD发生情况、POD相关不良事件发生情况、术后恢复情况及护理满意度。结果观察组与对照组POD发生率分别为12.00%和30.00%,POD持续时间分别为(3.42±1.09)h和(4.74±1.31)h,差异均有统计学意义(均P<0.05)。观察组POD相关不良事件包括跌倒/坠床、非计划性拔管、压力性损伤发生率均低于对照组,差异均有统计学意义(均P<0.05)。观察组与对照组术后恢复情况中,拔管时间、麻醉术后恢复室(PACU)停留时间、定向力恢复时间及术后住院时间均短于对照组,差异均有统计学意义(均P<0.05)。观察组护理满意度高于对照组,差异有统计学意义(P<0.05)。结论基于ERAS理念的麻醉苏醒期能够有效预防老年髋部骨折全麻手术患者POD的发生,促进患者术后恢复。
