Comparative analysis of operation time and intraoperative fluoroscopy time between intramedullary and extramedullary fixation in trochanteric fractures treatment

Introduction/Objective. Subtrochanteric fractures are unstable, tending to a varus, antecurvatum, and shortening deformity. The aim of this paper was to compare operation time and fluoroscopy time between different internal fixation methods in the treatment of subtrochanteric fractures. Method. The prospective study of the group of 27 patients with a subtrochanteric fracture treated by the SIF (selfdynamisable internal fixator with a trochanteric unit) method had been done. Operation time and fluoroscopy time values from this group were compared to the same parameters data from the literature for intramedullary (IM) nails, proximal femur locking plates (PF-LCP), dynamic condylar screws (DCS), and the 95?-angled blade plate. Results. In the SIF group, operation time was 62.2 (25?140) minutes and fluoroscopy time was 43 (20?95) s. Average operation time from the literature data was: 102.1 (43?181) minutes for IM nail, 94.2 (75?129) minutes for PF-LCP, 105.3 (70?166) minutes for DCS and 221.5 (171?272) minutes for blade plate. Average fluoroscopy time from the literature data was: 109.6 (34?250) seconds for IM nail, 102.3 (47?180) seconds for PF-LCP, 238 seconds for DCS. Operation time and intraoperative fluoroscopy time were higher in IM nail, PF-LCP, DCS and blade plate comparing to SIF method (p < 0.05). Conclusion. The above mentioned difference could be explained by a degree of required accuracy in the initial operative technique maneuvers, by used number of screws and by the type of the fracture reduction performance in different fixation methods. Operation time during IM nailing of subtrochanteric fractures sometimes can be shorter than average operation time in SIF method, what could be explained by the skill of the surgeon to perform as fast closed reduction for insertion of guide wire.

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ADAPT system is a dramatic advance in computer-assisted surgery for femoral trochanteric fractures

SICOT-J ◽

10.1051/sicotj/2021056 ◽

2021 ◽

Vol 7 ◽

pp. 55

Author(s):

Tomotoshi Murakami ◽

Kazuhiro Yamazaki ◽

Hiroyoshi Ogasa

Keyword(s):

Intramedullary Nailing ◽

Operative Time ◽

Computer Assisted Surgery ◽

Fluoroscopy Time ◽

Control Group ◽

Computer Assisted ◽

Trochanteric Fractures ◽

Implant Placement ◽

Head Surface ◽

Intraoperative Fluoroscopy

Introduction: In recent years, computer-assisted surgery has made it possible to undergo surgery with a high degree of precision. This study aimed to investigate the usefulness of computer-assisted surgery for femoral trochanteric fractures using the ADAPT (ADAptive Positioning Technology) system. Methods: A total of forty patients with femoral trochanteric fracture underwent intramedullary nailing for fracture fixation: in twenty patients, the ADAPT system (ADAPT group), and in the other twenty, it was not used (control group). The operative time, intraoperative fluoroscopy time, tip apex distance (TAD), and tip to head surface distance (TSD) were measured and compared between the two groups to assess the efficiency and accuracy of the surgery. Results: The operative time was significantly shorter (P < 0.05), intraoperative fluoroscopy time was significantly reduced (P < 0.01), and implant placement was significantly better in the ADAPT group (P < 0.01). Conclusion: Navigation systems have been developed to improve the efficiency of surgery. The ADAPT system was considered a very useful device for intramedullary nailing of femoral trochanteric fractures, as it reduced the intraoperative fluoroscopy time and improved the accuracy of implant placement, also reducing the operative time.

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Clinical Application of a 3D-Printed Positioning Module and Navigation Template for Percutaneous Vertebroplasty

Surgical Innovation ◽

10.1177/15533506211062404 ◽

2021 ◽

pp. 155335062110624

Author(s):

Jing Yang ◽

Penghui Ni ◽

Lina Zhang ◽

Zhanxin Lu ◽

Dapeng Liu ◽

...

