[Pattern of injuries to the surgical team during ophthalmosurgical interventions]. / Verletzungsmuster des Operationsteams bei augenchirurgischen Eingriffen.

BACKGROUND: Accidental sharp injuries among the health-care workers are frequent, especially in the surgical disciplines. Because there are only limited data available about accidental sharp injuries in small surgical disciplines, we investigated the occurrence of sharp injuries among ophthalmosurgeons in Switzerland. METHODS: An anonymous questionnaire was sent to all 500 members of the Swiss Ophthalmological Association. We asked how often the surgeons or any member of the surgical team suffered injury during an ophthalmic surgery within the last 2 years and which instrument had caused the injury. Using linear regression we analysed the connection between the occurrence of injuries and various factors, e.g., the age or experience of the surgeon, whether any actions in the case of an injury were taken, whether the event was documented and whether actual guidelines were followed. RESULTS: In the 117 analysed questionnaires we counted 193 injuries. 42.7 % of the surgeons (n = 50, 95 % CI 33.7 % - 51.8 %) had injured themselves at least once during the past two years and 59.8 % of the surgeons (n = 70, 95 % CI 50.9 % - 68.7 %) reported injuries among the rest of the surgical team. On average, surgeons were injured 0.66 times in two years (range 0-4 injuries per person). Most injuries were caused by hollow needles [28.2 % of self injuries (95 % CI 18.2 % - 38.2 %)], 24.3 % of injuries of team members (95 % CI 16.5 % - 32.1 %). 53.0 % of the surgeons (n = 63, 95 % CI 44.0 % - 62.0 %) reported the case whereas 18.8 % (n = 22, 95 % CI 11.7 % - 25.9 %) never reported them. Some questionnaires did not contain the answers to those last questions. Using chi-square, we could observe more injuries in the middle-age section and in surgeons with 11-30 years of surgical experience (p < 0.05). The regression did not show any dependence on the rate of injuries on the surgeon's experience and the number of performed surgeries. CONCLUSIONS: We conclude that in ophthalmosurgery sharp injuries to surgeons or their surgical team happen frequently and only about 50 % of the cases are reported. This study shows that there is room for improvement concerning the documentation and the actions taken after an injury. Thereby potential sources of danger could be better monitored.

Chiari pelvic osteotomy in Perthes disease.

A retrospective study of 17 Chiari osteotomies performed on patients with Perthes disease who were followed until the end of growth is presented. The average age at operation was 8 years 9 months. Catterall grading was mainly group IV. Chiari osteotomy provided satisfactory femoral head coverage with a decreased acetabular index and a 19.6 degrees improvement of the Wiberg angle. Good femoral coverage was related to age at operation and the site of the osteotomy on the upper rim of the acetabulum. The postoperative result was less successful on younger patients or when the osteotomy was performed higher. At follow-up, the results of femoral head sphericity studied by Mose measurements were favorable under Catterall grading.