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Khominets, Vladimir V., and Aleksey L. Kudyashev. "Foundation and development of the oldest orthopedic department and clinic of Russia." Bulletin of the Russian Military Medical Academy 24, no. 2 (July 13, 2022): 431–38. http://dx.doi.org/10.17816/brmma107291.
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Issues of the foundation and development of scientific schools, medical specialties, departments, and clinics of the Military Medical Academy of S.M. Kirov, as well as their succession, remain largely debatable to this day. Moreover, their study appears to be extremely interesting when understanding the processes underlying the differentiation of the fundamental sections of medicine, formation of new areas of surgery, and their evolution to the state of independent surgical specialties. Several archival documents, reports, historical essays on the departments of desmurgy and mechanurgy, orthopedics, military field surgery, desmurgy and orthopedics, orthopedics and traumatology, and traumatology and orthopedics are analyzed. The origins of the formation and stages of transformation of the modern department of military traumatology and orthopedics are traced. Scientific orthopedics in Russia was started at the end of the 18th century in the bowels of the fundamental surgical departments of the Imperial Medical and Surgical Academy. On March 7, 1836, by the resolution of the conference of the Academy, the Department of Surgery was divided into the Department of General and Private Surgery with theoretical oculistics and the Department of Operative Surgery and Oculistics, Desmurgy and Mechanurgy, and Surgery on troupes. On February 20, 1888, an independent department of desmurgy and mechanurgy was established at the Academy. On March 24, 1900 (April 6, O.S.), based on Order No. 301 of the Minister of War of October 29, 1899, the Academy Conference decided to create the Orthopedic Clinic headed by Professor G.I. Turner, and the date mentioned went down in history as the birthday of the first orthopedic chair and clinic in Russia. From August 21, 1924, to August 8, 1931, it was renamed the Department of Military Field Surgery, Desmurgy and Orthopedics (Order no. 205 of August 9, 1924, by the Military Sanitary Department), and the reading of this subject was assigned to the senior assistant of the department E.Yu. Osten-Sacken who prepared the corresponding programs. From August 8, 1931, the department and the clinic reverted to their former name the Department and Clinic of Orthopedics, and Professor V.A. Oppel headed already an independent, established based on the Decree of the Union of Soviet Socialist Republics Revolutionary Military Council of April 2, 1931, the Department of Military Field Surgery. In 1955, the Department of Orthopedics was renamed the Department of Orthopedics and Traumatology (Directive of the Chief of Staff of the Army No. OSN 5/1367869 of November 28, 1955), and in 1960, due to the pronounced traumatological orientation in educational and clinical work, to the Department of Traumatology and Orthopedics (Directive of the Chief of the Union of Soviet Socialist Republics Defense Ministry No. ST/2/711247 of June 4, 1960). In 1974 the department was renamed Military Traumatology and Orthopedics Department (Directive No. 158/0267 of the Headquarters of the Union of Soviet Socialist Republics Armed Forces Rear No. 158/0267 of February 15, 1974). Based on the analysis, it appears reasonable to offer readers a view of the prehistory of the origin, continuity, and development of the specialty traumatology and orthopedics at the Military Medical Academy of S.M. Kirov.
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Georgescu, Nicolae. "The history of orthopedics and traumatology in Iasi." Jurnalul de Chirurgie 17, no. 1 (April 20, 2021): 56–62. http://dx.doi.org/10.7438/jsurg.2021.01.08.
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In Iasi, Orthopedics-Traumatology later appeared as a distinct specialty. In a first stage, orthopedics developed in surgical clinics - the period of surgical clinics (1879-1970). In each surgical clinic there were surgeons who dedicated themselves to orthopedic pathology: Radu Dimitrie, Theodor Căpățînă (Surgery I), Filimon Cicerone, Eusebiu Neagoe, Iulian Grădinaru (Surgery II), Paul Trosc (Surgery III). In 1967, at the Charity Hospital, two surgical services were carried out: The Surgery and Children's Orthopedic Clinic (Th. Economu) and the Osteoarticular Tuberculosis Clinic (A. Berneaga). Also, this year, 1970, in Iasi, the construction of a new medical unit will be completed - the Children's Hospital where the Clinic of Pediatric Surgery and Orthopedics will be moved. The Charity Hospital is disbanded and the Emergency Clinical Hospital will be established on the site of the former establishment. A second period begins - the transition period (1970-1983) - characterized by the search for optimal solutions, which involved changes and temporary until the establishment of orthopedic clinics. The newly established unit, the Emergency Clinical Hospital, was designed to include three departments: General Surgery IV (I. Jitaru), Medical Clinic (G. Popa) and an Orthopedics and Traumatology Clinic (conf. Gh. Floareș). This clinic treated all surgical pathology of orthopedics, traumatology and had didactic activity with fourth year students. The Orthopedics-Traumatology Department had 40 beds. There is also an Orthopedics-Traumatology department, with 40 beds, located in the Dr. C. I. Parhon Hospital run first by A. Berneaga and then by P. Trosc. Dimitrie Radu, Iulian Grădinaru and G. Herescu worked in this department. A new Recovery Hospital appears in Iasi. The new hospital also has an Orthopedics-Traumatology department (with 111 beds) where the orthopedics department will be transferred from Parhon Hospital. In 1983, Professor Gh. Floareș opted to move the clinic from the Emergency Hospital to the new Rehabilitation Hospital. At the Emergency Hospital there remains an Orthopedics-Traumatology Department staffed by a single doctor - Nicolae Georgescu who will develop a new team, which also have teaching activity: T. Cozma, L. Stratan, P. Sîrbu, Ovidiu Alexa, Paul Corlaci, Cezar Popescu. There are eight resident doctors (Elena Glod, Luminița Lăbușcă, Victor Pencu, G. Ghinoiu, C. Nanu, T. Bunescu, R. Malancea, L. Pacu). During this period (1992-1996) a basic A.O. course was organized in Iași. internationally, on which occasion many orthopedists are persuaded to routinely use modern means of osteosynthesis. Two more doctors come in this clinic: B. Puha, R. Asaftei, D. Cionca and A. Ciubara. After 1989, the ATOM was born: The Association of Traumatologists and Orthopedists of Moldova, congresses and postgraduate courses are organized. In 2012 the Orthopedic Clinic moved to the St. Spiridon Emergency Clinical Hospital (Prof. Ovidiu Alexa). The orthopedic clinic at the Recovery Hospital treats chronic osteoarticular pathology (prof Paul Sirbu).
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Okhotskiy, V. P. "V.V. Klyuchevsky. "Surgery of injuries" (Guide for paramedics, surgeons and traumatologists of district hospitals). Publishing house DIA-press, Yaroslavl, 1999." N.N. Priorov Journal of Traumatology and Orthopedics 6, no. 4 (November 15, 1999): 69–70. http://dx.doi.org/10.17816/vto105620.
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Professor V.V. For almost a quarter of a century, Klyuchevsky has been head of the Department of Traumatology, Orthopedics and Military Field Surgery at the Yaroslavl Medical Academy. The Orthopedic and Trauma Center headed by him has 10 specialized departments for the treatment of patients with any injuries of the musculoskeletal system, head, chest, abdomen, pelvis, spine, as well as departments for thermal injuries, microsurgery and plastic surgery.
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Goodrich, Eric, and Richard P. Goodrich. "Orthopedic Surgery and Flight Surgery: Income Differences Between the Navy Health Professions Scholarship Program and Civilian Orthopedic Surgery." Military Medicine 185, no. 11-12 (November 1, 2020): e1913-e1918. http://dx.doi.org/10.1093/milmed/usaa214.
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Abstract Introduction The purpose of this study to analyze the financial impact of choosing a civilian or military orthopedic surgery career. It will examine the most common scenarios to become an orthopedic surgeon in the Navy Health Professions Scholarship Program to include becoming a flight surgeon. To the authors’ knowledge, there is no peer-reviewed literature that financially analyzes the most common scenarios for a Navy Health Professions Scholarship Program scholarship recipient to become an orthopedic surgeon. Materials and Methods Salaries for Navy orthopedic surgeons, residents, and flight surgeons were recorded using the 2020 Defense Finance and Accounting Service pay tables and Navy Fiscal Year 2019 Medical Corps Special Pay Guidance. The median income of civilian orthopedic surgeons was recorded using Salary.com. The present value (PV) and future value (FV) were calculated using the Consumer Price Index-U and average Department of Defense pay increases over the past 20 years. Six common scenarios were utilized to calculate the PV and FV of civilian compared to Navy orthopedic surgeons. Results The two highest earning net FVs among all Navy scenarios were those surgeons who kept their Navy tour to 5 years or less (flight surgeon tour/separate or civilian deferment/separate). The civilian throughout scenario had the highest net FV of $19,974,673 after retiring at the age of 65. Flight surgeon tour/separate and civilian deferment/separate scenarios only made $843,751 and $1,401,630 less respectively than a pure civilian career due to the tax shelter afforded by the military pay. All Navy retirement scenarios to include Navy throughout, civilian deferment/Navy throughout, flight surgeon tour/Navy throughout resulted in a net FV less than $17,700,000. Civilian residency/deferment and retiring in the Navy had the worst net FV among all scenarios. Conclusions It was found that the shorter tours in the Navy had a higher net FV than those who made the Navy a career in orthopedic surgery. Flight surgery is a rewarding operational experience with among the highest net FV among Navy scenarios and is only slightly less than the net FV of a pure civilian career. However, it can be more difficult to apply for civilian orthopedic surgery after serving a flight surgeon tour. Lastly, the net FV was very similar between a civilian orthopedic surgeon career and the shorter tours served in the Navy. Factors such as higher civilian income with associated loan repayment/signing bonuses makes the civilian orthopedic surgery route the best financial option. This study will help those medical students considering a military versus a civilian career in orthopedic surgery and aid in Department of Defense recruitment/retention.
