Fracturas diafiarias de los miembros inferiores: planificación preoperatoria digital / Diaphyseal fractures of the lower limbs: digital preoperative planning

La planificación preoperatoria es procedimiento indispensable previo a la realización de cualquier cirugía ortopédica con el fin de obtener un resultado exitoso, sin embargo, el proceso suele ser lento y engorroso, por lo que pocos cirujanos ortopedistas lo realizan de manera rutinaria. Planteamos el desarrollo de un Software de planificación preoperatoria digital para fracturas diafisiarias de miembros inferiores que pueda ser utilizado como una herramienta confiable en la práctica diaria del cirujano ortopedista. Mediante la obtención de un archivo de imagen con la fractura que se desea planificar, a través de una cámara digital o de un sistema PACS integrado, nuestro software permitirá la realización de una planificación preoperatoria de manera precisa y rápida brindándole al usuario herramientas de registros y almacenamiento de datos, calibración y mejoramiento de imagen, medición de distancias y ángulos, segmentación del trazo de fracturas, etc. También se incluyen galería implantes ortopédicos, así como sistema de clasificación AO, todo lo anterior con el fin de generar de un reporte que incluya todos los detalles necesarios que puedan facilitar la labor del ortopedista previo al momento del acto quirúrgico

Preoperative planning is a cornerstone procedure prior any orthopaedic surgery in terms of achieving excellent results, however, the process is slow and difficult; hence,there are few orthopaedic surgeons who perform it on a day-to-day basis. We Propose the Development of a Preoperative Planning Software for the lower limbs long bone diaphiseal fractures that can serve as reliabletool for the orthopaedic surgeon. Using an image archive with the fracture site, obtained from a digital camera or a PACS integrated system, our software can perform a preoperative planning in a fast and precise manner, giving the user tools to perform data managementand storing, image calibration and rendering, distance measuring and angle calculation, fracture site segmentation, etc. Also includes a diverse orthopaedic implants gallery, and the AO comprehensive classificationsystem; all of the above made it with the final goal to generate a report who includes all the necessary details,to facilitate the surgeon duty, prior to the surgery per se.

Management of cardiac arrest in operation theatre.

Cardiac arrest is better prevented than treated. Cardiac arrest in operation theatre is reversible in 90% cases. So as soon as cardiac arrest occurs immediate treatment should be started. Time is very important factor. Cardiac arrest in patient with cardiac diseases, other medical diseases, electrolyte disturbances are difficult to reverse. The time interval between cardiac arrest and the death of tissue in the central nervous system is approximately three and half minutes and there is ample clinical justification for accepting this period, though patients have survived intact for longer intervals. It can, however, only be completely acceptable on the basis that the patient is adequately oxygenated up to the moment of cardiac arrest. If hypoxia is present before this occurs, then severe neurological damage may result from even shorter periods of ischaemia than three and a half minutes. Resuscitation will often be ineffective if the precipitating cause is not recognised and treated. It requires a calm and logical mind with a good understanding of medicine to sort out and treat the underlying condition while at the same time performing emergency resuscitation. A review of management of cardiac arrest in operation theatre is presented.