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Human factors in trauma and orthopaedic surgery: a short overview 创伤和矫形外科中的人为因素：简要概述
Orthopaedics and Trauma Pub Date : 2024-06-01 DOI: 10.1016/j.mporth.2024.03.002
John A. Hardie, Peter A. Brennan
{"title":"Human factors in trauma and orthopaedic surgery: a short overview","authors":"John A. Hardie,&nbsp;Peter A. Brennan","doi":"10.1016/j.mporth.2024.03.002","DOIUrl":"10.1016/j.mporth.2024.03.002","url":null,"abstract":"<div><p>A human factors (HF) approach can help optimize individual and team performance in healthcare and across related professions that work together. Trauma and orthopaedic surgeons carry out high-stakes tasks within a cognitively and physically demanding environment. This is compounded by the challenges of working in complex healthcare systems. Error is a ‘normal’ part of being human, and must be managed in order to prevent harm to patients and staff. HF is the science of how people work within their teams, and in the workplace. It examines interactions with equipment, and the processes used to achieve the desired outcome. It uses theory from fields as diverse as ergonomics, psychology and engineering in order to achieve these aims. This article outlines key topics relevant to surgeons striving to help improve patient safety and wellbeing within teams. These include theories of error in healthcare, systems-based approaches, performance-limiting factors, and non-technical skills.</p></div>","PeriodicalId":39547,"journal":{"name":"Orthopaedics and Trauma","volume":"38 3","pages":"Pages 124-129"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141054909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Management of haematogenous bone and joint infection in developing countries 发展中国家血源性骨与关节感染的管理
Orthopaedics and Trauma Pub Date : 2024-06-01 DOI: 10.1016/j.mporth.2024.03.005
Myung-Sang Moon
{"title":"Management of haematogenous bone and joint infection in developing countries","authors":"Myung-Sang Moon","doi":"10.1016/j.mporth.2024.03.005","DOIUrl":"10.1016/j.mporth.2024.03.005","url":null,"abstract":"<div><p>Haematogenous pyogenic bone and joint infection is rarely seen in developed countries, but in the developing world it is still a major and common problem. New forms of acute fulminating osteomyelitis are likely to appear due to immunosuppression in the wake of the worldwide spread of HIV infection, AIDS, and the increased use of steroids, antibiotics, and immune activators. Osteomyelitis due to candida and cryptococcus infection in certain regions, are occasionally observed, whilst osteomyelitis that is resistant to treatment is associated with diabetes mellitus. Bone and joint infections are difficult to cure. This difficulty is related to the presence of bacteria adherent to dead bone and foreign material in many cases, and also to the drug resistance and limited penetration of antibiotics into infected bone. This presentation summarizes present knowledge of bone and joint infection and its management.</p></div>","PeriodicalId":39547,"journal":{"name":"Orthopaedics and Trauma","volume":"38 3","pages":"Pages 145-151"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141057659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The Scottish Arthroplasty Project: Scotland's approach to a National Joint Registry 苏格兰关节成形术项目：苏格兰建立国家关节登记处的方法
Orthopaedics and Trauma Pub Date : 2024-06-01 DOI: 10.1016/j.mporth.2024.03.003
Justine Burt, Andrew Brunt, Andrew J. Hall, Jon V. Clarke, Phil Walmsley
{"title":"The Scottish Arthroplasty Project: Scotland's approach to a National Joint Registry","authors":"Justine Burt,&nbsp;Andrew Brunt,&nbsp;Andrew J. Hall,&nbsp;Jon V. Clarke,&nbsp;Phil Walmsley","doi":"10.1016/j.mporth.2024.03.003","DOIUrl":"10.1016/j.mporth.2024.03.003","url":null,"abstract":"<div><p>The core function of joint registries is to collect, collate, and present data about patients who undergo joint replacement surgery, and afford clinicians and administrators a range of analytic functions to monitor service performance. This article describes the development, evolution, and future of arthroplasty registries, drawing particularly from the experience of the Scottish Arthroplasty Project (SAP). The SAP was established in 1999 and is one of the oldest arthroplasty registries in the world. It collects information on patients undergoing hip, knee, ankle, shoulder, and elbow arthroplasty. The primary aim is to encourage continual improvement in the quality of care provided for arthroplasty patients in Scotland. It is distinct in terms of administration and methodology from the National Joint Registry (NJR) of England, Wales, and Northern Ireland as it monitors patients rather than implants. Since its inception, its work has contributed to a reduction in overall complication rates and a significant decrease in hospital length of stay for the growing number of patients undergoing arthroplasty. It continues to provide a robust database that is used to underpin national guidance through data-driven research. The research carried out by dedicated SAP fellows has enhanced the research portfolio of the SAP and raised its profile through high quality peer-reviewed publications. The SAP continues to evolve and by collaborating with other Scottish registries it will provide larger datasets containing greater diversity and granularity of information. These developments as well as ongoing analysis of existing areas ensure that the SAP continues to maintain and improve standards in arthroplasty across Scotland.</p></div>","PeriodicalId":39547,"journal":{"name":"Orthopaedics and Trauma","volume":"38 3","pages":"Pages 130-136"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141044852","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Skeletal muscle structure, function and pathology 骨骼肌结构、功能和病理
