Lombok earthquake that occurred in July 2018 has three large magnitude earthquakes that caused huge losses; 564 victims died, 1684 injured, 445 343 refugees, and 215 628 houses were damaged. The role of anesthesiology is very important to give prompt therapy for injured victims. This research gave an overview of the important role of Anesthesiologist and the selection of anesthesia techniques during the natural disasters’ victims’ management. This study was conducted by collecting data of all earthquake victims treated at the emergency room (ER) of RSUD NTB on August 6^th and 7^th 2018 and all victims operated during August 5 – 25^th 2018. All data were recorded, analyzed, and presented in descriptive form using frequency, pie chart, and bar diagrams. The result shown that the highest number of patients treated in ER are during the first seven days after the earthquake and reduced to several weeks. The majority of patients treated are trauma patients who need orthopedic surgery. Since limited number of anesthesiologist should be considered with the right selection of anesthesia techniques, so that the disaster preparedness could be prepared well and the disaster management could run well. General anesthesia was widely used than regional anesthesia, but the different is not significant. The type of regional anesthetic drug usually used is lidodex in combination with catapres. The role of anesthesiologist during disaster is important to handle a safe and optimal surgical condition.

Introduction: The application of external fixation devices consists of wires insertion through the skin and soft tissue to the bone. We examined the possible analgesic effect of stimulating an acupoint by the fixation wires which mimics the acupunctures treatment. Material and methods: retrospective work. Between 2015 to 2018 107 patients were treated with an external fixation for a tibial fracture. 33 patient files were found to be eligible for the review. Patients were retrospectively divided into two groups: the study group included patients with a wire inserted through the ST36 (Zu San li) acupoint location, the control group had the wire inserted elsewhere. Patient's record was reviewed for 5 days following surgery. Data collected included analgesic consumption and pain level recorded on a visual analog scale (VAS). Results: 33 patients were included in the review. 20 patients in the study group and 13 served as the control group. In the study group VAS average was Mean (M)=1.4853 ± 1.30 while in the control group M=2.3885± 1.77 with no statistical relevance (P>0.05). Only on day 4 the study group had less pain than the control: M=0.40 ± 0.843, versus M=2.57 ± 2.149 (Mann=Whitney Z= -2.413, P<0.05). No statistical difference was found between groups in relation to analgesic consumption. Conclusions: In patients suffering from a tibial fracture treated with an Ilizarov external fixation device, locating a wire in the anatomical location of acupoint ST 36 had no effect on analgesic consumption and a minimal effect on patients’ pain levels.

Background: We aimed to describe the patterns, management, and outcome of traumatic femoral shaft fractures. Methods: An observational descriptive retrospective study was conducted for all trauma patients admitted with femoral shaft fractures between January 2012 and December 2015 at the only level 1 trauma center and tertiary hospital in the country. Data were analyzed and compared according to the time to intramedullary nailing, mechanisms of injury and age groups. Main outcomes included in-hospital complications and mortality Results: A total of 605 cases were analyzed, with mean age of 30.7±16.2 years. The majority of fractures were unilateral (96.7%) and 91% were closed fractures. Three-fourth of fractures were treated by reamed intramedullary nailing (rIMN); antegrade in 80%. The pyriform fossa nails were used in 71.6% while trochanteric entry nails were used in 28.4%. Forty-five (8.9%) of fractures were treated with external fixator, 37 (6.1%) had conservative management. Traffic-related injuries occurred more in patients aged 14-30 years whereas; injuries related to fall were significantly higher in patients aged 31-59 years. Thirty-one patients (7.8%) had rIMN < 6 h post-injury, 106 (25.5%) had rIMN < 6-12 h and 267 (66.8%) had rIMN > 12 h. The implant type, duration of surgery, DVT prophylaxis, in-hospital complications and mortality were comparable among the three treatment groups. Conclusion: In our center, the frequency of femoral fracture is 11% which mainly affects severely injured young males due to traffic-related collisions or falls. Further multicenter studies are needed to reach a consensus for the appropriate management based on the location and timing of injury

The purpose of this paper is to highlight the main themes and insights from the Journal of Orthopedic Research (JOR)/JOR Spine Workshop during the Orthopedic Research Society 2022 Annual Meeting in Tampa Bay, Florida. This workshop, organized by JOR Editor-in-Chief Dr. Linda Sandell, focused on communication strategies (particularly using social media) to broadcast published work in orthopedic research. In this manuscript, we summarize data that support the beneficial impacts of amplifying scholarly works on social media and outline a linearized workflow for constructing a Twitter posts, which can be generalized to other social media platforms, to share academic research. Finally, we identify resources to alleviate barriers to social media use and help promote professionalism and success online in the orthopedic research community. As early career scientists in orthopedics, we see immense value in using social media, particularly Twitter, to communicate our research findings and build our scholarly networks. We hope this information will be persuasive to those in the orthopedic field and be broadly applicable to others in related scientific fields who wish to disseminate findings and engage a public audience on social media. For the orthopedic research society and journal of orthopedic research, social media can assist in accomplishing our mission of creating a world without musculoskeletal limitations via the timely dissemination of orthopedic research findings and news.

