Injury
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In-hospital 3D printing is being implemented in orthopaedic departments worldwide, being used for additive manufacturing of fracture models (or even surgical guides) which are sterilized and used in the operating room. However, to save time and material, prints are nearly hollow, while 3D printers are placed in non-sterile rooms. The aim of our study is to evaluate whether common sterilization methods can sterilize the inside of the pieces, which would be of utmost importance in case a model breaks during a surgical intervention. ⋯ High temperatures reached during the procedure of additive manufacturing can decrease the bacterial load of the biomodels. However, there is a potential risk of contamination during the procedure. We recommend sterilization with EtO for in-hospital 3D-printed PLA hollow biomodels or guides. Otherwise, in case of using Gas Plasma, an infill of 100% should be applied.
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A 83yo female tripped on a rug at home. She fell onto her left knee. She had immediate left knee pain. She had never hurt her left knee before. ⋯ There is a C3 left sided comminuted distal femoral fracture. The bilateral total hip arthroplasties are in good position and appear normal (Fig. 1).
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Review
Low-intensity pulsed ultrasound (LIPUS) for stimulation of bone healing - A narrative review.
The use of low intensity pulsed ultrasound (LIPUS) to accelerate the fracture repair process in humans was first reported by Xavier & Duarte in 1983 [1]. This success led to clinical trials and the 1994 approval of LIPUS in the United States for the accelerated healing of certain fresh fractures. LIPUS was approved in the US for the treatment of established non-unions in 2000, and is also approved around the world. ⋯ Evaluation of results from studies, both positive and negative, has enabled an understanding that the patient population with potentially the greatest benefit from receiving LIPUS are those at-risk for fracture healing, e.g. diabetic & elderly patients. The elucidation of a pathway to activate the Rac-1 pathway by LIPUS might explain this beneficial effect. Overall, there is a strong need for further clinical trials, particularly for acute fractures at risk of progressing to non-union and in established non-unions including a comparison to the current standard of care.