Glatt Vaida, O'Toole Robert, Mehta Samir, Ricci William, Nauth Aaron, Schemitsch Emil, Hast Michael W
Department of Orthopaedic Surgery, University of Texas Health Science Center San Antonio, San Antonio, TX.
Department of Orthopaedic Surgery, University of Maryland Medical System, Baltimore, MD.
OTA Int. 2023 May 4;6(2 Suppl):e249. doi: 10.1097/OI9.0000000000000249. eCollection 2023 May.
At the 2021 annual meeting of the Orthopaedic Trauma Association, the Basic Science Focus Forum hosted its first ever debate-style symposium focused on biomechanics and fracture repair. The 3 subjects of debate were "Mechanics versus Biology-Which is 'More Important' to Consider?" "Locked Plate versus Forward Dynamization versus Reverse Dynamization-Which Way Should I Go?" and "Sawbones versus Cadaver Models-What Should I Believe Most?" These debates were held because fracture healing is a highly organized synergistic response between biological factors and the local mechanical environment. Multiple studies have demonstrated that both factors play roles in governing bone healing responses, and the causal relationships between the 2 remain unclear. The lack of clarity in this space has led to a spectrum of research with the common goal of helping surgeons make good decisions. Before reading further, the reader should understand that the questions posed in the debate titles are unanswerable and might represent a false choice. Instead, the reader should appreciate that the debates were held to gain a more thorough understanding of these topics based on the current state of the art of experimental and clinical studies, by using an engaging and thought-provoking format.
在2021年骨创伤协会年会上,基础科学聚焦论坛举办了有史以来第一场以生物力学和骨折修复为主题的辩论式研讨会。辩论的三个主题分别是“力学与生物学——哪个‘更重要’需要考虑?”“锁定钢板与正向动力化与反向动力化——我该选择哪种方法?”以及“人工骨模型与尸体模型——我最应该相信哪个?”之所以举办这些辩论,是因为骨折愈合是生物因素与局部力学环境之间高度组织化的协同反应。多项研究表明,这两个因素在控制骨愈合反应中都发挥着作用,而两者之间的因果关系仍不明确。这一领域的不明确导致了一系列研究,其共同目标是帮助外科医生做出明智的决策。在继续阅读之前,读者应该明白,辩论标题中提出的问题是无法回答的,可能代表着错误的选择。相反,读者应该认识到,举办这些辩论是为了通过引人入胜且发人深省的形式,基于当前实验和临床研究的最新水平,更全面地理解这些主题。