Training in Lumbar Pedicle Screw Instrumentation Using a 3D-Printed Model: From Validation to Transferability Onto a Cadaver Model.

Lumbar pedicle screw placement in spinal surgery is complex and prone to errors, with notable risks to patients. Standard training methods, such as mentorship in operating rooms, pose safety concerns, prompting the need for alternative training tools. This study aimed to validate and use a three-dimensional (3D)-printed simulation model for lumbar pedicle screw insertion training and assess its effectiveness compared with standard methods.

An online training and feedback module enhances the musculoskeletal examination performance of medical interns.

Background: Pathologies of the locomotor system are frequent and can cause disability and impact the quality of life of the people affected. In recent years, online training and feedback have emerged as learning tools in many fields of medicine.

Objective: This study aims to evaluate medical interns' musculoskeletal examination performance after completing an online training and feedback module.

Simulation-Based Training Program for Peripherally Inserted Central Catheter Placement: Randomized Comparative Study of in-Person Training With Synchronous Feedback Versus Distance Training With Asynchronous Feedback.

Introduction: Simulation training that includes deliberate practice is effective for procedural skill training. Delivering feedback remotely and asynchronously has been examined for more cost-efficient training. This prospective randomized study aimed to compare 2 feedback techniques for simulation training: synchronous direct feedback versus asynchronous distance feedback (ASYNC).

Evaluation of the Chilean National Orthopaedic Examination Over 11 Years: Progress and Outcomes of National and International Examinees.

Introduction: The National Orthopaedics Examination (EMNOT) was initially designed for Chilean orthopaedic program graduates and is now a crucial component of the revalidation process for international orthopaedic surgeons seeking practice in Chile. This study aims to describe participation and performance of EMNOT examinees based on their origin and to analyze the difficulty and discrimination indexes during its first 11 years of implementation.

Methods: A retrospective assessment was conducted on all EMNOT results from 2009 to 2019.

Tibial tubercle to trochlear groove and the roman arch method for tibial tubercle lateralisation are reliable and distinguish between subjects with and without major patellar instability.

Purpose: Patellofemoral (PF) instability recurrence depends on several factors including the relative lateralisation of tibial tubercle (TT) regarding the trochlear groove (TG). TT relative lateralisation quantification has long been a topic of debate. Multiple measuring techniques have been described including TT-trochlear groove (TT-TG), TT-posterior cruciate ligament (TT-PCL) and TT-roman arch (TT-RA), with no clear consensus regarding the most reliable index or pathologic threshold.

Skyline view of the patella does not increase fracture detection: A non-inferiority diagnostic study.

Purpose: Patella fractures are frequent injuries in the adult population. Initial study is made by plain radiographs and the standard set includes the skyline view of patella. Recommendation for use of this projection is variable among the experts, without data that support its performance in the diagnosis of patella fractures.

The AO classification system for tibial plateau fractures: An independent inter and intraobserver agreement study.

Purpose: Classifying tibial plateau fractures is paramount in determining treatment regimens and systemizing decision making. The original AO classification described by Müller in 1996 and the Schatzker classification of 1970 are the most cited classifications for tibial plateau fractures, demonstrating substantial to almost perfect agreement. The main problem with these classifications schemes is that they lack the detail required to convey the variety of fracture patterns encountered.

The distance between the fibular collateral ligament tunnel and the common peroneal nerve allows a posterolateral corner reconstruction without neurolysis.

Purpose: The most popular knee posterolateral corner (PLC) reconstruction techniques describe that a common peroneal nerve (CPN) neurolysis must be done to safely address the posterolateral aspect of the knee. The purpose of this study was to measure the distance between the CPN and the fibular insertion of the FCL in different degrees of knee flexion in cadaveric specimens, to identify if tunnel drilling could be done anatomically and safely without a CPN neurolysis.

Methods: Ex vivo experimental analytical study.

[Presence of women in medical publications in Chile].

Background: Despite recent initiatives and efforts, gender inequality still exists in medicine and academia. There is a higher proportion of male authors in international scientific publications.

Aim: To compare the proportion of female and male authors in the scientific publications of the main medical journals in Chile.

The use of intraoperative comparative fluoroscopy allows for assessing sagittal reduction and predicting syndesmosis reduction in ankle fractures.

Unlabelled: Intraoperative fluoroscopic parameters have shown to be poor predictors for ankle syndesmosis reduction, with up to 52% of syndesmotic malreduction (SMR) reported in the literature. Anteroposterior Tibio-Fibular index (APTF) was previously described to evaluate sagittal tibiofibular alignment in lateral ankle radiographs with a high correlation between both ankles in uninjured subjects. Reproducible intraoperative measurements for sagittal syndesmotic reduction are lacking.

Mid and lower thoracic kyphosis changes during adulthood: the influence of age, sex and thoracic coronal curvature.

Introduction: There is conflicting data on how thoracic kyphosis changes throughout adulthood. We evaluated mid and lower thoracic kyphosis (MTK) in various age groups and the influence of age, sex and coronal curve (CC) on MTK.

Material And Methods: We studied 1323 patients 15-80 years-old (54.

Tibial Cut Accuracy in Mechanically Aligned Total Knee Arthroplasty Using Extensor Hallucis Longus Tendon to Determine Extramedullary Tibial Guide Position.

