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There are many digital solutions which assist the orthopaedic trauma surgeon. This already broad field is rapidly expanding, making a complete overview of the existing solutions difficult.
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The AO Foundation has established a task force to address the need for an overview of digital solutions in the field of orthopaedic trauma surgery.
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Areas of new technology which will help the surgeon gain a greater understanding of these possible solutions are reviewed.
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We propose a categorization of the current needs in orthopaedic trauma surgery matched with available or potential digital solutions, and provide a narrative overview of this broad topic, including the needs, solutions and basic rules to ensure adequate use in orthopaedic trauma surgery. We seek to make this field more accessible, allowing for technological solutions to be clearly matched to trauma surgeons’ needs.
Cite this article: EFORT Open Rev 2020;5:408-420. DOI: 10.1302/2058-5241.5.200021
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Department of Orthopaedics & Trauma, Royal Adelaide Hospital, Adelaide, South Australia, Australia
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Purpose
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The purpose of this study was to investigate differences in aseptic reoperation rates between single or dual lag screw femoral nails,in the treatment of intertrochanteric fractures (ITF) in elderly patients.
Methods
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Electronic databases were searched for RCTs and prospective cohort studies treating elderly ITF patients with a single or dual screw femoral nails. Data for aseptic reoperation rates between single screw, dual separated screw and dual integrated screw devices were pooled using a random-effects meta-analysis with 95% CIs. Pooled proportions were compared using a N-1 chi-squared test. Complications contributing to aseptic reoperation rates were extracted, and the contribution of cut-out and periprosthetic fracture as a proportion of reoperations was analysed using a negative binomial regression model.
Results
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Forty-two (n = 42) studies were evaluated, including 2795 patients treated with a single screw device, 1309 patients treated with a dual separated screw device and 303 patients treated with a dual integrated screw device. There was no significant difference in aseptic reoperation rates between single and dual lag screw femoral nails of both separated and integrated lag screw designs. Moreover, complications of cut-out and periprosthetic fracture as a proportion of reoperations did not differ significantly between devices.
Conclusion
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The current evidence showed that aseptic reoperation rates were not significantly different between single and dual screw nails of a separated lag screw design. For dual integrated screw devices, due to insufficient evidence available, further high quality RCTs are required to allow for decisive comparisons with these newer devices.
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(ISS), Rome, Italy Institutes for health technology assessment • Austrian Institute for Health Technology Assessment (AIHTA), Vienna, Austria • Fundación Pública Andaluza Progreso y Salud / Andalusian Health Technology Assessment Unit (AETSA), Seville
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decision problem (e.g. an investment decision for a hospital or to inform a reimbursement request to the government). However, the European Network for Health Technology Assessment (EUnetHTA) recommends that all economic evaluations to be conducted from a
Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, UK
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-marketing surveillance, health technology assessment, reimbursement and procurement decisions, and allows healthcare provider benchmarking. Registries can also generate risk alerts, which are relevant for all stakeholders. The Australian registry for example flags
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, reproduction and distribution of the work without further permission provided the original work is attributed. References 1. Dreinhöfer KE Dieppe P Günther K-P Puhl W (Eds.). EUROHIP. Health technology
Botnar Research Centre, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, UK
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National Institute for Health Research Oxford Biomedical Research Centre, John Radcliffe Hospital, Oxford, UK
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derived from the published literature is complemented by annual reports from registries, which monitor real-world safety and performance of implants at the national or regional level over the long term ( 2 ). EU regulatory and health technology assessment
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Collaboration: 4 Cochrane Database of Systematic Reviews Cochrane Central Register of Controlled Trials (CENTRAL) Cochrane Methodology Register Database of Abstracts of Reviews of Effects (DARE) Health Technology Assessment
Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
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National Institute for Health Research Oxford Biomedical Research Centre, John Radcliffe Hospital, Oxford, UK
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National Institute for Health Research Oxford Biomedical Research Centre, John Radcliffe Hospital, Oxford, UK
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, biomedical engineers, manufacturers, health technology assessment (HTA) specialists, regulators, notified bodies, device data custodians, toxicologists, materiovigilance, and pharmaco-epidemiology specialists, and potentially others. Fragmentation has made it
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as the data generated by a registry may be of interest to a broad range of stakeholders, including patients, clinicians, authorities, device manufacturers, health technology assessment bodies and other decision makers in a health system. These
