Survey to orthopedics surgeons in Italy about Leg length discrepancy and total hip arthroplasty: postoperative management
0
Citation
14
Reference
10
Related Paper
Abstract:
Abstract Background We created a Survey for Italian orthopaedics surgeons on how they approach leg length discrepancy (LLD) when dealing with primary total hip arthroplasty. Aim of the study was to show how surgeons manage LLD and follow literature recommendations during clinical practice. Methods The Survey was composed of 25 questions divided in 4 sections: surgeon’s profile, preoperative and intraoperative evaluation, postoperative management. In this paper we report absolute and relative frequencies of answers to section 4 “postoperative management”. Then regarding the treatment of residual LLD we reported if trauma surgeons (TR) and experts in reconstructive surgery (RS) had higher odds ratio (OR) to give the “literature based” answers than orthopaedics physicians (OP) Results Only four questions received more than 70% of agreement on one of the answers. The OR to give the “literature based” answer taking OP as reference was 1.57 for TR and 1.72 for RS for 10 mm LLD at first follow up (FU) and 1.23 TR and 1.32 RS when 20 mm. When 10 mm LLD at 3 months FU the OR was 0.88 TR and 1.15 RS. The OR for treatment of LLD after the first examination of a new patient was 2.16 TR and 1.85 RS. Conclusions LLD is a debated topic with no definitive recommendations. Many decisions still depend on tradition, treatment of LLD during clinical practice often differs from literature recommendations.Keywords:
Clinical Practice
Objective
To analyze the related risk factors of the orthopedic surgical site infection and investigate application of Wechat follow-up so as to provide reference for reducing infection after orthopedic surgery.
Method
A total of 1 453 patients with orthopedic surgery from Jan. 2016 to Dec. 2016 were selected and retrospectively analyzed the related risk factors of the orthopedic surgical site infection at the time of hospitalization and post-discharge.
Results
Among 1 453 patients with orthopedic surgery, there were 26 cases of surgical site infection, accounting for 1.79%; the surgical site infection occurred in 8 of 1 427 patients after discharge, accounting for 0.56%. Age, basic disease, the time of operation, implant situation, incision situation at discharge, and follow-up visit were the factors that might cause orthopedic surgical site infection, with statistically significant differences (P<0.05).
Conclusions
There are many factors that are related to the orthopedic surgical site infection, thus it is necessary to implement strictly the preoperative evaluation and preparation, intraoperative sterile operation and tissue protection, postoperative aseptic dressing during hospitalization. After the discharge, we should add Wechat follow-up on the basis of telephone follow-up, it can increase the knowledge of postoperative care to reduce the surgical site infection.
Key words:
Orthopedic surgery; Infection; Risk factor; Wechat follow-up
Surgical Site Infection
Asepsis
Orthopedic Procedures
Risk of infection
Cite
Citations (0)
LAY SUMMARY Many non-acute muscle and skeletal injuries can be rehabilitated with conservative management, such as physiotherapy or physiatry, rather than orthopedic surgery. In the primary care centre, the authors noted that almost half of patients with non-acute muscle and skeletal injuries referred to orthopedic surgery did not need orthopedic intervention. Referrals to orthopedic surgery, for which conservative management is more appropriate, contribute to wait times and delay the recovery process. To improve access to conservative management and reduce the demand for orthopedic services, this study looked at the benefits of using physiotherapists to screen electronic medical records (EMRs) to determine if patients needed orthopedic intervention or conservative management. The results show physiotherapy screening increased the percentage of patients referred to orthopedic surgery that truly required orthopedic intervention from 47.9% to 63.7%. This emerging practice may lead to shorter wait times for patients to see an orthopedic surgeon, fewer in-person assessments, and improved access to conservative treatment.
Orthopedic Procedures
Conservative Management
Cite
Citations (2)
Cite
Citations (4)
✓ Selective dorsal rhizotomy (SDR) is an evidence-based treatment for cerebral palsy (CP) spasticity. During their lifetime, patients with CP spasticity may require orthopedic surgery for muscles and joints to correct physical deformities and provide a better quality of life. In this review, the authors discuss the timing of such orthopedic surgery, its necessity, and whether it is influenced by the performance of SDR. A review of findings from the authors' 19 years of experience yields the following conclusions: 1) that SDR reduces orthopedic surgery requirements when compared with historical controls; 2) that SDR performed in patients at a young age (2–4 years) can reduce future orthopedic surgery requirements; 3) that independent walkers and diplegic patients will have the smallest amount of orthopedic surgery post-SDR; and 4) that patients who need assistance walking and those with quadriplegia will have the greatest amount, although the frequency of orthopedic surgery for quadriplegic patients is not as high as popularly believed.