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Kim, Ki-Soo, Seung-Hee Ko, Chang-Moon Suh, Yong-Soo Choi, Kyung-Ho Kim, Dong-Myung Lee, and Yang-Min Jung. "Department of Orthopedic Surgery, Kwang Ju Christian Hospital." Journal of the Korean Society of Fractures 7, no. 2 (1994): 553. http://dx.doi.org/10.12671/jksf.1994.7.2.553.
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Mears, MD, PhD, Simon C., Asa Shnaekel, MD, MPH, John Wilkinson, MD, Caroline Chen, BS, and C. Lowry Barnes, MD. "A departmental policy can reduce opioid prescribing after orthopedic surgery." Journal of Opioid Management 16, no. 1 (January 1, 2020): 41–47. http://dx.doi.org/10.5055/jom.2020.0549.
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Objective: The authors hypothesized that implementation of a department-wide opioid prescribing program would reduce opioid tablets and morphine milligram equivalents (MMEs) prescribed as well as prescription refills.Design: A retrospective study was conducted to determine the effects of a department wide opioid prescribing policy.Setting: A university teaching hospital Orthopaedic Surgery Department. Patients, participants: All prescriptions written by members of our department were reviewed for 3 months before and 3 months after program implementation. There were 1,445 patients in the pre-intervention and 1,209 patients in the postintervention cohort. Two thousand two hundred forty-six total prescriptions written during the pre-intervention period and 1,530 written during the post-intervention period of the study.Interventions: A departmental opioid prescribing policy was introduced through several department teaching sessions. The policy included recommendations on numbers of tablets per procedures and patient education about the dangers of narcotic medications.Main outcome measure(s): The primary study outcome measures were the number of opioid tablets prescribed, the number of MMEs prescribed, and the number of prescription refills.Results: The mean number of tablets per prescription decreased from 47.2 (95% confidence interval (CI): 46.4-47.9) tablets in the pre-intervention cohort to 39.2 (95% CI: 38.1-40.4) tablets in the post-intervention cohort (p 0.0001). Likewise, the mean MME per prescription decreased from 354 (95% CI: 344-364) in the pre-intervention cohort to 265 (95% CI: 249-281) in the post-intervention cohort (p 0.0001). A refill prescription was provided 949 times in the pre-intervention group and 404 times in the post-intervention group. Prior to the introduction of prescription guidelines, the average number of prescriptions was 1.76 per patient (95% CI: 1.71-1.81). This fell to 1.34 prescriptions per patient (95% CI: 1.31-1.38) after policy institution. Noncompliance with policy was not related to provider, service, or procedure size. Conclusions: Implementation of a departmental policy can successfully reduce the number of opioid tablets and MMEs prescribed per procedure. Policies also decrease the number of refill prescriptions per procedure. Standardization of prescription practices is effective in improving opioid prescription stewardship. Level of evidence: Level III, retrospective cohort study.
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Kittipittayakorn, Cholada, and Kuo-Ching Ying. "Using the Integration of Discrete Event and Agent-Based Simulation to Enhance Outpatient Service Quality in an Orthopedic Department." Journal of Healthcare Engineering 2016 (2016): 1–8. http://dx.doi.org/10.1155/2016/4189206.
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Many hospitals are currently paying more attention to patient satisfaction since it is an important service quality index. Many Asian countries’ healthcare systems have a mixed-type registration, accepting both walk-in patients and scheduled patients. This complex registration system causes a long patient waiting time in outpatient clinics. Different approaches have been proposed to reduce the waiting time. This study uses the integration of discrete event simulation (DES) and agent-based simulation (ABS) to improve patient waiting time and is the first attempt to apply this approach to solve this key problem faced by orthopedic departments. From the data collected, patient behaviors are modeled and incorporated into a massive agent-based simulation. The proposed approach is an aid for analyzing and modifying orthopedic department processes, allows us to consider far more details, and provides more reliable results. After applying the proposed approach, the total waiting time of the orthopedic department fell from 1246.39 minutes to 847.21 minutes. Thus, using the correct simulation model significantly reduces patient waiting time in an orthopedic department.
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Baindurashvili, Alexey G. "Andrey Ivanovich Krasnov. 29.04.1947–15.11.2021." Pediatric Traumatology, Orthopaedics and Reconstructive Surgery 9, no. 4 (December 15, 2021): 491–92. http://dx.doi.org/10.17816/ptors88835.
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On November 15, 2021, at the age of 75, an outstanding orthopedic traumatologist, Honored Doctor of the Russian Federation, Candidate of Medical Sciences, associate professor of the Educational and Methodological Department of the FSBI "NMIC of Pediatric Traumatology and Orthopedics named after G. I. Turner" of the Ministry of Health of Russia, associate Professor of the Department of Pediatric Traumatology and Orthopedics of the I. I. Mechnikov Northwestern State Medical University of the Ministry of Health of Russia Andrey Ivanovich Krasnov passed away.
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Aaron, Friday E., Rex Friday Ogoronte A. Ijah, and Tonye Obene. "Pattern of orthopaedic case presentations at the rivers state university teaching hospital: a ten-year review." International Surgery Journal 9, no. 4 (March 28, 2022): 781. http://dx.doi.org/10.18203/2349-2902.isj20220935.
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Background: Pattern of diseases help institutions and governments to know the dominant disease conditions and how to allocate scarce resources. Knowledge of the pattern of orthopedic disease conditions seen and treated in the Rivers State university teaching hospital will help in guiding the repositioning effort of the department/discipline, especially in the light of the new status of the institution as a teaching hospital for teaching, service delivery and research. The aim of this study therefore was to determine the pattern of orthopedic cases seen in the surgery department of the Rivers State university teaching hospital from January 2010 to January 2019.Methods: A descriptive retrospective cross-sectional study was carried out at the emergency room, clinic, operating theatre, and wards of the surgery department of the Rivers State university teaching hospital, using hospital registers. The study was analyzed using the Microsoft excel spreadsheet.Results: There were 2854 orthopedic emergency room cases seen, comprising 621 fractures, 463 lumbar spondylosis/ spondylolisthesis, 392-foot ulcer/sepsis, 375 dislocations, 310 acute osteomyelitis, and 864 osteoarthritis with other conditions. The common orthopedic cases seen in the out-patient clinics in descending order of occurrence were lumbar spondylitis / spondylolisthesis (881), osteoarthritis (655), fractures (560), dislocations (227), etc.Conclusions: Trauma-related disease care constituted the bulk of work of the orthopedic surgeon in our environment in the emergency room, operating theatre and ward admissions, and younger males were more affected.
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Stevanovic, V., Z. Blagojevic, Z. Ganic, I. Diklic, A. Crnobaric, and M. Glisic. "Intramedullary fixation and proximal femoral fractures: Diversity in use through case reports." Acta chirurgica Iugoslavica 57, no. 1 (2010): 35–40. http://dx.doi.org/10.2298/aci1001035s.
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Proximal femoral fractures, including intertrochanetric and subtrochanteric with diaphiseal propagation represent a significant challenge in orthopedic surgery, especially in older population. Retrospective analysis of patients, after the application of 'Bi Nail (Bioimpianti Inc.) intramedullary nail for fractures and pathological conditions of proximal femur, was done at the Department of Adult Orthopedics, Institute of Orthopedic surgery Banjica, during the three year period. We present patients with complex fractures and pathological conditions (metastasis and pseudoarthrosis) of proximal femur; most of the fractures were result of effects of low energy, and the most common pathological fracture is due to metastasis of breast cancer. The analysis included the technical characteristics and duration of surgery, intraoperative and postoperative complications as well as the coalescence time of fracture healing and postoperative quality of life after rehabilitation. We believe that the described surgical method, although technically demanding, with a variable length duration of surgery and treatment of high risk elderly patients, provides stable fracture fixation with early rehabilitation to improve the quality of life.
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Abdel, Matthew P., Mark E. Morrey, Sébastien Parratte, Nicolaas Budhiparama, and Bernard F. Morrey. "The Mayo Clinic Department of Orthopedic Surgery: an international foundation." European Journal of Orthopaedic Surgery & Traumatology 25, no. 3 (January 22, 2015): 409–10. http://dx.doi.org/10.1007/s00590-015-1592-7.
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Stern, Caryn A., Zsolt T. Stockinger, William E. Todd, and Jennifer M. Gurney. "An Analysis of Orthopedic Surgical Procedures Performed During U.S. Combat Operations from 2002 to 2016." Military Medicine 184, no. 11-12 (April 24, 2019): 813–19. http://dx.doi.org/10.1093/milmed/usz093.
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Abstract Introduction Orthopedic surgery constitutes 27% of procedures performed for combat injuries. General surgeons may deploy far forward without orthopedic surgeon support. This study examines the type and volume of orthopedic procedures during 15 years of combat operations in Iraq and Afghanistan. Materials and Methods Retrospective analysis of the US Department of Defense Trauma Registry (DoDTR) was performed for all Role 2 and Role 3 facilities, from January 2002 to May 2016. The 342 ICD-9-CM orthopedic surgical procedure codes identified were stratified into fifteen categories, with upper and lower extremity subgroups. Data analysis used Stata Version 14 (College Station, TX). Results A total of 51,159 orthopedic procedures were identified. Most (43,611, 85.2%) were reported at Role 3 s. More procedures were reported on lower extremities (21,688, 57.9%). Orthopedic caseload was extremely variable throughout the 15-year study period. Conclusions Orthopedic surgical procedures are common on the battlefield. Current dispersed military operations can occur without orthopedic surgeon support; general surgeons therefore become responsible for initial management of all injuries. Debridement of open fracture, fasciotomy, amputation and external fixation account for 2/3 of combat orthopedic volume; these procedures are no longer a significant part of general surgery training, and uncommonly performed by general/trauma surgeons at US hospitals. Given their frequency in war, expertise in orthopedic procedures by military general surgeons is imperative.