Orthopaedics and Trauma Pub Date : 2024-06-01 DOI: 10.1016/j.mporth.2024.03.004
James Allen, Mark Ramsden, Sohail Nisar
{"title":"Skeletal muscle structure, function and pathology","authors":"James Allen,&nbsp;Mark Ramsden,&nbsp;Sohail Nisar","doi":"10.1016/j.mporth.2024.03.004","DOIUrl":"10.1016/j.mporth.2024.03.004","url":null,"abstract":"<div><p>Skeletal muscle is an important structure responsible for producing movement, storing nutrients, maintaining posture and providing stability across joints. Unlike smooth and cardiac muscle, control can be voluntary. This review article will outline the macroscopic and microscopic appearance of skeletal muscle, the method by which it contracts, the types of skeletal muscle and pathology associated with it.</p></div>","PeriodicalId":39547,"journal":{"name":"Orthopaedics and Trauma","volume":"38 3","pages":"Pages 137-144"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141024242","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Reducing morbidity and mortality in the hip fracture patient group 降低髋部骨折患者群体的发病率和死亡率
Orthopaedics and Trauma Pub Date : 2024-02-20 DOI: 10.1016/j.mporth.2024.01.004
Martyn J Parker
{"title":"Reducing morbidity and mortality in the hip fracture patient group","authors":"Martyn J Parker","doi":"10.1016/j.mporth.2024.01.004","DOIUrl":"https://doi.org/10.1016/j.mporth.2024.01.004","url":null,"abstract":"<div><p>A review of the literature was undertaken to determine which amenable factors could be identified that would potentially improve the morbidity or mortality after hip fracture. Only four factors were identified that have been clearly reported to be associated with a reduction in mortality or morbidity, these were early surgery, cemented arthroplasty and experience of the surgeon and peri-operative antibiotics. Five interventions were identified that may reduce mortality or morbidity: nerve blocks, nutritional support, pharmacological thromboembolic prophylaxis, mechanical intermittent pneumatic compression and nail fixation of extracapsular fractures. Several other factors were identified for which it remains uncertain if they will reduce mortality or morbidity: preoperative assessment, β-blockers, blood transfusion, anti-embolism stockings, choice of surgical implant, cardiac output monitoring during surgery, choice of anaesthesia, prevention of intraoperative hypotension, anabolic steroids, multidisciplinary care, and rehabilitation. Continuing research is required to define which interventions are clearly effective and to further identify any adverse effects.</p></div>","PeriodicalId":39547,"journal":{"name":"Orthopaedics and Trauma","volume":"38 2","pages":"Pages 89-94"},"PeriodicalIF":0.0,"publicationDate":"2024-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140290529","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Sub-trochanteric femoral fractures: challenges and solutions 股骨转子下骨折：挑战与解决方案
Orthopaedics and Trauma Pub Date : 2024-02-20 DOI: 10.1016/j.mporth.2024.01.002
James Edward Dixon, Jun Wei Lim, Iain McWilliam Stevenson
{"title":"Sub-trochanteric femoral fractures: challenges and solutions","authors":"James Edward Dixon,&nbsp;Jun Wei Lim,&nbsp;Iain McWilliam Stevenson","doi":"10.1016/j.mporth.2024.01.002","DOIUrl":"https://doi.org/10.1016/j.mporth.2024.01.002","url":null,"abstract":"<div><p>Sub-trochanteric femoral fractures represent around 10–34% of proximal femoral fragility fractures. They are notoriously difficult to treat, particularly achieving and maintaining reduction, which in turn can lead to longer operative time, more blood loss and higher rates of non-union. This review article provides an update on the potential reasons why fixation of sub-trochanteric fractures may fail, which implants are available, and what techniques can be used to try to avoid failure. Key papers from 2016 onwards were reviewed to deliver an overview of complications, implant choice, reduction techniques and consequences of open reduction.</p></div>","PeriodicalId":39547,"journal":{"name":"Orthopaedics and Trauma","volume":"38 2","pages":"Pages 78-84"},"PeriodicalIF":0.0,"publicationDate":"2024-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140290443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
What's new in the management of osteoporosis and prevention of fragility fractures? 骨质疏松症的治疗和脆性骨折的预防有何新进展？
Orthopaedics and Trauma Pub Date : 2024-02-20 DOI: 10.1016/j.mporth.2024.01.006
Gillian Fordyce, Rosemary Hollick, Alison Black
