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Applications of finite element simulation in orthopedic and trauma surgery

World Journal of Orthopedics 2012年第4期3卷 25-41页

作者： Antonio Herrera Elena Ibarz José Cego?ino Antonio Lobo-Escolar Sergio Puértolas Enrique López Jesús Mateo Luis Gracia Department of Orthopaedic and trauma surgery Miguel Servet University HospitalMedicine SchoolUniversity of Zaragoza Department of Mechanical Engineering University of Zaragoza

Research in different areas of orthopedic and trauma surgery requires a methodology that allows both a more economic approach and the ability to reproduce different situations in an easy way. Simulation models have been introduced recently in bioengineering and could become an essential tool in the study of any physiological unity, regardless of its complexity. The main problem in modeling with finite elements simulation is to achieve an accurate reproduction of the anatomy and a perfect correlation of the different structures, in any region of the human body. Authors have developed a mixed technique, joining the use of a three-dimensional laser scanner Roland Picza captured together with computed tomography(CT) and 3D CT images, to achieve a perfect reproduction of the anatomy. Finite element(FE) simulation lets us know the biomechanical changes that take place after hipprostheses or osteosynthesis implantation and biological responses of bone to biomechanical changes. The simulation models are able to predict changes in bone stress distribution around the implant, so allowing preventing future pathologies. The development of a FE model of lumbar spine is another interesting application of the simulation. The model allows research on the lumbar spine, not only in physiological conditions but also simulating different load conditions, to assess the impact on biomechanics. Different degrees of disc degeneration can also be simulated to determine the impact on adjacent anatomical elements. Finally, FE models may be useful to test different fixation systems, i.e., pedicular screws, interbody devices or rigid fixations compared with the dynamic ones. We have also developed models of lumbar spine and hip joint to predict the occurrence of osteoporotic fractures, based on densitometric determinations and specific biomechanical models, including approaches from damage and fracture mechanics. FE simulations also allow us to predict the behavior of orthopedic splints applied

关键词： Finite element simulation Hip prosthesis Lumbar spine Lumbar fixations Osteoporotic fractures Splints

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Critical adjustments and trauma surgery trends in adaptation to COVID-19 pandemic in Malaysia

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Chinese Journal of traumatology 2020年第4期23卷 207-210页

作者： Henry Tan Chor Lip Tan Jih Huei Yuzaidi Mohamad Rizal Imran Alwi Tuan Nut'Azmah Tuan Mat Department of General surgery Hospital Sultanah AminahMalaysia Ministry of HealthJohor BahruMalaysia trauma surgery Unit Department of General SurgeryHospital Sultanah AminahMalaysia Ministry of HealthJohor BahruMalaysia Department of General surgery Faculty of MedicineNational University of Malaysia Medical CentreKuala LumpurMalaysia

Malaysia has one of the highest total numbers of COVID-19 infections amongst the Southeast Asian nations,which led to the enforcements of the Malaysian"Movement Control Order"to prohibit disease *** overwhelming increasing amount of infections has led to a major strain on major healthcare *** leads to shortages in hospital beds,ventilators and critical personnel protective *** article focuses on the critical adaptations from a general surgery department in Malaysia which is part of a Malaysian tertiary hospital that treats COVID-19 *** core highlights of these strategies enforced during this pandemic are:(1)surgery ward and clinic decongestions;(2)deferment of elective surgeries;(3)restructuring of medical personnel work force;(4)utilization of online appli cations for tele-communication;(5)operating room(OR)adjustments and patient screening;and(6)continuing medical education and updating practices in context to *** adaptations were important for the continuation of emergency surgery services,preventing transmission of COVID-19 amongst healthcare workers and optimization of medical personnel work force in times of a global *** addition,an early analysis on the impact of COVID-19 pandemic and lockdown measures in Malaysia towards the reduction in total number of elective/emergent/trauma surgeries performed is described in this article.

