植入物移除:优点和缺点——对来自意大利骨科外科和创伤学会(SIOT)的500名参与者的调查结果,并与其他国际趋势进行比较。

IF 2.6 3区 医学 Q2 ORTHOPEDICS
International Orthopaedics Pub Date : 2025-08-01 Epub Date: 2025-05-26 DOI:10.1007/s00264-025-06564-7
Virginia Masoni, Corrado Ciatti, Luca Andriollo, Giovanni Vicenti, Fabrizio Rivera
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引用次数: 0

摘要

导言:自从电子游戏和增强现实技术的引入,与电子竞技相关的伤害已经引起了研究人员和医疗保健专业人员越来越多的关注。这篇综述文章检查了与电子游戏和增强现实相关的损伤范围,并描述了与游戏损伤相关的诊断的细微差别。材料和方法:向意大利骨科外科和创伤学会(SIOT)的所有成员分发了一份包含25个项目的在线调查问卷,内容包括他们的适应症、常规做法和上肢和下肢硬体取出术的并发症。该调查于2024年7月至2024年10月开放。采用排除和纳入标准。结果:共收到问卷500份。虽然种植体移除主要是在有症状的患者中实现的,但对于无症状的患者,则不常规进行,16-40岁的患者移除的倾向略高。这些趋势在上肢和下肢都有记录,上肢的硬体移除更为沉默。96%的受访者表示缺乏关于这类手术的医院指南。术中最担心的并发症是螺钉剥离和假体断裂,只有0.6%的受访者表示术中无困难。虽然患者不适和避免未来并发症是切除的主要指征,但术后并发症发生在伤口瘢痕、症状持续和出血等方面。尽管不被认为是“住院医生的程序”,但当住院医生被特别询问时,在76%的情况下,他们在1到10的范围内感到自信≥7。最后,62%的受访者表示,钛种植体比不锈钢种植体更难移除。结论:这项调查描述了一般倾向于不常规移除种植体,即使是在下肢,特别是上肢的年轻患者,除非有症状。由于术中技术上的困难,硬件移除可能从一个简单的过程演变成一个更复杂的手术。意大利全境缺乏普遍的政策和指导方针。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Implant removal: benefits and drawbacks - Results of a survey with five hundred participants from the Italian Society of Orthopedic Surgery and Traumatology (SIOT) and comparison with other international trends.

Implant removal: benefits and drawbacks - Results of a survey with five hundred participants from the Italian Society of Orthopedic Surgery and Traumatology (SIOT) and comparison with other international trends.

Implant removal: benefits and drawbacks - Results of a survey with five hundred participants from the Italian Society of Orthopedic Surgery and Traumatology (SIOT) and comparison with other international trends.

Implant removal: benefits and drawbacks - Results of a survey with five hundred participants from the Italian Society of Orthopedic Surgery and Traumatology (SIOT) and comparison with other international trends.

Introduction: Implant removal in orthopedics and traumatology is still a controversial topic. Benefits and drawbacks lead to relative indications, mainly depending on patients' demands and surgeons' perspectives. This study aims to report the current attitudes and practices of Italian surgeons who participated in a survey.

Materials and methods: An online-based questionnaire of 25 items was distributed to all the members of the Italian Society of Orthopedic Surgery and Traumatology (SIOT) regarding their indications, usual practices, and complications encountered with hardware removal in upper and lower limbs. The survey was open from July 2024 to October 2024. Exclusion and inclusion criteria were applied.

Results: Five hundred answers were received. While implant removal is primarily achieved in symptomatic patients, in the case of asymptomatic patients, it is not routinely performed, with a slightly higher tendency of removal in those aged 16-40 years old. These tendencies were registered both for the upper and lower limbs, with more reticence in hardware removal in the upper limbs. 96% of respondents declared the lack of hospital guidelines regarding this kind of surgery. The most feared intraoperative complications during the removal concerned screw stripping and implant breakage, with only 0.6% of respondents reporting no intraoperative difficulties. While patient discomfort and avoidance of future complications were the main indications for removal, postoperative complications occurred as wound scarring concerns, persistence of symptoms and bleeding. Despite not being considered a "procedure for the resident", when residents were specifically questioned, in 76% of cases they felt self-confident ≥ 7 on a scale from 1 to 10. Lastly, according to 62% of the respondents, titanium implants are more difficult to remove than stainless steel ones.

Conclusion: This survey describes a general tendency to not routinely remove implants, even in younger patients in the lower and especially upper limbs, unless in case of symptoms. Hardware removal could evolve from a simple procedure into a more complex surgery due to intraoperative technical difficulties. A lack of universal policy and guidelines exists throughout the Italian territory.

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来源期刊
International Orthopaedics
International Orthopaedics 医学-整形外科
CiteScore
5.50
自引率
7.40%
发文量
360
审稿时长
1 months
期刊介绍: International Orthopaedics, the Official Journal of the Société Internationale de Chirurgie Orthopédique et de Traumatologie (SICOT) , publishes original papers from all over the world. The articles deal with clinical orthopaedic surgery or basic research directly connected with orthopaedic surgery. International Orthopaedics will also link all the members of SICOT by means of an insert that will be concerned with SICOT matters. Finally, it is expected that news and information regarding all aspects of orthopaedic surgery, including meetings, panels, instructional courses, etc. will be brought to the attention of the readers. Manuscripts submitted for publication must contain a statement to the effect that all human studies have been approved by the appropriate ethics committee and have therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki. It should also be stated clearly in the text that all persons gave their informed consent prior to their inclusion in the study. Details that might disclose the identity of the subjects under study should be omitted. Reports of animal experiments must state that the "Principles of laboratory animal care" (NIH publication No. 85-23, revised 1985) were followed, as well as specific national laws (e.g. the current version of the German Law on the Protection of Animals) where applicable. The editors reserve the right to reject manuscripts that do not comply with the above-mentioned requirements. The author will be held responsible for false statements or for failure to fulfil the above-mentioned requirements.
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