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改善未来肌肉骨骼疾病患者护理的挑战与障碍——一篇辩论文章及全球视角

Challenges and barriers to improving care of the musculoskeletal patient of the future - a debate article and global perspective.

作者信息

Fayaz Hangama C, Jupiter Jesse B, Pape Hans Christoph, Smith R Malcolm, Giannoudis Peter V, Moran Christopher G, Krettek Christian, Prommersberger Karl J, Raschke Michael J, Parvizi Javad

机构信息

Department of Orthopaedic Surgery, Harvard Medical School, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA.

出版信息

Patient Saf Surg. 2011 Sep 25;5:23. doi: 10.1186/1754-9493-5-23.

Abstract

BACKGROUND

With greater technological developments in the care of musculoskeletal patients, we are entering an era of rapid change in our understanding of the pathophysiology of traumatic injury; assessment and treatment of polytrauma and related disorders; and treatment outcomes. In developed countries, it is very likely that we will have algorithms for the approach to many musculoskeletal disorders as we strive for the best approach with which to evaluate treatment success. This debate article is founded on predictions of future health care needs that are solely based on the subjective inputs and opinions of the world's leading orthopedic surgeons.Hence, it functions more as a forum-based rather than a scientific-based presentation. This exposé was designed to stimulate debate about the emerging patients' needs in the future predicted by leading orthopedic surgeons that provide some hint as to the right direction for orthopedic care and outlines the important topics in this area.

DISCUSSION

The authors aim to provide a general overview of orthopedic care in a typical developed country setting. However, the regional diversity of the United States and every other industrialized nation should be considered as a cofactor that may vary to some extent from our vision of improved orthopedic and trauma care of the musculoskeletal patient on an interregional level.In this forum, we will define the current and future barriers in developed countries related to musculoskeletal trauma, total joint arthroplasty, patient safety and injuries related to military conflicts, all problems that will only increase as populations age, become more mobile, and deal with political crisis.

SUMMARY

It is very likely that the future will bring a more biological approach to fracture care with less invasive surgical procedures, flexible implants, and more rapid rehabilitation methods. This international consortium challenges the trauma and implants community to develop outcome registries that are managed through health care offices and to prepare effectively for the many future challenges that lie in store for those who treat musculoskeletal conditions.

摘要

背景

随着肌肉骨骼疾病患者护理技术的更大发展,我们正进入一个对创伤性损伤病理生理学、多发伤及相关疾病的评估与治疗以及治疗结果的理解迅速变化的时代。在发达国家,随着我们努力寻求评估治疗成功的最佳方法,很有可能会拥有针对许多肌肉骨骼疾病的治疗算法。这篇辩论文章基于对未来医疗保健需求的预测,而这些预测仅仅基于世界顶尖骨科医生的主观意见。因此,它更多地是作为一个基于论坛而非基于科学的陈述。这篇阐述旨在激发关于骨科医生预测的未来新兴患者需求的辩论,这些需求为骨科护理的正确方向提供了一些线索,并概述了该领域的重要主题。

讨论

作者旨在对典型发达国家环境下的骨科护理进行总体概述。然而,美国和其他工业化国家的地区多样性应被视为一个可能在一定程度上与我们对跨地区改善肌肉骨骼疾病患者骨科和创伤护理的愿景有所不同的辅助因素。在这个论坛中,我们将界定发达国家与肌肉骨骼创伤、全关节置换术、患者安全以及与军事冲突相关的损伤有关的当前和未来障碍,所有这些问题只会随着人口老龄化、流动性增强以及应对政治危机而增加。

总结

未来很可能会带来一种更具生物学特性的骨折护理方法,采用侵入性较小的手术程序、灵活的植入物以及更快速的康复方法。这个国际联盟向创伤和植入物领域发起挑战,要求开发通过医疗保健机构管理的结果登记系统,并为那些治疗肌肉骨骼疾病的人员所面临的众多未来挑战做好有效准备。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aaa8/3196685/e4296e1a571e/1754-9493-5-23-1.jpg

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