Dissertations / Theses on the topic 'Orthopedics'
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1
Blackwelder, Reid B. "Anemia, Office Orthopedics, Pediatric Orthopedics, Menopause and DUB, Pain Management, and others." Digital Commons @ East Tennessee State University, 2011. https://dc.etsu.edu/etsu-works/6967.
2
Moorcroft, Preston Fenner. "The orthopaedic management of spina bifida cystica : the Cape Town experience." Master's thesis, University of Cape Town, 1985. http://hdl.handle.net/11427/26273.
3
Шищук, Дмитро Володимирович, Дмитрий Владимирович Шищук, Dmytro Volodymyrovych Shyshсhuk, and О. Л. Яковенко. "Особливості діагностики компресійних синдромів при унковертебральному артрозі." Thesis, Видавництво СумДУ, 2008. http://essuir.sumdu.edu.ua/handle/123456789/6868.
4
Babaie, Elham. "Synthesis of Amorphous Alkaline Earth phosphate and its Applications in Orthopedics." University of Toledo / OhioLINK, 2016. http://rave.ohiolink.edu/etdc/view?acc_num=toledo1480934404657247.
5
BRIGUGLIO, MATTEO. "INTEGRATION OF NUTRITIONAL SUPPORT IN ORTHOPEDICS: DIETARY AND NUTRITIONAL ASPECTS OF SURGICAL PATIENTS." Doctoral thesis, Università degli Studi di Milano, 2022. https://hdl.handle.net/2434/945376.
Abstract:
The nutritional support in orthopedic surgery is an unclear idea to date. In these years, the goal of this project has been to clarify what is meant by nutritional support in patients undergoing hip or knee replacement and spine surgery, demonstrating its value in relation to the perioperative path. This aim was pursued by applying a methodology of first studying the literature, then analyzing the setting, evidencing shortcomings, proposing management protocols, and verifying the effectiveness of nutritional strategies. The literature search highlighted the multiple phases that should be coordinated, including prehabilitation, perioperative, and postdischarge management. When applying optimization strategies, such as anemia correction, it may be necessary to examine the eating behavior and anticipate the metabolic responses according to the patient’s state of health. The predictive potential of hemoglobin on the clinical outcome in spine surgery has been investigated through retrospective analysis of existing data, suggesting the need to refine decision-making algorithms that identify the patients to be treated, underlining the importance of having high hemoglobin values in the preoperative period to have more chances of clinical success. Prospective observational studies confirmed that patients either after spine surgery or arthroplasty do not meet their needs for what concerns energy and proteins. It seems to be vital to redefine the tactics to promote early oral nutrition, counteract the depletion of body reserves, and acknowledge the impairment of the olfactory stimulus caused by anesthetic drugs. More transparent information on diet and nutrition should be conveyed to patients. The nutritional support program might include a healthy eating education that teaches the concepts of nutritional value, quantity, quality, and timing. Clear information on what to eat or not to eat before surgery must be accompanied by dietary advice also for postoperative recovery. New management proposals can integrate aspects of healthy eating education into a multimodal approach that includes advice on increasing physical activity and promoting night sleep. A risk management system inspired by the hazard analysis and critical control points system can be effectively applied before orthopedic surgery to manage malnutrition. The interventional trials proved that nutrient deficiencies, including those of vitamin D and iron, are common in the surgical population. Dietary supplements should be carefully selected for what concerns the pharmaceutical formula, as well as for the content of important cofactors that may be necessary to boost the metabolic response. Early cardiovascular effects can derive from correcting hypovitaminosis D with a liquid form of vitamin D, and promising data on enhancing preoperative hemoglobin values can derive from using a supplement containing iron and B vitamins. The future of perioperative medicine in orthopedic surgery should choose a pragmatic integration of dietary and nutritional aspects in orthopedics, thus possibly improving health performance and patient experience.
6
Choi, Yi-king. "Computer visualization techniques in surgical planning for pedicle screw insertion /." Hong Kong : University of Hong Kong, 2001. http://sunzi.lib.hku.hk:8888/cgi-bin/hkuto%5Ftoc%5Fpdf?B22956475.
7
Chan, Yee-loi. "Surface modification of NiTi for long term orthopedic applications." Click to view the E-thesis via HKUTO, 2007. http://sunzi.lib.hku.hk/HKUTO/record/B39557406.
8
Spear, Rose Louis. "Peptide functionalisation of carbon nanomaterials for biomedical applications." Thesis, University of Cambridge, 2011. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.609475.
9
Корж, Ю. М. "Розвиток сили основних м`язових груп у дітей старшого дошкільного віку з порушенням ора." Thesis, Видавництво СумДУ, 2009. http://essuir.sumdu.edu.ua/handle/123456789/11302.
10
Хоппестад, Н., В. А. Пятигор, Володимир Дмитрович Шищук, Владимир Дмитриевич Шищук, and Volodymyr Dmytrovych Shyshchuk. "Опыт применения клексана в травматологии и ортопедии с целью профилактики тромбоэмболических осложнений в раннем послеоперационном периоде." Thesis, Издательство СумДУ, 2009. http://essuir.sumdu.edu.ua/handle/123456789/6069.
11
Шищук, Володимир Дмитрович, Владимир Дмитриевич Шищук, and Volodymyr Dmytrovych Shyshchuk. "Достижения ортопедии и травматологии в ХХ веке." Thesis, Издательство СумГУ, 2011. http://essuir.sumdu.edu.ua/handle/123456789/22225.
12
Шищук, Володимир Дмитрович, Владимир Дмитриевич Шищук, and Volodymyr Dmytrovych Shyshchuk. "Сучасні етапи викладання дисципліни "ортопедія та травматологія"." Thesis, Видавництво СуДУ, 2010. http://essuir.sumdu.edu.ua/handle/123456789/4923.
13
Chang, Ta-Cheng. "Simulation Assisted Robotic Orthopedic Surgery in Femoroacetabular Impingement." Scholarly Repository, 2011. http://scholarlyrepository.miami.edu/oa_dissertations/618.
Abstract:
Femoroacetabular impingement (FAI) has been increasingly recognized as a cause of early hip osteoarthritis. FAI is characterized by pathologic contact between the femur and acetabular rim during hip join movement, caused by morphological abnormalities. Arthroscopic technique has become increasingly popular for FAI surgical treatment because of its minimal invasiveness. However, it involves cumbersome procedures and over- or under-resection are likely to occur. To tackle this issue, robot-assisted FAI arthroscopy is a well suited approach because it results in high accuracy and reproducible surgical outcomes. This dissertation provides new approaches and methods for the current challenges in the development of robot-assisted FAI arthroscopy. The study has three objectives: 1) to develop a robust calibration method for the A-mode ultrasound probe used for noninvasive bone registration, 2) to develop a bone registration simulator for verifying the registration accuracy and consistency for any given registration point-pattern, and 3) to develop a hip range of motion simulation system that returns the virtual range of motion and determines the bone resection volume. Carefully designed calibration procedures and simulation experiments have been conducted during the study of this research. From the experimental results, the developed ultrasound calibration method successfully reduces the registration errors and is proved to be robust. The results from the registration simulator indicate that the pattern with widely distributed points lead to better registration accuracy and consistency. The hip range of motion simulation system results in acceptable accuracy and successfully generates the resection volume. With further modifications, the ultrasound probe can be successfully calibrated with the developed method, and will be applied for noninvasive bone registration. The registration simulator can also be served as a useful tool for determining the optimized registration point-pattern, which can lead to reduced surgical trauma and registration time. Finally, the developed range of motion simulation system can allow the surgeon to evaluate the surgical outcome and to determine the resection volume even before the surgery begins. To conclude, this dissertation provides useful approaches, methods, and software for developing robot-assisted FAI arthroscopy.
14
Chan, Yee-loi, and 陳以來. "Surface modification of NiTi for long term orthopedic applications." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2007. http://hub.hku.hk/bib/B39557406.
15
Whiteley, Joanna. "Lives and limbs : re-membering Robert Jones : a biography." Thesis, University of St Andrews, 2010. http://hdl.handle.net/10023/1986.