关键词： Pandemics COVID-19 General surgery Malaysia

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Use of three-dimensional printing in preoperative planning in orthopaedic trauma surgery: A systematic review and meta-analysis

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World Journal of Orthopedics 2020年第1期11卷 57-67页

作者： Catrin Morgan Chetan Khatri Sammy A Hanna Hutan Ashrafian Khaled M Sarraf trauma and Orthopaedics Imperial College NHS TrustLondon W21NYUnited Kingdom The Royal London Hospital Barts Health NHS TrustLondon E11BBUnited Kingdom Department of surgery and Cancer Imperial College LondonLondon W21NYUnited Kingdom

BACKGROUND With the increasing complexity of surgical interventions performed in orthopaedic trauma surgery and the improving technologies used in threedimensional(3D)printing,there has been an increased interest in the *** has been shown that 3D models allow surgeons to better visualise anatomy,aid in planning and performing complex *** is however not clear how best to utilise the technique and whether this results in better *** To evaluate the effect of 3D printing used in pre-operative planning in orthopaedic trauma surgery on clinical *** We performed a comprehensive systematic review of the literature and a ***,Ovid and Embase were searched from inception to February 8,*** controlled trials,case-control studies,cohort studies and case series of five patients or more were included across any area of orthopaedic *** primary outcomes were operation time,intra-operative blood loss and fluoroscopy *** Seventeen studies(922 patients)met our inclusion criteria and were *** use of 3D printing across all specialties in orthopaedic trauma surgery demonstrated an overall reduction in operation time of 19.85%[95%confidence intervals(CI):(-22.99,-16.71)],intra-operative blood loss of 25.73%[95%CI:(-31.07,-20.40)],and number of times fluoroscopy was used by 23.80%[95%CI:(-38.49,-9.10)].CONCLUSION Our results suggest that the use of 3D printing in pre-operative planning in orthopaedic trauma reduces operative time,intraoperative blood loss and the number of times fluoroscopy is used.

关键词： Orthopaedic surgery trauma Three-dimensional printing

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Bibliometric analysis of research on the effects of human immunodeficiency virus in orthopaedic and trauma surgery

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World Journal of Orthopedics 2021年第3期12卷 169-177页

作者： Ciaran Brennan Maritz Laubscher Sithombo Maqungo Simon Matthew Graham Orthopaedic Research Unit University of Cape TownCape Town 7925South Africa Division of Orthopaedic surgery Groote Schuur HospitalCape Town 7925South Africa Institute of Population Health Sciences University of LiverpoolLiverpool L97ALUnited Kingdom Department of Orthopaedic and trauma surgery Liverpool University Teaching Hospitals TrustLiverpool L97ALUnited Kingdom Department of Clinical Sciences Liverpool School of Tropical MedicineLiverpool L97ALUnited Kingdom

BACKGROUND There is little research investigating how human immunodeficiency virus(HIV)affects outcomes in orthopaedic *** advances in treatment,HIV has become a chronic health problem and the chance of orthopaedic surgeons encountering it in clinical practice is *** To ascertain the quantity and quality of peer-reviewed publications in orthopaedic journals about *** A search of the Web of Science database was carried out,identifying any articles relating to HIV published in orthopaedic *** were assessed for geographic origin and level of *** Of 48.7%of orthopaedic journals listed on the Web of Science database had published articles relating to *** were 168 articles about HIV in orthopaedic journals with only 40.5%(n=68)published in the time frame we analysed(January 2007 to September 2017).Very few articles came from lowincome countries and any articles published from that setting were *** of the articles were low level of *** There is a need for more high level orthopaedic and trauma research investigating the effects of HIV,particularly research from low-income countries,where higher level research will help to guide improvements in their treatment of its musculoskeletal manifestations and complications.

关键词： Human immunodeficiency virus Research Bibliometric analysis Analysis Orthopaedic

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Investigation of litigation in trauma orthopaedic surgery

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World Journal of Clinical Cases 2023年第5期11卷 1000-1008页

作者： Maryam Salimi Mohammad Bagher Heidari Zohre Ravandi Seyedarad Mosalamiaghili Peyman Mirghaderi Meisam Jafari Kafiabadi Farsad Biglari Amirhossein Salimi Amir Sabaghzadeh Irani Seyyed Saeed Khabiri Department of Orthopaedic surgery Shiraz University of Medical SciencesShiraz ***Iran Department of General surgery Kermanshah University of Medical SciencesKermanshah ***Iran Student Research Committee Kermanshah University of Medical SciencesShiraz ***Iran Student Research Committee Shiraz University of Medical SciencesShiraz 716549834Iran Students’Scientific Research Center(SSRC) Tehran University of Medical SciencesTehran 714356743Iran Clinical Research Development Unit of Shohada-e Tajrish Hospital Shahid Beheshti University of Medical SciencesTehran 715643498Iran Student Research Committee Shahid Sadoughi University of Medical SciencesYazd 719167534Iran

