Fixation Point Research Articles

Perioperative Considerations in Patients with Rett Syndrome as Compared to Those with Cerebral Palsy.

Retrospective cohort study. This study aimed to compare perioperative outcomes of Rett syndrome and Cerebral palsy patients undergoing posterior spinal fusion for neuromuscular scoliosis. Surgical correction in the treatment of scoliosis for patients with Rett syndrome (RS) has been shown to increase survival rate. Cerebral palsy (CP) patients, like RS patients, are often nonverbal, nonambulatory, with frequent surgical complications. Retrospective review of 36 RS and 80 CP patients undergoing PSF from 2005-2023. Data and x-ray measurements were collected pre- and post-operatively. Sub-analysis was performed comparing non-ambulatory patients (GMFCS IV-V). Wilcoxon-Rank Sum, Fisher's Exact, and Chi-square tests were utilized. The primary outcome measure, complication rates, was similar between the groups (P=0.09). Preoperative Cobb angle, levels fused, fixation points, and LOS were similar (P>0.05). EBL was significantly higher in CP patients as was rate of transfusion (P=0.001) and surgical time (P=0.001). Postoperative Cobb angle (P=0.002) was significantly higher for CP patients. There was no significant difference between CP and RS patients in both preoperative (P=0.383) and postoperative (P=0.051) coronal decompensation. Nonambulatory status was associated with increased odds of having a postoperative complication (OR=6.17, 95% C.I. 1.36 - 28.04). Sub-analysis of non-ambulatory RS and CP patients revealed significantly higher postoperative Cobb (P=0.008), EBL (P=0.019) and surgical time (P=0.017) in CP patients compared to RS patients. There were no significant differences in preoperative Cobb, levels fused, fixation points, hospital stay, or complication rate (P>0.05). RS patients are shown to have better outcomes to CP patients in terms of surgical, perioperative, and radiographic variables. Ambulatory status was identified as an independent risk factor for complications.

Retinal "sweet spot" for myopia treatment.

We studied which retinal area controls short-term axial eye shortening when human subjects were exposed to + 3.0D monocular defocus. A custom-built infrared eye tracker recorded the point of fixation while subjects watched a movie at a 2m distance. The eye tracker software accessed each individual movie frame in real-time and covered the points of fixation in the movie with a uniform grey patch. Four patches were programmed: (1) foveal patch (0-3 degrees), (2) annular patch (3-9deg), (3) foveal patch (0-3deg) combined with an annular patch (6-9deg), and (4) full-field patch where only 6-10deg were exposed to the defocus. Axial eye shortening was elicited similarly with full-field positive defocus and with the foveal patch, indicating that the fovea made only a minor contribution (-11 ± 12μm vs. -14 ± 17μm, respectively, n.s.). In contrast, patching a 3-9 degrees annular area or fovea together with an annular area of 6-9 degrees, completely suppressed the effect when compared with full-field defocus (+ 3 ± 1μm or -2 ± 13μm vs. -11 ± 12μm, respectively, p < 0.001). Finally, we found that the near-peripheral retina (6-10 degrees) is a "sweet spot" for positive defocus detection and alone can regulate eye growth control mechanism, and perhaps long-term refractive development (-9 ± 8μm vs. full-field: -11 ± 12μm, n.s.).

The overestimation of gaze for horizontal, vertical, and diagonal fixation points.

A widely known result from gaze-perception research is the overestimation effect where gaze endpoints are seen farther to the side than they actually are. While horizontal gaze directions have been studied repeatedly, there is scarce research on other directions after early reports that vertical gaze is perceived accurately. It is argued that if participants base their judgment on the movements of the iris-pupil-complex in relation to eye size, vertical gaze should be overestimated similarly as horizontal gaze. This is what was found in the reported experiment. However, horizontal gaze was actually overestimated more than diagonal and vertical gaze. The small difference in overestimation between the axes may be explained by the horizontal-vertical illusion, entailing that horizontal extensions are seen as shorter than vertical extensions.

A Biomechanical Analysis of Instrumentation Constructs During Vertebral Column Resection: Stability When You Need It!