Abstract:
This is a biography of Robert Jones, 1857-1933. He was a surgeon, and is credited with bringing orthopaedics from its quack past into its scientific present. This work explores Jones’ life and times, and examines whether he is entitled to the epithet ‘father of orthopaedics’. It looks at the history of bonesetting, the influences on Jones’ development and medical training, and some key moments in his career – notably his involvement in the building of the Manchester Ship Canal, the planning of Heswall Children’s Hospital, and the Great War. It argues that although there are other medical men who could have been credited with fathering orthopaedics, he is indeed the father – at least of orthopaedics in Britain, if not internationally. This version of Jones’ life begins with something of his biographer’s journey, before it explores what and who influenced Jones, and in turn what his legacy has been to the medical profession. The accompanying Critical Commentary explores whether or not it is possible to offer a definition of biography as a genre in the light of its history and purpose. It examines critical views, considers the mythology that grows up around historical figures, and also explains the rationale for the structure chosen for organising the material presented in this new biography of Robert Jones, Live and Limbs: Re-membering Robert Jones.
16
Dick, Christian [Verfasser], Rüdiger [Akademischer Betreuer] Westermann, and Markus [Akademischer Betreuer] Gross. "Computational Steering for Implant Planning in Orthopedics / Christian Dick. Gutachter: Markus Gross. Betreuer: Rüdiger Westermann." München : Universitätsbibliothek der TU München, 2012. http://d-nb.info/1020273615/34.
17
Mcfaddin, Marie O. "Adaptive customization new design opportunities in orthopedics, driven by the merging of imaging and surgery /." Connect to this title online, 2007. http://etd.lib.clemson.edu/documents/1181669299/.
18
Downes, S. "Polymethylmethacrylate as a drug carrier in orthopedics : Particular attention to gentamicin and human growth hormone." Thesis, Teesside University, 1988. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.380777.
19
Dias, Luis Gustavo Gosuen Gonçalves [UNESP]. "Desenvolvimento e aplicação clínica de haste intramedular bloqueada angulada no tratamento de fraturas tibiais em cães." Universidade Estadual Paulista (UNESP), 2009. http://hdl.handle.net/11449/101146.
Abstract:
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As fraturas de tíbia em cães representam 20% das que ocorrem em ossos longos. Vários métodos são utilizados nas osteossínteses desse osso, contudo, atualmente as hastes bloqueadas vêm ganhando espaço, especialmente por suas vantagens biomecânicas quando comparadas às demais técnicas. O presente trabalho teve por objetivo desenvolver e avaliar o uso de haste intramedular bloqueada angulada para fraturas tibiais em cães, visando minimizar erros de bloqueio de parafusos e consequentemente problemas na consolidação óssea. Hastes anguladas, de aço inoxidável da série 316L, foram confeccionadas nos diâmetros de 5, 6, 7 e 8 mm, com comprimentos variados. Num período de 17 meses, ocorreu a implantação destas em 15 cães com fratura de tíbia. As avaliações clínica e radiográfica ocorreram no pré e pós-operatório imediato e a cada 30 dias até completar quatro meses. Clinicamente, a recuperação da função do membro se deu no período médio de 10 dias após a cirurgia. Em três animais, utilizou-se além da haste angulada e parafusos, pinos de Schanz como bloqueio (fixador externo), que posteriormente foram retirados. Radiograficamente verificou-se consolidação óssea em média de 70 dias de pós-operatório. A haste intramedular bloqueada angulada mostrou-se eficaz como método de osteossíntese em fraturas tibiais de cães.
In dogs, tibial fractures account for approximately 20% of all long bone fractures. Different methods of fracture repair are used in this bone; however, interlocking nails have gained popularity in recent years owing to its biomechanical advantages when compared to other techniques. The present study aimed to develop and to evaluate the usefulness of an angulated interlocking nail model in tibial fractures of dogs to minimize blocking errors arising from inaccurate bolt stabilization, responsible for generation osseous consolidation. Angulated stainless steel pins from series 316L were manufactured with 5, 6, 7 and 8 mm of diameter, and variable length. During 17 months, pins were implanted in 15 dogs with tibial fracture. Clinical and radiographic findings were recorded on preoperative and on the immediate postoperative period, and every 30 days, until the last recheck, 4 months latter. Clinically, animals recovered the hind function on an average of 10 days after surgery. In three dogs, in addition to the angulated interlocking nail and bolts, scat pins (external fixator) were used. Radiographically, bone consolidation was evident on an average of 70 days of postoperative period. The angulated interlocking nail is a feasible method to repair tibial fractures of dogs.
20
Lai, Wang-to Derek. "Prediction of pathological fracture risk due to metastatic bone defect using finite element method." Click to view the E-thesis via HKUTO, 2006. http://sunzi.lib.hku.hk/hkuto/record/B37060831.
21
Choi, Yi-king, and 蔡綺瓊. "Computer visualization techniques in surgical planning for pedicle screw insertion." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2001. http://hub.hku.hk/bib/B31224234.
22
McCree, Peter. "Impairment, disability and handicap in patients on orthopaedic waiting lists." Thesis, University of Oxford, 1993. http://ora.ox.ac.uk/objects/uuid:5fe90c7b-7e12-4bba-b1b8-92f8a1b94aa5.
23
Waterbrook, Anna, Gail Pritchard, Allison Lane, Lisa Stoneking, Bryna Koch, Robert McAtee, Alice Min, et al. "Development of a novel sports medicine rotation for emergency medicine residents." DOVE MEDICAL PRESS LTD, 2016. http://hdl.handle.net/10150/615113.
Abstract:
Musculoskeletal complaints are the most common reason for patients to visit a physician, yet competency in musculoskeletal medicine is invariably reported as a deficiency in medical education in the USA. Sports medicine clinical rotations improve both medical students' and residents' musculoskeletal knowledge. Despite the importance of this knowledge, a standardized sports medicine curriculum in emergency medicine (EM) does not exist. Hence, we developed a novel sports medicine rotation for EM residents to improve their musculoskeletal educational experience and to improve their knowledge in musculoskeletal medicine by teaching the evaluation and management of many common musculoskeletal disorders and injuries that are encountered in the emergency department. The University of Arizona has two distinct EM residency programs, South Campus (SC) and University Campus (UC). The UC curriculum includes a traditional 4-week orthopedic rotation, which consistently rated poorly on evaluations by residents. Therefore, with the initiation of a new EM residency at SC, we replaced the standard orthopedic rotation with a novel sports medicine rotation for EM interns. This rotation includes attendance at sports medicine clinics with primary care and orthopedic sports medicine physicians, involvement in sport event coverage, assigned reading materials, didactic experiences, and an on-call schedule to assist with reductions in the emergency department. We analyzed postrotation surveys completed by residents, postrotation evaluations of the residents completed by primary care sports medicine faculty and orthopedic chief residents, as well as the total number of dislocation reductions performed by each graduating resident at both programs over the last 5 years. While all residents in both programs exceeded the ten dislocation reductions required for graduation, residents on the sports medicine rotation had a statistically significant higher rate of satisfaction of their educational experience when compared to the traditional orthopedics rotation. All SC residents successfully completed their sports medicine rotation, had completed postrotation evaluations by attending physicians, and had no duty hour violations while on sports medicine. In our experience, a sports medicine rotation is an effective alternative to the traditional orthopedics rotation for EM residents.
24
Sembenelli, Guilherme [UNESP]. "Análise biomecanica de placa modificada de tplo em modelo experimental de falha óssea proximal em tíbias sintéticas caninas." Universidade Estadual Paulista (UNESP), 2017. http://hdl.handle.net/11449/151345.