Keyword(s):

Percutaneous Vertebroplasty ◽

Operation Time ◽

Vertebral Compression Fractures ◽

Control Group ◽

Compression Fractures ◽

Intraoperative Fluoroscopy ◽

3D Printed ◽

Vas Scores ◽

Experimental Group ◽

Navigation Template

Background This study aimed to evaluate a personalized 3D-printed percutaneous vertebroplasty positioning module and navigation template based on preoperative CT scan data that was designed to treat patients with vertebral compression fractures caused by osteoporosis. Methods A total of 22 patients with vertebral compression fractures admitted to our hospital were included in the study. Positioning was performed with the new 3D-printed positioning module, and the navigation template was used for patients in the experimental group, and the traditional perspective method was used for patients in the control group. The experimental group consisted of 11 patients, 2 males and 9 females, with a mean age of 67.27 ± 11.86 years (range: 48 to 80 years), and the control group consisted of 11 patients, 3 males and 8 females, with a mean age of 74.27 ± 7.24 years (range: 63 to 89 years). The puncture positioning duration, number of intraoperative fluoroscopy sessions, and preoperative and postoperative visual analog scale (VAS) scores were statistically analyzed in both groups. Results The experimental group had shorter puncture positioning durations and fewer intraoperative fluoroscopy sessions than the control group, and the differences were statistically significant (P < .05). There were no significant differences in age or preoperative or postoperative VAS scores between the two groups (P > .05). Conclusions The new 3D-printed vertebroplasty positioning module and navigation template shortened the operation time and reduced the number of intraoperative fluoroscopy sessions. It also reduced the difficulty in performing percutaneous vertebroplasty and influenced the learning curve of senior doctors learning this operation to a certain degree.

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Comparative Analysis of Non-Full and Full Endoscopic Spine Technique via Interlaminar Approach for the Treatment of Degenerative Lumbar Spinal Stenosis: A Retrospective, Single Institute, Propensity Score-Matched Study

Global Spine Journal ◽

10.1177/21925682211039181 ◽

2021 ◽

pp. 219256822110391

Author(s):

Qiang Jiang ◽

Yu Ding ◽

Zhengcao Lu ◽

Hongpeng Cui ◽

Jianjun Zhang ◽

...

Keyword(s):

Propensity Score ◽

Radiation Exposure ◽

Spinal Stenosis ◽

Lumbar Spinal Stenosis ◽

Clinical Efficacy ◽

Operation Time ◽

Degenerative Lumbar Spinal Stenosis ◽

Interlaminar Approach ◽

Intraoperative Fluoroscopy ◽

Lumbar Spinal

Study Design: Retrospective study. Objective: To compare the clinical efficacy of posterior lumbar laminectomy decompression under full endoscopic technique (Endo-LOVE) and percutaneous endoscopic medial foraminal decompression (PE-MFD) in the treatment of degenerative lumbar spinal stenosis (DLSS). Methods: Between April 2017 and April 2018, 96 patients with DLSS underwent Endo-LOVE or PE-MFD, including 58 with Endo-LOVE and 38 with PE-MFD. After propensity score matching (PSM), patient characteristics, operation time, intraoperative fluoroscopy times, postoperative bedridden time, hospital stay and postoperative complications were recorded and compared. The clinical efficacy was evaluated according to Oswestry disability index (ODI), visual analogue scale (VAS), lumbar disease JOA and modified MacNab criteria. Results: A total of 96 patients with DLSS were included in the study. After PSM, the 2 groups were comparable in patient demographic and baseline characteristics. The operation time and intraoperative fluoroscopy times in PE-MFD group were significantly more than those in Endo-LOVE group ( P < .05). The operation time in PE-MFD group was significantly less than that in Endo-LOVE group ( P < .05). The intraoperative fluoroscopy times in PE-MFD group were significantly more than that in Endo-LOVE group ( P < .05). The ODI, VAS and lumbar disease JOA in the 2 groups were significantly improved comparing with those before operation ( P < .05). According to the modified MacNab criteria, the excellent and good rates of the 2 groups were 93.5% in Endo-LOVE group and 87.1% in PE-MFD group ( P > .05). Conclusion: Endo-LOVE and PE-MFD technique can both effectively treat DLSS, and the short-term follow-up results are positive. Endo-LOVE technique has the advantages of fast puncture positioning, less radiation exposure and wider indications. However, PE-MFD needs more radiation exposure and has the possibility of incomplete decompression for complex multiplanar spinal stenosis.