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Jati Nugroho, Bagus, Bintang Soetjahjo, Udi Heru Nefihancoro, Rieva Ermawan, Rhyan Darma Saputra, Galih Santoso Putra, Fathih Kaldani, Muhammad David Perdana Putra, Zaltri Rhani Lebang, and Dea Alberta Setiawati. "Orthopedic Department of Education Center and Service Provide During Coronavirus Disease-2019 Pandemic: An Experience from Single-Center Hospital." Open Access Macedonian Journal of Medical Sciences 9, B (April 28, 2021): 250–54. http://dx.doi.org/10.3889/oamjms.2021.6027.
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BACKGROUND: In the global pandemic of the 2019 coronavirus disease (COVID-19), many countries have reported a decrease in visits to hospitals, and health-care systems around the world are reshaping health protocols. Health service and education in orthopedics are also affected although not at the frontline in dealing COVID-19. METHODS: The data from this study collected from several official databases, including the Indonesian Ministry of Health, Central Java provincial government, general hospital, and orthopedic surgery cases. RESULTS: Pandemic COVID-19 started in March 2020 in Indonesia. Surakarta has become one of the epicenters. Health services in the orthopedic department also experienced a decrease cases on all divisions (outpatient clinics, emergency rooms, and inpatients). Mann–Whitney non-parametric comparative test showed significance result in p value operation of orthopedic cases and inpatients (p = 0.016 and p = 0.016; p < 0.05), meanwhile, outpatient visits did not show significance result with p = 0.0509 (p > 0.05). The decrease in the number of cases being treated in the orthopedic service also has an impact on education and training programs. The digital era is one of the choices in the field of education. However, digital resources cannot substitute for direct patient exposure. CONCLUSION: The average number of orthopedic patients during the pandemic period from January to December 2020 decreased compared to visits in the same period in 2019 so that orthopedic services at tertiary and academic referral hospitals experienced a significant decrease in cases. The education and services department must adapt to the policy on educational activities for residents and medical students. The education department and hospital institutions restructured and reorganized resident doctors to continue providing services. The digital era is an option that supports the education process during a pandemic.
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Grujovic, Zoran, Milena Ilic, and Biljana Milicic. "The level of microbial contamination and frequency of surgical site infections at the Department of Orthopedic and Traumatologic Surgery of the Clinical Hospital Center in Kragujevac." Medical review 58, no. 5-6 (2005): 287–91. http://dx.doi.org/10.2298/mpns0506287g.
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Introduction. The level of microbial contamination is an important risk factor for surgical site infections. The aim of this study was to investigate the frequency of surgical site infections in regard to the level of microbial contamination at the Department of Orthopedic and Traumatologic Surgery of the Clinical Hospital Center in Kragujevac. Material and methods. This study included 474 patients who underwent surgery in the period from January 1, 2002 to December 31, 2002 at the Department of Orthopedic and Traumatologic Surgery of the Clinical Hospital Center in Kragujevac. Hospital infections were identified using CDC definitions, modified to fit our circumstances. The traditional classification of surgical sites in regard to the level of microbial contamination includes three categories: clean, contaminated and dirty. Results The incidence of surgical site infections was higher at the Orthopedic Surgery Ward (5.94%) compared to Traumatologic Surgery Ward (5.02%). Additionally, a significantly higher frequency of deep surgical site infections, which were classified as clean were established at the Orthopedic Surgery Ward, in regard to the level of microbial contamination, whereas the greatest frequency of surface infections in clean surgical sites (p=0.000) were established at the Traumatologic Surgery Ward. Surgical site infections were more frequent in patients undergoing multiple surgeries at the Orthopedic Surgery Ward than in those treated at the Traumatologic Surgery Ward (p=0.037). Conclusion It is of utmost importance to estimate the frequency of surgical site infections and identify associated risk factors in order to undertake adequate measures for their prevention and control. .
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Akter Sumi, Sharmin, Raquib Mohammad Manzur, Shuva Debnath, Subrata Sharkhar Kar, Sajedur Reza Faruquee, Abul Kalam, and Vaikunthan Rajaratnam. "Epidemiology of hand surgical cases operated in tertiary referral centers in Dhaka." International Surgery Journal 10, no. 2 (January 27, 2023): 214–19. http://dx.doi.org/10.18203/2349-2902.isj20230256.
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Background: Hand surgical cases in Bangladesh are managed both by orthopedic and plastic surgeons. There are very limited number of hand surgeons available in the country. Tertiary referral centers especially in the city of Dhaka cater for most of the hand surgery patients treated in the country. Objective were to understand the needs of the community for hand surgery. Methods: This rretrospective study spanning July, 2017 to June, 2018- used data from the operation register of the Burn and Plastic surgery department, DMCH (Dhaka medical college and hospital) and hand surgery department, NITOR (National institute of traumatology and orthopedics). Results: Of the sample of 2000 cases, 1000 data were collected from Dhaka medical college hospital, of which 670 (67%) were routine cases and 330 (33%) were emergency department cases. Of the 1000 cases from NITOR including 317(31.7%) routine cases and 683 (68.3%) cases from emergency department. Demography of the population 76% male and 24% female cases from DMCH; and 80% male and 20% female from NITOR. In Burn and Plastic surgery department of DMCH the percentage of diagnosed cases-acute burn (55%), acute trauma (9.5%), PBSC (21.5%), post trauma deformity (9%), and congenital cases (5%) and in NITOR- acute burn (1%), acute trauma (68%), PBSC (9%), post trauma deformity (20%), and congenital cases (2%) respectively. Conclusions: This study shows the needs of the community for hand surgery and the portfolio of cases performed would be guide for an evidence-based approach to the development of services and training of hand surgeon in Bangladesh.
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Willhuber, Gaston Camino, Joaquin Stagnaro, Matias Petracchi, Agustin Donndorff, Daniel Godoy Monzon, Juan Astoul Bonorino, Danilo Taype Zamboni, et al. "Short-term complication rate following orthopedic surgery in a tertiary care center in Argentina." SICOT-J 4 (2018): 26. http://dx.doi.org/10.1051/sicotj/2018027.
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Introduction: Registration of adverse events following orthopedic surgery has a critical role in patient safety and has received increasing attention. The purpose of this study was to determine the prevalence and severity of postoperative complications in the department of orthopedic unit in a tertiary hospital. Methods: A retrospective review from the postoperative complication registry of a cohort of consecutive patients operated in the department of orthopedic surgery from May 2015 to June 2016 was performed. Short-term complications (3 months after surgery), age gender, types of surgery (elective, scheduled urgency, non-scheduled urgency, and emergency), operative time, surgical start time (morning, afternoon or evening), American Society of Anesthesiologists score and surgeon's experience were assessed. Complications were classified based on their severity according to Dindo-Clavien system: Grade I complications do not require alterations in the postoperative course or additional treatment; Grade II complications require pharmacological treatment; Grade III require surgical, endoscopic, or radiological interventions without (IIIa) or with (IIIb) general anesthesia; Grade IV are life-threatening with single (IVa) or multi-organ (IVb) dysfunction(s), and require ICU management; and Grade V result in death of the patient. Complications were further classified in minor (Dindo I, II, IIIa) and major (Dindo IIIb, IVa, IVb and V), according to clinical severity. Results: 1960 surgeries were performed. The overall 90-day complication rate was 12.7% (249/1960). Twenty-three complications (9.2 %) were type I, 159 (63.8%) type II, 9 (3.6%) type IIIa, 42 (16.8%) type IIIb, 7 (2.8%) type IVa and 9 (3.6%) were grade V according to Dindo-Clavien classification (DCC). The most frequent complication was anemia that required blood transfusion (27%) followed by wound infection (15.6%) and urinary tract infection (6%). Discussion: The overall complication rate after orthopedic surgery in our department was 12.7%. The implementation of the DCC following orthopedic surgery was an important tool to measure the standard of care.
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Rasovic, Predrag, Vladimir Harhaji, Srdjan Ninkovic, Ivica Lalic, Marija Marinkovic, and Miroslav Milankov. "Correlation between graft contamination incidence and length of surgery performed to reconstruct anterior cruciate ligament." Medical review 69, suppl. 1 (2016): 67–71. http://dx.doi.org/10.2298/mpns16s1067r.
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Introduction. Anterior cruciate ligament reconstruction is one of the most performed procedures in orthopedic surgery. Due to the increasing number of population and their better access to health care, as well as the ever faster pace of modern living, this procedure is likely to become the most performed surgical procedure in orthopedics generally. One of the most common complications after this procedure is septic arthritis of the knee. The concept of intraoperative contamination of the graft during the procedure as one of the possible causes of the development of postoperative infection was mentioned as late as at the end of last and the beginning of this century and it has become the subject of much controversy among orthopedic surgeons. Material and Methods. This study was conducted at the Department of Orthopedic Surgery and Traumatology, Clinical Center of Vojvodina in Novi Sad and included 200 patients who had undergone primary anterior cruciate ligament reconstruction. Graft swabs were taken during the reconstruction intraoperatively, immediately before its implantation. The follow-up period was 24 months. Results. Of the 200 samples taken intrao?peratively, 33 swabs were positive. The most common cause of intraoperative contamination was coagulase-negative Staphylococcus (in 72.7%). Average duration of surgery was 55.15 minutes, being 66.82 minutes in the group of patients with isolated positive swabs and 52.84 minutes in the group with negative swabs. Conclusion. The results of the study clearly show that prolonged duration of surgery significantly influences the incidence of graft intaoperativne contamination.