Abstract:
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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
O objetivo do presente estudo foi desenvolver placa de TPLO bloqueada modificada e avaliar a eficácia da estabilização óssea proporcionada pelo implante desenvolvido comparativamente a outros dois métodos convencionais de fixação óssea (placa bloqueada e placa bloqueada associada a pino intramedular). Por meio de estudos biomecânicos, avaliaram-se as construções às forças de torção, flexão craniocaudal, flexão mediolateral e compressão axial. Foram utilizadas sessenta tíbias sintéticas dividas em três grupos. O Grupo 1 (placa TPLO modificada), o Grupo 2 (placa bloqueada) e o Grupo 3 (placa bloqueada associada a pino intramedular) foram qsubdivididos em quatro grupos de cinco tíbias. Os ensaios foram realizados até a falha da montagem (implantes e/ou tíbia) e os resultados obtidos comparados entre os grupos. As variáveis estudadas foram analisadas sob delineamento inteiramente casualizado no esquema fatorial 3 por 4 com 5 repetições para cada combinação do esquema fatorial. Os resultados foram submetidos à análise de variância e as médias comparadas entre si pelo teste de Tukey a 5% de probabilidade. No ensaio de compressão axial houve diferença significativa em relação a variável força máxima em que o Grupo 3 obteve maior média, não havendo diferença significativa entre os Grupos 1 e 2. Todas as montagens falharam devido à flexão da placa na região de falha no corpo de prova. No ensaio de flexão em três pontos craniocaudal houve diferença significativa em relação às três variáveis estudas. Na variável força máxima G2>G3=G1, na variável deflexão G3>G1=G2 e na variável rigidez G3=G2, G2=G1 G3>G1. Todas as montagens falharam devido à quebra do corpo de prova. No ensaio de flexão mediolateral houve diferença significativa em relação a variável rigidez em que G3>G2=G1. Todas as montagens falharam devido à flexão da placa na região de falha no corpo de prova. No ensaio de torção houve diferença significativa em relação às variáveis ângulo no pico de torque e rigidez. Na variável ângulo no pico de torque G2>G1=G3. Na variável rigidez G1=G3>G2. Todas as montagens falharam devido à quebra do corpo de prova distal a placa. Conclui-se a placa de TPLO modificada apresentou semelhança biomecânica com a placa reta convencional na maioria das variáveis estudadas. O grupo, da associação placa e pino, obtive maiores índices de rigidez comparativamente aos outros dois grupos, exceto no teste de torção em que o grupo da placa de TPLO modificada apresentou o mesmo índice de rigidez que o da associação placa e pino.
The aim of this study was to develop modified TPLO locked plate and to evaluate the effectiveness of stabilization provided by the implant developed compared to two other conventional methods of stabilization (locked plate and plate-rod). Through biomechanical studies the constructions were evaluated to craniocaudal and mediolateral bending, axial compression and torsional forces. Sixty synthetic tibias were used divided into three groups. Group 1 (modified TPLO plate), Group 2 (locked plate) and Group 3 (plate-rod) were subdivided into four groups of five tibiae. The tests were perfomed until failure of the construction (implants / tibia) and the results compared between the groups. The variables studied were analyzed under a completely randomized design in the factorial scheme 3 by 4 with 5 replicates for each combination of the factorial scheme. The results were submitted to analysis of variance and the means compared to each other by the Tukey test at 5% probability. In the axial compression test there was a significant difference in relation to the variable maximum force in which Group 3 obtained higher mean, not having significant difference between Groups 1 and 2. All constructions failed due to plate bending in the gap region of the synthetic tibia. In the three-point craniocaudal flexion test there was a significant difference in relation to the three variables studied. In the variable force maximum G2> G3 = G1, in the variable deflection G3> G1 = G2 and in the variable stiffness G3 = G2, G2 = G1 G3> G1. All constructions failed because of the breaking of the synthetic tibia. In the three-point craniocaudal flexion test there was a significant difference in relation to the three variables studied. In the variable force maximum G2> G3 = G1, in the variable deflection G3> G1 = G2 and in the variable stiffness G3 = G2, G2 = G1 G3> G1. All constructions failed because of the breaking of the synthetic tibia. In the mediolateral flexion test there was a significant difference in relation to the stiffness variable in which G3> G2 = G1. All constructions failed due to plate bending in the gap region of the synthetic tibia. In the torsion test there was a significant difference in relation to the variables angle at peak torque and stiffness. In the variable angle at the torque peak G2> G1 = G3. In the stiffness variable G1 = G3> G2. All constructs failed due to the breaking of the synthetic tibia distally to the plate. It is concluded that the modified TPLO plate presented biomechanical similarity with the conventional plate in most of the studied variables. The groups of locking plate an plate-rod constructions obtained higher stiffness indices compared to the other two groups, except for the torsion test in which the modified TPLO plate group had the same stiffness index as the plate and plate-rod.
FAPESP: 2015/14602-8
25
Calciolari, Karina. "Proteinograma sérico e sua relação com a reparação óssea em coelhos (Oryctolagus cuniculus) submetidos à ostectomia parcial do rádio /." Jaboticabal, 2019. http://hdl.handle.net/11449/191247.
Abstract:
Orientador: Bruno Watanabe MintoResumo: Os traumas ósseos desencadeiam resposta inflamatória aguda e consequentemente alteram a concentração sérica das proteínas de fase aguda (PFAs), podendo essas serem um parâmetro para avaliação da evolução do processo inflamatório relacionado a ortopedia. Objetivou-se avaliar a efetividade da mensuração de PFAs como um biomarcador laboratorial para diagnóstico e acompanhamento da inflamação relacionada a regeneração óssea. Foram utilizados 22 coelhos, machos jovens sendo realizado ostectomia parcial do osso do rádio direito. Para acompanhamento da evolução do processo inflamatório foram realizados hemograma, mensuração de PFAs (Albumina, Ceruloplasmina, Haptoglobina, Proteína C Reativa e Transferrina) e acompanhamento radiológico. Foi observado a melhor correlação da haptoglobina e da transferrina junto ao processo inflamatório e achados radiológicos frente as demais PFAs mensuradas. A haptoglobina apresentou pico máximo 24 horas dos pós operatório e a transferrina após 36 horas, entretanto essa última PFA já mostrou indícios de alteração (diminuiu) já nas primeiras 6 horas do pós-cirúrgico, antecipadamente a resposta leucocitária. Conclui-se que o conjunto haptoglobina, transferrina e leucograma apresentaram resultados promissores ao diagnóstico e prognóstico de processos inflamatórios relacionados a ortopedia.
Doutor
26
Sawaia, Rogerio Naim 1970. "Estudo das complicações no tratamento das fraturas transtrocanterianas do fêmur utilizando pino deslizante extramedular com técnica minimamente invasiva, Sistema Minus." [s.n.], 2011. http://repositorio.unicamp.br/jspui/handle/REPOSIP/309913.
