OBJECTIVES: To analyze the characteristics of medical malpractices in orthopaedic surgeries, to explore principles and methods in medical legal identification, and to provide basic data for uniform medicolegal standard for the future medical identification. METHODS: A retrospective analysis was conducted on 100 cases of medical malpractices in orthopaedic surgery, among the 364 cases archived in Medicolegal Expertise Center of Xi'an Jiaotong University during 2002-2015. RESULTS: In the 100 cases of orthopedic medical malpractices, with 104 hospitals involved in, 95 cases were judged with medical errors and the other 9 cases with no error. The top 3 reasons for errors were （1） inadequate observation or estimation of diseases （27.9%）, （2） intraoperative improper operation （17.3%）, and （3） delayed or missed diagnosis and treatment （12.5%）. The consequences of medical malpractices were mostly disability （61%）, followed by prolonged diseases （31%） and death （8%）. With regard to the causal relationship between medical errors and consequences, 95 cases （91.4%） were with causality and the other 9 cases （8.6%） with no causality. Specifically, 56 cases （53.9%） were with medical errors as the secondary causes accounting for 25% causative potency, and 20 cases （19.2%） were with medical errors as the major causes accounting for 75% causative potency. CONCLUSIONS It is pivotally important for determining the causative potency of medical errors to analyse the causes of damages in orthopaedic surgery and to distinguish subjective factors from objective ones of medical errors.
Humans ; Malpractice ; Medical Errors ; Orthopedic Procedures/standards* ; Orthopedics ; Retrospective Studies

Clinical Protocols ; standards ; Humans ; Orthopedic Procedures ; methods ; standards ; Patellar Dislocation ; surgery

A great deal of comparisons on domestic standards for Orthopedic implants with ISO and ASTM standards have been presented, and some conclusions have been drawn: Domestic standards for orthopedic implants coincide with ISO and ASTM standards in the items of materials, geometry and classification. There are much bigger differences in some key performances of implants such as assembly, fatigue, wear and tear and so on. Some constructive ways have been suggested.
Materials Testing ; Orthopedic Procedures ; standards ; Prostheses and Implants ; standards

The mechanics of a new shape memory alloy cervical hook for atlantoaxial instability was analyzed with finite element method on the basis of a three-dimensional model reconstructed from the images of CT scanning of an adult cadaveric upper cervical at 1-mm interval. The stress and displacement of every nodule and element in the course of deformation of the internal fixation were tested, and the results showed that the cervical hook was strong enough against tensile stress, which concentrates in the middle of the device. The pull was 237.58 N at the loading point. With such mechanical performance, this cervical hook can be reliable for correction of atlantoaxial instability.
Adult ; Alloys ; Atlanto-Axial Joint ; Cadaver ; Finite Element Analysis ; Humans ; Joint Instability ; diagnostic imaging ; surgery ; Male ; Memory ; Orthopedic Fixation Devices ; standards ; Orthopedic Procedures ; instrumentation ; methods ; Radiography ; Reproducibility of Results ; Tensile Strength

OBJECTIVETo design transoralpharyngeal atlantoaxial reduction plate (TARP), evaluate its biomechanical performance and observe its preliminary clinical effect.

METHODSA brand-new TARP system was designed, including butterfly titanium alloy plate, self-locking screws, atlantoaxial reductor and other operation instruments. Twelve fresh occipital bone-C(3) specimen were designed for biomechanical test including range of motion (ROM) (n = 6) and screw pull-out strength (n = 12). Preliminary clinical application of TARP was reported.

RESULTSThe reduction mechanism of the TARP system was designed cleverly. TARP had equal effect with Magerl + Brooks and it was more stable than the other three clinically widely used atlantoaxial fixators: Magerl, Brooks and anterior transarticular screw fixation through C(2) vertebral body. TARP's C(1) and C(2) screws were strong enough for atlantoaxial arthrodesis and their antipull-out performance was excellent. Clinical application on irreducible atlantoaxial dislocation proved that TARP had the function of instant reduction, the operation was feasible and the operation effect was significant.

CONCLUSIONTARP's design is novel and it has excellent biomechanical performance. The operation procedure is simple and reasonable. Furthermore, instant reduction could be completed during the operation and the fixation is strong. Above all, TARP is creative and will have excellent prospect.

Adolescent ; Adult ; Atlanto-Axial Joint ; surgery ; Equipment Design ; standards ; Equipment and Supplies ; adverse effects ; standards ; Female ; Humans ; Joint Dislocations ; etiology ; surgery ; Male ; Orthopedic Procedures ; methods ; Pharynx ; surgery ; Treatment Outcome

OBJECTIVETo evaluate and generalize the application of intermaxillary fixation screw in the jaw fracture.

METHODS41 cases of jaw fracture have been treated with intermaxillary fixation screw.

RESULTSBoth function and appearance have recuperated in 40 cases except 1 case has light malocclusion.

CONCLUSIONSApplication of intermaxillary fixation screw advanced the traditional therapy.

Adolescent ; Adult ; Bone Screws ; standards ; Female ; Humans ; Jaw Fractures ; surgery ; Male ; Maxillary Fractures ; surgery ; Middle Aged ; Orthopedic Fixation Devices ; standards ; Reconstructive Surgical Procedures ; instrumentation ; methods ; Treatment Outcome