scholarly journals Virtual pre-operative planning in acetabular surgery using a patient-specific biomechanical model: a prospective clinical study.

10.29007/gp5w ◽  
2020 ◽  
Author(s):  
Mehdi Boudissa ◽  
Matthieu Chabanas ◽  
Gaetan Bahl ◽  
Hadrien Oliveri ◽  
Jérôme Tonetti
Keyword(s):  
Clinical Study ◽  
Blood Loss ◽  
Acetabular Fracture ◽  
Biomechanical Model ◽  
Patient Specific ◽  
Prospective Clinical Study ◽  
Anatomic Reduction ◽  
Operative Complications ◽  
Simulation Surgery ◽  
Operative Planning

The first patient-specific biomechanical model for pre-operative planning in acetabular surgery was developed in our institution and validated in previous retrospective studies. The aim of this prospective clinical study was to confirm the previous promising.Between January 2019 and June 2019, every patients operated by the first author for acetabular fracture were included in this prospective study. A biomechanical model was implemented in acustom software made from combination of several open-sources software allowing a biomechanical simulation. The surgery was then performed according to the simulation. Surgery duration, blood loss, radiological results and per- operative complications were recorded.Ten patients were included. Mean simulation time was 22 min ± 4 [range, 18-31]. The mean operative time was 113 min ± 33 [range, 60-180] and mean blood loss was 505 mL ± 189 [range, 100-750]. On Matta’s criteria, anatomic reduction was achieved in 9 of the 10 patients (90%; 0.8 mm ± 1 [range, 0-3]). No per-operative complications were recorded.This study confirms the promising results of pre-operative planning in acetabular surgery based on a patient-specific biomechanical model.The model needs larger-scale prospective validation, but offers a new tool suitable for teaching purposes and for assessment of surgical strategies in acetabular fracture.

scholarly journals Full in-Office Guided Surgery with Open Selective Tooth-Supported Templates: A Prospective Clinical Study on 20 Patients

2018 ◽  
Vol 15 (11) ◽  
pp. 2361 ◽  
Author(s):  
Francesco Mangano ◽  
Uli Hauschild ◽  
Oleg Admakin
Keyword(s):  
Clinical Study ◽  
Low Cost ◽  
Prospective Clinical Study ◽  
3D Printer ◽  
Guided Surgery ◽  
Operative Complications ◽  
Edentulous Patients ◽  
One Year ◽  
Single Crowns ◽  
Surgical Templates

Background: Guided implant surgery appears to have several benefits, such as the possibility of inserting flapless implants in a prosthetically driven manner, avoiding dangerous anatomical structures. However, to date, only a few surgeons routinely use guided surgery in partially edentulous patients. Aim: To present the results obtained with tooth-supported surgical templates characterized by an innovative open design with selective support, and manufactured via a full in-office procedure with a low-cost desktop 3D printer. Methods: Over a two-year period (2016–2018), all partially edentulous patients with one to three missing teeth (in maxilla and/or mandible), referred to a private dental practice for restoration with dental implants, were considered for inclusion in this prospective clinical study. An intraoral scanner (CS 3600®, Carestream Dental) and cone beam computed tomography (CS 9300®, Carestream Dental) were used to acquire the 3D information on the patients. Guided surgery software (SMOP®, Swissmeda) was used to plan the surgeries and to design open, selective, tooth-supported templates that were fabricated with a stereolithographic (SLA) desktop 3D printer (XFAB2000®, DWS). Guided implant surgeries were performed and patients were followed for a period of one year. The study outcomes were fit and stability of surgical templates, duration (time) of surgery, intra and post-operative complications, and implant stability and survival. Results: Twenty (20) partially edentulous patients (9 males, 11 females; mean age 54.4 ± 9.4 years) were included in the study; 28 open, selective, tooth-supported templates were designed with the aim of inserting 38 implants. Among the surgical templates, 24 had optimal fit and stability, three had optimal fit and sufficient stability, and only one had inadequate fit and unsatisfactory stability and was therefore not suitable for clinical use. The average time of the intervention was 15.7 ± 5.2 min per template. No intra-operative complications were reported, but one implant was not stable at placement and had to be removed. In total, 36 implants were restored with 10 two-unit fixed partial prostheses and 16 single crowns. All implants were successfully functioning at one year, even if, in two single crowns, minor prosthetic complications (abutment screw loosening) occurred. Conclusions: Full in-office guided surgery with open, selective, tooth-supported templates seem to represent a clinically predictable surgical procedure to restore partially edentulous patients. Further studies are needed to confirm these positive outcomes.

scholarly journals Management of syndactyly: a clinical study

2019 ◽  
Vol 6 (8) ◽  
pp. 2806
Author(s):  
Nagaprasad Nangineedi ◽  
Gangavaram Praveen Harish ◽  
Mohammed Rafi
Keyword(s):  
Clinical Study ◽  
Treatment Strategies ◽  
Prospective Clinical Study ◽  
Basic Principles ◽  
Operative Complications ◽  
Web Space ◽  
Almost All ◽  
Surgical Corrections ◽  
The Web

Background: Syndactyly is a congenital anomaly, basic principles of surgical release of syndactyly have been well established, each patient requires a thorough assessment of the soft-tissue and bony components in the syndactylized region. Reconstruction must be planned carefully when more than two digits are involved or when the syndactyly is a component of a systemic congenital syndrome. The aim of the treatment strategies for syndactyly is to separate the fused digits, create a functional hand, and produce an aesthetically acceptable web.Methods: The prospective clinical study is conducted in the Department of Plastic & Reconstructive surgery, between October 2016 to October 2018. Twenty six patients with congenital syndactyly and post burn syndactyly of fingers were included in this study.Results: There were no intra operative complications and no cases had any neurovascular compromise. Integrity of Dorsal and volar flaps, quality of scars, aesthetical aspects of fingers are reasonably good in almost all the cases that are operated in this study. Overall 97% of patients treated achieved good function and superior results following single surgery.Conclusions: Primary syndactyly is more common than secondary syndactyly. In this study the primary goal is separation of fused digits/toes and covering the web space with dorsal flap, and covering the separated digits/ toes with a graft and create a functional hand and produce an aesthetically web with fewest complications and fewest surgical corrections. 

scholarly journals Complications associated with splenectomy in thalassemia

2016 ◽  
Vol 11 (4) ◽  
Author(s):  
Farogh Zahra ◽  
Muhammad Ashraf ◽  
Muhammad Aslam ◽  
Qaim Deen ◽  
Javeria Mannan
Keyword(s):  
Clinical Study ◽  
Study Design ◽  
Perioperative Management ◽  
Late Complications ◽  
Prospective Clinical Study ◽  
Massive Splenomegaly ◽  
Study Materials ◽  
Operative Complications ◽  
Post Operative Complications

Aims and Objectives: The study aims at investigating the complications associated with splenectomy in thalassemic patients Study Design: It was a prospective clinical study. Materials and Method: Sixty Splenectomies were preformed electively after pre-operative preparation in Sir Ganga Ram Hospital, Lahore during the year Jan 2003 to Sep 2005. Results: Complications were categorized into per-operative, early post-operative and late complications. The frequency of per-operative complications was 3%, early post-operative complications were 10% and late complications were 1.6%. Interpretation and Conclusion: The rate of complications has decreased markedly as the patients are well prepared and improved post operative carp has also reduced the post-operative complications. With good perioperative management, splenectomy in children with massive splenomegaly is both safe and effective.

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