Biomechanical Testing. Investigate the optimal construct for stabilization of the spine during vertebral column resection (VCR). VCR is a powerful technique for achieving correction in severe cases of spinal deformity. However, this also creates an unstable spine which requires stable fixation to prevent iatrogenic neurologic injury. It is common practice to place a temporary unilateral rod configuration to achieve this stability during surgery but no study to date has investigated the optimal construct configuration. A unilateral VCR model representing an acute 50° kyphotic deformity with a standardized 30mm resection was created. Three conditions underwent testing: 1) Rod material and diameter, 2) rod configuration, and 3) number of fixation points. Six unique samples were tested in each group in both flexion-extension. Prior to testing a 10N preload and underwent cyclical testing in flexion/extension. System stiffness was calculated and compared across groups. Assessment of rod size and composition using a single screw construct (2 total screws) demonstrated that for Titanium (Ti) rods, increasing rod size significantly increased the construct stiffness (P=0.001). Although Cobalt-chromium (Co-Cr) rods where significantly stiffer than the corresponding sized Ti rods, there was no significant difference between rod diameters for Co-Cr (P=0.98). However, when tested using a dual screw (4 total screws) construct, these constructs were significantly stiffer than the corresponding single screw constructs (P<0.0001). Of the various rod configurations, the dual rod demonstrated the greatest stiffness (34.8±2.1N/mm; P<0.0001). Surgical construct stiffness during a VCR is multifactorial. Larger rod diameter, increased number of fixation points, stiffer rod material, and increased number of rods across the resection site increase the construct stiffness. With minimal points of fixation using Co-Cr rods, increasing rod diameter does not impart greater construct stiffness unless additional fixation points are included.

Predicting Shot Accuracy in Badminton Using Quiet Eye Metrics and Neural Networks

This paper presents a novel approach to predicting shot accuracy in badminton by analyzing Quiet Eye (QE) metrics such as QE duration, fixation points, and gaze dynamics. We develop a neural network model that combines visual data from eye-tracking devices with biomechanical data such as body posture and shuttlecock trajectory. Our model is designed to predict shot accuracy, providing insights into the role of QE in performance. The study involved 30 badminton players of varying skill levels from the Chinese Swimming Club in Singapore. Using a combination of eye-tracking technology and motion capture systems, we collected data on QE metrics and biomechanical factors during a series of badminton shots for a total of 750. Key results include: (1) The neural network model achieved 85% accuracy in predicting shot outcomes, demonstrating the potential of integrating QE metrics with biomechanical data. (2) QE duration and onset were identified as the most significant predictors of shot accuracy, followed by racket speed and wrist angle at impact. (3) Elite players exhibited significantly longer QE durations (M = 289.5 ms) compared to intermediate (M = 213.7 ms) and novice players (M = 168.3 ms). (4) A strong positive correlation (r = 0.72) was found between QE duration and shot accuracy across all skill levels. These findings have important implications for badminton training and performance evaluation. The study suggests that QE-based training programs could significantly enhance players’ shot accuracy. Furthermore, the predictive model developed in this study offers a framework for real-time performance analysis and personalized training regimens in badminton. By bridging cognitive neuroscience and sports performance through advanced data analytics, this research paves the way for more sophisticated, individualized training approaches in badminton and potentially other fast-paced sports. Future research directions include exploring the temporal dynamics of QE during matches and developing real-time feedback systems based on QE metrics.

Eye-tracking investigation of emotional feedback to southern Hebei courtyard gates

ABSTRACT The attention of residents has always been drawn to the courtyard gates of rural residential buildings, this is the basis for evaluating the first impression of the countryside by first-time visitors. Using eye-tracking technology, this study measures the pupil diameter, fixation duration, and fixation point of subjects as objective physiological data, Then combined with the results of the subjective satisfaction questionnaire for a comprehensive analysis. The findings showed that, When the subjects evaluated their satisfaction with the courtyard gates, the proportion and color of the modeling elements led to the subjects’ emotional changes, and the subjects focused mainly on the central axis and the connection of various structures with raised areas. In order to elicit positive emotions in the subjects, village gate designs should therefore adhere to the standard specification’s requirements as well as the following: the width of the gate should be 0.8 times the height, the height should be 5 times the width of the gateposts, and the color should match the material’s color. To meet the emotional needs of the visitors, the final design strategy of the proportion and color of rural courtyard gates in southern Hebei Province is proposed.

