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Factors influencing the continuity of evidence-based practice in perioperative airway management for elderly patients with fractures:A qualitative study

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World Journal of clinical Cases 2024年第22期12卷 5032-5041页

作者： Jia Zeng Jia Zhang Rui Li Zhi-Heng Guo Fang Wu Si-Meng Wang Hai-Yue Zhang Fei-Hu Qian Wuxi School of Medicine Jiangnan UniversityWuxi 214122Jiangsu ProvinceChina Department of Nursing Shanghai Tongren HospitalShanghai 200335China Department of Emergency Shanghai Tongren HospitalShanghai 200335China Department of orthopedics Shanghai Tongren HospitalShanghai 200335China

BACKGROUND More and more evidence-based practices are emerging,but researchers mostly focus on short-term effects,resulting in evidence-based practices not being applied in the clinic in the long *** this study,we took the evidence-based practice of perioperative airway management in elderly fracture patients as an example and adopted a descriptive phenomenological approach to understand the influencing factors of its sustainability to provide a reference basis for promoting the continuity of evidence-based practice in the *** To explore factors influencing the persistence of evidence-based practice in perioperative airway management in elderly patients with *** This study was qualitative *** nurses who implemented evidencebased practice in the orthopedic ward of a tertiary comprehensive hospital in Shanghai from September 2023 to October 2023 were selected using purposive sampling as research ***-structured interviews were conducted with them,and the data were analyzed using the Colaizzi phenomenological analysis method based on the three dimensions and ten factors of the NHS sustainability *** Three main themes and ten subthemes were identified:Process aspects(benefits to patients,benefits to nurses,lack of follow-up,complex processes);staff aspects(insufficient human resources,inadequate training and education,lack of leadership support);and organizational environment aspects(inadequate infrastructure,poor patient compliance,poor doctor cooperation).CONCLUSION Human resources,training and education,leadership support,infrastructure,and patient-physician collaboration are important factors influencing the sustainability of evidence-based practice for perioperative airway management in older patients with fractures.

关键词： Elderly Fracture Airway management Evidence-based practice Sustainability Sustainability model

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Evaluation of Intraobserver and Interobserver Reliability of Mechanical Axis Alignment Measure of the Lower Limb through the Panoramic Radiograph in Patients in the Preoperative and Postoperative Periods of Total Knee Arthroplasty

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Open Journal of orthopedics 2020年第9期10卷 221-233页

作者： Murilo Barroso Matos José Leonardo Rocha de Faria Douglas Mello Pavão Márcio Liu Sandt Breno Chaves de Almeida Pigozzo Pedro Guilme Teixeira de Sousa Filho Rodrigo Pires e Albuquerque clifor-orthopedics and fractures clinic Vitória Brazil Knee Surgery Center National Institute of Traumatology and Orthopedics Rio de Janeiro Brazil Genutarso-orthopedics clinic Rio de Janeiro Brazil Genu Surgery Group Fortaleza Brazil

Objective: To evaluate intraobserver and interobserver reliability of the measurement of the mechanical axis of the lower limb by means of the panoramic radiograph of lower limbs by physicians with different levels of medical practice. Method: A retrospective cross-sectional study with preoperative and postoperative radiographic analysis of a group of 100 patients submitted to total knee arthroplasty. Results: It was observed that there is a highly significant intraobserver and interobserver agreement (p Conclusion: The panoramic radiograph of the lower limbs is a reliable method for measuring the mechanical axis of the lower limb in patients submitted to total knee arthroplasty, regardless of the level of medical practice of the evaluator.

关键词： Knee Mechanical Axis Total Knee Arthroplasty

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Femoral neck stress fracture and medial tibial stress syndrome following high intensity interval training: A case report and review of literature

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World Journal of clinical Cases 2022年第23期10卷 8323-8329页

作者： Dawn Suwanie Tan Fiona Millicent Cheung Dekai Ng Tin Lung Alan Cheung Department of Orthopaedic Surgery International Orthopaedic ClinicSingapore329563Singapore

BACKGROUND Femoral and tibial stress injuries are commonly found in long distance running *** fractures have rarely been reported in athletes performing high intensity interval training(HIIT)*** objective of this study was to report a case of a patient who presented with medial tibial stress syndrome and femoral neck stress fracture after performing HIIT *** SUMMARY A 26 year old female presented with bilateral medial tibial *** had been performing HIIT exercise for 45 min,five times weekly,for a seven month *** tibial pain was gradual in onset,and was now severe and worse on exercise,despite six weeks of *** resonance imaging(MRI)revealed bilateral medial tibial stress *** she was taking norethisterone for birth control,a dual energy X-ray absorbitometry scan was performed which demonstrated normal bone mineral density of her lumbar spine and femoral *** was managed conservatively with analgesia and physiotherapy,but continued to exercise against medical *** presented again six months later with severe right hip *** of her right hip demonstrated an incomplete stress fracture of her subtrochanteric *** symptoms resolved with strict rest and *** HIIT may cause stress injury of the tibia and femur in young individuals.