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Baptiste Ramampisendrahova, Jean, Andriamanantsialonina Andrianony, Andrianina Ismaël Razaka, Rado Razafimahatratra, and Gaëtan Duval Solofomalala. "EVALUATION DE LA PERTE SANGUINE DURANT LA PÉRIODE PÉRIOPÉRATOIRE EN CHIRURGIE ORTHOPÉDIQUE ET TRAUMATOLOGIQUE ASSESSMENT OF BLOOD LOSS DURING THE PERIOPERATIVE PERIOD IN ORTHOPEDIC AND TRAUMA SURGERY." EPH - International Journal of Medical and Health Science 6, no. 4 (December 27, 2020): 13–18. http://dx.doi.org/10.53555/eijmhs.v6i4.146.
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Introduction: The recognition of perioperative blood loss as a factor in patient mortality and morbidity led to the operating room patient safety checklist recommended by the World Health Organization.
Methods: This was a prospective, descriptive study over a ten-month period from January to October 2019 including all the patients hospitalized in the Orthopedic Surgery and Traumatology department of the CHU Anosiala. All patients operated on for an orthopedic or trauma pathology were included in this study, patients having undergone percutaneous surgery were excluded and not included patients not operated on.
Results: One hundred and twelve patients were collected. The average age of the patients was 32.9 years, there is a male predominance with a sex ratio of 2.5. Screw-retained plate osteosynthesis was the most frequent intervention (29.5%) in traumatology, in Orthopedics the installation of the total hip arthroplasty (THA) (6.3%) and sequestrectomy (11.6%) in osteo-articular infection. The mean blood loss for the whole procedure was 508 milliliters (ml) of which in orthopedics, the placement of the total knee arthroplasty (TKA) had the highest mean loss (1630 ml) followed by THA and open reduction neglected dislocations with a respective loss of and 1101 ml and 623.3 ml. In trauma, screw-retained plate osteosynthesis of the femur was the most hemorrhagic with an average blood loss of 820.3 ml and in osteoarticular infections, sequestrectomy with an average loss of 596.2 ml.
Conclusion: The amount of blood loss in orthopedic and trauma surgery varies depending on the type of surgery performed. Arthroplasty, open reduction of a neglected dislocation, screw-retained femoral plate osteosynthesis and sequestrectomy were the most hemorrhagic type of procedure in the perioperative period
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Khan, A., M. S. Zardad, Abdussaboor awan, M. Tahir, M. A. E. Bhattani, and S. A. Shah. "Prevalence of Hepatitis ‘B’ and ‘C’ in Orthopaedics Patients Admitted In Khyber Pakhtunkhwa Hospitals." Pakistan Journal of Medical and Health Sciences 15, no. 5 (May 30, 2021): 1208–10. http://dx.doi.org/10.53350/pjmhs211551208.
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Background and Aim: Hepatitis B and C are widespread global health issues that are rapidly spreading in developing countries due to ineffective preventive measures.Undiagnosed hepatitis B (HBV) and hepatitis C (HCV) viral infections in hospitalized patients and outdoor attendees must be addressed in order to obtain a more accurate picture of HBV and HCV prevalence.The purpose of this study was to determine the prevalence of HBV and HCV in patients admitted to the orthopedic department. Materials and Methods: This is a descriptive cross-sectional study of 1080 patients admitted to the department of orthopedics at Ayub Medical Teaching Institute Abbottabad and Orthopaedics department of DHQ Hospital Thimergara Dir lower for duration of six months fromSeptember 2019 to February 2020.The study included patients of both sex and all ages who were undergoing surgery. Venous blood was drawn from 1080 people and tested for infection using ELISA.All patients were screened for Hepatitis B and C, and positive patients were confirmed using the Elisa method. Results:Out of 1080 patients, 756 (70%) were male and 324 (30%) were female. Hepatitis B and C were found in 86 (8%) of the patients. Out of 86 infected patients, 49 (4.53 %t) had hepatitis C and 37 (3.42 %) had hepatitis B. The prevalence of both hepatitis B and C infections were 4 (0.37 %) of the patients. Of the 49 hepatitis C patients, 32 (65.3%) were male and 17 (34.7%) were female. Thirty-one (83.8 %) of the 37 hepatitis B patients were male, while six (16.21 %) were female.The prevalence of risk factors were history of blood transfusion 14 (16.27 %) patients, Previous history of surgery 17 (19.8 %), dental procedure 6 (7.00 %), and abroad visit in 5 (5.81 %) patients. Conclusion:Hepatitis B and C are common in orthopedic patients, with the following risk factors: prior history of surgery or blood transfusion. To prevent the transmission of HBV and HCV to others, a routinely screened procedure should be followed on a regular basis. Keywords:Prevalence, Hepatitis B, Hepatitis C, Orthopedic patients.
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Kopp, Jason A., Ashley B. Anderson, Jonathan F. Dickens, Andrew C. Graf, Crevan O. Reid, Pierre-Etienne C. Cagniart, Jason M. Wang, and Krista B. Highland. "Orthopedic Surgeon Decision-Making Processes for Postsurgical Opioid Prescribing." Military Medicine 185, no. 3-4 (November 29, 2019): e383-e388. http://dx.doi.org/10.1093/milmed/usz397.
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Abstract Introduction Acute pain and chronic pain are significant burdens in the Department of Defense, compounded by the ongoing opioid crisis. Given the ubiquity of (leftover) opioid prescriptions following orthopedic surgery, it is essential to identify feasible and acceptable avenues of opioid risk mitigation efforts. The present quality improvement project builds on recent studies by evaluating factors related to opioid prescribing decisions in a sample of orthopedic surgery providers. Materials and Methods This quality improvement project received a Determination of Not Research and was conducted through a collaboration between the Department of Orthopaedic Surgery and the Department of Anesthesiology and Pain Management at Walter Reed National Military Medical Center. Providers in the Department of Orthopaedic Surgery completed an anonymous online survey assessing opioid prescribing education, factors influencing prescribing practices, opioid-safety practices, and perspectives on potential opioid safety initiatives. Results In total, 39 respondents completed surveys. There was variability in exposure to different types of opioid prescribing education, with some variation between attendings/physician assistants and residents. Patients’ acute postsurgical pain, using a standardized amount for most patients, and prescription histories were the three most influential factors. Concern of patients running out and fear of patient dissatisfaction were the least influential factors. Respondents commonly reported engagement in promoting nonpharmacological pain management, as well as coordinating with chronic pain providers when applicable, but did not commonly report educating patients on leftover opioid disposal. Respondents indicated that a barrier to opioid risk mitigation was the difficulty of accessing appropriate electronic health record data to inform decisions. Lastly, they reported openness to proposed opioid safety initiatives. Conclusion The results of this quality improvement project identified several target areas for future initiatives focused on improving opioid prescribing practices. This included a provider training program, improved patient education system, increased awareness and use of opioid tracking databases, and development of a standardized (but adaptable per patient characteristics and history) recommended dose for common orthopedic surgeries. Future projects will target tailored development, implementation, and evaluation of such efforts.
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Feihl, Susanne, Christiane Querbach, Alexander Hapfelmeier, Dirk H. Busch, Rüdiger von Eisenhart-Rothe, Friedemann Gebhardt, Florian Pohlig, and Heinrich M. L. Mühlhofer. "Effect of an Intensified Antibiotic Stewardship Program at an Orthopedic Surgery Department." Surgical Infections 23, no. 2 (March 1, 2022): 105–12. http://dx.doi.org/10.1089/sur.2021.040.
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Khan, Alamzeb, Israr Ahmed, and Gul Sher. "Frequency of Orthopedic Trauma in Patients Attending Khalifa Gul Nawaz Teaching Hospital: A Retrospective Analysis." ANNALS OF ABBASI SHAHEED HOSPITAL AND KARACHI MEDICAL & DENTAL COLLEGE 27, no. 03 (August 30, 2022): 87–93. http://dx.doi.org/10.58397/ashkmdc.v27i03.481.
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Objective: The present study aimed to assess the frequency of orthopedic trauma injuries in patients admitted to the Orthopedic Department at Khalifa Gul Nawaz Teaching Hospital in Bannu.
Methodology: This retrospective snapshot study was conducted at the Orthopaedic & Traumatology Department of K.G.N. Hospital in Bannu, KPK. Data were extracted from hospital records of 380 patients admitted for emergency orthopedic surgery due to fractures, lacerations, and/or fractures with lacerations. The frequency and etiologies of orthopedic diagnoses were recorded.
Results: Out of the 380 cases admitted during the study, the majority were males (76.05%). Furthermore, these orthopedic trauma injuries were more common in individuals aged 21 to 50 years (66.83%) than the other age groups. Road Traffic Accidents (RTA) were the major etiological factor (49.21%), followed by falls from height (31.84%). Upper limb fractures were diagnosed in 46.27% of patients, and 53.63% had lower limb fractures. Isolated radius (14.47%) and femoral fractures (23.94%) were the most frequent diagnosis.
Conclusion: The present study provides a brief overview of the major etiologies and diagnoses for orthopedic emergencies. It is essential to identify the risk factors and strategize a prevention plan that should be the priority of the healthcare system to avoid morbidities and mortalities associated with orthopedic traumas.
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Lazarova, Biljana, Aleksandra Kapedanovska Nestorovska, Zoran Sterjev, and Ljubica Suturkova. "Evaluation of costs and outcomes associated with pharmacological thromboprophylaxis (unfractionated heparin and low molecular weight heparins) of venous thromboembolism at orthopedic ward in Clinical Hospital Stip." Macedonian Pharmaceutical Bulletin 63, no. 01 (2017): 25–34. http://dx.doi.org/10.33320/maced.pharm.bull.2017.63.01.002.