In oral pathology, the appearance of a large ulcerated lesion may suggest a malignant process that requires an early diagnosis given the uneasiness of the patient and his or her family. Finding lingual carcinoma in children is, however, extremely rare We present the case of a 13-year-old girl who came to the oral medicine clinic, referred by her orthodontist, with a large round lesion on the ventral side of the tongue (15 x 12 mm) that did not heal, after three weeks of evolution and after eliminating the existing traumatic factors (orthodontic appliance in the lower jaw) and treatment with topical gel based on PVP (polyvinyl pyrrolidone), glycyrrhetinic acid and hyaluronic acid (Aloclair PLUS®). The objective of this article is analyse the possible causes and provide a review of the literature of a large ulcerated lesions.

Thermoregulation is important for maintaining homeostasis of our body. It can be easily broken under anesthesia. An appropriate method to measure the core body temperature is needed, especially for elderly patients because the efficiency of thermoregulation gradually decreases with age. The aim of this study was to examine the accuracy and feasibility of using of SpotOn® sensor in lower extremity orthopedic surgery in elderly patients aged over 80 years by comparing a SpotOn® sensor with two other reliable minimal-invasive methods: a tympanic membrane thermometer and a bladder thermometer. This study enrolled 45 patients aged over 80 years who were scheduled to undergo a lower extremity surgery. Body temperature was measured using a SpotOn® sensor, tympanic membrane thermometer and bladder thermometer. Agreements between the SpotOn® sensor and the other two methods were assessed using Bland and Altman plots for repeated measures adjusted for unequal numbers of measurements per patient. Compared with TempBladder, bias and limits of agreement for TempZHF were 0.07℃ ± 0.58℃. Compared with TempTympanic, bias and limits of agreement for TempZHF were -0.28℃ ± 0.61℃. 3M SpotOn® sensor using ZHF method for patients aged over 80 years undergoing lower extremity surgery shows feasible measurement value and sensitivity.

Medical implants made of biodegradable materials could be of advantage for temporary applications such mechanical support during bone-healing or as vascular stents to keep blood vessels open. After completion of the healing process the implant would disappear, avoiding long-term side effects or the need for surgical removal. Various corrodible metal alloys based on magnesium, iron or zinc have been proposed as sturdier and potentially less inflammatory alternative to degradable organic polymers, in particular for load-bearing applications. Despite the recent introduction of magnesium-based screws the remaining hurdles to routine clinical applications are still challenging, such as limiting mechanical material characteristics or unsuitable corrosion characteristics. Here, salient features and clinical prospects of currently investigated biodegradable implant materials are summarized with a main focus on magnesium alloys. A mechanism of action for the stimulation of bone growth due to the exertion of mechanical force by magnesium corrosion products is discussed. To explain divergent in vitro and in vivo effects of magnesium a novel model for bacterial biofilm infections is proposed which predicts crucial consequences antibacterial implant strategies.

Materials based on Mg2+-containing phosphates are gaining great relevance in the field of bone tissue repair via regenerative medicine methods. Magnesium ions, together with condensed phosphate ions, play a significant role in the process of bone remodeling, affecting the early stage of bone regeneration through active participation in the process of osteosynthesis. Here we pro-vide a comprehensive overview of the usage of biomaterials based on magnesium phosphate and magnesium calcium phosphate in bone reconstruction. The role of magnesium ions in angiogene-sis, an important process associated with osteogenesis, is considered. Finally, the biological properties of magnesium phosphates for bone regeneration are summarized. They show promis-ing results in terms of use as bone replacement material.

The method of micro-arc oxidation has been utilized to synthesize a protective biocompatible coating for a bioresorbable orthopedic Mg implant. This paper presents the results of a comprehensive research of micro-arc coatings based on diatomite – a biogenic material consisting of shells of diatom microalgae. The main focus of this study was the functionalization of diatomite-based micro-arc coatings by incorporating the particles of titania (TiO2) into them. Various properties of the resulting coatings were examined and evaluated. The XRD analysis has revealed the formation of a new magnesium orthosilicate phase – forsterite (Mg2SiO4). It has been established that the corrosion current density of the coatings has decreased by 2-4 orders of magnitude after the inclusion of TiO2 particles, depending on the coating process voltage. The adhesion strength of the coatings has increased following the particle incorporation. The processes of dissolution of both coated and uncoated samples in a sodium chloride solution were studied. The in vitro cell viability was assessed, which showed that the coatings significantly reduce the cytotoxicity of Mg samples.