关键词： High intensity interval training Medial tibial stress syndrome Femoral neck stress fracture Exercise Fracture Case report

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Does pelvic injury trigger erectile dysfunction in men？

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Chinese Journal of Traumatology 2015年第4期18卷 229-231页

作者： H. Huseyin Ceylan Ersin Kuyucu Remzi Erdem Gokhan Polat Ferit Yllmaz Bilal Gumus Mehmet Erdil Department of orthopedics Sultanciftligi LNB Government Hospital Istanbul Turkey Department of orthopedics Denizli Government Hospital. Denizli Turkey Urology clinic Haydarpasa Training and Education Hospital Istanbul Turkey Istanbul University Medical Faculty Istanbul Turkey Department of orthopedics lzmir Training and Education Hospital lzmir Turkey Department of orthopedics Medipol University. Istanbul Turkey

Purpose:Pelvic ring fractures constitute 3%-8% of all fractures of the skeletal system and are generally related with high energy trauma. Sexual dysfunction following pelvic fracture has a high incidence, and affects the male patients both physically and psychologically. In this study, we aimed to investigate the impact and frequencies of comorbidities such as erectile dysfunction (ED) with adverse sociocultural and psychological consequences for the patient who had a pelvic ring fracture.Methods:This study included 26 men who corresponded to the inclusion criteria and agreed to participate our study.Results:According to fracture types, most of our cases were Tile type A1 and type A2. Severe and moderate ED were detected in 46.1% (12/26) of these patients via the International Index of Erectile Function-5 questionnaire.Conclusion:ED develops following pelvic fractures, especially in Tile type B and C pelvic fractures.

关键词：下线服务迁移

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Successful results obtained in the treatment of adolescent forearm fractures with locked intramedullary nailing

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Chinese Journal of Traumatology 2021年第5期24卷 295-300页

作者： Yiiksel Ugur Yaradilmi Ali Tecirli Department of Orthopaedics and Traumatology University of Health SciencesKeqdren Health Practice and Research CenterAnkaraTurkey orthopedics and Traumatology clinic Rankin State HospitalRankinTurkey

Purpose:In the surgical treatment of paediatric forearm fractures,plate-screw and titanium elastic nails are *** the transformation of ligamento-osseous structures from adolescence form into adult form,more stable fixation is *** aim of this study was to evaluate the results of locked intramedullary nail fixation in adolescent forearm ***:A retrospective examination was made on 36 adolescent patients who underwent surgery with locked intramedullary nail fixation due to a forearm *** included patients were in the adolescent age group(12-17 years),did not meet conservative follow-up criteria and had unstable fractures(>10 angulation and18 years orfractures,multitrauma,history of physeal injuries or could not be contacted during ***'age,gender,body mass index,affected side,and the pronation and supination values during follow-up were *** evaluation of the patients was performed with disabilities of the arm,shoulder and hand score and the surgical outcomes were evaluated according to the Price *** time to union,infection during follow-up,re-fracture and vascular nerve damage were also *** were analyzed using SPSS 22 Windows package program ***:The patients comprised 30 males and 6 females(ratio,5:1)with a mean age of(14.7±2.1)years(range,12-18 years).According to the Price criteria,the results of 33 patients were excellent,3 were good and there were no moderate or poor *** mean disabilities of the arm,shoulder and hand score was 11.2±6.1(range,4-28).The mean time to union was(8.7±2.2)weeks(range,6-14 weeks),while patients aged>15 years had prolonged time to union([11.1±1.8]weeks).There were no non-unions,re-fractures or *** complications were observed during implant *** of the patients had sensorial radi

关键词： Adolescent forearm fracture Intramedullary locked nail Functional results Complications

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Comparisons in finite element analysis of minimally invasive, locking,and non-locking plates systems used in treating calcaneal fractures of Sanders type Ⅱ and type Ⅲ

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Chinese Medical Journal 2014年第22期127卷 3894-3901页

作者： He Kai Fu Su Liu Song Wang Zhifa Jin Dan Department of orthopedics and Traumatology Nanfang HospitalSouthern Medical University Guangzhou Guangdong 510515 China Department of Orthopaedics The Ordos Center Hospital The Ordos Clinic Medical College Inner Mongolia Medical University OrdosInner Mongolia 017000 China