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Clinical trials have shown Low-molecular weight heparins (LMWHs) to be at least as safe and efficacious as unfractionated heparin (UFH) for preventing venous thromboembolism (VTE) in patients undergoing major orthopedic surgery who are at highest risk of developing VTE. The retrospective study was conducted at orthopedic department in Clinical Hospital – Stip for period of 12 months (January-December 2013), where LMWHs and UFH are accepted thromboprophylaxis options. 320 patients (144 males and 157 females, medium age 58 years and 70 years, respectively) were hospitalized for various types of major orthopedic surgical interventions. 212 (66%) patients were admitted because of hip or knee fractures, 26 (8%) had conditions after hip or knee fractures and 82 (26%) were hospitalized for removal or implanting of osteosynthetic devices. After the surgical intervention, patients were subjected to anticoagulant prophylaxis (UFH or LMWHs). Which type of prophylaxis will be used depended exclusively on the surgeon’s decision. VTE complications resulting death were observed in 8 (2.5%) out of 13 patients. Death because of PE occurred in 2 (25%) out of 8 patients, compared to 6 (75%) patients who had fatal DVT complications. The average hospital cost for patients treated with LMWHs prophylaxis as first line thromboprophylaxis option was 52831.92 MKD/patient compared to 70082.24 MKD/patient for UFH first line thromboprophylaxis option. We observed that LMWHs thromboprophylaxis, applied in recommended doses subcutaneously once a day, is potentially more effective and cost saving option compared to UFH and should be considered as pharmacological treatment of first choice for the prevention of VTE (DVT and PE) in patients recovering from major orthopedic surgery at the orthopedic department in Clinical Hospital Stip. Keywords: Thromboprophylaxis, major orthopedic surgery, LMWHs, UFH
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Folmer, Willem, Wim Lammers, Terry Mulligan, Esther M. M. Van Lieshout, Peter Patka, Zhenye Xu, Yiming Lu, and Dennis Den Hartog. "Patient Demographics in Acute Care Surgery at the Ruijin Hospital in Shanghai." ISRN Surgery 2011 (July 7, 2011): 1–8. http://dx.doi.org/10.5402/2011/801404.
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Acute Care Surgery is a discipline that includes trauma care, surgical critical care, and emergency surgery. It is organized in different models and provides mainly operative and nonoperative care. The aim of this study was to provide a demographic analysis of the care of surgical patients at the Emergency Department (ED) in a large teaching hospital in Shanghai, where general surgeons and orthopedic surgeons take care for most of all acute surgery. A bilingual questionnaire was developed to collect data for patients referred to the general or orthopedic surgeon in the ED (June–September 2008). Data about the gender, age, diagnosis, diagnostic tools, treatments, and outcomes were collected. A total of 255 questionnaires were collected; the most common diagnoses of patients were infections of abdominal organs and fractures. Complementary diagnostics like X-ray (59%), blood tests (36%), and ultrasound (17%) were frequently used. More than half of the patients were discharged afterwards most of them with followup. This study gives a first overview of acute care surgery of the emergency patients of the ED in a large Chinese metropolitan hospital.
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Baidoo, Paa K., Agbeko Ocloo, Velarie Ansu, and Joojo N. Baidoo. "Impact of battery-powered orthopedic drills on the practice of orthopedic surgery in a resource limited country." International Surgery Journal 5, no. 3 (February 26, 2018): 954. http://dx.doi.org/10.18203/2349-2902.isj20180810.
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Background: The study aimed at assessing the impact of the availability of battery-powered drills on the management of orthopedic cases presenting to the orthopedic unit of the department of surgery at a major teaching hospital serving the southern part of Ghana.Methods: This study was a single center retrospective study. Authors examined the total number of cases, average time spent on cases in the operating room, and the average patient waiting time for surgery between January 2012 and December 2014. A paired sample t-test was used to evaluate the effectiveness of the orthopedic drills for the pre-and post-intervention periods.Results: There were statistical significant differences in the total number of cases (p<0.01), the average time spent on cases in the operating room (p<0.01), and the average waiting time for surgery (p<0.05) between January 2012 to June 2013 when manual hand drills were in use and July 2013 to December 2014 when the battery-powered drills were introduced.Conclusions: The introduction of the battery-powered drills led to a significant improvement in the total number of cases done. There was a reduction in time spent per case in the operating room as well as the average waiting time to having surgery.
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Mijovic, Biljana, Ljiljana Markovic-Denic, Dusica Bankovic-Lazarevic, and Maja Račić. "First outbreak of Clostridium difficile infections in Serbia: An experience of the department for orthopedic surgery." Journal of Epidemiological Research 5, no. 1 (March 7, 2019): 50. http://dx.doi.org/10.5430/jer.v5n1p50.
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Objectives: Increased C. difficile infection rates were observed during the last decade, as well as the onset of complicated forms of the disease. The primary objective of this study was to report the first outbreak of C. difficile in a Serbian hospital, aiming to determine clinical and environmental factors associated with the outbreak. The secondary objective was to describe outbreak control measures taken.Design: The retrospective cohort study conducted from 18 April to 22 May 2013 in Serbian healthcare. Ninety-five patients hospitalized at the Department for orthopedic surgery during the CDI outbreak.Results: Prophylactic antibiotic therapy was identified among 93.3% patients with and 87.9% without C. difficile infection. The multivariate logistic regression analysis has shown that the independent risk factors for C. difficile infection incidence are the age beyond 70 (OR = 4.5; 95%CI = 1.1-18.2; p = .031) and the length of antibiotic therapy (OR = 1.5; 95%CI = 1.1-2.1; p = .017).Conclusion: The length of antibiotic prophylaxis is linked with the incidence. Orthopedic departments have a risk of C. difficileinfection. Infection control measure, antimicrobial stewardship programs and compliance to guidelines for the prescribing of antibiotics play important role in the prevention of C. difficile infection burden.
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Meraghni, Nadhir, Riad Benkaidali, Mohamed Derradji, and Zoubir kara. "Orthopedic healthcare in the time of COVID-19: Experience of the orthopedic surgery department at Mustapha Bacha Hospital, Algeria." Annals of Medicine and Surgery 55 (July 2020): 164–66. http://dx.doi.org/10.1016/j.amsu.2020.05.025.
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AlRashed, Rawan Hameed. "Evaluate the Effects COVID-19 Pandemic in Saudi Arabia on the Field of Orthopedics: Review Article." International Journal for Research in Applied Science and Engineering Technology 9, no. VII (July 31, 2021): 3242–47. http://dx.doi.org/10.22214/ijraset.2021.37065.
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As the COVID-19 pandemic continues to spread across Saudi Arabia, as many other health departments or specialties within the field of medicine and surgery, COVID-19 has affected the field of orthopedics to a greater extent, This might have affected not only the timely and effective care for orthopedic patients but also have resulted in new directions and plans in the field of orthopedics that will shift the care degree. In addition, orthopedic surgeons might experience challenges in providing effective and required for their patients with an overall decline of care due to COVID-19 pandemic. Moreover, it is also essential to reflect on the future directions and changes that need to be adopted by the health specialists working in the field of orthopedics. This can include the reopening of facilities for elective surgery. Given the current circumstances, much remains unknown about COVID-19. It is important that individuals continue to follow guidance of Saudi ministry of health, that said, the Saudi of Orthopaedic Surgeons like to share some important considerations that individuals should consider before making any decisions.
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Osmanovic, Elvedin, Mensura Aščerić, and Esed Omerkic. "Implementation of the hemoprophylactic protocol in orthopedic surgery." Journal of Health Sciences 1, no. 3 (December 15, 2011): 171–74. http://dx.doi.org/10.17532/jhsci.2011.133.
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Introduction: Antibiotic prophylaxis is defined as the use of antimicrobials in the absence of symptoms of infection, with the aim of preventing or reducing the incidence of infection after surgery. We analyzed the incidence of surgical wound infection in patients in whom a protection of hemoprophylaxis conducted using cefazolin and gentamicin, and determine the frequency of surgical wound infection in patients in whom there was a deviation in the implementation of hemoprophylaxis protection.Methods: This retrospective-prospective study included 100 patients surgically treated at the The Department of Orthopedics and Traumatology, University Clinical Center in Tuzla from December 2007 to February 2010, which examined the incidence of surgical wound infection after surgical treatment of fractures or degenerative changes in the hip, thigh and lower leg fractures.Results: In the first group, in patients who were treated with cefazolin were detected in 2 cases (5.7%) while the length of hemoprophylaxis was 7 days, patients who were treated with cefazolin and gentamicin were detected in 1 case (2.8%) and duration hemoprophylaxis was 7 days. In another control group tah was found 9 cases of wound infection (30%), and hemoprophylaxis duration was 10 days.Conclusion: The combination of cefazolin and gentamycin for a period of 5 days significantly reduces the incidence of infection and significantly shortened the time of antibiotics in group that is respected application protocol in accordance with international recommendation.
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Earp, Brandon E., Dafang Zhang, Kyra A. Benavent, Laura Byrne, and Philip E. Blazar. "The Early Effect of COVID-19 Restrictions on an Academic Orthopedic Surgery Department." Orthopedics 43, no. 4 (July 1, 2020): 228–32. http://dx.doi.org/10.3928/01477447-20200624-03.
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Lazarova, Biljana, Aleksandra Kapedanovska Nestorovska, Zoran Sterjev, and Ljubica Suturkova. "Cost-effectiveness of LMWHs versus UFH for the prevention of postsurgical venous thromboembolism at orthopedic department in Clinical Hospital Stip." Macedonian Pharmaceutical Bulletin 64, no. 01 (2018): 79–88. http://dx.doi.org/10.33320/maced.pharm.bull.2018.64.01.007.
