Ostrum Robert F
Department of Orthopaedic Surgery, University of North Carolina, 3160 Bioinformatics Building, CB 7055, Chapel Hill, NC 27599, USA.
Adv Orthop. 2015;2015:834582. doi: 10.1155/2015/834582. Epub 2015 Apr 5.
There is a perception that distal freehand interlocking (DFHI) of intramedullary nails can be difficult and time consuming. This study consists of a survey of surgeons' practices for DFHI screws and their reasons for not using this technique. A survey was sent to 1400 orthopaedic surgeons who were asked to agree or disagree with statements regarding the difficulty and indications for the usage of distal freehand interlocking screws. The results were analyzed by practice demographics, resident availability, and completion of an orthopaedic trauma fellowship. Overall, 316 surgeons (22.6%) responded to the survey. Fellowship trained surgeons were 60% less likely to find DFHI difficult when compared to nonfellowship surgeons and surgeons with residents were 76% less likely to perceive DFHI as difficult than surgeons without residents. In all groups, 40-43% of surgeons used distal interlocking based on their comfort with the technique and not the fracture pattern. Distal freehand interlocking is perceived as difficult by community orthopaedic surgeons without residents and surgeons who have not done an orthopaedic trauma fellowship. Forty percent of surgeons based their usage of DFHI screws on their comfort with the technique and not the fracture pattern.
有一种观点认为，髓内钉的远端徒手交锁（DFHI）可能既困难又耗时。本研究包括一项关于外科医生使用DFHI螺钉的操作情况及其不使用该技术原因的调查。向1400名骨科医生发送了一份调查问卷，要求他们对有关远端徒手交锁螺钉使用难度和适应证的陈述表示同意或不同意。结果按执业人口统计学、住院医师可用性以及是否完成骨科创伤 fellowship 进行分析。总体而言，316名外科医生（22.6%）回复了调查。与未参加 fellowship 的外科医生相比，接受 fellowship 培训的外科医生认为DFHI困难的可能性降低了60%，有住院医师的外科医生认为DFHI困难的可能性比没有住院医师的外科医生降低了76%。在所有组中，40 - 43%的外科医生基于对该技术的熟练程度而非骨折类型使用远端交锁。没有住院医师的社区骨科医生以及未完成骨科创伤 fellowship 的外科医生认为远端徒手交锁困难。40%的外科医生基于对该技术的熟练程度而非骨折类型来使用DFHI螺钉。