Abstract:
Orientador: William Dias BelangeroTese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas
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Resumo: INTRODUÇÃO: O tratamento cirúrgico das fraturas intertrocanterianas do fêmur ainda é motivo de estudo e controvérsias. As vantagens da utilização de técnicas minimamente invasivas para essas fraturas já despontam na literatura. O objetivo deste estudo foi avaliar as complicações da técnica minimamente invasiva que utiliza um implante e um instrumental desenvolvidos especificamente (Sistema Minus) para o tratamento dessas fraturas. CASUÍSTICA E MÉTODO: Foram estudados 172 pacientes com fratura intertrocanteriana do fêmur, tratados com o Sistema Minus, dos quais 52 pacientes foram excluídos do estudo por não terem preenchido os critérios de inclusão. No protocolo inicial foram registrados o gênero, a idade, detalhes operatórios como tempo cirúrgico, tempo de uso da fluoroscopia, qualidade da redução e da fixação da fratura. Como parâmetros clínicos foram incluídos a capacidade de marcha, dor, classificação da fratura segundo os critérios de Tronzo e o risco anestésico segundo a classificação de ASA. Dividimos as complicações em dois grupos. As complicações gerais, subdivididas em infecção e mortalidade e as complicações específicas, subdivididas em migração do implante, a perda da redução e a falta de união. Embora a migração do pino deslizante não seja considerada na literatura como uma complicação do DHS (Hrubna e Skotak, 2010)1, no presente estudo ela foi incluída. Cabendo salientar que foi considerada como migração, a impacção lateral da fratura sem a ocorrência de perda de redução. RESULTADOS: O gênero feminino ocorreu em 93 casos e obteve percentual de 77,5%, foi prevalente em relação ao masculino com 27 casos e 22,5%. A idade variou de 52 a 95 anos, com a média de 80,06 anos e desvio padrão de 7,87 anos. A média de idade do gênero masculino foi de 76,19 anos e desvio padrão de 8,321. O gênero feminino obteve a média de 81,18 anos com desvio padrão de 7,407. O tempo cirúrgico médio foi de 39,35 minutos, variando de 25 a 65 minutos. O tempo médio de radioscopia foi 1min7s, variando de 0,6 a 2 minutos e 3s. A redução foi considerada adequada em 92 casos (76,6%), quando obteve-se o alinhamento do eixo de carga, como valgo em 20 casos (16,6%) e como varo em oito casos (6,6%). O somatório médio do TAD (Tip Apex Distance) na incidência Ântero-posterior (AP) foi de 1,19cm, variando de 0,2 a 2,8cm; e no Perfil (P), de 1,14cm, variando de 0,3 a 2,52cm. Dos pacientes, 112 (93,3%) voltaram a andar e a dor pós-operatória em uma escala de 0 a 10, teve a média de 4,44. Dos 120 pacientes, 11 foram classificados como Tronzo I (9,1%), 24 como Tronzo II (20%), 58 como Tronzo III (48,3%), sete Tronzo III variante (5,8%) e 20 Tronzo IV (16,7%). As fraturas instáveis ocorreram em 85 (70,8%) pacientes, os quais 74 (61,6%) tinham idade superior a 75 anos. Já as fraturas estáveis em 35 (29,1%) pacientes, os quais 17 (14,1%) possuíam idade superior a 75 anos. Em relação ao risco anestésico, oito (6,6%) foram classificados como ASA I, 33 (27,5%) ASA II, 74 (61,6%) ASA III e cinco ASA IV (4,16%). Houve um caso de infecção (0,83%). Ocorreram 13 óbitos (10,8%) dentro do primeiro ano de pós-operatório. Desses, um (0,83%) foi classificado como Asa II, cinco (4,16%) como Asa III e sete (5,83%) Asa IV. Dos 85 pacientes com fraturas instáveis, 36 (30%) apresentaram complicações, como perda de redução em 7(5,88%) e migração do pino deslizante em 29 (24,1%). No grupo das 35 fraturas estáveis, as complicações ocorreram em 4 casos (3,33 %), sendo que a perda de redução ocorreu em um caso (0,83%) e a migração em 3 casos (2,5%). No total, a migração ocorreu em 33 casos (27,6%), sendo que desses, todos evoluíram para consolidação. A perda de redução ocorreu em oito (6,7%) e a falta de união, em um caso (0,83%). CONCLUSÃO: Concluímos que a técnica minimamente invasiva, Sistema Minus, é uma técnica segura, que permite a realização da cirurgia com baixa incidência de complicações, quando comparada aos demais métodos existentes
Abstract: INTRODUCTION: The surgical treatment of intertrochanteric fractures is still controversial, resulting in further studies. Many papers have appeared in reference to the advantages of minimal invasive procedures for these fractures. The aim of this study was to evaluate the complications of a minimal invasive procedure using a specific implant and instruments developed for the treatment of intertrochanteric fractures (Minus System). MATERIAL AND METHOD: One hundred and seventy two patients with intertrochanteric fractures of the femur were studied, and submitted to treatment with the Minus System. Fifty two patients were excluded from the study as they did not fulfil all criteria for inclusion. The initial protocol registered gender, age, operative details such as length of operation, length of fluoroscopy use, quality of reduction and fixation of the fracture. The clinical parameters considered included deambulatory ability, pain, Tronzo fracture classification and anesthesia risk according to ASA classification. Complications were divided into two groups: general complications (infection and mortality rate) and specific complications (implant migration, loss of reduction and non-union). Although the migration of a sliding nail has not been considered in the literature as a DHS complication (Hrubna e Skotak, 2010)1 RESULTS: There were 93 feminine cases (77.5%) prevailing on 27 masculine cases (22.5%). Age span was 52 to 95 years, with an average of 80.06 years (standard deviation of 7.87 years). The average age for men was 76.19 years with a standard deviation of 8.321. The average age for women was 81.18 years with a standard deviation of 7.407. The average operative length of time was 39.35 minutes (25 to 65 minutes). The average time of fluoroscopy was 1min 7sec (0.6 to 2min 3sec). Fracture reduction was considered adequate in 92 cases (76.6%), , in the present study it was taken into account. It is important to mention that migration here is the lateral impaction of the fracture without loss of reduction. when alignment with weight-bearing axis was obtained, valgus in 20 cases (16.6%) and varus in eight cases (6.6%). The average Tip Apex Distance (TAD) on an anteroposterior view was 1.19cm (variation of 0.2 to 2.52 cm) and lateral view was 1.14cm (variaton of 0.3 to 2.52cm). One hundred and twelve patients (93,3%) were able to walk with postoperative pain (average of 4.4 on a pain scale of 0 to 10). The classification of the 120 patients is as follows: 11 patients with Tronzo I (9,1%), 24 cases of Tronzo II (20%), 58 Tronzo III (48.3%), seven Tronzo III variant (5.8%) and 20 Tronzo IV (16.7%). Unstable fractures occured in 85 (70.8%) patients, and 74 (61.6%) were over 75 years of age. There were 35 stable fractures (29.1%), with 17 patients (14.1%) over 75 years of age. As to the anesthesia risk eight (6.6%) were classified as ASA I, 33 (27.5%) ASA II, 74 (61.6%) ASA III and five patients as ASA IV (4.16%). There was one case of infection (0.83%). During the first postoperative year there were 13 deaths (10.8%). Of these, one patient (0.83%) had been classified as ASA II, five (4.16%) as ASA III and seven (5.83%) as ASA IV. There were 36 patients (30%) with complications out of 85 patients with unstable fractures, with loss of reduction in seven (5.88%) and migration of the sliding nail in 29 (24.1%). In the group of 35 stable fractures there were complications in four cases (3.3 %), with loss of reduction in one case (0.83%) and migration in three (2.5%). The total number of migrations was 33 (27.5%), but resulted in union in all patients. The loss in reduction occurred in eight patients (6.7%) and non-union in one case (0.83%). CONCLUSION: The minimal invasive procedure, the Minus System, is a safe procedure, that provides adequate surgery with a low incidence of complications, when compared to other existing techniques
Doutorado
Fisiopatologia Cirúrgica
Doutor em Ciências
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Chow, Lop-keung Raymond. "Clinical morbidity of resorbable plates and screws for internal fixation in orthognathic surgery." Click to view the E-thesis via HKUTO, 2003. http://sunzi.lib.hku.hk/hkuto/record/B31954285.
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İlhan, Mücahit Aydoğan Nevres Hürriyet. "Gonartrozlu hastalarda viskosuplementasyon sonrası MDA, DOS, GSH-Px ve katalaz düzeyleri /." Isparta : SDÜ Tıp Fakültesi, 2006. http://tez.sdu.edu.tr/Tezler/TT00254.pdf.
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Plint, Amy, Isabelle Gaboury, Janice Owen, and Nancy Young. "Activities Scale for Kids: An Analysis of Normals." Lippincott Williams & Wilkins, 2003. https://zone.biblio.laurentian.ca/dspace/handle/10219/102.
Abstract:
Several outcome tools have been developed to measure physical functioning in pediatric orthopedic patients. One such tool, the Activities Scale for Kids (ASK), allows assessment of physical functioning in the community in 5-to 15-year-olds. Previous validation of the ASK showed a significant difference in scores according to global ratings of disability. In this study, the ASK was administered to children without musculoskeletal disability to determine how normal respondents scored. ASK questionnaires were distributed to 137 children and 122 (89%) were returned. Normal children scored quite high, with a mean summary score of 93.12 (SD 6.45). This score differs significantly from the mean summary score for children with mild disabilities as determined in previous studies of disability (P = 0.005).Study conducted at the Children’s Hospital of Eastern Ontario, Universityof Ottawa, Ottawa, Ontario, Canada.
Dr. Plint is supported in part by a Junior Clinical Investigator Award from the Children’s Hospital of Eastern Ontario Research Institute.
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Botha, Adriaan Hendrik, Toit Jacques Du, and Robert P. Lamberts. "The outcome of relapsed and residual clubfeet treated with the Taylor Spatial Frame." Thesis, Stellenbosch : Stellenbosch University, 2014. http://hdl.handle.net/10019.1/97178.