BACKGROUND It has been said that the number of orthopaedic claims has increased in the last few years. Investigation through the most prevalent cause would help to prevent further *** To review the cases of medical complaints in orthopedic patients who had been involved in a traumatic *** A retrospective multi-center review of trauma orthopaedic-related malpractice lawsuits from 2010 to 2021 was conducted utilizing the regional medicolegal database. Defendant and plaintiff characteristics along with fracture location, allegations, and litigation outcomes were *** A total of 228 claims referred to trauma-related conditions with a mean age of 31.29 ± 12.56 were enrolled. The most common injuries were at hand, thigh, elbow, and forearm, ***, the most common alleged complication was related to malunion or nonunion. In 47% of the cases, the main problem that led to the complaint was the inappropriate or insufficient explanation to the patient, and in 53%, there was a problem in the surgery. Eventually, 76% of the complaints resulted in a defense verdict, and 24% resulted in a plaintiff *** Surgical treatment of hand injuries and surgery in non-educational hospitals received the most complaints. The majority of litigation outcomes were caused by a physician’s failure to fully explain and educate the traumatic orthopedic patients and technological errors.

关键词： Clinical negligence Litigation Medicolegal claims Mismanagement Patient satisfaction

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Application of indocyanine green in surgery: A review of current evidence and implementation in trauma patients

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World Journal of Gastrointestinal surgery 2023年第5期15卷 757-775页

作者： Husham Abdelrahman Ayman El-Menyar Ruben Peralta Hassan Al-Thani trauma surgery Hamad Medical CorporationDoha 3050Qatar trauma and Vascular surgery Hamad Medical CorporationDoha 3050Qatar

Background:Modern surgical medicine strives to manage trauma while improving outcomes using functional *** of viable tissues is crucial for the surgical management of polytrauma and burn patients presenting with soft tissue and hollow viscus *** anastomosis after traumarelated resection is associated with a high rate of *** ability of the surgeon’s bare eye to determine bowel viability remains limited,and the need for a more standardized objective assessment has not yet been ***,there is a need for more precise diagnostic tools to enhance surgical evaluation and visualization to aid early diagnosis and timely management to minimize traumaassociated *** green(ICG)coupled with fluorescence angiography is a potential solution for this *** is a fluorescent dye that responds to near-infrared ***:We conducted a narrative review to address the utility of ICG in the surgical management of patients with trauma as well as elective ***:ICG has many applications in different medical fields and has recently become an important clinical indicator for surgical ***,there is a paucity of information regarding the use of this technology to treat ***,angiography with ICG has been introduced in clinical practice to visualize and quantify organ perfusion under several conditions,leading to fewer cases of anastomotic *** has great potential to bridge this gap and enhance the clinical outcomes of surgery and patient ***,there is no consensus on the ideal dose,time,and manner of administration nor the indications that ICG provides a genuine advantage through greater safety in trauma surgical ***:There is a scarcity of publications describing the use of ICG in trauma patients as a potentially useful strategy to facilitate intraoperative decisions and to limit the extent of surgical *** review will impro

关键词： trauma Indocyanine green Fluorescence angiography Perfusion imaging Fluorescence guided surgery Acute care surgery

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Current role of extracorporeal membrane oxygenation for the management of trauma patients:Indications and results

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World Journal of Critical Care Medicine 2025年第1期14卷 42-48页

作者： Mohammed Abdulrahman Maryam Makki Malak Bentaleb Dana Khamis Altamimi Marcelo AF Ribeiro Junior Department of surgery College of Medicine and Health SciencesKhalifa UniversityAbu Dhabi 11001United Arab Emirates Department of surgery Division of TraumaCritical Care and Acute Care SurgerySheikh Shakhbout Medical CityAbu Dhabi 11001United Arab Emirates Department of surgery Sheikh Shakhbout Medical CityAbu Dhabi 91888ADUnited Arab Emirates Department of surgery R Adams Cowley Shock Trauma CenterUniversity of MarylandBaltimoreMD 21201United States

