Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Feb 2024
Randomized Controlled TrialSynchronous and asynchronous telerehabilitation methods produce similar benefits in individuals with non-specific neck pain.
Evidence exists on clinical benefits of synchronous and asynchronous telerehabilitation for patients with non-specific neck pain (NSNP); however, limited studies are comparing synchronous and asynchronous telerehabilitation (TR) programs in this population. The aim of this study was to estimate the relative effectiveness of an 8-week synchronous or asynchronous TR in improving pain, functional disability, kinesiophobia, and mobility in patients with NSNP. ⋯ Telerehabilitation technologies are expanding at a rapid rate, and it is essential to understand the outcomes produced using these technologies in health conditions. This study showed that synchronous and asynchronous telerehabilitation produces similar results in patients with NSNP, supporting that either method can be used interchangeably.
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Arch Orthop Trauma Surg · Feb 2024
Observational StudyPostoperative cognitive dysfunction after beach chair positioning compared to supine position in orthopaedic surgery in the elderly.
Postoperative cognitive dysfunction (POCD) occurs in up to 26% of patients older than 60 years 1 week after non-cardiac surgery. Intraoperative beach chair positioning (BCP) is advantageous for some types of shoulder surgery. However, this kind of positioning leads to a downward bound redistribution of blood volume, with possible hypoperfusion of the brain. We hypothesized that patients > 60 years undergoing orthopaedic shoulder surgery in a BCP might experience more POCD than patients operated in the supine position (SP). ⋯ POCD at 1 week after surgery tended to occur more often in patients operated in beach chair position compared to patients in supine position without being statistically significant.
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Arch Orthop Trauma Surg · Feb 2024
Simplifying radiologic reports with natural language processing: a novel approach using ChatGPT in enhancing patient understanding of MRI results.
The aim of this prospective cohort study was to assess the factual accuracy, completeness of medical information, and potential harmfulness of incorrect conclusions by medical professionals in automatically generated texts of varying complexity (1) using ChatGPT, Furthermore, patients without a medical background were asked to evaluate comprehensibility, information density, and conclusion possibilities (2). ⋯ By using ChatGPT, MRI reports can be simplified automatically with consistent quality so that the relevant information is understandable to patients. However, a report generated in this way does not replace a thorough discussion between specialist and patient.
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Arch Orthop Trauma Surg · Feb 2024
Clinical outcomes following tibiotalocalcaneal arthrodesis with intramedullary nailing combined with partial fibulectomy and onlay bone graft.
Although intramedullary nailing is a popular method for tibiotalocalcaneal arthrodesis, nonunion is one of the most commonly reported complications. This study aimed to evaluate the fusion rate, improvement in functional outcomes, and occurrence of complications in tibiotalocalcaneal arthrodesis using retrograde intramedullary nailing with partial fibulectomy and onlay bone graft technique. ⋯ Our technique of tibiotalocalcaneal arthrodesis with partial fibulectomy and onlay bone grafting could be a good option where both the tibiotalar and subtalar joints need to be fused.
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Arch Orthop Trauma Surg · Feb 2024
Femoral neck shortening as a sequela of internal fixation for femoral neck fractures and its effect on the coronal alignment of the limb: a pilot study.
Femoral neck shortening is a common phenomenon following osteosynthesis for femoral neck fractures, which was shown to have a negative effect on hip function. There is paucity of literature on the effect of shortening on the ipsilateral limb mechanical axis and knee coronal alignment. We hypothesized that postoperative femoral neck shortening can alter the limb's mechanical axis into valgus. ⋯ We found a more lateralized mechanical axis in limbs that demonstrated post-operative ipsilateral femoral neck severe shortening. These findings may provide a possible explanation and rationale for knee pain and perhaps for the development of knee osteoarthritis as a sequalae of femoral neck shortening. Further investigation and larger cohort, long-term studies are needed to further explore this hypothesis.