Background Calcaneal fractures are relatively common but complex,while the treatment of these fractures is still *** objective of this study was to compare the biomechanical stability of minimally invasive,locking,and non-locking plating systems used for fixing Sanders type Ⅱ and type Ⅲ calcaneal *** element analysis was used for comparing the three types of plating *** study helped in guiding the clinical management of calcaneal *** The CT data acquired from a volunteer was used to construct a finite element model of *** fracture lines were made according to Sanders type Ⅱ （A,B,C） and type Ⅲ （AB,AC,BC） and six calcaneal fractures models were constructed *** fixation methods used in clinical treatment were simulated by design tools （minimally invasive plating with percutaneous screws,Y-size non-locking plating,and locking plating） and then fixed to these fracture models with the help of clinical *** single minimally invasive plating fixation was also tested to compare the function of percutaneous ***,the neutral force was applied on established *** displacement and presses distribution condition in various plating models were analyzed and *** The levels of displacement and compressive press on the bone around fixation or strains on plating were within the physiological limit,indicating that the three methods were suitable for *** with the locked and unlocked plates,the minimally invasive plating caused a relatively lower displacement without the high stress in bone or *** minimum stress in fixation was observed in locking plate as the distribution of stress was concentrated in the anterior part of locking *** The minimally invasive plating method could be a better alternative method in treating Sanders type Ⅱ and type Ⅲ calcaneal *** observed stiffness of locking plate was not obviously stronger than unlo

关键词： calcaneal fractures Sanders type finite element analysis fixation minimally invasive plate

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Does serum calcium relate to different types of hip fracture？ A retrospective study

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Chinese Journal of Traumatology 2016年第5期19卷 275-277页

作者： Peng-Fei Li Zi-Ling Lin Zhi-Hui Pang Yi-Rong Zeng First clinic Medical College Guangzhou University of Chinese Medicine Cuangzhou 510405 China Department of orthopedics First Affiliated Hospital of Guangzhou University of Chinese Medicine Guangzhou 510405 China

目的将调查在新潮的破裂和浆液钙层次的二种不同类型之间的潜在的关联。我们连续地学习了大腿骨的颈骨折的 101 个案例和大腿骨的 intertrochanteric 的 95 个案例的方法在 2011 年 1 月和 2013 年 12 月之间断裂。Fasting 血样品被拿... 详细信息

目的将调查在新潮的破裂和浆液钙层次的二种不同类型之间的潜在的关联。我们连续地学习了大腿骨的颈骨折的 101 个案例和大腿骨的 intertrochanteric 的 95 个案例的方法在 2011 年 1 月和 2013 年 12 月之间断裂。Fasting 血样品被拿，浆液钙大小在三个时期分别地被执行：承认， postoperation，和分泌物的时间。Creatinine，碱的磷酸酶和白朊也被分析。在承认， postoperation 和分泌物的时候考虑在二个组之间的浆液钙的层次的结果，在承认和分泌物有重要差别(p p > 0.05 ) 。浆液钙变化的大小比大腿骨的 intertrochanteric 组在大腿骨的颈组是更大的。有关在承认的碱的磷酸酶和白朊层次，二个组之间没有重要差别(p > 0.05 ) 。结论保留的能力和在有大腿骨的颈骨折的病人的浆液钙的恢复在有大腿骨的 intertrochanteric 骨折的病人比那好。低浆液钙水平可能产生大腿骨的 intertrochanteric 骨折。

关键词：钙新潮的破裂大腿骨的颈破裂

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Three-dimensional(3D) Printing Technology Assisted by Minimally Invasive Surgery for Pubic Rami fractures

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Current Medical Science 2018年第5期38卷 827-833页

作者： Wen-bo NIE Fa-gang YE Jian-lin MA Jiang-ping YU Ming-xing WANG Zhen-hua ZHANG Fu-jie SUN Department of orthopedics Affiliated Hospital of Qingdao UniversityQingdao 266000China Department of orthopedics Huxi Hospital Affiliated to Jining Medical College (Shanxian Central Hospital)Heze 274300China Department of orthopedics Qingdao Chengyang District People's HospitalQingdao 266100China