Rhizotomy
Orthopedic Procedures
Cite
Citations (28)
Orthopedic Procedures
Cite
Citations (1)
Orthopedic Procedures
Cite
Citations (6)
We did a survey on the development of orthopedic surgery in Estonia, especially during the past 10 years, including education, hospital-based orthopedic surgery and orthopedic research. The main types of orthopedic operations were analyzed, on the basis of data from the Estonian Social Ministry, Bureau of Medical Statistics and several departments of orthopedic. On the average, 11,831 orthopedic operations were performed yearly during the years 1996-1998 in hospital departments.
Christian ministry
Cite
Citations (1)
Outcomes in children with supracondylar humerus fractures were stratified by type of treating orthopedic surgeon: pediatric orthopedic surgeon and nonpediatric orthopedic surgeon.The outcome factors in 444 children examined included: open reduction rate, complications, postoperative nerve injury, repinning rate, need for physical therapy, and residual nerve palsy at final follow-up.For the severe fractures, significantly more fractures were treated by open reduction in the pediatric orthopedic surgeon group than in the nonpediatric orthopedic surgeon group. There were no other significant differences in outcomes between the fractures treated by the pediatric orthopedic surgeons and nonpediatric orthopedic surgeons.This study supports the assertion that both pediatric and nonpediatric orthopedic surgeons in an academic setting have sufficient training, skill, and experience to treat these common injuries.
Cite
Citations (35)
Orthopedic surgery or orthopedics, also spelled orthopaedics, is the branch of surgery concerned with conditions involving the musculoskeletal system. Orthopedic surgeons use both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, sports injuries, degenerative diseases, infections, tumors, and congenital disorders. The musculoskeletal system comprises the framework of the body and the mechanics that make it function. While orthopedics focuses on this system specifically, the reality is that just about every medical specialty has some overlap with this specialty. While some orthopedic surgeons undergo additional training to perform specialized types of surgeries, orthopedic surgeons in general spend the majority of their time treating patients outside of the operating room. Most orthopedic specialists have a busy office-based practice. Orthopedic surgeons can also be found working in the emergency room, taking care of patients in hospital wards, or even on the sidelines of sporting events. It takes around 10 years of schooling and training post-college to become an orthopedic surgeon, but it's a highly in-demand specialty. And even after more than a decade of training, many surgeons further sub-specialize within orthopedics. Orthopedic conditions are the most common reason people seek medical care, although not every patient with an orthopedic condition is seen by an orthopedic specialist.
Specialty
Orthopedic Procedures
Cite
Citations (0)
Objective: To determine the knowledge of Brazilian Orthopedic Surgeons on the costs of orthopedic surgical devices used in surgical implants. Methods: A questionnaire was applied to Brazilian Orthopedic Surgeons during the 46th Brazilian Congress on Orthopedics and Traumatology. Results: Two hundred and one Orthopedic Surgeons completely filled out the questionnaire. The difference between the average prices estimated by the surgeons and the average prices provided by the supplier companies was 47.1%. No differences were found between the orthopedic specialists and other subspecialties on the prices indicated for specific orthopedic implants. However, differences were found among orthopedic surgeons who received visits from representatives of implant companies and those who did not receive those visits on prices indicated for shaver and radiofrequency device. Correlation was found between length of orthopedic experience and prices indicated for shaver and interference screw, and higher the experience time the lower the price indicated by Surgeons for these materials. Conclusion: The knowledge of Brazilian Orthopedic Surgeons on the costs of orthopedic implants is precarious. Reduction of cost of orthopedics materials depends on a more effective communication and interaction between doctors, hospitals and supplier companies with solid orientation programs and awareness for physicians about their importance in this scenario.Level of Evidence III, Cross-Sectional Study.
Traumatology
Orthopedic Procedures
Cite
Citations (7)