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Paretsis, Nicole Fidalgo. "Avaliação histológica e histomorfométrica da regeneração óssea a partir da utilização de mantas ósseas à base quitosana, hidroxiapatita e colágeno como substituto ósseo em falhas ósseas induzidas em tíbias de ovinos." Universidade de São Paulo, 2016. http://www.teses.usp.br/teses/disponiveis/10/10137/tde-26092016-151116/.
Abstract:
Falhas ósseas são comumente encontradas na medicina veterinária em diferentes enfermidades, principalmente por traumas em grandes animais. Frequentemente faz-se necessário auxiliar este reparo tecidual para melhor correção desta falha. Os biomateriais foram desenvolvidos para cumprir esta função. A fim de avaliar o comportamento celular perante estes substitutos ósseos, a realização de testes in vivo é fundamental. A partir da observação da unidade morfofuncional do tecido é possível avaliar a quantidade e a qualidade do tecido neoformado. Atualmente, em estudos ortopédicos, os ovinos são considerados animais de escolha como modelo experimental. Falhas ósseas foram realizadas experimentalmente em ovinos, onde foram implantados biomateriais à base de quitosana, hidroxiapatita e colágeno. Após 60 dias foi realizada biopsia no local do reparo tecidual e por meio da histomorfometria, da análise descritiva da microscopia de luz e da microscopia eletrônica de transmissão, o tecido neoformado foi avaliado e comparado. Na histomorfometria, não houve diferença significativa quanto à quantidade de tecido neorformado do grupo controle e do grupo com biomaterial, porém quando comparado ao osso pré-existente, retirado no momento da confecção da falha, a área de matriz óssea foi menor. Na descrição da microscopia de luz e em maiores detalhes na análise ultra estrutural, observou-se o biomaterial em contato íntimo com o tecido neoformado, sugerindo boa biocompatibilidade. Foi possível observar o padrão da reparação tecidual, onde o membro controle e o membro com biomaterial não diferiram quanto à arquitetura tecidual, porém nas amostras com o implante do biomaterial foi identificada a presença do mesmo. Todas estas informações sugerem que o biomaterial de estudo apresenta potencial para auxiliar na rotina ortopédica de grandes animais.Bone defects are commonly found in veterinary medicine through different disease such as trauma, especially in large animals. Frequently it is necessary to assist this tissue repair for better regeneration. Biomaterials in general are designed to this function. In order to understand the bone cells in the presence of bone substitutes, tests in vivo are essential for these studies. The quantity and quality of new tissue formation can be assessed by observation of tissue morphofunctional unit. Currently, in orthopedic studies sheep are considerated animals of choice for experimental development. Bone defects were performed experimentally in sheep and were implanted chitosan, hydroxyapatite and collagen biomaterials. After 60 days, biopsy was performed at the site of tissue repair and the new tissue formation was described, evaluated and compared by histomorphometry and electronic transmission microscopy. After hystomorfometry analysis there was no difference between control group and biomaterial group, but when compare with pre-existent tissue, the values are smaller. In descriptive analysis was observed intimate contact with biomaterial and new tissue formation suggesting biocompatibility. It observed the pattern of tissue repair in control group and biomaterial group did not differ in the architecture tissue. However, in the biomaterial group was identified presence of the biomaterial in the specimen. All these data suggest that the biomaterial study has the potential to assistant in orthopedic routine of large animals.
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Гудименко, Олена Олександрівна, Елена Александровна Гудыменко, and Olena Oleksandrivna Hudymenko. "Порівняння методів виготовлення титанових пластин для металостеосинтезу." Thesis, Сумський державний університет, 2017. http://essuir.sumdu.edu.ua/handle/123456789/61230.
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Roepke, William B., Brian V. Viscomi, Derek A. Lance, Jordan B. Newby, Ryan P. Serbin, Ethan R. Harris, Robert M. Becker, Caroline L. Abercrombie, and Paul W. Gorman. "Are Thiel-embalmed Cadavers Effective Tools in Educating Medical Students to Perform Knee Arthrocentesis?" Digital Commons @ East Tennessee State University, 2020. https://dc.etsu.edu/asrf/2020/presentations/5.
Abstract:
INTRODUCTION: The purposes of this study are to determine whether Thiel-embalmed cadavers are an effective educational tool in teaching medical students to perform knee arthrocentesis, to compare the use of Thiel-embalmed cadavers to formalin-embalmed cadavers in arthrocentesis education, and to determine whether the use of Thiel-embalmed cadavers is potentially generalizable to the instruction of other orthopedic procedures.
METHODS: Sixty-eight third-year medical students participated in the study. The participants first completed a pre-survey to assess their prior experience with arthrocentesis procedures and Thiel-embalmed cadavers. Participants then attended an instructional session where the knee arthrocentesis procedure was demonstrated on a Thiel-embalmed cadaver. Participants then individually performed the simulated knee arthrocentesis procedure twice: once on a Thiel-embalmed cadaver and once on a formalin-embalmed cadaver. Success of each attempt was determined through the visualization of aspirated joint fluid. Following the laboratory session, each participant completed a post-survey to determine whether the session improved their perceived confidence in performing knee arthrocentesis, if they preferred the use of Thiel-embalmed cadavers or formalin-embalmed cadavers as a teaching tool, and if they believed simulated practice using Thiel-embalmed cadavers would be effective for learning other orthopedic procedural skills.
RESULTS: Sixty-eight students participated in the laboratory session and successfully completed both pre- and post-course surveys. 96% of participants reported that they felt confident performing knee arthrocentesis under physician supervision following their participation in the laboratory session (versus 15% of participants in the pre-survey). 96% of participants reported that the Thiel-embalmed cadavers provided a more realistic teaching model than formalin-embalmed cadavers for learning knee arthrocentesis. 100% of participants believed the incorporation of simulated practice using Thiel-embalmed cadavers is an effective method in teaching students to perform knee arthrocentesis. 100% of participants reported that they would participate in future sessions using Thiel-embalmed cadavers to learn and practice other orthopedic procedural techniques.
DISCUSSION: This study used a moderate sample size of third-year medical students to provide data regarding the suitability of using Thiel cadavers in arthrocentesis education. Results indicate that Thiel cadavers are effective tools in teaching medical students to perform knee arthrocentesis, that students preferred the Thiel cadavers to the formalin cadavers, and that the use of Thiel cadavers is a safe, engaging, and high-quality teaching modality for demonstrating proper arthrocentesis procedural technique to medical students. Since this study looked specifically at teaching knee arthrocentesis to medical students, it is uncertain whether the benefits of Thiel cadavers are generalizable to the education of other orthopedic procedures and subject groups such as residents, fellows, and practicing physicians. Further studies should be performed to assess whether Thiel cadavers are beneficial in teaching other orthopaedic procedures and if these benefits extend to other subject groups.
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Crowell, Harrison Philip. "Gait retraining for the reduction of lower extremity loading." Access to citation, abstract and download form provided by ProQuest Information and Learning Company; downloadable PDF file, 142 p, 2009. http://proquest.umi.com/pqdweb?did=1694575271&sid=7&Fmt=2&clientId=8331&RQT=309&VName=PQD.
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Riley, Donna J. "Predictors of fitness test performance in young men /." Diss., Connect to a 24 p. preview or request complete full text in PDF format. Access restricted to UC campuses, 2004. http://wwwlib.umi.com/cr/ucsd/fullcit?p3123671.
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Stoffel, Karl Kilian. "Modern concepts in plate osteosynthesis." University of Western Australia. School of Surgery and Pathology, 2007. http://theses.library.uwa.edu.au/adt-WU2007.0116.
