Der Unfallchirurg
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Many publications, mainly from other countries, suggest that the treatment of seriously injured children might be better in specialised paediatric trauma centres than in general trauma centres. Data from Germany are not available yet, but those from abroad were used for the recommendations made by the German Association for Trauma Surgery (DGU) on the topic of paediatric trauma in the "White Paper on Trauma Care". The goal of this study was to analyse whether the outcome of severely injured children is dependent on treatment level and on the availability of a paediatric surgeon based on the given data. ⋯ Overall, the medical care of seriously injured and polytraumatised children in Germany is good at all levels of treatment whether a paediatric surgeon is involved or not.
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Despite great advances in the development of hardware and software components, surgical navigation systems have only seen limited use in current clinical settings due to their reported complexity, difficulty of integration into clinical workflows and questionable advantages over traditional imaging modalities. ⋯ Our AR navigation using RGBD cameras offers a flexible and intuitive visualization of the operating field for the navigated osteosynthesis without IR tracking markers, enabling surgeons to complete operations quicker and with a lower radiation exposure to the patient and surgical staff.
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Around 5% of all trauma patients suffer from spinal trauma. Spinal fractures are mainly located in the thoracic and lumbar spine. For multisegmental vertebral fractures categorized as instable, combined dorsal instrumentation and ventral stabilization is recommended. Numerous vertebral body replacement systems are available for ventral stabilization. ⋯ The current study shows that in the case of multisegmental fractures complete reposition by ligamentotaxis and by the percutaneous instrumentation system is possible. In addition to the percutaneous dorsal instrumentation, the implantation of a hydraulically expandable vertebral body replacement may allow a stable fusion after complex traumatic fractures of the thoracic and lumbar spine. Patients are very satisfied with their outcome after this procedure.
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Review
[Interactive augmented reality systems : Aid for personalized patient education and rehabilitation].
During patient education, information exchange plays a critical role both for patient compliance during medical or rehabilitative treatment and for obtaining an informed consent for an operative procedure. ⋯ Novel technologies, such as augmented reality are a door opener for many innovations in medicine. In the future, patient-specific systems, such as the Magic Mirror will be used increasingly more in areas such as patient education and rehabilitation. In order to maximize the benefits of such systems, further evaluation studies are necessary to find out about the best use cases and to start an iterative optimization process of these systems.
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One of the main challenges for modern surgery is the effective use of the many available imaging modalities and diagnostic methods. Augmented reality systems can be used in the future to blend patient and planning information into the view of surgeons, which can improve the efficiency and safety of interventions. ⋯ In order to integrate mixed and augmented reality displays into medical practice, highly specialized solutions need to be developed. Such systems must comply with the requirements with respect to accuracy, fidelity, ergonomics and seamless integration into the surgical workflow.