Masoni Virginia, Ciatti Corrado, Andriollo Luca, Vicenti Giovanni, Rivera Fabrizio
University of Turin, Turin, Italy.
Guglielmo da Saliceto Hospital, Piacenza, Italy.
Int Orthop. 2025 May 26. doi: 10.1007/s00264-025-06564-7.
Since the introduction of videogames and augmented reality technology, injuries associated with e sports have garnered increased attention from researchers and healthcare professionals. This review articles examines the spectrum of injuries associated with videogames and augmented reality and describes the nuances of the diagnoses associated with gaming injuries.
An online-based questionnaire of 25 items was distributed to all the members of the Italian Society of Orthopedic Surgery and Traumatology (SIOT) regarding their indications, usual practices, and complications encountered with hardware removal in upper and lower limbs. The survey was open from July 2024 to October 2024. Exclusion and inclusion criteria were applied.
Five hundred answers were received. While implant removal is primarily achieved in symptomatic patients, in the case of asymptomatic patients, it is not routinely performed, with a slightly higher tendency of removal in those aged 16-40 years old. These tendencies were registered both for the upper and lower limbs, with more reticence in hardware removal in the upper limbs. 96% of respondents declared the lack of hospital guidelines regarding this kind of surgery. The most feared intraoperative complications during the removal concerned screw stripping and implant breakage, with only 0.6% of respondents reporting no intraoperative difficulties. While patient discomfort and avoidance of future complications were the main indications for removal, postoperative complications occurred as wound scarring concerns, persistence of symptoms and bleeding. Despite not being considered a "procedure for the resident", when residents were specifically questioned, in 76% of cases they felt self-confident ≥ 7 on a scale from 1 to 10. Lastly, according to 62% of the respondents, titanium implants are more difficult to remove than stainless steel ones.
This survey describes a general tendency to not routinely remove implants, even in younger patients in the lower and especially upper limbs, unless in case of symptoms. Hardware removal could evolve from a simple procedure into a more complex surgery due to intraoperative technical difficulties. A lack of universal policy and guidelines exists throughout the Italian territory.
自从电子游戏和增强现实技术问世以来，与电子竞技相关的损伤越来越受到研究人员和医疗保健专业人员的关注。这篇综述文章探讨了与电子游戏和增强现实相关的损伤范围，并描述了与游戏损伤相关诊断的细微差别。
向意大利骨外科和创伤学会（SIOT）的所有成员发放了一份包含25个项目的在线问卷，内容涉及他们在上肢和下肢取出内固定物的适应证、常规做法及遇到的并发症。该调查于2024年7月至2024年10月开放。应用了排除和纳入标准。
共收到500份回复。虽然取出内固定物主要针对有症状的患者，但对于无症状患者，一般不常规进行，16至40岁的患者取出内固定物的倾向略高。上肢和下肢均有这些倾向，上肢取出内固定物时更为谨慎。96%的受访者表示缺乏关于此类手术的医院指南。取出内固定物时最令人担忧的术中并发症是螺钉滑丝和内固定物断裂，只有0.6%的受访者表示术中没有困难。虽然患者不适和避免未来并发症是取出内固定物的主要适应证，但术后并发症包括伤口瘢痕问题、症状持续和出血。尽管不被视为“住院医师的手术”，但当专门询问住院医师时，76%的病例中他们在1至10分的量表上自我感觉自信程度≥7分。最后，62%的受访者认为钛合金内固定物比不锈钢内固定物更难取出。
这项调查表明，即使在下肢尤其是上肢的年轻患者中，除非有症状，一般不常规取出内固定物。由于术中技术困难，取出内固定物可能会从一个简单的手术演变为一个更复杂的手术。意大利全境缺乏统一的政策和指南。