{"title":"What's new in the management of osteoporosis and prevention of fragility fractures?","authors":"Gillian Fordyce,&nbsp;Rosemary Hollick,&nbsp;Alison Black","doi":"10.1016/j.mporth.2024.01.006","DOIUrl":"https://doi.org/10.1016/j.mporth.2024.01.006","url":null,"abstract":"<div><p>With an increasingly ageing population it has never been more important to reduce the burden of fragility fractures. Fragility fractures, especially those of spine and hip, affect an individual's morbidity and mortality and carry a significant economic burden. There has been a recent shift towards a more stratified approach to the management of fracture risk, using fracture assessment tools, in combination with assessment of bone mineral density using dual X-ray absorptiometry scanning. Primary and secondary fracture prevention will be outlined including the important role of fracture liaison services. The use of medications which reduce fracture risks are discussed including the use of zoledronate in the immediate post-hip fracture setting.</p></div>","PeriodicalId":39547,"journal":{"name":"Orthopaedics and Trauma","volume":"38 2","pages":"Pages 99-107"},"PeriodicalIF":0.0,"publicationDate":"2024-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140290500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The National Hip Fracture Database: lessons learned and future horizons 国家髋部骨折数据库：经验教训与未来展望
Orthopaedics and Trauma Pub Date : 2024-02-20 DOI: 10.1016/j.mporth.2024.01.007
Will Eardley, Antony Johansen
{"title":"The National Hip Fracture Database: lessons learned and future horizons","authors":"Will Eardley,&nbsp;Antony Johansen","doi":"10.1016/j.mporth.2024.01.007","DOIUrl":"https://doi.org/10.1016/j.mporth.2024.01.007","url":null,"abstract":"<div><p>The effective management of older patients with fragility fractures of the femur remains central to modern trauma care. Processes of assessment and communication alongside means of identifying poor performance are vital to improving care in this population. The National Hip Fracture Database (NHFD) now contains around 1 million cases and has evolved over time to reflect contemporary practices in the care of older injured patients. The NHFD is in a unique position to inform hip fracture care and the wider global management of injured older patients. This report provides an update and details the processes within the NHFD, the scope, lessons learned and highlights future direction.</p></div>","PeriodicalId":39547,"journal":{"name":"Orthopaedics and Trauma","volume":"38 2","pages":"Pages 108-113"},"PeriodicalIF":0.0,"publicationDate":"2024-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140290501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The management of intertrochanteric hip fractures: an update 髋关节转子间骨折的治疗：最新进展
Orthopaedics and Trauma Pub Date : 2024-02-20 DOI: 10.1016/j.mporth.2024.01.001
Sophia M. Wakefield, Paul L. Rodham, Peter V. Giannoudis
{"title":"The management of intertrochanteric hip fractures: an update","authors":"Sophia M. Wakefield,&nbsp;Paul L. Rodham,&nbsp;Peter V. Giannoudis","doi":"10.1016/j.mporth.2024.01.001","DOIUrl":"https://doi.org/10.1016/j.mporth.2024.01.001","url":null,"abstract":"<div><p>Intertrochanteric fractures are a common type of proximal femoral fracture, and account for high morbidity and mortality. Early recognition and management of such fractures is important, with surgery preferably undertaken within 48 hours. The choice of surgical strategy remains variable between centres and individual surgeons; in part because evidence to support a specific strategy has been weak. Herein, we provide the latest evidence on the management of these fractures.</p></div>","PeriodicalId":39547,"journal":{"name":"Orthopaedics and Trauma","volume":"38 2","pages":"Pages 70-77"},"PeriodicalIF":0.0,"publicationDate":"2024-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140290383","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Techniques for cemented hemiarthroplasty 骨水泥半关节成形术的技术
Orthopaedics and Trauma Pub Date : 2024-02-19 DOI: 10.1016/j.mporth.2024.01.005
Joel Lim Wei-An, John AF Charity
{"title":"Techniques for cemented hemiarthroplasty","authors":"Joel Lim Wei-An,&nbsp;John AF Charity","doi":"10.1016/j.mporth.2024.01.005","DOIUrl":"https://doi.org/10.1016/j.mporth.2024.01.005","url":null,"abstract":"<div><p>With an ageing population, hip fractures are a progressively worsening global burden that impact both the patient and healthcare systems. More than half of hip fractures are intracapsular and the majority of them are treated with arthroplasty surgery for pain relief and restoration of mobility. For most hip fracture patients, who are generally older and frail, the aim of the surgeon is to provide treatment with the lowest possible mortality, complication and revision rates, coupled with improved health-related quality of life. Registry data show more favourable outcomes with cemented rather than cementless hemiarthroplasty in this challenging patient group. This article describes the techniques for cementing the femur during a hemiarthroplasty to recreate the patient's anatomy, as well as how to perform safe cementing techniques to reduce the risk of cement related complications.</p></div>","PeriodicalId":39547,"journal":{"name":"Orthopaedics and Trauma","volume":"38 2","pages":"Pages 95-98"},"PeriodicalIF":0.0,"publicationDate":"2024-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140290499","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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