Routine early post-operative X-ray following internal fixation of intertrochanteric femoral fractures is unjustified: a quality improvement study

Segal, David; Palmanovich, Ezequiel; Faour, A.; Marom, Elad; Feldman, Viktor; Yaacobi, Eyal; Slevin, Omer; Kish, B.; Brin, Yaron S.

doi:10.1186/s13018-018-0896-9

Cited by 13 publications

(12 citation statements)

References 29 publications

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“…Based on the change of density in this experiment, higher concentrations of calcium from the BCP/ alginate scaffold may have created an apatite layer around the defect, resulting in decreased density [19]. For hip joint and femur fractures, the proper timing of the first radiograph is 6 weeks after the operation [20]. Several factors affect the density score, including the manual chemical process of the X-ray film and the stabilization of electric current during the X-ray exposure [21].…”

Section: Discussionmentioning

confidence: 99%

Assessment of biphasic calcium phosphate 70/30 alginate scaffold on the tibia in pigs

et al. 2020

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Background and Aim: Calcium phosphate bioceramics have been used for at least a decade, and many investigations have focused on the use of hydroxyapatite (HA) derivative in the regeneration of bone defects. Biphasic calcium phosphate (BCP) is a biomaterial composed of HA and beta-tricalcium phosphate (BCP), with a structure similar to bone. The aim of the study was to determine the influence of the BCP/alginate scaffold on tissue growth, blood, the lungs, and the electrical activity of the heart during bone healing in the tibia of pig. Materials and Methods: Three pigs were implanted with BCP/alginate scaffolds in the tibias. Pigs were acclimatized and treated with antibiotics and anthelminthic drugs 14 days before implantation. Each pig was implanted with a BCP/ alginate scaffold in the right tibia and a defect without the implant was made in the left tibia as the control. Radiographic images of the tibia were captured 0, 7, 30, and 60 days after the operation. Erythrograms, radiography of the lungs, and electrocardiogram (ECG) recordings were done 0, 30, and 60 days after the operation. Results: Radiographic evaluations showed that the implant and peri-implant density of BCP decreased throughout the process of bone healing. The erythrogram profile indicated that a substantial amount of time (60 days) was required to adapt and return to pre-operative conditions. No significant differences in ECG recordings or pulmonary radiography were detected. Conclusion: The BCP/alginate scaffold did not induce a faster recovery rate from the bone defect compared to the control with no implant. However, the BCP/alginate scaffold was biodegradable, bioresorbable, and non-toxic.

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Section: Discussionmentioning

confidence: 99%

Assessment of biphasic calcium phosphate 70/30 alginate scaffold on the tibia in pigs

et al. 2020

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“…Most studies were based on case series (n=33) 22,31,33,34,36,38,41,[43][44][45][46][47][48][49][50]56,57,[60][61][62][63][64]66,[68][69][70][71][72]74,75,7785,89,90 followed by systematic reviews with or without meta-analysis (n=12) [23][24][25]28,29,39,53,59,67,78,83,86,88,91 , prospective cohorts (n=9) 30,32,35,37,42,…”

Section: Study Characteristics According To Categories Of Low Value Practicesmentioning

confidence: 99%

Low value Injury Care in the Adult Orthopaedic Trauma Population: A Systematic Review

Bérubé

Moore

Tardif

et al. 2021

Preprint

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Objectives. Fifteen potentially low value practices in adult orthopaedic trauma care were previously identified in a scoping review. The aim of this study was to synthesize the evidence on these practices. Methods. We searched four databases for systematic reviews, randomized controlled trials (RCTs), cohort studies and case series that assessed the effectiveness of selected practices. Methodological quality was evaluated using the Measurement Tool to Assess Systematic Reviews version 2 (AMSTAR-2) for systematic reviews and the Critical Appraisal Checklist for Case Series. We evaluated risk of bias with the Cochrane revised tool for RCTs and the risk of bias in non-randomized studies of interventions tool for observational studies. We summarized findings with measures of frequency and association for primary outcomes. Results. Of the 30,670 records screened, 70 studies were retained. We identified high-level evidence of lack of effectiveness or harm for routine initial imaging of ankle injury, orthosis for A0-A3 thoracolumbar burst fracture in patients < 60 years of age, cast or splint immobilization for suspected scaphoid fracture negative on MRI or confirmed fifth metacarpal neck fracture, and routine follow-up imaging for distal radius and ankles fractures. However, evidence was mostly based on studies of low methodological quality or high risk of bias. Conclusion. In this review, we identified clinical practices in orthopedic injury care which are not supported by current evidence and whose use may be questioned. In future research we should measure their frequency, assess practice variations and evaluate root causes to identify practices that could be targeted for de-implementation.

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“…Namun penggunaan X-Ray tidak direkomendasikan untuk digunakan pada anak-anak dan ibu hamil karena dapat menggangu perkembangan janin dalam kandungannya [1]. David dkk dalam penelitiannya juga menyebutkan bahwa penggunaan X-Ray secara rutin untuk patah tulang tidak dapat dibenarkan [2]. Selain pertimbangan bahaya radiasi yang ditimbulkan X-ray, pasien juga harus mengeluarkan biaya yang tidak sedikit untuk melakukan scan X-Ray tersebut.…”

Section: Pendahuluanunclassified

Prototipe Deteksi PEN dalam Tubuh Menggunakan B-Mode Ultrasonic Scanning

Prianto¹,

Gunawan²,

Tamami³

2019

JRE

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Internal fixation is a method of healing fractures by connecting them using metal called pen. Pen metal in the body isn’t permanent, when the bone was strong the pen must be removed to avoid infection. In finding the pen, X-Ray are usually used. But X-Ray has bad effect, so not everyone is allowed to use it. The solution given by make prototype to detect pen location using B-Mode ultrasonic scanning method, it uses 5MHz single transducerultrasonic. Objects measurement is the animal bones connected with metals placed in the jelly with different heights. From the two transducers, the concave surface transducer has a better result and smaller percentage error than the flat surface transducer. The concave surface transducer has a focal length area 1.94cm above the transducer surface. The maximum slope angle of the object is 20o, which more than that makes the echo signal unreadable the object.The measurement results of objects displayed in the B-Mode 1 dimensional on PC that displays the structure of the bottom surface of an object, based on comparison between the actual object and the B-Mode display an error less than 6%, meaning B-Mode can represent the surface structure bottom of the actual object.

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Routine early post-operative X-ray following internal fixation of intertrochanteric femoral fractures is unjustified: a quality improvement study

Cited by 13 publications

References 29 publications

Assessment of biphasic calcium phosphate 70/30 alginate scaffold on the tibia in pigs

Assessment of biphasic calcium phosphate 70/30 alginate scaffold on the tibia in pigs

Low value Injury Care in the Adult Orthopaedic Trauma Population: A Systematic Review

Prototipe Deteksi PEN dalam Tubuh Menggunakan B-Mode Ultrasonic Scanning

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