This study aimed to determine the tibial cut (TC) accuracy using extensor hallucis longus (EHL) tendon as an anatomical landmark to position the total knee arthroplasty (TKA) extramedullary tibial guide (EMTG), and its impact on the TKA mechanical alignment (MA). We retrospectively studied 96 TKA, performed by a single surgeon, using a femoral tailored intramedullary guide technique. Seventeen were prior to the use of the EHL and 79 used the EHL tendon to position the EMTG.

Anterior and distal tunnel orientation for anatomic reconstruction of the medial patellofemoral ligament is safer in patients with open growth plates.

Purpose: In patients with open growth plates, the direction of tunneling that avoids distal femoral physis (DFP) damage in anatomic reconstructions of the medial patellofemoral ligament (MPFL) has been a topic of discussion. The objective of this study was to determine the ideal orientation for anatomic reconstructions of MPFL tunneling that minimized DFP damage while avoiding breaching the intercondylar notch.

Methods: Eighty magnetic resonance images of patients aged 10 through 17 were obtained, randomly sampled from the institutional database.

The new AO classification system for intertrochanteric fractures allows better agreement than the original AO classification. An inter- and intra-observer agreement evaluation.

Background: A new AO classification for intertrochanteric fractures was recently published; no studies have evaluated its inter- and intra-observer agreement.

Methods: Six evaluators (three hip subspecialists and three residents) assessed radiographs of 68 intertrochanteric fractures; fractures were classified using the original and the new AO classifications. The cases were displayed in a random sequence after a six-week interval for repeat evaluation.

An Isolated Transosseous Flexible Suture Frame in the Treatment of Patellar Tendon Rupture Provides Adequate Mechanical Resistance.

Introduction: Acute patellar tendon ruptures are frequently observed in patients with metabolic comorbidities, and the benchmark treatment is surgical repair. It is desirable not to harm an already fragile biologic environment with sutures and hardware. We aimed to compare the mechanical requirements of an isolated, flexible, high-strength nonabsorbable transosseous suture frame with that of the Krackow suture technique.

Management of patients with low back pain in the emergency department: Is it feasible to follow evidence-based recommendations?

Objective: Low back pain is frequently seen in patients visiting the ED, but many patients receive medical care with no demonstrable benefits. We studied the clinical characteristics of patients visiting two EDs in Santiago, Chile, and their management to evaluate how it adheres to evidence-based recommendations.

Methods: We studied 519 patients and retrieved their demographic and clinical data, imaging testing and treatments.

An Independent Validation of the Brighton Spondylodiscitis Score and a Proposal to Modify the Score.

Introduction: The Brighton Spondylodiscitis Score (BSS) aims to identify patients with pyogenic spinal infections (PSIs) requiring surgery; an independent assessment of the BSS is required.

Methods: We evaluated 60 patients with PSIs. Using the BSS, we determined whether patients with low, moderate, and high risk (LMHR) had different rates of surgery.

Do Patients Older Than 60 Years With Inflammatory Bowel Disease Have More Vertebral Fractures Than Age-matched Controls? A Study Using Abdominal and Pelvic CT Scans With Sagittal Reformatting as Screening Tool.

Introduction: It is undetermined whether patients with inflammatory bowel diseases (IBDs) have increased prevalence of vertebral compression fractures (VCFs) since many VCFs are asymptomatic and radiographs may overlook them. We compared the prevalence of VCFs in patients older than 60 years with and without IBDs.

Methods: We studied 55 patients with IBDs and 165 controls who underwent CT scans for nonspinal conditions.

Orthopaedic Residents' Transfer of Knee Arthroscopic Abilities from the Simulator to the Operating Room.

Introduction: The ultimate goal for any surgical simulation program is to prove the capability of transferring the skills learned to real-life surgical scenarios. We designed an arthroscopic partial meniscectomy (APM) training program and sought to determine its ability to transfer skills to real patients.

Methods: Eleven junior orthopaedic residents and three expert knee surgeons were included.

Incidental identification of vertebral compression fractures in patients over 60 years old using computed tomography scans showing the entire thoraco-lumbar spine.

Introduction: Vertebral compression fractures (VCF) are frequently asymptomatic; incidental diagnosis is a valuable opportunity to identify low bone mass and to start treatment. We aimed to determine the proportion of patients over 60 years old evaluated with chest plus abdominal and pelvic computed tomography (CT) scans, allowing visualization of the entire thoraco-lumbar spine, who incidentally present VCF.

Materials And Methods: We evaluated 300 patients over 60 years old who under went chest plus abdominal and pelvic CT scans.

Scheuermann's disease in patients 15-40 years old: A study to determine its prevalence and its relationship with age and sex using chest radiographs as screening tool.

Background: There is insufficient knowledge of the epidemiology of Scheuermann's disease. The data available comes from estimations from young adults with obvious deformity, from studies evaluating children who may not have developed the deformity yet, or from older populations who can develop vertebral wedging secondary to other causes. We aimed to determine the prevalence of Scheuermann's disease in patients 15-40 years old using plain chest radiographs as a screening tool.

Case Report of Frostbite with Delay in Evacuation: Field Use of Iloprost Might Have Improved the Outcome.

Frostbite is a common injury in high altitude medicine. Intravenous vasodilators have a proven efficacy and, recently, have been proposed as a safe outpatient treatment. Nevertheless, the lack of availability and consequently delayed application of this treatment option can result in poor clinical outcomes for patients.