Abstract:
[Truncated abstract] Renewed interest in the fixation of fractures using plates has been stimulated by an improved understanding of the biology of fracture healing and a drive towards minimally invasive surgery. This has led to a change in the way we use plates nowadays and the way in which we build the bone-plate construct, as well as the development of new implants better suited to these techniques. As a result of this, we have now the potential to safely expand the indications for plate fixation especially in the management of fractures in osteopenic bone. This thesis provides scientific evidence allowing for better formulation of the optimum way to use the modern plating systems in the clinical setting. Biological fracture repair with conventional plates, in terms of a less rigid construct to enhance fracture healing, is becoming increasingly popular. By omitting screws the construct becomes more flexible with a risk of fixation failure. It was the aim of the first paper to investigate in an experimental model the construct strength of different conventional plate lengths and number / position of the screws, and if an oblique screw at the plate end could increase the fixation strength. Our data suggest that the plate length is the most important factor in withstanding forces in cantilever bending. Longer plates with an equal number of screws require greater peak loads to failure than short plates with more screws. Furthermore, an oblique screw at the plate end produces an increased strength of fixation in all different test setups. However, the difference is more significant in shorter plates and in constructs with no screw omission adjacent to the fracture site. ... Following cyclic loading, however, locking plates can better retain fracture reduction compared to compression plates. On the other hand, under torsional load the compression plate appears to be biomechanical superior to the locking system. In supracondylar comminuted femur fractures, combining the two principles results in less plastic deformation, and a higher load to failure compared to their single application. The last two papers examine the behaviour of locking plates in osteopenic bone. In cadaveric intra-articular calcaneal fractures, the locking plate showed a significantly lower irreversible deformation during cyclic loading and a significantly higher load to failure. In dorsal and volar fixed angle distal radius constructs in a cadaveric model, all constructs showed adequate stability with minimal deformation on fatigue testing under physiological conditions in good bone quality. In osteoporotic bone, however, dorsal fixed angle constructs are stiffer and stronger than volar constructs. The addition of a styloid plate to a volar plate does not significantly improve stability.
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Demko, Jennifer Lynn. "Axial pull-out strength of 3.5 cortical and 4.0 cancellous bone screws placed in canine proximal tibias using manual and power tapping." Master's thesis, Mississippi State : Mississippi State University, 2008. http://library.msstate.edu/etd/show.asp?etd=etd-03312008-205137.
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Luckner, Christoph [Verfasser], Andreas [Akademischer Betreuer] Maier, and Andreas [Gutachter] Maier. "Tomosynthesis in Orthopedics: Ultra-Small-Angle Tomosynthesis and Applications Beyond / Christoph Luckner ; Gutachter: Andreas Maier ; Betreuer: Andreas Maier." Erlangen : Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 2020. http://d-nb.info/1220506060/34.
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Cholfe, Bruno Fornitano [UNESP]. "Estudo retrospectivo das alterações radiográficas em touros atletas com afecções ortopédicas." Universidade Estadual Paulista (UNESP), 2012. http://hdl.handle.net/11449/88978.
Abstract:
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cholfe_bf_me_botfmvz.pdf: 1229666 bytes, checksum: e834e1b96f0ab5a618064ca9adede975 (MD5)Universidade Estadual Paulista (UNESP)
No Brasil é crescente o número de bovinos utilizados na prática de esportes. Assim como o cavalo atleta, o bovino atleta fica sujeito a lesões ortopédicas, que a semelhança do equino, podem ser relacionadas com a modalidade esportiva. Apesar destas lesões serem amplas e exaustivamente estudadas nos equinos os estudos referentes à etiopatogenia, diagnóstico e tratamento na espécie bovina, necessitam ser incrementados. Os objetivos deste estudo foram: realizar um estudo retrospectivo dos achados radiográficos de touros atletas, acometidos de claudicação; estabelecer quais as lesões que acometem os touros atletas, correlacionado as afecções com o peso, idade, membro acometido e região do membro. Foram avaliadas 151 imagens radiográficas de 136 touros atendidos no Hospital Veterinário Dr. Halim Atique - UNIRP variando sua idade entre 4 a 13 anos, com peso médio de 800 kg e comprovada atividade física prévia, mediante participações em rodeios. Observou-se que 71,6% dos touros estudados e acometidos de claudicação, possuíam lesão radiográfica, com predomínio nos animais experientes. As enteseopatias nos touros iniciantes e experientes, artrite séptica nos iniciantes, fraturas e doença articular degenerativa nos experientes, foram as mais frequentes lesões radiográficas diagnosticadas. Os membros pélvicos foram os mais acometidos nos animais jovens, enquanto nos animais adulto a distribuição da lesão entre os membros foi equilibrada. A região do membro onde ocorreram a maioria das alterações radiográficas foi o dígito. Os fatores de risco e a ocorrência de afecções do aparelho locomotor, aos quais os touros atletas são submetidos, fazem com que as lesões se assemelhem aquelas citadas na literatura para os equinos de esporte. Este estudo possibilitou formar uma base de dados para pesquisa na área da medicina veterinária esportiva de bovinos atletas
In Brazil, there is a growing number of bovine animals used in sports Just as the athletic horse, the athletic bovine shall be subject to orthopedic injuries, that, similar to the horse, may be related to the Sport modality. Although these lesions are extensive and thoroughly studied in equine, studies regarding the pathogenesis, diagnosis and treatment in the bovine species, need to be increased The objectives of this study were to establish a database for future research and demonstrate which lesions affect the athlete bulls, correlating the disorders with weight, age, affected limb and its region. Radiographic images were evaluated for 136 bulls who were taken care of at the Veterinary Hospital Dr. Halim Atique – UNIRP, ranging in age from 4 to 13 years, with an average weight of 800 kg and proven prior physical activity through participation in rodeos. It was observed that 71.6% of bulls studied and suffering from lameness, had radiographic lesions, predominantly in experienced animals the enthesopathy in starters and experienced bulls, septic arthritis in starters bulls, fractures and degenerative joint disease in experienced bulls, were the most frequent radiographic lesions diagnosed. The pelvic limbs were the most affected in starters animals, while in experienced animals the distribution of injuries among the members was balanced. The region of limb where the majority of radiographic changes occurred was the digits. Risk factors and occurrence of diseases of the locomotor system, to which athlete bulls are subjected, are similar to those of sports equines Risk factors and occurrence of diseases of the locomotor system, to which athlete bulls are subjected, are similar to those of sports equines
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Barros, Luciano Pereira de [UNESP]. "Estudo experimental e comparativo entre as técnicas de pino em cavilha com fio fluorcarbono monofilamentar e colocefalectomia para estabilização coxofemoral em cães." Universidade Estadual Paulista (UNESP), 2009. http://hdl.handle.net/11449/89093.
Abstract:
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barros_lp_me_jabo.pdf: 894125 bytes, checksum: 291c2da790713462f8653ad7c1ce412f (MD5)No presente trabalho comparou-se, experimentalmente, duas técnicas: a estabilização coxofemoral com pino em cavilha ou “toggle pin” e a colocefalectomia. Foram utilizados 16 cães, machos ou fêmeas, distribuidos em dois grupos: o de Pino (GP) e o Colocefalectomia (GC), os quais foram separados em 4 subgrupos: animais com peso superior e, inferior ou igual a 15 kg. Avaliou-se o tempo de cirurgia, o grau de atrofia muscular, a deambulação e a dor, além de presença ou não de alterações radiograficas da articulação. O tempo cirúrgico, devido a maior complexidade da técnica do pino, foi menor no GC. A técnica do GP foi melhor quanto à recuperação do membro, apresentando menor atrofia muscular
On the present assay was compared experimentally between two techniques: hip joint stabilization with toggle pin and hip joint stabilization with head of the femur. Were used 16 dogs, female or male, distributed in 2 groups: the pin group (GP) and head of the femur group (GC), the groups were distributed in 4 subgroups: by weight equal, more or less than 15kg. Evaluating the time of surgery, and the notch of muscle atrophy, wander around the pain and also with the presence or not of alterations on the joint radiograph. The time of surgery is longer in the technique of pin than on the group GC, because the technique of pin had more complexity. So the technical of the group GP was better on the recovery member, which presented less muscle atrophy
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Chow, Lop-keung Raymond, and 周立強. "Clinical morbidity of resorbable plates and screws for internal fixation in orthognathic surgery." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2003. http://hub.hku.hk/bib/B31954285.
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Cholfe, Bruno Fornitano. "Estudo retrospectivo das alterações radiográficas em touros atletas com afecções ortopédicas /." Botucatu : [s.n.], 2012. http://hdl.handle.net/11449/88978.
