The overall image-to-reality accuracy for CT- and Iso-C-based navigation was assessed in the described experimental setup. An apparent tendency towards higher accuracy with Iso-C-based navigation was evaluated; however, the differences were not significant.

Background: Cellular phone use within the hospital setting has increased as physicians, nurses, and ancillary staff incorporate wireless technologies in improving efficiencies, cost, and maintaining patient safety and high quality healthcare [11]. Through the use of wireless, cellular communication, an overall improvement in communication accuracy and efficiency between intraoperative orthopaedic surgeons and floor nurses may be achieved.Methods: Both communication types occurred while the surgeon was scrubbed in the operating room (OR). Indirect communication occurred when the pager call was answered by the OR circulating nurse with communication between the surgeon, circulating nurse, and floor nurse. Direct communication consisted of cell phone and Jabra Bluetooth BT200 wireless ear piece used by the surgeon. The surgeon answered the floor nurse's cellular call by phone ring-activated automatic answering. The study was conducted during scheduled orthopaedic procedures. An independent observer measured time variables with a stop-watch while orthopaedic nurses randomly called via pager or cell phone. The nurses asked for patient caregiver confirmation and answers to 30 different patient-care questions.Results: Sixty trials were performed with 30 cell and 30 page communications. Direct cellular communication showed a better response rate than indirect page (Cell 100%, Page 73%). Indirect page communication allowed a 27% and 33% error rate with patient problem and surgeon solution communications, respectively. There were no reported communication errors while using direct wireless, cellular communication.When compared to page communications, cellular communications showed statistically significant improvements in mean time intervals in response time (Cell = 11s, Page = 211s), correct patient identification (Cell = 5s, Page = 172s), patient problem and solution time (Cell = 13s, Page = 189s), and total communication time (Cell = 32s, Page = 250s) (s = seconds, all P < 0.001). Floor nurse satisfaction ratings (dependent on communication times and/or difficulties) were improved with direct cellular communication (Cell = 29 excellent, Page = 11 excellent). Intraoperative case interruptions (defined as delaying surgical progress) were more frequent with indirect page communication (10 page v. 0 cell).Conclusion and significance: Our study demonstrates that direct wireless communication may be used to improve intraoperative communication and enhance patient safety. Direct wireless, cellular intraoperative communication improves communication times, communication accuracy, communication satisfaction, and minimizes intraoperative case interruption. As a result of this study, we hope to maintain our transition to direct wireless, cellular intraoperative orthopaedic communication to reduce medical errors, improve patient care, and enhance both orthopaedic surgeon and nursing efficiencies.

The overall image-to-reality accuracy for CT- and Iso-C-based navigation was assessed in the described experimental setup. An apparent tendency towards higher accuracy with Iso-C-based navigation was evaluated; however, the differences were not significant.

A 20-month-old patient with a markedly displaced pelvic ring disruption was successfully managed with fluid resuscitation, immobilization using bolsters, and percutaneous screw fixation of the posterior ring coupled with hip spica casting.

Posttraumatic orthopaedic wound infections can occur and when they do they may cause significant morbidity and cost to patients. Orthopaedic wound infections must be recognized as early as possible to afford patients the best chances of recovery. Wound infections often require repeat hospitalization(s), operative revision(s), infectious disease consultation, physiological optimization, and an extended period of oral or intravenous antibiotics or both. An orthopaedic surgeon or caregiver must be cognizant of the patient's risk factors and appropriate preventive measures preoperatively, intraoperatively, and postoperatively to maximize best practices. By being aware of the clinical signs, symptoms, and best diagnostic tools, an orthopaedic surgeon will help decrease the morbidity and mortality from orthopaedic wound infections. The goals of this review article are to enhance the orthopaedic surgeon's knowledge in diagnosis and treatment of orthopaedic wound infections by providing an overview of the most up-to-date materials that will help in the recognition and definitive management of posttraumatic orthopaedic wound infections.