The feasibility of three-dimensional (3D) printing technology cgmbined with minimally invasive surgery in the treatment of pubic rami fractures was *** August 2015 to October 2017,a series of 30 patients who underwent surgical stabilization of their anterior pelvic ring (all utilizing the 3D printing technology)by one surgeon at a single hospital were *** minimally invasive incisions were made through anterior inferior cilia spine and pubic *** collected included the operative duration,the blood loss,the damage of the important tissue,the biographic union and therecovery of the function after the *** on inlet and outlet pelvic cardiograph were made immediately post-operation and at all follow-up clinic *** scores of reduction and function were measured during *** showed that the wounds of 30 patients were healed in the first stage,and there was no injury of important structures such as blood vessels and *** to the Matta criteria,excellent effectiveness was obtained in 22 cases and good in 8 *** to the functional evaluation criteria of Majeed,excellent effectiveness was obtained in 21 cases and good in 9 *** was suggested that the 3D printing technology assisted by minimally invasive surgery can better evaluate the pelvic fracture before operation,which was helpful in plate modeling, and can shorten surgery duration and reduce intraoperative blood loss and complications. The positioning accuracy was improved,and better surgical result was finally achieved.

关键词： digital design three-dimensional printing anterior ring pelvic fractures minimally invasive surgery

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Floating elbow combining ipsilateral distal multiple segmental forearm fractures: A case report

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World Journal of clinical Cases 2021年第14期9卷 3372-3378页

作者： Guo-Hua Huang Jiang-An Tang Tie-Yi Yang Yue Liu Department of orthopedics Shanghai Pudong New Area Gongli HospitalAffiliated to the Second Military Medical UniversityShanghai 200135China

BACKGROUND Floating elbow along with ipsilateral multiple segmental forearm fracture is a rare and high-energy injury,although elbow dislocation or fracture of the ulna and radius may occur *** SUMMARY We report the case of a 37-year-old woman with open(IIIA)fracture of the right distal humerus with multiple shaft fractures of the ipsilateral radius and ulna with a history of falling from a height of almost 20 m from a *** providing advanced trauma life support,damage control surgery was performed to debride the arm wound and temporarily stabilize the right upper limb with external fixators in the emergency operating ***,one-stage internal fixation of multiple fractures was performed with normal values of biochemical indicators and reduction in limb *** patient achieved good outcome at the 7 mo *** One-or two-stage treatment must be performed according to the type of injury;we efficiently used the“damage control principle.”

关键词： Floating forearm Advanced trauma life support Internal fixation Multiple fractures Open fracture Case report

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Emergent and delayed hybrid external fixation management of tibial pilon fractures: A multicentric retrospective analysis of 80 patients

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Journal of Acute Disease 2017年第4期6卷 169-174页

作者： Giuseppe Rollo Marco Filipponi Paolo Pichierri Valentina Russi Lorenzo Nalbone Michele D'Arienzo Sara Cavalera Gianfranco Corina Michele Bisaccia Luigi Meccariello Departement of orthopedics and Traumatology Vito Fazzi HospitalLecceItaly Orthopaedics and Traumatology clinic the University of Palermo Hospital'Paolo Giaccone'PalermoItaly Departement of orthopedics and Traumatology University Hospital"Policlinico di Modena"ModenaItaly Departement of orthopedics and Traumatology Di Summa-Perrino HospitalBrindisiItaly Division of orthopedics and Trauma Surgery University of PerugiaS.Maria della Misericordia HospitalPerugiaItaly

Objective:To report our experience with the hybrid external fixator in ***:We assessed 80 cases of pilon fracture treated with the external fixator during the period of January 2009 and December 2016:55 men (69%) and 30 women (33%) with a mean age of 40 years (range between 16 and 70 ). About 45 occurred as isolated trauma, 35 instead were politrauma. Each patient underwent standard radiographic examination and a CT examination. There were 28 open fractures (35%), (Gustilo type 1, 2 and 3) while closed fractures showed soft tissue involvement of various grade (2-3 Tscherne classification). In all cases, the external fixation, sometimes associated with other reduction and synthesis techniques, was used. The timing of surgery was dictated by the condition of the soft tissues. For clinical evaluation, the Mazur score with mean follow-ups at 12 months was ***:The final range of ankle motion was 15 dorsal and 10 plantar flexion. In about 80 cases there was an average Mazur score of83. The mean score was 90;in open fractures 85 to 72. Radiographic healing of fractures in 60 patients occurred in 120 days (mean 105 days), at the time when the external fixator was ***:Pilon fractures are complex and often present complications;the definitive treatment, in emergency or delayed, with hybrid external fixator permits a stable synthesis with minimal soft tissue damage. Weight bearing maybe allowed early and functional recovery is generally good.

关键词： Tibial Pilon External fixation Hybrid external fixation Outcomes Open fracture Soft tissue Injury

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