Abstract:
Orientador: Celso Antônio RodriguesBanca: Ana Liz Garcia Alves
Banca: Luis Cláudio Lopes Correia da Silva
Resumo: No Brasil é crescente o número de bovinos utilizados na prática de esportes. Assim como o cavalo atleta, o bovino atleta fica sujeito a lesões ortopédicas, que a semelhança do equino, podem ser relacionadas com a modalidade esportiva. Apesar destas lesões serem amplas e exaustivamente estudadas nos equinos os estudos referentes à etiopatogenia, diagnóstico e tratamento na espécie bovina, necessitam ser incrementados. Os objetivos deste estudo foram: realizar um estudo retrospectivo dos achados radiográficos de touros atletas, acometidos de claudicação; estabelecer quais as lesões que acometem os touros atletas, correlacionado as afecções com o peso, idade, membro acometido e região do membro. Foram avaliadas 151 imagens radiográficas de 136 touros atendidos no Hospital Veterinário Dr. Halim Atique - UNIRP variando sua idade entre 4 a 13 anos, com peso médio de 800 kg e comprovada atividade física prévia, mediante participações em rodeios. Observou-se que 71,6% dos touros estudados e acometidos de claudicação, possuíam lesão radiográfica, com predomínio nos animais experientes. As enteseopatias nos touros iniciantes e experientes, artrite séptica nos iniciantes, fraturas e doença articular degenerativa nos experientes, foram as mais frequentes lesões radiográficas diagnosticadas. Os membros pélvicos foram os mais acometidos nos animais jovens, enquanto nos animais adulto a distribuição da lesão entre os membros foi equilibrada. A região do membro onde ocorreram a maioria das alterações radiográficas foi o dígito. Os fatores de risco e a ocorrência de afecções do aparelho locomotor, aos quais os touros atletas são submetidos, fazem com que as lesões se assemelhem aquelas citadas na literatura para os equinos de esporte. Este estudo possibilitou formar uma base de dados para pesquisa na área da medicina veterinária esportiva de bovinos atletas
Abstract: In Brazil, there is a growing number of bovine animals used in sports Just as the athletic horse, the athletic bovine shall be subject to orthopedic injuries, that, similar to the horse, may be related to the Sport modality. Although these lesions are extensive and thoroughly studied in equine, studies regarding the pathogenesis, diagnosis and treatment in the bovine species, need to be increased The objectives of this study were to establish a database for future research and demonstrate which lesions affect the athlete bulls, correlating the disorders with weight, age, affected limb and its region. Radiographic images were evaluated for 136 bulls who were taken care of at the Veterinary Hospital Dr. Halim Atique - UNIRP, ranging in age from 4 to 13 years, with an average weight of 800 kg and proven prior physical activity through participation in rodeos. It was observed that 71.6% of bulls studied and suffering from lameness, had radiographic lesions, predominantly in experienced animals the enthesopathy in starters and experienced bulls, septic arthritis in starters bulls, fractures and degenerative joint disease in experienced bulls, were the most frequent radiographic lesions diagnosed. The pelvic limbs were the most affected in starters animals, while in experienced animals the distribution of injuries among the members was balanced. The region of limb where the majority of radiographic changes occurred was the digits. Risk factors and occurrence of diseases of the locomotor system, to which athlete bulls are subjected, are similar to those of sports equines Risk factors and occurrence of diseases of the locomotor system, to which athlete bulls are subjected, are similar to those of sports equines
Mestre
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Carneiro, Leandro Ziemer. "Haste intramedular bloqueada na estabilização de osteotomia intertrocantérica varizante em cães – estudo ex vivo." Universidade Federal do Pampa, 2015. http://dspace.unipampa.edu.br:8080/xmlui/handle/riu/340.
Abstract:
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Osteotomia intertrocantérica varizante (OIV) objetiva diminuir o ângulo de inclinação de cabeça e colo femoral, comumente aumentado em animais displásicos. Pode ser estabilizada por diferentes métodos, sendo a placa de compressão e parafusos o método mais tradicional. Embora a haste intramedular bloqueada (HIB) ainda não tenha sido relatada em estabilizações pós OIV, sabe-se que em fraturas femorais este método é considerado mais eficiente que as placas compressivas, além de permitir tempo cirúrgico menor. Deste modo, objetivou-se avaliar a aplicabilidade da HIB como método de fixação pós OIV em comparação com a placa compressiva. Foram utilizados dez cadáveres caninos com peso superior a 15 kg, com ambos os fêmures intactos. Nos fêmures esquerdos foram realizadas as OIVs, com remoção de cunha óssea de 20o na face medial e fixação por meio de HIB. Os fêmures contralaterais foram utilizados como controle e, após a realização da mesma técnica cirúrgica, fixou-se os segmentos ósseos por meio de placas de compressão e parafusos. As articulações coxofemorais foram radiografadas em projeção ventrodorsal e os ângulos de Norberg e de inclinação de cabeça e colo femoral comparados antes e após o procedimento cirúrgico entre os métodos de fixação. Também foi comparado o tempo dispendido para a colocação dos implantes. Os resultados demonstraram aumento do ângulo de Norberg em relação ao ângulo pré-operatório (passando de 106,84±5.55o para 111.22o ± 3.89) apenas no grupo HIB; ambos os grupos apresentaram redução do ângulo de ICF, mas sem diferença entre eles; e o tempo de colocação de cada implante também não diferiu entre os dois grupos. Assim, o uso da HIB na estabilização pós OIV foi factível em cadáveres, produzindo resultados similares à placa em relação ao tempo de execução e redução do ângulo ICF, além de permitir aumento o ângulo de Norberg.
Intertrochanteric varus osteotomy (IVO) aims to decrease the angle of head and femoral neck, commonly increased in dysplastic animals. It can be stabilized by different methods, and the compression plate and screws is the most commonly applied. The application of locked intramedullary nail (IN) in femoral fractures has been more efficient and faster than the compressive plates. However, is not known if the IN would be effective in stabilization post IVO. Thus, this study aimed to compare the application of the IN post IVO with compression plate. For this, were used ten canine cadavers weighing more than 15 kg, with both intact femurs. In the left femur were performed IVO, with bone wedge removal of 20o on the medial side and fixation with IN. The contralateral femurs were used as control and, after performing the same surgical technique, the bone segments were fixed with compression plates and screws. The hip joints were radiographed in Ventrodorsal projection, and compared the angles of Norberg and inclination of the head and femoral neck (IHF), obtained before and after surgery. The time spent for the placement of implants as compared too. IHF between the fixing methods before and after surgery. Finally, there was an increase of Norberg angle (from 106.84 ± 5.55o to 111.22o ± 3.89) only in the IN group; Similar results between the two groups were obtained with regard to reducing the IHF angle and the implant placement time compared to the compression plate. Thus, the use of IN post IVO stabilization was feasible in cadavers, producing similar results to the plate in relation to the execution time and reducing the angle IHF, and increasing the Norberg angle.
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Lemke, Sean Paul. "Biomechanical Effects of Component Alignment Variability in Total Knee Arthroplasty: A Computer Simulation Study of an Oxford Rig." The Ohio State University, 2012. http://rave.ohiolink.edu/etdc/view?acc_num=osu1338305228.
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Garfjeld-Roberts, Patrick. "Improving simulation training in orthopaedics." Thesis, University of Oxford, 2018. http://ora.ox.ac.uk/objects/uuid:c48dcc24-6850-476f-b143-b02cda4e0429.
Abstract:
The way surgical trainees acquire technical skills is changing in modern surgical training programmes: simulation is proposed as a key part of those changes. Arthroscopy is a surgical technique that is increasing in both incidence and technical complexity; where simulation is becoming common, but evidence is limited. Real-world performance improvements can be measured following simulation training in other fields, but equivalent measures of intra-operative performance are inadequate. Thus, although surgical simulation is popular and improves simulated performance, there is little objective evidence that it improves intra-operative performance. The original contribution of this thesis is to objectively demonstrate the transfer of simulation training into improved intra-operative technical skills. To achieve this, a systematic literature review investigated the quantitative metrics currently used to measure arthroscopic performance, identifying wireless motion analysis as a potential method to assess performance intra-operatively. Motion analysis is a recognised objective method to measure surgical activity which correlates with surgical experience, so wireless motion analysis was validated against a wired motion analysis method commonly used in simulation but not feasible for intra-operative use. Wireless motion analysis metrics were further validated with a simulated arthroscopy list: this environment allowed deliberate practice of arthroscopic sub-skills with proximate feedback for independent practice. This simulated arthroscopy list with wireless motion analysis was used in two randomised studies: the penultimate study of this thesis investigated the impact of simulated practice on the arthroscopic learning curve and showed that performance improved rapidly with independent practice but was not modified by feedback, while the final study investigated additional simulation practice during early surgical training, and objectively demonstrated that additional simulation training improved intra-operative performance compared to traditional training alone. This thesis is the first to objectively show that simulation affects intra-operative behaviour. It sets the groundwork for further investigations into efficient, cost-effective simulation and the impact of simulation training on patient outcomes.
