ABSTRACT
Este artigo tem como objetivo apresentar a modelagem conceitual de um simulador baseado em realidade virtual para treinamento de anestesia regional. A partir da sistematização dos conceitos relacionados ao aprendizado da técnica a partir de revisão acerca de simuladores previamente desenvolvidos e suas características, bem como levantamento dos elementos teóricos e dos problemas relacionados à execução das técnicas, foi desenvolvido um mapa conceitual, contendo todos os conceitos relacionados de forma hierarquizada, e um fluxograma com eventos e consequências observadas durante a realização do procedimento. Concluiu-se com este trabalho que não existe um simulador totalmente virtual para o treinamento de técnicas de anestesia regional e que o processo de modelagem de um simulador para treinamento necessita da sistematização dos conceitos para guiar o processo de desenvolvimento.
The objective of this research is present the conceptual modeling of a simulator based on virtual reality to support the training in regional anesthesia. From the systematization of concepts related to the learning process ofthe techniques obtained from previously developed simulators and from the identification of theoretical elements and problems related to the execution of the techniques, a concept map was designed with the related concepts organized hierarchically and a flowchart was developed to present events and consequences observed in the execution of the procedure. From the research was possible to observe that there isn't a completely virtual simulator for the training of regional anesthesia techniques and that the process of development of one needs systematization of concepts to guide the process of development.
Subject(s)
Humans , Computer Simulation , Education, Medical/methods , Anesthesia, Conduction , Congresses as Topic , Anesthesiology/educationABSTRACT
BACKGROUND: Multidirectionally unstable supracondylar fracture of the distal humerus presents with severe instability in both flexion and extension. Closed reduction and percutaneous fixation is challenging and may not be obtained by the traditional reduction maneuver. METHODS: We retrospectively evaluated 8 children (4 boys and 4 girls) with a mean age at presentation of 7.6 years (range, 5.3 to 10.9 y) who underwent closed reduction and percutaneous fixation using a joystick technique for the treatment of multidirectionally unstable supracondylar fractures. Clinical and functional results were assessed by the system described by Flynn. Radiographs at last follow-up were compared with those taken immediate after pinning as well as with normal contralateral elbow radiographs at final follow-up. RESULTS: After an average follow-up of 14.5 months (range, 12 to 24 mo), there was no difference between the injured upper extremity and the contralateral side according to cosmetic, functional, and radiographic evaluation. There was no complication such as pin-site infection, loss of fixation, malunion, cubitus varus, iatrogenic nerve injury, or need for further surgery. CONCLUSIONS: The joystick technique is a safe and effective method that can avoid aggressive and frustrating attempts of closed reduction and further open reduction of multidirectionally unstable supracondylar fractures of the humerus in children. LEVEL OF EVIDENCE: Level IV-case series.