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This study aimed to evaluate the cost-effectiveness of thromboprophylaxis with LMWHs vs UFH in the prevention of venous thromboembolism (VTE) after orthopedic surgery from the perspective of the Clinical hospital in Stip. A model was developed that included both acute VTE (represented as a decision tree) and long-term complications (represented as a Markov process with one-year cycles). Transition probabilities were derived from phase III clinical trials comparing LMWHs with UFH and published literature. Unit costs were taken from the official, publically available hospital and health care insurance data and included direct drug costs for VTE (DVT and PE) prophylaxis (UFH/10000 IU and LMWHs/4000 IU) and hospitalization costs (hospital full board, disposables, medical services, concomitant therapy, healthcare professional time). Costs are reported in Macedonian Denars (MKD). When LMWHs and UFH are compared in orthopedic patients, LMWHs dominates UFH and are associated with improved health outcomes, measured by increased quality-adjusted life years (QALYs; 0.05) and with lower cost (savings of 20438.96 MKD) per patient. LMWHs are a cost-saving alternative to UFH for VTE prophylaxis in patients undergoing orthopedic surgery. Over a one-year horizon, LMWHs dominated UFH in the prevention of VTE events in patients undergoing surgery, providing more quality-of-life benefit at a lower cost. Keywords: anticoagulants, surgery, thrombosis
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Sharma, Bishnu Dev, and Jyoti Sitaula. "ASSESSMENT OF POSTOPERATIVE PAIN AND ANALGESIC USE IN PATIENTS UNDERGOING ORTHOPEDIC SURGERY." Journal of Chitwan Medical College 11, no. 3 (September 30, 2021): 53–57. http://dx.doi.org/10.54530/jcmc.461.
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Background: Pain is an unpleasant sensation and occurs frequently in the post-operative period. Pain impairs treatment and recovery of patients and thus should be adequately managed. This study aimed to assess the intensity of pain in the post-operative patients undergoing orthopedic surgery and to evaluate the adequacy of the analgesics used. Methods: This was a prospective observational study conducted at Chitwan Medical College, Department of Orthopedics from May to August 2019. Ninety-six patients who underwent orthopedic surgery were evaluated upto 72 hours after surgery and assessed for pain using interview, Visual Analogue Scale and medical record analysis. Type of analgesic used and its adequacy, using Pain Management Index, were also studied. Results: There were 58 male and 38 female patients with age 18-79 years (mean 38.16 ± 16.34 years). 97.9% patients complained of pain in immediate, 91.7% in 1st and 82.3% in 2nd post-operative period with mean Visual Analogue Scale scores of 6.68, 3.74 and 2.68 respectively. Non-steroidal anti-inflammatory drug was the most frequently prescribed analgesic followed by its combination with opioid. Pain management was inadequate in immediate post-operative (61.5%), but there was significant improvement in 1st and 2nd post-operative period (inadequate Pain Management Index in 28.1% and 12.5% respectively). Conclusions: Most patients experienced pain in the post-operative period, but the intensity decreased as the post-operative hours passed by. Pain management in the immediate post-operative period was inadequate in our study and therefore proper attention should be given to manage pain in the post-operative period.
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Yang, Judy, Yuanzheng Lu, Xiaoxing Liao, and Mary P. Chang. "Examining patient trust towards physicians between clinical departments in a Chinese hospital." PLOS ONE 16, no. 11 (November 29, 2021): e0259945. http://dx.doi.org/10.1371/journal.pone.0259945.
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The purpose of this cross-sectional survey study is to quantitatively examine the differences in patient trust towards physicians between four different clinical departments in a Chinese hospital. Using a validated modified Chinese version of the Wake Forest Physician Trust Scale, we measured patient trust in each department, and also collected data on patient demographics. A total of 436 patients or family members were surveyed in the departments of emergency medicine, pediatrics, cardiology, and orthopedic surgery. Significant differences were found between the departments, especially between pediatrics (trust score 43.23, range 11–50) and emergency medicine and cardiology (trust scores 45.29 and 45.79, respectively with range of 11–50). The average total score across all four departments was 44.72. There are indications that specifically comparing departments, such as patient demographics or department structure, could be helpful in tailoring patient care to improve physician-patient relationships.
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Trisolino, Giovanni, Renato Maria Toniolo, Lorenza Marengo, Daniela Dibello, Pasquale Guida, Elena Panuccio, Andrea Evangelista, et al. "Resilience Against COVID-19: How Italy Faced the Pandemic in Pediatric Orthopedics and Traumatology." Children 8, no. 7 (June 22, 2021): 530. http://dx.doi.org/10.3390/children8070530.
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Background: We aimed to investigate the variation of medical and surgical activities in pediatric orthopedics in Italy, during the year of the COVID-19 pandemic, in comparison with data from the previous two years. The differences among the first wave, phase 2 and second wave were also analyzed. Methods: We conducted a retrospective multicenter study regarding the clinical and surgical activities in pediatric orthopedics during the pandemic and pre-pandemic period. The hospital databases of seven tertiary referral centers for pediatric orthopedics and traumatology were queried for events regarding pediatric orthopedic patients from 1 March 2018 to 28 February 2021. Surgical procedures were classified according to the “SITOP Priority Panel”. An additional classification in “high-priority” and “low-priority” surgery was also applied. Results: Overall, in 2020, we observed a significant drop in surgical volumes compared to the previous two years. The decrease was different across the different classes of priority, with “high-priority” surgery being less influenced. The decrease in emergency department visits was almost three-fold greater than the decrease in trauma surgery. During the second wave, a lower decline in surgical interventions and a noticeable resumption of “low-priority” surgery and outpatient visits were observed. Conclusion: Our study represents the first nationwide survey quantifying the impact of the COVID-19 pandemic on pediatric orthopedics and traumatology during the first and second wave.
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Zhang, Ning, and Jiahu Fang. "Clinical Features and Surgical Strategies of Distal Radius Posttraumatic Deformity." Emergency Medicine International 2022 (September 19, 2022): 1–7. http://dx.doi.org/10.1155/2022/5268822.
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Objective. To investigate the clinical features and surgical strategies of distal radius posttraumatic deformity. Methods. A retrospective analysis was performed on the data of 30 patients with distal radius posttraumatic deformity treated by osteotomy and orthopedic surgery in the department of orthopedics, the First Affiliated Hospital of Nanjing Medical University, from February 2016 to November 2018. All the patients underwent preoperative anterior and lateral X-ray plain scanning of bilateral wrist joints, showing different degrees of radius shortening, inferior ulnar and radial mismatch, palmar angle, and ulnar deviation angle, among which 11 patients had an uneven joint surface. After a full evaluation, osteotomy and orthopedic surgery were performed to restore the original anatomical structure, plaster fixation was performed for two weeks after surgery, and regular outpatient follow-up was conducted. The function of the wrist was evaluated by the MMWS (wrist joint improvement) scoring scale before and after surgery, and the changes in the wrist joint-related treatment parameters were evaluated according to X-ray. Results. All 30 patients had no neurological symptoms after surgery, and all wounds healed within the first stage. All patients were followed up for 6–12 months, with an average healing time of 3.5 months. There was no reduction loss, internal fixation loosening, or fracture in the regular postoperative review. Postoperative MMWS (wrist joint improvement) score scale data were significantly higher than those before surgery, and there were differences between groups ( P < 0.05 ). Postoperative treatment parameters of wrist joints such as palmar inclination angle, ulnar deviation angle, radius height, and lower ulnar and radial matching were significantly improved, and there were differences between groups ( P < 0.05 ). Conclusions. The patients with distal radius posttraumatic deformity have the clinical characteristics of shortening of radius, mismatch of lower ulnar and radius, an abnormal inclination of palm, and ulnar declination. For patients with distal radius posttraumatic deformity, osteotomy and orthopedic surgery can effectively improve wrist function and improve patients’ quality of life, which is worthy of clinical reference.
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DiBartola, Alex C., Christine Barron, Scott Smith, Catherine Quatman-Yates, Ajit M. W. Chaudhari, Thomas J. Scharschmidt, Susan D. Moffatt-Bruce, and Carmen E. Quatman. "Decreasing Room Traffic in Orthopedic Surgery: A Quality Improvement Initiative." American Journal of Medical Quality 34, no. 6 (January 17, 2019): 561–68. http://dx.doi.org/10.1177/1062860618821180.
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Operating room (OR) traffic and door openings increase potential for air contamination in the OR and create distractions for surgical teams. A multidisciplinary intervention was developed among OR staff, surgical staff, vendors, radiology, and anesthesia and approved by the hospital system’s patient and quality safety department for implementation. Interventions included education, OR signage, and team-based accountability and behavioral interventions. After interventions were implemented, a second prospective, observational data collection was performed and compared to preintervention OR traffic. A total of 35 cases were observed over the 3-month period in the preintervention group; 42 cases were observed in the postintervention group. Average door openings per minute decreased by 22% ( P = .0011) after intervention. All surgical groups excluding anesthesia had significant reductions in OR traffic following the intervention. Behavioral interventions that focus on education, awareness, and efficiency strategies can decrease overall OR traffic for orthopedic cases.
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Yang, Brian W., and Peter M. Waters. "Implementation of an Orthopedic Trauma Program to Safely Promote Resident Autonomy." Journal of Graduate Medical Education 11, no. 2 (April 1, 2019): 207–13. http://dx.doi.org/10.4300/jgme-d-18-00277.1.
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ABSTRACT Background There is ongoing tension in graduate medical education between progressive resident autonomy with entrustable professional activities and the need for supervision to ensure patient safety. Objective We implemented a pediatric orthopedic surgical trauma safety program that utilized a postcall review conference to provide residents graduated responsibility learning opportunities during overnight trauma call without compromising patient safety. Methods In the program, all orthopedic trauma cases seen in our main tertiary hospital emergency department by the overnight orthopedic resident were reviewed in a case conference. For 1 year, we performed an analysis of all fracture patients who were treated in the emergency department by our orthopedic surgery residents. From June 1, 2016, through June 30, 2017, all care delivery encounters were reviewed for decision-making errors, technical errors, and complication rates. Two resident groups rotated through our institution over the course of the study. Results During the year of analysis, all 1298 fracture patients seen overnight in the main tertiary hospital emergency department were reviewed. From the first to the second halves of their rotations, the rate of resident decision-making errors (3.1% [12 of 385] to 2.3% [9 of 399]) and technical errors (9.1% [35 of 395] to 7.3% [29 of 399]) decreased. Excluding decision-making and technical errors, the complication rate for patients discharged home was 3.4% (27 of 784). Conclusions Residents demonstrated decreased decision-making and technical error rates on overnight call while maintaining low complication rates.
