BACKGROUND With the increasing complexity of surgical interventions performed in orthopaedic trauma surgery and the improving technologies used in threedimensional(3D)printing,there has been an increased interest in t...BACKGROUND With the increasing complexity of surgical interventions performed in orthopaedic trauma surgery and the improving technologies used in threedimensional(3D)printing,there has been an increased interest in the concept.It has been shown that 3D models allow surgeons to better visualise anatomy,aid in planning and performing complex surgery.It is however not clear how best to utilise the technique and whether this results in better outcomes.AIM To evaluate the effect of 3D printing used in pre-operative planning in orthopaedic trauma surgery on clinical outcomes.METHODS We performed a comprehensive systematic review of the literature and a metaanalysis.Medline,Ovid and Embase were searched from inception to February 8,2018.Randomised controlled trials,case-control studies,cohort studies and case series of five patients or more were included across any area of orthopaedic trauma.The primary outcomes were operation time,intra-operative blood loss and fluoroscopy used.RESULTS Seventeen studies(922 patients)met our inclusion criteria and were reviewed.The use of 3D printing across all specialties in orthopaedic trauma surgery demonstrated an overall reduction in operation time of 19.85%[95%confidence intervals(CI):(-22.99,-16.71)],intra-operative blood loss of 25.73%[95%CI:(-31.07,-20.40)],and number of times fluoroscopy was used by 23.80%[95%CI:(-38.49,-9.10)].CONCLUSION Our results suggest that the use of 3D printing in pre-operative planning in orthopaedic trauma reduces operative time,intraoperative blood loss and the number of times fluoroscopy is used.展开更多
Led by four generations of leadership from late Prof.JIANG Sichang(academician,Chinese Academy of Engineering),Prof.YANG Weiyan(Honorary President,Division of Otolaryngology Head and Neck Surgery,Chinese Medical Assoc...Led by four generations of leadership from late Prof.JIANG Sichang(academician,Chinese Academy of Engineering),Prof.YANG Weiyan(Honorary President,Division of Otolaryngology Head and Neck Surgery,Chinese Medical Association),Prof.HAN Dongyi(President Elected,Division of Otolaryngology Head and Neck Surgery,Chinese Medical Association)to now Prof.YANG Shiming(President,Division of Otolaryngologists,展开更多
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
目的探讨加速康复外科(ERAS)临床路径在创伤骨科患者围术期中的应用效果。方法选择行手术治疗的100例老年髋部骨折、中青年桡骨远端骨折及踝关节骨折患者为研究对象,根据围术期是否行ERAS将患者分为非ERAS组与ERAS组,每组各50例。比较2...目的探讨加速康复外科(ERAS)临床路径在创伤骨科患者围术期中的应用效果。方法选择行手术治疗的100例老年髋部骨折、中青年桡骨远端骨折及踝关节骨折患者为研究对象,根据围术期是否行ERAS将患者分为非ERAS组与ERAS组,每组各50例。比较2组患者手术情况、术后恢复情况、VAS评分和并发症发生情况。结果2组术中出血量、手术时间比较差异均无统计学意义(P均>0.05)。与非ERAS组相比,ERAS组的首次进食时间和下床活动时间较早,住院时间较短,非手术住院费用明显减少(P均<0.001)。术后第24 h、48 h,ERAS组患者VAS评分均低于非ERAS组(P均<0.001),2组术后72 h VAS评分比较差异无统计学意义(P>0.05)。ERS组的术后并发症总发生率低于非ERAS组(P<0.001)。结论ERAS应用于创伤骨科手术患者围术期管理中,能够缓解患者术后初期疼痛感,减少并发症发生,有助缩短康复进程,减轻患者的经济负担。展开更多
文摘BACKGROUND With the increasing complexity of surgical interventions performed in orthopaedic trauma surgery and the improving technologies used in threedimensional(3D)printing,there has been an increased interest in the concept.It has been shown that 3D models allow surgeons to better visualise anatomy,aid in planning and performing complex surgery.It is however not clear how best to utilise the technique and whether this results in better outcomes.AIM To evaluate the effect of 3D printing used in pre-operative planning in orthopaedic trauma surgery on clinical outcomes.METHODS We performed a comprehensive systematic review of the literature and a metaanalysis.Medline,Ovid and Embase were searched from inception to February 8,2018.Randomised controlled trials,case-control studies,cohort studies and case series of five patients or more were included across any area of orthopaedic trauma.The primary outcomes were operation time,intra-operative blood loss and fluoroscopy used.RESULTS Seventeen studies(922 patients)met our inclusion criteria and were reviewed.The use of 3D printing across all specialties in orthopaedic trauma surgery demonstrated an overall reduction in operation time of 19.85%[95%confidence intervals(CI):(-22.99,-16.71)],intra-operative blood loss of 25.73%[95%CI:(-31.07,-20.40)],and number of times fluoroscopy was used by 23.80%[95%CI:(-38.49,-9.10)].CONCLUSION Our results suggest that the use of 3D printing in pre-operative planning in orthopaedic trauma reduces operative time,intraoperative blood loss and the number of times fluoroscopy is used.
文摘Led by four generations of leadership from late Prof.JIANG Sichang(academician,Chinese Academy of Engineering),Prof.YANG Weiyan(Honorary President,Division of Otolaryngology Head and Neck Surgery,Chinese Medical Association),Prof.HAN Dongyi(President Elected,Division of Otolaryngology Head and Neck Surgery,Chinese Medical Association)to now Prof.YANG Shiming(President,Division of Otolaryngologists,
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.
文摘目的探讨加速康复外科(ERAS)临床路径在创伤骨科患者围术期中的应用效果。方法选择行手术治疗的100例老年髋部骨折、中青年桡骨远端骨折及踝关节骨折患者为研究对象,根据围术期是否行ERAS将患者分为非ERAS组与ERAS组,每组各50例。比较2组患者手术情况、术后恢复情况、VAS评分和并发症发生情况。结果2组术中出血量、手术时间比较差异均无统计学意义(P均>0.05)。与非ERAS组相比,ERAS组的首次进食时间和下床活动时间较早,住院时间较短,非手术住院费用明显减少(P均<0.001)。术后第24 h、48 h,ERAS组患者VAS评分均低于非ERAS组(P均<0.001),2组术后72 h VAS评分比较差异无统计学意义(P>0.05)。ERS组的术后并发症总发生率低于非ERAS组(P<0.001)。结论ERAS应用于创伤骨科手术患者围术期管理中,能够缓解患者术后初期疼痛感,减少并发症发生,有助缩短康复进程,减轻患者的经济负担。
