Injury
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Today's orthopedic surgery could not be imagined without intraoperative x-ray-based imaging. This enables surgeons to assess operative interim steps as well as the result before wound closure and finishing the procedure. ⋯ These very exciting developments will change the integration of imaging into the surgical workflows, giving options of augmented reality, reduction of radiation dose, automatized acquisition and analysis of images and low-level guidance in procedures. This paper gives a review of current innovations and possible future trends in fluoroscopic 2D and 3D imaging.
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Medicine in general is quickly transitioning to a digital presence. Orthopaedic surgery is also being impacted by the tenets of digital health but there are also direct efforts with trauma surgery. Sensors are the pen and paper of the next wave of data acquisition. ⋯ The Internet of Things (IoT) [1] now has a subset which is the Internet of Medical Devices [2-5] permitting a much more in-depth dive into patient procedures and outcomes. IoT devices are now being used to enable remote health monitoring, in hospital treatment, and guide therapies. This article reviews current sensor technology that looks to impact trauma care.
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Virtual (VR), augmented (AR), mixed reality (MR) and haptic interfaces make additional avenues available for surgeon assessment, guidance and training. We evaluated applications for open trauma and emergency surgery to address the question: Have new computer-supported interface developments occurred that could improve trauma training for civilian and military surgeons performing open, emergency, non-laparoscopic surgery? ⋯ Medical Knowledge, Practice Based Learning and Improvement, Patient Care, Systems-Based Practice.
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In this article we discuss the evolution of computers and the use of VR for trauma education. We reflect on available literature and share the lessons we learned. VR allows you to share your most interesting and rare patient cases with a bedside teaching experience. ⋯ Based on our experience we advise to limit VR educational sessions to a maximum of one hour. Although the VR techniques currently have some limitations, the quality and possibilities of this technique are rapidly improving. VR education will certainly be a part of trauma education in the future; Be prepared!
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Skin and soft-tissue defects around the foot and ankle remain a challenge for orthopedic and plastic surgeons. Anterolateral thigh (ALT) flap and sural neurofasciocutaneous (NFC) flap are both used to reconstruct lower-extremity soft-tissue defects. The purpose of this study was to compare outcomes of the two flaps and attempt to provide an optimal strategy. ⋯ The study showed that anterolateral thigh flaps in wound coverage of foot and ankle achieved better outcomes than neurofasciocutaneous flaps in terms of recipient benefits and donor-site compromise with a special indication for larger and more distally located defects.