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Quirino, Angela, Nadia Marascio, Giuseppe Guido Maria Scarlata, Claudia Cicino, Grazia Pavia, Marta Pantanella, Giovanni Carlisi, et al. "Orthopedic Device-Related Infections Due to Emerging Pathogens Diagnosed by a Combination of Microbiological Approaches: Case Series and Literature Review." Diagnostics 12, no. 12 (December 19, 2022): 3224. http://dx.doi.org/10.3390/diagnostics12123224.
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Orthopedic and trauma device-related infections (ODRI) due to high virulence microorganisms are a devastating complication after orthopedic surgery. Coagulase-negative Staphylococci (CoNS) are mainly involved but commensal bacteria, located in human mucous membranes, are emerging pathogens in ODRI. Currently, bacterial culture is the gold standard for ODRI but the diagnostic process remains time consuming and laborious. We evaluated a combination of microbiological approaches in the diagnosis of emerging pathogens involved in ODRI. We analyzed two synovial fluids, five tissue samples and five surgical wound swabs from two different patients with ODRI, attending the Department of Orthopedic and Trauma Surgery of Mater Domini Teaching Hospital, Catanzaro, Italy. Identification was carried out with a combination of microbiological approaches (culture, mass spectrometry and 16s rRNA gene sequencing). We demonstrated the importance of a combination of microbiological approaches for the diagnosis of emerging pathogens in ODRI, because the low number of cases in the literature makes it very difficult to formulate guidelines for the management of patients.
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Heinz, Tizian, Annette Eidmann, Axel Jakuscheit, Tino Laux, Maximilian Rudert, and Ioannis Stratos. "Demographics and Trends for Inbound Medical Tourism in Germany for Orthopedic Patients before and during the COVID-19 Pandemic." International Journal of Environmental Research and Public Health 20, no. 2 (January 10, 2023): 1209. http://dx.doi.org/10.3390/ijerph20021209.
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Medical tourism is a rapidly growing sector of economic growth and diversification. However, data on the demographics and characteristics of the traveling patients are sparse. In this study, we analyzed the common demographic properties and characteristics of the inbound medical tourists seeking orthopedic medical care in Germany for the years 2010 to 2019 compared to a domestic group. At the same time, we examined how the COVID-19 pandemic outbreak of 2020 changed the field of medical tourism in Germany. Calculations were performed using administrative hospital data provided by the Federal Statistical Department of Germany. Data were analyzed from the years 2010 to 2020. A total of six elective orthopedic surgery codes (bone biopsy, knee arthroplasty, foot surgery, osteotomy, hardware removal, and arthrodesis) were identified as key service indicators for medical tourism and further analyzed. Factors including residence, sex, year, and type of elective surgery were modeled using linear regression analysis. Age and sex distributions were compared between patients living inside Germany (DE) or outside Germany (non-DE). Between 2010 and 2020, 6,261,801 orthopedic procedures were coded for the DE group and 27,420 key procedures were identified for the non-DE group. Medical tourists were predominantly male and significantly younger than the domestic population. The linear regression analysis of the OPS codes over the past years showed a significantly different slope between the DE and non-DE groups only for the OPS code “hardware removal”. With the COVID-19 pandemic, an overall decline in performed orthopedic procedures was observed for the non-DE and the DE group. A significant reduction below the 95% prediction bands for the year 2020 could be shown for hardware removal and foot surgery (for DE), and for hardware removal, knee arthroplasty, foot surgery, and osteotomy (for non-DE). This study is the first to quantify inbound medical tourism in elective orthopedic surgery in Germany. The COVID-19 pandemic negatively affected many—but not all—areas of orthopedic surgery. It has to be seen how this negative trend will develop in the future.
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Mehdi, Muntazir, Waleed Ali, Muhammad Fahim Qasim, Adil Saidullah, Rizwan Farooq, and Abid Munir. "Prevalence of Anxiety and Depression among Orthopedic Trauma Inpatients." Pakistan Journal of Medical and Health Sciences 16, no. 12 (December 31, 2022): 734–36. http://dx.doi.org/10.53350/pjmhs20221612734.
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Background and aim: Orthopedic trauma patients experience anxiety and depression, both of which are undesirable psychological issues. The present study aimed was to determine the prevalence of anxiety and depression. Material and Methods: This cross-sectional study was conducted on 188 orthopedic trauma patients in Orthopaedics Department of Federal Govt. Polyclinic Hospital (FGPC) Islamabad and Wah Medical College / POF hospital Wah Cantt from October 2020 to September 2022. Prior to study conduction, ethical approval from research and ethical committee was taken. Informed written consent was obtained from each individual. Social characteristics, demographic details, and clinical examination were recorded. Hospital anxiety and depression scale (HADS) was used for the assessment of patient’s anxiety and depression. SPSS version 26 was used for data analysis. Results: Of the total 188 patients, there were 112 (60%) male and 76 (40%) females. The overall mean age was 46.82 ± 12.94 years with an age range (15-75 years). Age-wise distribution of patients was as follows: 56 (29.8%) in 15-30 years, 44 (23.4%) in 31-45 years, 38 (20.2%) in 46-60 year, and 50 (26.6%) in 61-75 years. Out of 188 orthopedic trauma patients, the incidence of road traffic accident (RTA) and ground fall was 96 (51.1%) and 92 (48.9%) respectively. The incidence of anxiety and depression before and after orthopedic surgery was 22 (11.7%) and 32 (17%) and 36 (19.1%) and 46 (24.5%) respectively. Anxiety and depression on HADS was 4.12 and 5.21 before surgery and increased substantially to 4.62 and 5.81 after surgery. The incidence of single, double, and triple fracture was 162 (85.2%), 24 (12.8%), and 2 (1.1%) respectively. Conclusion: The present study found that orthopedic trauma in the elderly often leads to emotional disorders. Anxiety and depression levels were low before surgery and increased after surgery in orthopedic trauma patients. However, age, poverty, and gender are directly related to anxiety and depression. Patients with geriatric disorders should be monitored closely by clinicians. Keywords: Orthopedic trauma, Psychological problems, anxiety, depression
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Franco-Donat, M., E. Soler-Company, C. Valverde-Mordt, S. García-Muñoz, A. Rocher-Milla, and M. J. Sangüesa-Nebot. "Medication reconciliation at hospital admission and discharge in an orthopedic surgery and traumatology department." Revista Española de Cirugía Ortopédica y Traumatología (English Edition) 54, no. 3 (January 2010): 149–55. http://dx.doi.org/10.1016/s1988-8856(10)70224-8.
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Ipsen, T., and B. Gahrn-Hansen. "Occurrence of methicillin-resistantStaphylococcus aureus in a department of orthopedic surgery 1970 to 1986." European Journal of Clinical Microbiology & Infectious Diseases 7, no. 3 (June 1988): 400–403. http://dx.doi.org/10.1007/bf01962345.
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Ninkovic, Srdjan, Sladjana Radosavljevic, Vladimir Harhaji, Ivica Lalic, Natasa Janjic, and Mirko Obradovic. "The use of partial prosthesis in shoulder surgery." Medical review 69, suppl. 1 (2016): 47–51. http://dx.doi.org/10.2298/mpns16s1047n.
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Introduction. Indications for the use of partial shoulder prosthesis are dislocated four-part fractures and multi-part and four-part fractures-dislocations, impressive fractures of the humeral head (including involvement of more than 40% of the articular surface) and ?head splitting? fractures of humerus. The aim of this study was to present the results of the application of partial shoulder prosthesis at the Department of Orthopedic Surgery and Traumatology, Clinical Center of Vojvodina in Novi Sad and identify risk groups among the participants. Material and Methods. The study, which was retrospective, included 22 patients who had undergone the partial shoulder arthroplasty in the period from 2005 to 2015 at the Department of Orthopedic Surgery and Traumatology, Clinical Center of Vojvodina. The functional results were evaluated on the basis of the Constant Shoulder Score. Results. The study sample consisted of 15 women and 7 men, whose mean age was 64.9 ? 9.1 years. The average time from the injury to surgery was 13.3 days. According to the Constant scoring scale, the result was excellent in 6 (27%) patients, good in 3 (14%), fair in 7 (32%), and poor in 6 (27%) participants. 75% of participants said they were satisfied with the results of the operation. Conclusion. Partial shoulder prosthesis gives good functional results and allows resumption of activities of daily living. Better results were obtained within the subjective segments (pain, daily activities, vitality), which points out a greater subjective patient?s satisfaction in relation to the measured functio?nal outcome.
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Arif, Anum, Alishba Kulsoom Rauf, Fatima Kharal, Ahsin Manzoor Bhatti, Muhammad Salman Imtiaz, and Raoon . "Audit of Surgical practice and performance in COVID Crisis – Lessons for the future." Pakistan Journal of Medical and Health Sciences 16, no. 7 (August 31, 2022): 192–95. http://dx.doi.org/10.53350/pjmhs22168192.
