对于隐藏的骨盆环不稳定性的动态应力测试的标准化和可重复性
Adam Keith Lee1, Geoffrey Scott Marecek, Cory Alan Collinge
1From the University of Chicago Medical Center, Chicago, IL (Lee), Cedars Sinai Medical Center, Los Angeles, CA (Marecek), and Texas Health Harris Methodist Hospital Fort Worth, Fort Worth, TX (Collinge).
概括
在麻醉下检查骨盆环损伤时施加的力量在经验丰富的外科医生之间有很大的差异. 这种变化凸显了需要标准化的协议,以确保对骨盆不稳定性的一致评估.
科学领域:
- 整形外科手术 整形外科手术
- 创伤护理 创伤护理
- 生物力学 生物力学
背景情况:
- 骨盆环损伤需要评估隐性不稳定性,以防止移位和发病率.
- 目前在麻醉下检查 (EUA) 协议缺乏标准化的武力应用.
- 在 EUA 期间施加力的变化可能会影响诊断的准确性.
研究的目的:
- 量化经验丰富的骨科创伤外科医生在骨盆 EUA 中使用的力量.
- 在标准化的 EUA 机动中识别力应用的变化.
主要方法:
- 模拟的 EUA 机动 (内部旋转,外部旋转,推拉) 是由 18 名骨科创伤学家在尸体上进行的.
- 在模拟检查期间,使用手持式动力计测量了力.
- 外科医生的经验水平从不到5年到超过20年不等.
主要成果:
- 应用了各种各样的力: 40.4374.9 N (IR), 72.9338.4 N (ER) 和 25323 N (推拉).
- 在施加力方面观察到显著的外科医生间变异性.
- 超过50N的外科医生内部变异性在18%的内部轮换连续试验中被发现.
结论:
- 这项研究是第一个测量骨盆 EUA 期间的力,以评估稳定性.
- 外科医生之间存在很大的差异,甚至在同一外科医生进行的连续检查中也存在很大的差异.
- 需要进一步的研究来规范 EUA 位移测量和临床管理的不稳定性值.
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