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Stable Trochanteric Fractures. A Comparative Analysis of four Methods of Internal Fixation

Acta Orthopaedica Scandinavica ◽

10.3109/17453678008990878 ◽

1980 ◽

Vol 51 (1-6) ◽

pp. 811-816 ◽

Cited By ~ 36

Author(s):

J. Steen Jensen ◽

E. Tøndevold ◽

S. Sonne-Holm

Keyword(s):

Comparative Analysis ◽

Internal Fixation ◽

Trochanteric Fractures

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Does a fluoro-assisted direct anterior approach for total hip arthroplasty pose an excessive risk of radiation exposure to the surgeon?

SICOT-J ◽

10.1051/sicotj/2020004 ◽

2020 ◽

Vol 6 ◽

pp. 6

Author(s):

Yuta Jinnai ◽

Tomonori Baba ◽

Xu Zhuang ◽

Hiroki Tanabe ◽

Sammy Banno ◽

...

Keyword(s):

Total Hip Arthroplasty ◽

Radiation Exposure ◽

Anterior Approach ◽

Direct Anterior Approach ◽

Proximal Femoral Fracture ◽

Fluoroscopy Time ◽

Exposure Level ◽

Intraoperative Fluoroscopy ◽

Significant Difference ◽

The Mean

Introduction: Intraoperative fluoroscopy can be easily used because patients are placed in the supine position during total hip arthroplasty via direct anterior approach (DAA-THA) to reduce complications. However, the cumulative level of radiation exposure by intraoperative fluoroscopy increases as the annual number of cases increases, increasing the risk of influencing the health of both the patients and medical workers. The objective of the study was to compare the radiation exposure time of DAA-THA with osteosynthesis and to determine if the level of radiation exposure exceeded safety limits. Material and methods: DAA-THA was performed in 313 patients between January 2016 and July 2018 and 60 patients with proximal femoral fracture were treated with osteosynthesis. The intraoperative fluoroscopy time was retrospectively surveyed and compared between these two groups. A total of eight surgeons operated DAA-THA employing the same procedure using a traction table. A total of nine surgeons operated osteosynthesis and fluoroscopy was appropriately used during reduction and implant insertion. Results: The mean operative time of DAA-THA was 103.3 min and that of osteosynthesis was 83.3 min, showing a significant difference (p < 0.05). The mean intraoperative fluoroscopy time was 0.83 min (SD ± 0.68) in DAA-THA and 8.91 min (SD ± 8.34) in osteosynthesis showing a significant difference (p < 0.05). Conclusions: The intraoperative exposure level was significantly lower and the fluoroscopy time was significantly shorter in DAA-THA than in osteosynthesis for proximal femoral fracture. It was clarified that the annual cumulative radiation exposure level in DAA-THA does not exceed the tissue dose limit.

