Ever think that those younger doctors with their new-fangled ways aren't nearly as good as the seasoned pros? Well while you might think that the veterans have the advantage, researchers are now saying that in the battle of old versus new it's technique not technology that wins the race. In fact, if properly done, new techniques hold far greater possibilities for improvement than older techniques, and the new surgeons learning these techniques directly in school may be the the best adept to their correct implementation.
In a new study presented Thursday Mar. 26 at the American Academy of Orthopedic Surgeons Annual Meeting, a team of orthopedic surgeons from the University of Pennsylvania School of Medicine revealed that when they investigated modern technology to heal fractures in the femur, contemporary methods were just as effective, if not more, than established alternatives when done correctly. The two methods the researchers investigated differ in the approach of applying "locked plating" and "non-locked plating" to the femur in an attempt to repair distal fractures. However, when the researchers examined the medical records of 95 patients who underwent the two surgeries they found that the two approaches did not reveal significant differences when it came to healing rates, hardware failure or the need for corrective surgery.
"Plates used in distal femur surgery come in various sizes, and have as many as 16 to 20 apertures, or screw holes," lead author of the study and chief of the division of Orthopaedic Trauma, Dr. Samir Mehta says. "In the early days of locked plating, some surgeons used screws in every one of these apertures, which we think lead to stiffness, rigidity and pain for patients."
"Today, surgeons are more judicious, using far fewer screws and picking and choosing which holes to insert the screws in based on factors in the case at hand. This improved decision-making on the part of surgeons is what we believe has resulted in the significant decrease in technical problems associated with locked plating."
In essence the two methods differ in that modern locked plating techniques eliminate the possibility of the plate shifting, however, in application the researchers and the surgeons found that this issue is far more complex when you take into account the varying medical histories of every patient involved. According to the researchers the major factor impacting healing was the duration of the time that the fracture was left open, but after factoring into the data all of the variants the researchers found little to no differences between the two techniques, if both were applied correctly.
"As surgeons become more adept at application of both established and developing implant technologies, outcomes will continue to improve," coauthor of the study, Dr. Ryan M. Taylor says. "However, we must remain cognizant of patient specific variables such as age, weight, and pre-existing comorbidities, which can affect overall care strategies and management."
