visualization of the operative field. Rapid or jerking movements deactivate the robotic device to help limit iatrogenic bone and soft tissue injury. The Navio Surgical System (Smith & Nephew, Andover, Texas, USA) is an imageless semi-active robotic system that
Babar Kayani, Sujith Konan, Atif Ayuob, Elliot Onochie, Talal Al-Jabri, and Fares S. Haddad
Alexei Buruian, Francisco Silva Gomes, Tiago Roseiro, Claudia Vale, André Carvalho, Emanuel Seiça, Antonio Mendes, and Carlos Pereira
being lower with newer designs. 38 Iatrogenic fractures: Peri-implant fractures generally occur around the distal tip of the nail, in approximately 1.1–2.6% of cases. One of the mechanisms suggested to predispose patients to peri
Alfonso Vaquero-Picado, Gaspar González-Morán, and Luis Moraleda
way to avoid iatrogenic ulnar nerve injury is to avoid medial pinning. Dorgan’s technique (a proximal lateral-entry point pin going from proximal-lateral to distal-medial) for crossed lateral-entry pins has been proposed as an alternative to avoid
Stefan Lazic, Oliver Boughton, Catherine F. Kellett, Deiary F. Kader, Loïc Villet, and Charles Rivière
Multimodal protocols for pain control, blood loss management and thromboprophylaxis have been shown to benefit patients by being more effective and as safe (fewer iatrogenic complications) as conventional protocols.
Proper patient selection and education, multimodal protocols and a well-defined clinical pathway are all key for successful day-case arthroplasty.
By potentially being more effective, cheaper than and as safe as inpatient arthroplasty, day-case arthroplasty might be beneficial for patients and healthcare systems.
Cite this article: EFORT Open Rev 2018;3:130-135. DOI: 10.1302/2058-5241.3.170031
Mirza Biscevic, Aida Sehic, and Ferid Krupic
In spine deformity surgery, iatrogenic neurologic injuries might occur due to the mechanical force applied to the spinal cord from implants, instruments, and bony structures, or due to ischemic changes from vessel ligation during exposure and cord distraction/compression during corrective manoeuvres.
Prompt reaction within the reversible phase (reducing of compressive/distractive forces) usually restores functionality of the spinal cord, but if those forces continue to persist, a permanent neurological deficit might be expected.
With monitoring of sensory pathways (dorsal column–medial lemniscus) by somatosensory-evoked potentials (SSEPs), such events are detected with a sensitivity of up to 92%, and a specificity of up to 100%.
The monitoring of motor pathways by transcranial electric motor-evoked potentials (TceMEPs) has a sensitivity and a specificity of up to 100%, but it requires avoidance of halogenated anaesthetics and neuromuscular blockades.
Different modalities of intraoperative neuromonitoring (IONM: SSEP, TceMEP, or combined) can be performed by the neurophysiologist, the technician or the surgeon. Combined SSEP/TceMEP performed by the neurophysiologist in the operating room is the preferable method of IONM, but it might be impractical or unaffordable in many institutions. Still, many spine deformity surgeries worldwide are performed without any type of IONM. Medicolegal aspects of IONM are different worldwide and in many cases some vagueness remains.
The type of IONM that a spinal surgeon employs should be reliable, affordable, practical, and recognized by the medicolegal guidelines.
Cite this article: EFORT Open Rev 2020;5:9-16. DOI: 10.1302/2058-5241.5.180032
Philippe Chiron and Nicolas Reina
posterior approach must be performed with reduction and osteosynthesis of the fragment as described in the following section ( 22 ). Iatrogenic femoral neck fracture: A total hip arthroplasty is to be planned as an emergency or delayed measure ( 23
Markus S. Hanke, Till D. Lerch, Florian Schmaranzer, Malin K. Meier, Simon D. Steppacher, and Klaus A. Siebenrock
ossification Grade 1–2 (Brooker) < 1–6% 119 – 122 Instrument breakage < 1% 119 , 122 , 123 Iatrogenic chondral injury 3% 119 , 124 Iatrogenic labral injury < 1–20% 119 , 125 Hypothermia 2
may lead to an iatrogenic fracture. It is the author’s recommendation that reaming should not be repeated after the insertion of the ‘blocking’ screw, thus avoiding unpredictable stress situations during the contact of the reamer with the ‘blocking
Oliver Marin-Peña, Marc Tey-Pons, Luis Perez-Carro, Hatem G. Said, Pablo Sierra, Pedro Dantas, and Richard N. Villar
, which allows a ‘bird’s-eye’ view of the hip joint. The posterolateral (PL) portal is not routinely performed but it facilitates the access to the posterior part of the hip down to the 10 o’clock position. The main iatrogenic injury with this portal is
Ahmed Fikry Elmenshawy and Khaled Hamed Salem
hemiarthroplasty (cemented and uncemented). Iatrogenic femoral fractures ( Fig. 7 ) occurred in 14 patients out of 540 cemented bipolar hemiarthroplasties (2.6%) and in 24 patients out of 642 uncemented bipolar hemiarthroplasties (3.7%) in the eight studies