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Management of unstable inter-trochanteric fractures by Dynamic Hip screw versus Proximal Femur Nailing- A Comparative Analysis

Journal of Medical Science And clinical Research ◽

10.18535/jmscr/v5i9.13 ◽

2017 ◽

Vol 5 (9) ◽

Author(s):

Dr Surendar Singh Bava ◽

Keyword(s):

Comparative Analysis ◽

Proximal Femur ◽

Dynamic Hip Screw ◽

Trochanteric Fractures ◽

Hip Screw

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Which factors affect the success of pediatric PCNL? Single center experience over 20 years

Archivio Italiano di Urologia e Andrologia ◽

10.4081/aiua.2020.4.345 ◽

2020 ◽

Vol 92 (4) ◽

Author(s):

Volkan Izol ◽

Nihat Satar ◽

Yıldırım Bayazit ◽

Fatih Gokalp ◽

Nebil Akdogan ◽

...

Keyword(s):

Blood Transfusion ◽

Blood Loss ◽

Hospital Stay ◽

Percutaneous Nephrolithotomy ◽

Pediatric Patients ◽

Operation Time ◽

Fluoroscopy Time ◽

Postoperative Blood Transfusion ◽

Group 2 ◽

Group 1

Objective: We aimed to investigate the impact of surgeons’ experience on pediatric percutaneous nephrolithotomy (PCNL) outcomes. Materials and methods: Between June 1997 and June 2018, 573 pediatric patients with 654 renal units underwent PCNL for renal stone disease by senior surgeons. Data were divided into two groups, group-1 (n = 267), first ten years period, group-2 (n = 387); second ten years period. Results: Mean ± SD age of patients was 7.6 ± 4.9 (1-17) years. The stone-free rates (SFR) assessed after 4 weeks were 74.9% vs. 83.4% in group-1 vs. group-2, respectively (p = 0.03). The mean operation time, fluoroscopy time, and the number of patients requiring blood transfusion significantly decreased in group 2 (100.4 ± 57.5 vs. 63.63 ± 36.3, 12.1 ± 8.3 vs. 8.3 ± 5.4, and 24.3% vs. 2.9%; p < 0.001, p < 0.001, and p = 0.002 in group-1 versus group-2, respectively). On multivariate analysis, increasing stone size increased operation time (p < 0.001), fluoroscopy time (p < 0.001), intraoperative and postoperative blood transfusion rates (p = 0.006 and p = 0.018, respectively), and hospital stay (p = 0.002) but was not associated with change of glomerular filtration rate (GFR) (p = 0.71). Sheath size also correlated with increased fluoroscopy time (p < 0.001), operation time (p < 0.001), intraoperative blood transfusion (p < 0.001) and hospital stay, but sheath size did not affect postoperative blood transfusion (p = 0.614) or GFR change (p = 0.994). Conclusions: The percutaneous nephrolithotomy (PCNL) is a minimally invasive procedure and is well accepted because of its lower complication rate and high efficiency for pediatric patients. Stone and sheath size are predictive factors for blood loss and hospital stay. During 20 years, our fluoroscopy time, operation time, blood loss, and complication rates decreased, and stone-free rate increased.

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A precise navigation device for fixation of patella fractures with modified K-wire tension band: design and application

10.21203/rs.3.rs-38296/v1 ◽

2020 ◽

Author(s):

Fuming Wang ◽

Haolan Xiong ◽

Xiaotao Long ◽

Yang Li ◽

Xiaohua Chen ◽

...

Keyword(s):

