Injury
-
The severe disruptions caused by the SARS-CoV-2 coronavirus have necessitated a redistribution of resources to meet hospitals' current service needs during this pandemic. The aim is to share our experiences and outcomes during the first month of the Covid-19 pandemic, based on the strategies recommended and strategies we have implemented. ⋯ As priorities and resources increasingly shift towards the COVID-19 pandemic, it is possible to maintain the high standard and quality of care necessary for trauma and orthopaedics patients while the pandemic persists. We must be prepared to organize our healthcare workers in such a way that the needs of both inpatients and outpatients are met. It is still possible to operate on those patients who need it. Unfortunately, some healthcare workers will become infected. It is essential that we protect those most susceptible to severer consequences of Covid-19. Also crucial are optimized protective measures.
-
The keystone perforator flap is a simple, popular form of advancement flap that can solve many defects of the lower extremity that can avoid consideration of a microsurgical tissue transfer. The actual circulation to this local flap subtype has not yet been delineated. The recent introduction of inexpensive thermal imaging cameras that can be coupled with a SmartPhone allows thermagrams of these flaps where "hot spots" are known to correspond to the location of pertinent perforators that will provide the requisite flap vascularization. ⋯ The use of the SmartPhone for thermography is a simple, rapid, cheaper means for the evaluation of viability of keystone flaps in all surgical phases. This provides a safe method for checking not only flap circulation, but also identification of "cold spots" or flap regions where means to augment advancement by deep fascia interruption or undermining will not interfere with flap perfusion. There is virtually no learning curve in acquiring the skills to use this device, which should now allow anyone to raise actually any kind of local perforator flap as they find suitable.
-
Numerous treatment strategies have been reported for the treatment of chronic frank distal tibiofibular syndesmosis instability, including several small case series treated by syndesmosis arthrodesis. The aim of this study is to report the treatment of this condition using a specially contoured plate and the associated clinical outcomes. ⋯ Syndesmosis arthrodesis was a feasible method for the treatment of chronic frank syndesmosis instability according to our findings. Syndesmosis arthrodesis with plate and screw stabilization is another viable option to be considered into the surgeon's armamentarium. Larger scale studies are desirable to provide further evidence of this method of treatment.
-
Upper extremity injuries have a significant impact on social and professional life. They represent about 10% of visits to emergency departments. Nerve lacerations are one of the biggest problem because loss of innervation results in muscle atrophy, decreased sensibility, and therefore permanent dysfunction. Appropriate treatment is very important for patients to regain function. ⋯ Patients with shorter time from injury to repair and at a younger age had better DASH results. The median nerve had the best motor function between the groups. There was no difference in sensitivity or DASH scores between groups.
-
Treatment of large bone defects is still related to unsolved problems in orthopaedic trauma surgery. Minimally invasive intramedullary reaming with the use of the Reamer-Irrigator-Aspirator (RIA) device allows autograft harvesting of large bone graft amounts from the medullary canal of the femur. The aim of this study was to investigate the influence of RIA diameter on femoral bone strength and amount of harvested bone graft in a human cadaveric model. ⋯ Reaming with RIA diameter of 4.0 mm larger than the isthmus of the femur seems to influence considerably its torsional stiffness, however, it allows harvesting of a significantly bigger bone graft amount.