Purpose: To meet the challenges of the precision medicine era, quality assessment of shared sarcoma care becomes pivotal. The MDT approach is the most important parameter for succesfull outcome. Because of all MDTs disciplines surgery is the key step to render sarcoma patients disease free, defining the spectrum of a sarcoma surgeon is critical. To the best of the authors knowledge, a comprehensive interoperable digital platform to assess the scope of sarcoma surgery and the experience of a sarcoma surgeon in its full complexity is lacking. Methods: A web-based real-world data (RWD) registry on sarcoma surgery has been created to assess the clinical exposure, tumor characteristics, and surgical settings and techniques applied for both resections and reconstructions of sarcomas and thereby the surgical exposure of an individual surgeon over time. Results: During 10 years, there were 723 sarcoma board/MDT meetings discussing 3130 patients. A total of 1094 patients underwent 1250 surgical interventions on mesenchymal tumors by one single sarcoma surgeon. These included 615 deep soft tissue tumors (197 benign, 102 intermediate, 281 malignant, 27 simulator, 7 metastasis, 1 blood), 116 superficial soft tissue tumors (45 benign, 12 intermediate, 40 malignant, 18 simulator, 1 blood) and 519 bone tumors (129 benign, 112 intermediate, 182 malignant, 18 simulator, 46 metastasis, 14 blood and 18 sequelae of 1st treatment). Detailed types of resections and reconstructions were analyzed. Conclusion: A web-based RWD sarcoma surgeon registry with transparent real-time descriptive analytics is feasible and enables large scale definition of the surgical complexity and ultimately quality of sarcoma care.

An accurate, economical, and reliable device for detecting falls in persons ambulating with the assistance of an orthopedic walker is crucially important for the elderly and patients with limited mobility. Existing wearable devices such as wristbands are not designed for walker users, and patients may not wear them at all times. This research proposes a novel idea of attaching an internet-of-things (IoT) device with an inertial measurement unit (IMU) sensor directly to an orthopedic walker to perform real-time fall detection as well as activity logging. A dataset is collected and labeled for walker users in four activities, including idle, motion, step, and fall. Classic machine learning algorithms are evaluated using the dataset by comparing their classification performance. Deep learning with convolutional neural network (CNN) is also explored. Furthermore, the hardware prototype is designed by integrating a low-power microcontroller for onboard machine learning, an IMU sensor, a rechargeable battery, and Bluetooth wireless connectivity. The research results show the promise of improved safety and well-being of walker users.

Bioactive surface coatings have retained the attention of researchers and physicians due to their versatility and range of applications in orthopedics, particularly in infection prevention. Antibacterial metal nanoparticles (mNPs) are a promising therapeutic, with vast application opportunities on orthopedic implants. The current research aimed to construct a polyelectrolyte multilayer on a highly porous titanium implant using alternating thin film coatings of chitosan and alginate via the layer-by-layer (LbL) self-assembly technique, along with the incorporation of silver nanoparticles (AgNPs) or titanium dioxide nanoparticles (TiO2NPs), for antibacterial and osteoconductive activity. These mNPs were characterized for their physicochemical properties using quartz crystal microgravimetry with dissipation system, nanoparticle tracking analysis, scanning electron microscopy, and atomic force microscopy. Their cytotoxicity and osteogenic differentiation capabilities were assessed by AlamarBlue and alkaline phosphatase (ALP) activity assays, respectively. The antibiofilm efficacy of the mNPs tested against Staphylococcus aureus. The LbL polyelectrolyte coating was successfully applied to the porous titanium substrate. A dose-dependent relationship between nanoparticle concentration and ALP as well as antibacterial effects was observed. TiO2NP samples were also less cytotoxic than AgNP counterparts, although similarly antimicrobial. Together, these data serve as a proof-of-concept for a novel coating approach for orthopedic implants with antimicrobial and osteoconductive properties.

Titanium micro-scale topography results in excellent osteoconductivity and bone-implant integration. However, the biological effects of sub-micron topography are unknown. We compared osteoblastic phenotypes and in vivo bone and implant integration abilities between titanium surfaces with micro- (1–5 µm) and sub-micro-scale (0.1–0.5 µm) topographies and machined titanium. Average roughness was 12.5 ± 0.65 nm, 123 ± 6.15 nm, and 24 ± 1.2 nm for machined, micro-rough, and sub-micro-rough surfaces, respectively. The micro-rough surface showed the fewest cells attaching during the initial stage and the lowest proliferation. Calcium deposition and expression of osteoblastic genes were highest on the sub-micro-rough surface and lowest on the machined surface. Bone-to-implant integration was strongest for the micro-rough surface, consistent with it having the greatest ability to retain cells in vitro. Thus, the biological effects of titanium surfaces are not necessarily proportional to the degree of roughness in osteoblastic cultures or in vivo. Sub-micro-rough titanium ameliorates the disadvantage of micro-rough titanium by restoring cell attachment and proliferation and enhances the rate of osteoblastic differentiation over that of micro-rough titanium; however, bone integration and the ability to retain cells are compromised due to its lower interfacial mechanical locking compared to that of micro-rough titanium.