The effects of surgeon handedness on the efficacy and safety of proximal femoral nail antirotation fixation for intertrochanteric femur fractures in elderly patients: A single Center's experience.
IF 4.3 3区 工程技术Q1 BIOTECHNOLOGY & APPLIED MICROBIOLOGY
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引用次数: 0
Abstract
Background: Handedness refers to the lateral preference of using one hand more than the other. Surgeon handedness has been widely discussed in operative surgery and could cause clinical discrepancy. However, in the use of proximal femoral nail antirotation (PFNA) for the treatment of intertrochanteric femur fracture (IFF), the effect of handedness on clinical outcomes is easily overlooked. In fact, when right-handed surgeons operate on right-sided IFF patients, due to the specific nature of the surgical site, they have to use their left hand to perform the opening at the proximal end of the femur and insert the main nail. This study aimed to investigate the influence of surgeon handedness on the efficacy and safety of PFNA fixation for elderly patients with IFF.
Methods: A retrospective analysis was conducted on the basic data of 182 elderly patients with IFF who underwent surgical treatment in our department from January 2020 to December 2022 and had a minimum follow-up duration of 1 year. Equal numbers of left and right PFNA fixation were performed by four surgeons, two right-handed and two left-handed. Dominant group refers to a left IFF for a right-handed surgeon and a right IFF for a left-handed surgeon. Otherwise, it is called a non-dominant group. The patients were divided into the dominant group (90 cases) and the non-dominant group (92 cases), and differences between the two groups were analyzed.
Results: In terms of surgical safety, the dominant group had significantly shorter average operation time and lower blood loss compared to the non-dominant group (P < 0.05). In the final follow-up, the average Harris score of the dominant group was 84.60 ± 4.35, and that of the non-dominant group was 82.63 ± 4.98. The Harris score of the dominant group was significantly higher than that of the non-dominant group (P < 0.05). According to the 1-year follow-up results, there were 86 survivors and 4 deaths in the dominant group, and 80 survivors and 12 deaths in the non-dominant group. Although the non-dominant group (13.04%) had a higher mortality rate than the dominant group (4.44%), the difference between the two groups was not statistically significant (P > 0.05).
Conclusion: Surgeon handedness is a factor that influences the efficacy and safety of PFNA fixation for patients with IFF.
期刊介绍：
The translation of new discoveries in medicine to clinical routine has never been easy. During the second half of the last century, thanks to the progress in chemistry, biochemistry and pharmacology, we have seen the development and the application of a large number of drugs and devices aimed at the treatment of symptoms, blocking unwanted pathways and, in the case of infectious diseases, fighting the micro-organisms responsible. However, we are facing, today, a dramatic change in the therapeutic approach to pathologies and diseases. Indeed, the challenge of the present and the next decade is to fully restore the physiological status of the diseased organism and to completely regenerate tissue and organs when they are so seriously affected that treatments cannot be limited to the repression of symptoms or to the repair of damage. This is being made possible thanks to the major developments made in basic cell and molecular biology, including stem cell science, growth factor delivery, gene isolation and transfection, the advances in bioengineering and nanotechnology, including development of new biomaterials, biofabrication technologies and use of bioreactors, and the big improvements in diagnostic tools and imaging of cells, tissues and organs.
In today`s world, an enhancement of communication between multidisciplinary experts, together with the promotion of joint projects and close collaborations among scientists, engineers, industry people, regulatory agencies and physicians are absolute requirements for the success of any attempt to develop and clinically apply a new biological therapy or an innovative device involving the collective use of biomaterials, cells and/or bioactive molecules. “Frontiers in Bioengineering and Biotechnology” aspires to be a forum for all people involved in the process by bridging the gap too often existing between a discovery in the basic sciences and its clinical application.
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