Inclined position is associated with improved first pass success and laryngoscopic view in prehospital endotracheal intubations

Purpose

In hospital-based studies, patients intubated by physicians while in an inclined position compared to supine position had a higher rate of first pass success and lower rate of peri-intubation complications. We evaluated the impact of patient positioning on prehospital endotracheal intubation in an EMS system with rapid sequence induction capability. We hypothesized that patients in the inclined position would have a higher first-pass success rate.

An alternative treatment option for Paprosky Type IIIb acetabular defect using multiple tantalum wedges – A case report

The treatment of severe acetabular defects in revision total hip arthroplasty (Paprosky type IIIa and IIIb) is demanding and choosing the appropriate surgical technique remains controversial. The introduction of trabecular metal augments has led to a variety of new treatment options. The authors present a case of a Paprosky Type IIIb acetabular defect due to eight subsequent revisions of the left hip. The patient was treated with an alternative treatment option using multiple tantalum wedges. Anatomical reconstruction was achieved and at 12 months follow-up, the patient was pain free and was able to walk without walking aids.     

The 3D-printed patient-specific acetabular component in the management of extensive acetabular defect with combined bilateral pelvic discontuinity

Extensive acetabular defects with combined pelvic discontinuity is a surgical challenge. The ideal treatment choice is not adopted, yet. We here introduce the 3D-printed custom acetabular component in the management of extensive acetabular defect with combined pelvic discontinuity. The article presents the surgical technique and and discuss the advantages and disadvantages of this method. Furthermore, we present a successful treatment of a 64-year old using this construct.     

Quadrilateral plate fractures of the acetabulum: Proposition for a novel classification system

BackgroundCurrently, there is no definition or classification system for quadrilateral plate (QLP) fractures; the aim was to anatomically and radiologically characterise the QLP, propose a definition and classify QLP fractures.MethodsThis study included an anatomical component and a radiological component. The anatomical study aimed at defining the characteristics of the QLP; the QLP was identified using four articulating bony pelvis specimens. A titanium mesh was placed on the specimens’ quadrilateral surface; standard anteroposterior and oblique views were obtained, and axial CT images, to determine the radiological landmarks. The radiological study included the review of images of patients with QLP fractures; fractures involving the QLP were identified in a series of 609 consecutive patients with acetabular fractures.ResultsWe considered QLP fractures where the QLP is separated from both columns of the acetabulum; this was found in 16% (98 cases). They were mostly encountered with associated both columns fractures (60 cases; 61%), Separation of the QLP could be complete or incomplete, or simple or comminuted, so QLP fractures were divided into three types: QLP1, simple with incomplete separation; QLP2, comminuted with incomplete separation; QLP3, comminuted with complete separation (QLP4), simple with complete separation.ConclusionThe QLP was characterised, and a definition and classification system; Cairo University Hospitals (CUH) Classification was proposed for these fractures. We believe that this classification may prove useful in the future for the identification and management of these fractures.     

OUR-QGD型体部伽玛刀Y轴激光定位尺研制与临床应用

目的自行研制体部伽玛刀Y轴激光定位尺，使患者治疗计划在治疗设备上得以顺利实施。方法 Y轴激光定位尺由水平底座、刻度尺、滑动卡、激光笔及刻度指针组成，且操作简便易行。结果对照组50例治疗计划，Y轴方向有38例顺利通过治疗，通过率为76%；试验组50例治疗计划， Y轴方全部通过治疗，通过率为100%。结论使用体部伽玛刀Y轴激光定位尺定位，杜绝了治疗计划由于Y轴数值超出可行范围无法实施的情况，提高了工作效率、缩短了患者的治疗时间、确保治疗安全。     

髋臼横断伴后壁骨折的手术治疗

目的 总结髋臼横断伴后壁骨折手术治疗的临床疗效.方法 1993年8月- 2005年1月北京市顺义区院骨科手术治疗有明显移位的髋臼横断伴后壁骨折45例46髋,获得完整随访.影像学结果采取Matta放射学标准进行评价,临床效果采取改良的Merle d'Aubigné和Postel评分系统进行评价.结果 45例患者均获随访,随访时间16 ～48个月,平均34个月,复查X线片显示骨折均获愈合,愈合时间3～5个月.根据Matta的X线片评估标准:优17髋,良18髋,中7髋,差4髋；优良率76％.根据改良的Merle d' Aubigné和Postel评分系统对临床结果评估:优14髋,良22髋,中8髋,差2髋；优良率78.3％.结论 髋臼横断伴后壁骨折行手术治疗可以取得满意疗效,选择合适的手术时机、合理的手术入路、骨折解剖复位、坚强内固定是取得满意疗效的关键.     

无线定位技术在门诊信息系统中的应用研究

分析几种无线定位技术的优缺点,介绍其在门诊信息系统中的应用,包括电子导医、无线门诊输液系统、医疗设备与资产管理、药品定位及自动化库存管理、人员定位、呼叫系统以及输液病人体征检测等.