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Aim: To evaluate the pattern of surgical emergencies and surgical care provided during COIVD 19 pandemic. Study design: Cross-sectional Study Place and duration of study: Department of Surgery, CMH, Lahore from 15th March - 15 June 2020. Methodology: Data was collected retrospectively, of all the patients who were admitted in department of surgery over the duration of 3 months. Demographic variables, diagnosis, work up related to COVID-19, specialty of admission and surgical vs conservative management was recorded. Results: A total of 312 patients were included. Majority were male 216(69.2%). Most of the patients 191(61.2%) were admitted via clinic, predominantly in month of May 148(41%). COVID-19 PCR was done on 210 patients (67.3%), chest x-ray was done on 271(87.9%), HRCT chest was done on 113 patients (29.20%). Although general surgery was the busiest service line with a total patient admission of 89(43.1%), Orthopedic surgery top the operative interventions list with 85.1% of admissions underwent operative management. Conclusion: The current local guidelines about patient flow and management of patients in COVID crisis are practical and can be implemented. In the wake of the later waves of COVID 19 hospitals should prepare to divert their resources to high volume specialties like General and orthopedic surgery. Simple, but important procedures like arteriovenous fistula creation should only be stopped it there is shortage of manpower. MeSH words: Audit, COVID- 19, General Surgery, Pakistan, Vascular Surgery
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Nielsen, Alex W., Brian C. Law, Glenn G. Shi, and Jonathan C. Kraus. "Patient Knowledge of Provider Training Background and Preferences for Treatment of Foot and Ankle Conditions." Foot & Ankle Orthopaedics 4, no. 4 (October 1, 2019): 2473011419S0032. http://dx.doi.org/10.1177/2473011419s00321.
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Category: Professional, Patient Care Introduction/Purpose: Differences exist in the training backgrounds of medical providers who treat foot and ankle disorders. Considerable overlap and similarities also exist between podiatric and orthopaedic surgeons, though patients may be unaware of the differences. It is not known to what extent professional training influences how patients seek care. The purpose of this study is to understand patients’ knowledge of the differences in professional training background between podiatry and orthopedic surgery and to determine which factors are important to patients when selecting a provider. Methods: Patient survey data was gathered from Froedtert Memorial Lutheran Hospital and the Mayo Clinic. A 27-question survey was administered to new patients who were referred to the foot and ankle service in an orthopedic department at both institutions. Survey questions included data on patient demographics, patient opinion, and knowledge of differences between podiatry, orthopedics, and other foot and ankle providers. Patients were grouped by provider preference. Univariate and multivariate regressions were used to characterize the study population and determine provider preference. Significance was determined through t-tests, Fisher’s Exact test, and chi-square tests. Results: Of the 169 patients who completed the entire survey, 99 chose “orthopedic surgeon” as their provider of preference for any foot or ankle injury. Between the groups, there was no significant difference in age, healthcare affiliation, previous podiatric visits, level of education, and perceived knowledge about the differences between the two specialties (Table 1). For patients who listed podiatry as their preference, they were less likely to expect their doctor to have completed residency (76.2% vs. 90.7-94.9%, p=0.03). Patients preferred an orthopedic surgeon over a podiatrist for ankle (63.3% vs. 9.5%, p<0.001) and knee injuries (82.8% vs. 5.8%, p<0.001), while they preferred a podiatrist for toe pain (42.6% vs. 27.8%, p<0.001). 76.3% of patients thought orthopaedic surgeons and podiatrist undergo the same professional training. Conclusion: Foot and ankle patients have poor understanding of the different medical and surgical training backgrounds between a podiatrist and orthopedic surgeon. The majority of patients believe podiatrist and orthopaedic surgeons have the same professional training. However, patients also believed orthopaedic surgeons have a longer training period, though it was still underestimated by three years. Patients preferred care for podiatrist with conditions affecting the toes and orthopaedic surgeons for all other conditions.
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Falzarano, Gabriele, Antonio Piscopo, Predrag Grubor, Giuseppe Rollo, Antonio Medici, Valerio Pipola, Michele Bisaccia, et al. "Use of Common Inflammatory Markers in the Long-Term Screening of Total Hip Arthroprosthesis Infections: Our Experience." Advances in Orthopedics 2017 (2017): 1–7. http://dx.doi.org/10.1155/2017/9679470.
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Orthopedic implants have become essential components of modern medicine. The risk of infection of total hip arthroplasty (THA) is 1.5%−2%. Are the C-reactive protein (CRP), the erythrocyte sedimentation rate (ESR), and procalcitonin (PCT) good markers for THA infection screenings? From February 2009 to December 2012 at our Department of Orthopedics and Traumatology, 1248 patients were treated with THA. No prosthesis was cemented. All patients received antibiotic prophylaxis. All patients were discharged approximately 7.4 days after surgery with this clinical and radiographic follow-up program at 15 days and 1, 3, 6, 12, 24, and 36 months after surgery. Blood samples to determine ESR, CRP, and PCT values were taken at 1 hour before surgery and 15 days and 1, 3, 6, 12, 24, and 36 months after surgery. During follow-ups there were 22 cases of THA infections; according the Widmer classification, infections are hematogenous ones in 16 cases, late chronic ones in 5 cases, and early postoperative ones in 1 case. In all cases the three markers were considered positive; in 6 cases there were no radiological signs of septic loosening. ESR, CRP, and PCT proved to have a greater diagnostic accuracy than X-rays in predicting late chronic and early postoperative infections. These markers are valuable support for the surgeon in monitoring the prosthetic implant lifespan.
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Kolima, Akloa Komlavi Ehlissou, Ayouba Gamal, Towoezim Tchaa Hodabalo, Simwetare M’badia Fètoutou, Kombate ., Bakriga Batarabadja, Akpoto Menssavi Yaovi, Dellanh Yaovi Yannick, and Abalo Anani Grégoire. "Thromboembolic complications secondary to limb trauma in orthopedic surgery department of Sylvanus Olympio university hospital." National Journal of Clinical Orthopaedics 4, no. 2 (April 1, 2020): 09–11. http://dx.doi.org/10.33545/orthor.2020.v4.i2a.217.
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Greenfield, Paul T., Wesley J. Manz, Emily L. DeMaio, Sage H. Duddleston, John W. Xerogeanes, T. Scott Maughon, Corey C. Spencer, et al. "Telehealth Can Be Implemented Across a Musculoskeletal Service Line Without Compromising Patient Satisfaction." HSS Journal®: The Musculoskeletal Journal of Hospital for Special Surgery 17, no. 1 (February 2021): 36–45. http://dx.doi.org/10.1177/1556331620977171.
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Background: The COVID-19 pandemic has led to changes to in-office orthopedic care, with a rapid shift to telemedicine. Institutions’ lack of established infrastructure for these types of visits has posed challenges requiring attention to confidentiality, safety, and patient satisfaction. Purpose: The aim of this study was to analyze the feasibility of telemedicine in orthopedics during the pandemic and its effect on efficiency and patient satisfaction. Methods: Patients seen by the Emory University Department of Orthopaedics Sports Medicine and Upper Extremity Divisions via telemedicine from March 23 to April 24, 2020, were contacted by telephone. Each patient was asked to respond to questions on satisfaction, ease of use, and potential future use; satisfaction with telemedicine and previous clinical visits were measured using a modified 5-point Likert scale. Results: Of the 762 patients seen, 346 (45.4%) completed the telemedicine questionnaire. Satisfaction varied by visit type, with average scores of 4.88/5 for in-office clinic visits versus 4.61/5 for telemedicine visits. There was no significant difference among age groups for satisfaction ratings. Patients 65 years old or older reported significantly longer visit times and decreased ease of use with the telemedicine platform. Conclusion: Telemedicine in a large orthopedics department was successfully implemented without compromising patient satisfaction. The use of telemedicine allows many patients to be seen quickly and efficiently without diminishing their musculoskeletal clinical experience.
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Krupa, Sabina, Dorota Ozga, Edyta Tama, and Kazimierz Widenka. "Analysis of the effectiveness of combating postoperative pain in selected orthopedic procedures." BÓL 20, no. 3 (January 31, 2020): 11–22. http://dx.doi.org/10.5604/01.3001.0013.7880.
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Patients undergoing surgery have the right to feel severe pain, but the available painkillers should significantly or even eliminate it completely. Therefore, the main goal of the work was to determine which of these methods are the most effective – pharmacology and no pharmacology methods. This was done with the help of a questionnaire directly addressed to people after orthopedic surgery. In the study, the research method was a diagnostic survey. The results were obtained with the help of a survey technique, which survey tool was the questionnaire. The survey consisted of 32 questions. It contained open, closed and multiple-choice questions. In question No. 10 a visual analogue scale was used to test the level of pain. The V Kramer test was used to answer the research questions asked. On their basis, information about the strength of dependence between variables was obtained. The obtained results were subjected to statistical analysis, among them statistically significant for p <0.05. The questionnaire was addressed to patients after orthopedic procedures, who were in the Department of Orthopedics and Traumatology of the Motor Organ. After familiarizing patients with the purpose of the study, they voluntarily completed the questionnaire of 90 people, 88 of whom completed the questionnaire in a way that allowed drawing certain conclusions on their basis. Patients pointed to the high effectiveness of pharmacotherapy in pain relief. The level of pain felt decreased with time, however, it significantly disturbed night rest. Knee or hip joint replacement and anterior cruciate ligament reconstruction were considered the most painful procedures.
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Chen, Peiji, Zhangnan Zhou, Haixia Yu, Kun Chen, and Yun Yang. "Computerized-Assisted Scoliosis Diagnosis Based on Faster R-CNN and ResNet for the Classification of Spine X-Ray Images." Computational and Mathematical Methods in Medicine 2022 (June 6, 2022): 1–13. http://dx.doi.org/10.1155/2022/3796202.
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In order to reduce the subjectivity of preoperative diagnosis and achieve accurate and rapid classification of idiopathic scoliosis and thereby improving the standardization and automation of spinal surgery diagnosis, we implement the Faster R-CNN and ResNet to classify patient spine images. In this paper, the images are based on spine X-ray imaging obtained by our radiology department. We compared the results with the orthopedic surgeon’s measurement results for verification and analysis and finally presented the grading results for performance evaluation. The final experimental results can meet the clinical needs, and a fast and robust deep learning-based scoliosis diagnosis algorithm for scoliosis can be achieved without manual intervention using the X-ray scans. This can give rise to a computerized-assisted scoliosis diagnosis based on X-ray imaging, which has strong potential in clinical utility applied to the field of orthopedics.