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Heckelsmiller, David James. "Multimodal evaluation of local and whole-joint cartilage changes in an in vivo animal model." Thesis, University of Iowa, 2017. https://ir.uiowa.edu/etd/5497.
Abstract:
Osteoarthritis is a chronic, deleterious disease of the joints. It currently affects nearly 25 million Americans. Clinically, osteoarthritis presents as joint pain and verified by radiographic evidence of joint space narrowing. Unfortunately, symptomatic osteoarthritis describes the later stages of disease, at which point irreversible cartilage and bone damage has occurred. Cross-sectional imaging modalities offer the promise of visualizing early features of disease, enabling the development and evaluation of interventions to forestall or prevent degenerative change. Modalities of clinical interest include magnetic resonance imaging (MRI) and multi-detector computed tomography (MDCT).
The following work describes the efficacy of MRI-derived measures for the identification and accurate quantification of local and whole joint changes in articular cartilage thickness changes in vivo. This was performed as part of a study investigating the diagnostic potential of clinical morphometric and compositional MRI to identify early features of osteoarthritis in a large animal model of traumatic knee joint injury. Surgically induced trauma consisted of a partial medial meniscectomy and blunt impact of either 0 J, 0.6 J, or 1.2 J to the weight-bearing cartilage of the medial femur. The study was six months in duration. To evaluate the accuracy of MRI-derived measures of cartilage thickness, imaging acquired at time of euthanasia was compared to high-resolution contrast-enhanced micro-computed tomography (micro CT). 3-dimensional multimodal analysis demonstrated that morphometric MRI imaging is sensitive to sub-voxel changes in cartilage thickness. Therefore, MRI is a clinically relevant modality to quantify subtle cartilage damage, thereby presenting an opportunity to identify patients earlier in the disease process.
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Arbuah, Nancy. "Nonpharmacological Techniques and Pain Management." ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/6712.
Abstract:
The opioid epidemic in the United States continues to be a national health crisis affecting all populations. From 1999 to 2016, more than half a million people died from drug overdose. Nonpharmacological therapies are underused in nursing practice due to the gap in nurses' baseline knowledge and confidence related to nonpharmacological techniques for pain management. The purpose of this scholarly project was to develop and implement an expert-reviewed, evidence-based education program focused on nonpharmacological techniques for pain management. Participants included 18 registered nurses (RNs) from an orthopedic unit in a large academic medical center. A 45-minute educational session was conducted for RNs. A pre/postquestionnaire, including a 5-point Likert scale on nurses' self-perceived knowledge and confidence in using selected nonpharmacological techniques, was the method of data collection. Descriptive statistics were used to analyze the data. The results indicated an increase in nurses' self-perceived knowledge in all nonpharmacological techniques. The most significant increase in knowledge posteducation intervention was guided imagery with an increase of 72% in terms of the response Good. The data analysis indicates that the nurses self-perceived confidence posteducation intervention increased in terms of the response Good by 50 % and response Excellent by 33% demonstrating the efficacy of an evidence- based education program on nonpharmacological techniques. The implications of this project for social change include the empowerment of nurses to provide holistic patient-centered care, opioid sparing in keeping in alignment with patient safety, and the development of an evidence-based program that can be replicated in other settings.
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Ensing, Geert Tone. "Prevention and treatment of biomaterial related infection in orthopedics a study of application of ultrasound and of antibiotic release /." [S.l. : [Groningen : s.n.] ; University Library Groningen] [Host], 2006. http://irs.ub.rug.nl/ppn/291344038.
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Hogaboam, Liliya Stepanivna. "Assessment of Technology Adoption Potential of Medical Devices: Case of Wearable Sensor Products for Pervasive Care in Neurosurgery and Orthopedics." PDXScholar, 2018. https://pdxscholar.library.pdx.edu/open_access_etds/4205.
Abstract:
Information and communication technologies hope to revolutionize the healthcare industry with innovative and affordable solutions with a focus on pervasive care. Wearable sensors products can provide monitoring in a natural environment with a constant stream of information, enriching healthcare practices and enabling better pervasive care.
Wearable sensor technologies could monitor patients' mobility, gait, tremor, daily activity and other health indicators in real time that could allow for simple, non-invasive, tracking of spine care that may lead to increased patient engagement, integration, feedback, post-surgery analysis, monitoring of patient's condition, patient's data extraction and analysis and possibly aiding in better diagnosis, intervention, adherence to treatment for the betterment of quality of care.
This research focuses on the assessment of technology adoption potential of medical devices particular to tracking the mobility of patients of neurosurgery and orthopedics.
Wearable medical devices that track the mobility of patients after spinal procedures could help surgeons in providing post-operative care, analysis of treatment outcomes and patient mobility. The assessment of those devices by physicians is a complex process associated with various perspectives and criteria.
Therefore, the objective of this research is to assess the potential for technology adoption of those wearable medical devices through development of a hierarchical decision-making model (HDM) that incorporates the relevant perspectives and criteria encompassing the needs of hospital neurological surgery and orthopedics departments.
The proposed research builds on an existing body of knowledge researched through literature review and background of the field and expands the health technology assessment field by implementation of a holistic, comprehensive and multi-perspective approach to technology assessment in wearable sensor products adoption for pervasive care in neurosurgery and orthopedics.
The Hierarchical Decision Model (HDM) approach is used to break the problem down into hierarchical levels and then calculate the alternatives using pairwise comparison scales and a judgment quantification technique. Inconsistencies, disagreement, sensitivity and scenario analysis are performed as well. HDM research software is created with Ruby and R to facilitate the computation of some of these important model parameters to higher precision than is available in current statistical analysis software packages or extensions targeted for decision making. Patient perspective dominates as the main perspective for the technology adoption potential of wearable devices for pervasive care in neurosurgery and orthopedics, followed by technical and financial perspectives. Valedo, a wearable device aimed to relieve back pain through exercises, motivation and mobility tracking, received the highest ranking for adoption potential, while other devices also received high relative scores. The framework could serve as a supplementary technology assessment tool and could be tested in other settings: private, small clinic etc. with the experts and special needs of physicians in particular healthcare departments.
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Sharifi, Husham. "Cost Effectiveness Analysis in Orthopaedic Surgery." Yale University, 2010. http://ymtdl.med.yale.edu/theses/available/etd-03302010-163307/.
Abstract:
The purpose of this thesis was to explore the use of cost effectiveness for interventions in orthopaedics. This was done through three cost effectiveness articles that have been published by the author. In each of these articles, similar methodologies were used. Decision models were constructed for cost-effectiveness analyses of competing orthopaedic interventions. Outcome probabilities and effectiveness values were derived from the literature. Effectiveness was expressed in quality adjusted life years gained. Cost data were compiled and verified from either hospital cost data or from Medicare data. Costs and utilities were discounted in accord with the United States Panel on Cost Effectiveness in Health and Medicine. Principal outcome measures were average incremental costs, incremental effectiveness, incremental quality-adjusted life years, and, in the case of one article, net health benefits. In particular the articles compared the following: 1. Core decompression versus conservative management for osteonecrosis of the hip as a way to delay hip replacement; 2. Total knee arthroplasty versus unicompartmental knee arthroplasty; and 3. Periacetabular osteotomy versus total hip arthroplasty for a young adult with developmental dysplasia of the hip. The more cost effective intervention was identified in each case, along with implications of the results for clinical and operative decision-making. Cost effectiveness was found to be a useful tool in orthopaedic surgery under limited circumstances of either scarce data on new interventions or the need to use more resources to achieve greater effectiveness. It also can provide excellent insight into ways to direct future clinical research.