Extracorporeal membrane oxygenation(ECMO)has emerged as a vital circulatory life support measure for patients with critical cardiac or pulmonary conditions unresponsive to conventional *** allows blood to be extracted from a patient and introduced to a machine that oxygenates blood and removes carbon *** blood is then reintroduced into the patient’s circulatory *** process makes ECMO essential for treating various medical conditions,both as a standalone therapy and as adjuvant ***-venous(VV)ECMO primarily supports respiratory function and indicates respiratory ***,veno-arterial(VA)ECMO provides hemodynamic and respiratory support and is suitable for cardiac-related *** study reviews recent literature to elucidate the evolving role of ECMO in trauma care,considering its procedural intricacies,indications,contraindications,and associated ***,the use of ECMO in trauma patients,particularly for acute respiratory distress syndrome and cardiogenic shock,has demonstrated promising outcomes despite challenges such as anticoagulation management and complications such as acute kidney injury,bleeding,thrombosis,and *** studies have shown that VV ECMO was associated with significantly higher survival rates than conventional mechanical ventilation,whereas other studies have reported that VA ECMO was associated with lower survival rates than VV *** plays a critical role in managing trauma patients,particularly those with acute respiratory *** research is necessary to explore the full potential of ECMO in trauma *** should have a clear understanding of the indications and contraindications for the use of ECMO to maximize its benefits in treating trauma patients.

关键词： Extracorporeal membrane oxygenation treatments Multiple trauma Respiratory distress syndrome Cardiogenic shock Contraindications Anticoagulants

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Incorporating red blanket protocol within code crimson:Streamlining definitive trauma care amid the chaos

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World Journal of Critical Care Medicine 2025年第1期14卷 14-19页

作者： Sohil Pothiawala Savitha Bhagvan Andrew MacCormick Emergency Medicine Woodlands HealthSingapore 737628Singapore trauma and Emergency Services Auckland City HospitalAuckland 1023New Zealand Department of General surgery Middlemore HospitalAuckland 2025New Zealand

The care of a patient involved in major trauma with exsanguinating haemorrhage is time-critical to achieve definitive haemorrhage control,and it requires coordinated multidisciplinary *** initial resuscitation of a patient in the emergency department(ED),Code Crimson activation facilitates rapid decisionmaking by multi-disciplinary specialists for definitive haemorrhage control in operating theatre(OT)and/or interventional radiology(IR)*** this decision has been made,there may still be various factors that lead to delay in transporting the patient from ED to OT/*** Blanket protocol identifies and addresses these factors and processes which cause delay,and aims to facilitate rapid and safe transport of the haemodynamically unstable patient from ED to OT,while minimizing delay in resuscitation during the *** two processes,Code Crimson and Red Blanket,complement each *** would be ideal to merge the two processes into a single protocol rather than having two separate *** these quality improvement strategies and coor-dinated processes within the trauma framework of the hospitals/healthcare systems will help in further improving the multi-disciplinary care for the complex trauma patients requiring rapid and definitive haemorrhage control.

关键词： Red blanket protocol Code crimson Haemorrhage trauma

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Advances in laparoscopy for acute care surgery and trauma

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World Journal of Gastroenterology 2016年第2期22卷 668-680页

作者： Matteo Mandrioli Kenji Inaba Alice Piccinini Andrea Biscardi Massimo Sartelli Ferdinando Agresta Fausto Catena Roberto Cirocchi Elio Jovine Gregorio Tugnoli Salomone Di Saverio Department of Emergency and General surgery and trauma surgery Unit C.A.Pizzardi Maggiore Hospital Trauma Center40133 BolognaItaly Division of trauma surgery and Surgical Critical Care Department of SurgeryUniversity of Southern CaliforniaLos AngelesCA 90033United States Department of surgery Macerata Hospital62100 MacerataItaly Department of surgery Adria Hospital45011 AdriaRovigoItaly Department of Emergency and trauma surgery Maggiore Hospital43126 ParmaItaly Departement of Digestive surgery and Liver Unit St.Maria Hospital05100 TerniPerugiaItaly