Retrospective Study ◽

Surgical Procedure ◽

Evaluation Criteria ◽

Operation Time ◽

Tension Band ◽

Standard Position ◽

Patella Fractures ◽

Intraoperative Fluoroscopy ◽

Significant Difference ◽

K Wires

Abstract Background Traditionally, the technique of modified tension band wires (MTBW) has been the most commonly used surgical procedure. The purpose of this study is to design a precise navigation device that can obtain a standard position of K-wires for (MTBW), and to compare the precise MTBW (P-MTBW) by a navigation device with the conventional MTBW (C-MTBW) by hands in a retrospective study.Methods The device is designed by solidworks2012 software (USA), which can provide a precise guidance for obtaining a parallel K-wires. In addition, it can set the distance between two k-wires and the level of k-wires below patellar anterior surface. From June 2014 to August 2018, a total of 112 patients are employed in this retrospective study. The patients are divided into P-MTBW group and C-MTBW group according to the surgical technique with or without the precise navigation device. We need to record and analyze the operation time and the number of fluoroscopy, postoperative internal fixation imaging, knee function and complications.Results There were 54 patients in P-MTBW group and 58 patients in C-MTBW group. There were statistically significant differences(P＜0.001) in the operation time between P-MTBW group (39.5±4.7; range, 32–49 minutes) and C-MTBW group (53.7±6.8; range, 42–71 minutes). The number of intraoperative fluoroscopy was significantly less (P＜0.001) in P-MTBW group(4.2±1.4) versus that of C-MTBW group (8.3±2.7). According to Iowa knee score, there was no significant difference (P=0.268) in function between the two groups. According to our own evaluation criteria for MTBW, anyone in the P-MTBW group was excellent and 26 patients were excellent, 20 patients were good and 2 patients were fair in the C-MTBW group.Conclusion The navigation device can reduce operation time and intraoperative fluoroscopy frequency. P-MTBW fixation is an accurate and effective surgical procedure for patella fractures.

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Evaluation of the Lifecycle Environmental Benefits of Full Battery Powered Ships: Comparative Analysis of Marine Diesel and Electricity

Journal of Marine Science and Engineering ◽

10.3390/jmse8080580 ◽

2020 ◽

Vol 8 (8) ◽

pp. 580 ◽

Cited By ~ 1

Author(s):

Byongug Jeong ◽

Hyeonmin Jeon ◽

Seongwan Kim ◽

Jongsu Kim ◽

Peilin Zhou

Keyword(s):

Life Cycle ◽

Comparative Analysis ◽

Operation Time ◽

Assessment Method ◽

Simulation Software ◽

Propulsion System ◽

Environmental Benefits ◽

Sensitivity Analyses ◽

Energy Sources ◽

Important Message

The paper aims to investigate the holistic environmental benefits of using a battery system on a roll on/roll off (ro-ro) passenger ship which was originally fitted with a diesel engine engaged in Korean coastal service. The process of this research has multiple layers. First, the operating profiles of the case ship were collected, such as speed, output, operation time and the configuration of the diesel propulsion system. Second, the full battery propulsion system, in place of the diesel system, was modelled and simulated on a power simulation software (PSIM) platform to verify the adequacy of the proposed battery propulsion system. Then, the life cycle assessment method was applied to comprehensively compare the environmental footprint of the diesel-mechanical and fully battery-powered vessels. A focus was placed on the life cycle of the energy sources consumed by the case ship in consideration of the South Korea’s current energy importation and production status. Three life cycle stages were considered in the analysis: ‘production’, ‘transport’ and ‘use’. With the aid of Sphera GaBi Software Version 2019 and its extensive data library, the environmental impacts at the energy production and transport stages were evaluated, while the same impacts at the use stage were determined based on actual laboratory measurements. The environmental performance of the two scenarios in four impact categories was discussed: global warming potential (GWP), acidification potential (AP), eutrophication potential (EP) and photochemical ozone creation potential (POCP). Results of the comparative analysis are presented based on estimates of the overall reduction in the environmental impact potential, thereby demonstrating the overall benefits of using a battery driven propulsion, with a decrease of the GWP by 35.7%, the AP by 77.6%, the EP by 87.8% and the POCP by 77.2%. A series of sensitivity analyses, however, has delivered the important message that the integration of batteries with marine transportation means may not always be the best solution. The types of energy sources used for electricity generation will be a key factor in determining whether the battery technology can ultimately contribute to cleaner shipping or not. By casting doubts on the benefits of battery propulsion, this paper is believed to offer a meaningful insight into developing a proper road map for electrifying ship propulsion toward zero emission of shipping.

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