Ultrasound Images Guided under Deep Learning in the Anesthesia Effect of the Regional Nerve Block on Scapular Fracture Surgery

In order to discuss the clinical characteristics of patients with scapular fracture, deep learning model was adopted in ultrasound images of patients to locate the anesthesia point of patients during scapular fracture surgery treated with the regional nerve block. 100 patients with scapular fracture who were hospitalized for emergency treatment in the hospital were recruited. Patients in the algorithm group used ultrasound-guided regional nerve block puncture, and patients in the control group used traditional body surface anatomy for anesthesia positioning. The ultrasound images of the scapula of the contrast group were used for the identification of the deep learning model and analysis of anesthesia acupuncture sites. The ultrasound images of the scapula anatomy of the patients in the contrast group were extracted, and the convolutional neural network model was employed for training and test. Moreover, the model performance was evaluated. It was found that the adoption of deep learning greatly improved the accuracy of the image. It took an average of 7.5 ± 2.07 minutes from the time the puncture needle touched the skin to the completion of the injection in the algorithm group (treated with artificial intelligence ultrasound positioning). The operation time of the control group (anatomical positioning) averaged 10.2 ± 2.62 min. Moreover, there was a significant difference between the two groups ( p < 0.05 ). The method adopted in the contrast group had high positioning accuracy and good anesthesia effect, and the patients had reduced postoperative complications of patients (all P < 0.005 ). The deep learning model can effectively improve the accuracy of ultrasound images and measure and assist the treatment of future clinical cases of scapular fractures. While improving medical efficiency, it can also accurately identify patient fractures, which has great adoption potential in improving the effect of surgical anesthesia.

Computer-assisted preoperative planning of reduction of and osteosynthesis of scapular fracture: A case report

Introduction Reports on the use of computer-assisted trauma surgery of comminuted scapula fracture are still quite rare. In this article, we present a case of comminuted scapula fracture, the surgical reconstruction of which was pre-operatively planned using a complex software solution. Materials and methods For surgical planning of the fracture, we used the TraumaTech software facilitating virtual reconstruction (both manual and automatic), surgery planning, design of the implant, planning of screw placement and lengths, and production of a 3D print model of the fracture and the implant. The software also supported ordering such custom-made plate from a plate producer who was capable of fast and precise production of the plate. Results The surgery using the custom-ordered plate was successful. The actual used screw lengths did not differ from the planned ones by more than 2 mm. One year after the surgery, the patient was capable of more demanding activities and doing sports activities. Conclusion This approach provides a great way to prevent complications of the surgery and to shorten its duration. To the best of our knowledge, this is the first description of the treatment of a scapula comminuted fracture utilizing computer-assisted preoperative planning.

Floating Shoulder Injury Resulting in Delayed Onset of Infraclavicular Brachial Plexus Palsy

As the brachial plexus traverses the costoclavicular space, it is susceptible to compression by pathologies affecting the clavicle. Clavicle nonunions with hypertrophic callus may cause a delayed onset of brachial plexus palsy. We present a rare case of a floating shoulder injury causing medial and posterior cord brachial plexus palsy two months after initial injury. After the diagnosis was established, the patient was treated successfully with expeditious brachial plexus decompression, callus excision, and rigid osteosynthesis, with healing of the clavicle nonunion and scapular fracture, and recovery of sensory and motor deficits.

Regional anesthesia for scapular fracture surgery: an educational review of anatomy and techniques

Scapular fractures are very rare, and those requiring surgical interventions are even rarer. Most scapula surgeries are done under general anesthesia with or without the regional anesthesia (RA) technique as an adjunct. Since scapular innervation is complicated, a thorough review of the relevant anatomy is warranted. In this RAPM educational article, we aimed to summarize the target nerves and blocks needed to optimize analgesia or even to provide surgical anesthesia for scapula surgeries. In this review, we are describing an algorithmic “identify-select-combine” approach, which enables the anesthesiologist to understand detailed innervation of the scapula and to obtain a procedure-specific RA technique. Procedure-specific RA would probably be the way forward for defining future RA practices.