The greatest advantages of laparoscopy when compared to open surgery include the faster recovery times, shorter hospital stays, decreased postoperative pain, earlier return to work and resumption of normal daily activity as well as cosmetic benefits. Laparoscopy today is considered the gold standard of care in the treatment of cholecystitis and appendicitis worldwide. Laparoscopy has even been adopted in colorectal surgery with good results. The technological improvements in this surgical field along with the development of modern techniques and the acquisition of specific laparoscopic skills have allowed for its utilization in operations with fully intracorporeal anastomoses. Further progress in laparoscopy has included single-incision laparoscopic surgery and natural orifice trans-luminal endoscopic surgery. Nevertheless, laparoscopy for emergency surgery is still considered challenging and is usually not recommended due to the lack of adequate experience in this area. The technical difficulties of operating in the presence of diffuse peritonitis or large purulent collections and diffuse adhesions are also given as reasons. However, the potential advantages of laparoscopy, both in terms of diagnosis and therapy, are clear. Major advantages may be observed in cases with diffuse peritonitis secondary to perforated peptic ulcers,for example, where laparoscopy allows the confirmation of the diagnosis, the identification of the position of the ulcer and a laparoscopic repair with effective peritoneal washout. Laparoscopy has also revolutionized the approach to complicated diverticulitis even when intestinal perforation is present. Many other emergency conditions can be effectively managed laparoscopically, including trauma in select hemodynamically-stable patients. We have therefore reviewed the most recent scientific literature on advances in laparoscopy for acute care surgery and trauma in order to demonstrate the current indications and outcomes associated with a la

关键词： Laparoscopy Acute care surgery Singleincisionlaparoscopic surgery Natural orifice transluminalendoscopic surgery trauma

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Silk-based nerve guidance conduits with macroscopic holes modulate the vascularization of regenerating rat sciatic nerve

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Neural Regeneration Research 2025年第6期20卷 1789-1800页

作者： Carina Hromada Patrick Heimel Markus Kerbl LászlóGál Sylvia Nürnberger Barbara Schaedl James Ferguson Nicole Swiadek Xavier Monforte Johannes C.Heinzel Antal Nógrádi Andreas H.Teuschl-Woller David Hercher Department Life Science Engineering University of Applied Sciences Technikum WienViennaAustria Austrian Cluster for Tissue Regeneration ViennaAustria Ludwig Boltzmann Institute for traumatology The Research Center in Cooperation with AUVAViennaAustria University Clinic of Dentistry Medical University of ViennaViennaAustria Department of Plastic Reconstructive and Aesthetic SurgeryLandesklinikum Wiener Neustadt2700 Wiener NeustadtAustria Department of Anatomy Histology and EmbryologyAlbert Szent-Györgyi Medical SchoolUniversity of SzegedSzegedHungary Medical University of Vienna Department of Orthopedics and Trauma SurgeryDevision of Trauma SurgeryViennaAustria Department of Hand- PlasticReconstructive and Burn SurgeryBG Unfallklinik TuebingenUniversity of TuebingenTuebingenGermany

Peripheral nerve injuries induce a severe motor and sensory deficit. Since the availability of autologous nerve transplants for nerve repair is very limited, alternative treatment strategies are sought, including the use of tubular nerve guidance conduits(tNGCs). However, the use of tNGCs results in poor functional recovery and central necrosis of the regenerating tissue, which limits their application to short nerve lesion defects(typically shorter than 3 cm). Given the importance of vascularization in nerve regeneration, we hypothesized that enabling the growth of blood vessels from the surrounding tissue into the regenerating nerve within the tNGC would help eliminate necrotic processes and lead to improved regeneration. In this study, we reported the application of macroscopic holes into the tubular walls of silk-based tNGCs and compared the various features of these improved silk^(+) tNGCs with the tubes without holes(silk^(–) tNGCs) and autologous nerve transplants in an 8-mm sciatic nerve defect in rats. Using a combination of micro-computed tomography and histological analyses, we were able to prove that the use of silk^(+) tNGCs induced the growth of blood vessels from the adjacent tissue to the intraluminal neovascular formation. A significantly higher number of blood vessels in the silk^(+) group was found compared with autologous nerve transplants and silk^(–), accompanied by improved axon regeneration at the distal coaptation point compared with the silk^(–) tNGCs at 7 weeks postoperatively. In the 15-mm(critical size) sciatic nerve defect model, we again observed a distinct ingrowth of blood vessels through the tubular walls of silk^(+) tNGCs, but without improved functional recovery at 12 weeks postoperatively. Our data proves that macroporous tNGCs increase the vascular supply of regenerating nerves and facilitate improved axonal regeneration in a short-defect model but not in a critical-size defect model. This study suggests that further optimizatio

关键词： axon regeneration blood vessel functional recovery macroporous nerve lesion peripheral nerve repair sciatic nerve silk-based nerve guidance conduit vascularization

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