Das besondere Instrument: der LISS-Traktor

Abstract

Between May 1998 and September 2001, a total of 42 patients had their distal femoral fractures stabilized by LISS. The AO distractor was used from the 18th case onward. A time saving of approximately 13% was estimated, taking the learning curve of the LISS system into consideration. Three of 42 fractures showed relevant postoperative varus or valgus malalignment. No rotational malalignment was found. An effect of the LISS tractor on the incidence of malalignment could not be found with the limited number of cases examined; however, malalignment was correlated well with the rates found in literature for distal femoral fractures.

Learning curves in hip fracture surgery

“…In addition, duration of operation has economic implications due to the price of running an operating facility, as well as physiological implications to the patient. In this study we used operating time as a proxy measure for evidence of learning, which is supported by other studies using time to complete a task as a measurement of outcome [4,6].…”

“…Learning curves have been studied in a number of fields including arthroplasty surgery [1][2][3][4][5][6]. It has been used as an argument for subspecialisation [7], implying that certain procedures are technically challenging and have poor outcomes for physicians without enough experience to master the skills needed to perform them [8].…”

“…Outcome measures in depicting the learning curve are mostly proxy measures and have included time to completion of a task [4,6], number of X-rays necessary [4], rate of complications [11], radiological parameters [12], as well as measurements of screw placement [5,13] and the proportion of satisfactory results [7]. Time-action analysis is a video-based quantitative method that can be used to evaluate surgical technique and learning more objectively [14], but is not practical in a clinical setting.…”

“…New techniques might be regarded as technically more challenging, such as mini-invasive procedures or procedures that require a high level of precision [2,3]. However, new techniques might also be introduced to reduce the degree of difficulty or increase precision, such as novel aiming devices and computer navigation [4,6,16]. In clinical trials, the effect of the learning curve might be profound when an established technique is compared to novel methods [10,17].…”

Finite element analysis of the equivalent stress distribution in Schanz screws during the use of a femoral fracture distractor

“…Several studies have demonstrated its application in highly varied situations of orthopedic trauma. 2 , 3 …”