A multimodal physiological-psychological data-driven study on differentiation in miners' job burnout and risk preferences.

Existing research indicates that the personality traits of miners influence their emotional regulation strategies, and these strategies in turn affect their performance in work fatigue. However, whether there is an intermediary or moderating role among these factors remains unclear. Additionally, while some studies suggest an increased likelihood of unsafe behavior among miners following fatigue, physiological data concerning their cognition remains incomplete and requires further exploration. This study aims to explore the mediating and moderating effects of emotional regulation strategies among miners regarding their personality traits and work fatigue, and to expand understanding of the cognitive and physiological data related to miners' risk decision-making following fatigue. Fifty adult miners (Mage = 25, aged 18-40, 100% male) were selected as participants. Emotional regulation tendency, significant levels of personality traits based on the Big Five Personality Traits questionnaire, and the three-dimensional levels of work fatigue were measured using emotional regulation strategy scale, Big Five Personality Traits questionnaire, and work fatigue scale, respectively. The eye-brain consistency hypothesis posits that eye movement trajectories and fixation points reflect the brain's cognitive processes and focus. Therefore, combining eye-tracking experiments, miners' preferences in risk decision-making were further measured. Expressive suppression strategies mediated between conscientiousness and depersonalization; expressive suppression strategies moderated between agreeableness and emotional exhaustion. In eye-tracking physiological experiments, significant differences were found in eye movement data among miners with varying levels of emotional exhaustion. Preferences in emotional regulation strategies play mediating and moderating roles between miners' Big Five Personality Traits and work fatigue. The levels and dimensions of work fatigue are influenced not only by personality traits but also by individual tendencies in emotional regulation strategies, which significantly affect performance in risk decision-making. The findings of this study can further enrich theories related to work fatigue among miners and provide insights for personalized safety management in mining.

Evaluation of Optical Tracking to Distinguish Surgeon Experience During Endoscopic Stone Surgery.

Introduction and Objectives: Optical tracking (OT) has shown potential in assessing surgical skill but has yet to be evaluated for endoscopic urologic surgery. We sought to evaluate the potential for OT to distinguish expert and trainee surgeons during flexible ureteroscopy (fURS) for kidney stone treatment in both simulated and live surgical settings. Methods: We performed OT analysis of six surgeons performing stone localization during fURS in two settings. In the first setting, surgeons were tasked with fiducial localization in three separate kidney phantoms during fURS. In the second setting, surgeons performed stone localization via fURS in five separate patients. Surgeons were categorized as "expert" (n = 3, endourologist, average case volume of >100 fURS per year) or trainee (n = 3, trainee, <100 fURS per year). OT metrics were recorded for both settings using the Microsoft HoloLens 2© as the surgeons viewed the surgical monitor during fURS. Standard OT metrics of experts and trainees were compared, and included: area of eye gaze movement, gaze distance traveled, number of gaze fixation points, percentage of gaze fixation dwell time, and number of saccades. Results: In the simulated setting, the average time for stone localization was greater for trainees compared to experts (318 seconds vs 52 seconds, p < 0.01). Additionally, the mean area of eye gaze movements with area of interest (AOI) was greater for trainees compared to experts (1430 cm2 vs 1060 cm2, p < 0.01). The total gaze distance traveled was also greater for trainees compared to experts (1480 cm vs 730 cm, p < 0.01). In the live surgical setting, average time for stone localization was similar for trainees and experts (74 seconds vs 51 seconds, p = 0.05). The total area of eye gaze movements in AOI was greater for trainees compared to experts (700 cm2 vs 30 cm2, p < 0.01). Additionally, the total gaze distance traveled was greater for trainees compared to experts (14,000 cm vs 680 cm, p < 0.01). This suggests more varied and less point specific concentration on the surgical screen by trainees. There was no difference in percentage of gaze fixation dwell time and number of saccades between experts and trainees in either setting. Conclusions: OT analysis can objectively distinguish surgical experience between experts and trainee surgeons performing fURS in both simulated and live surgical settings. These findings may play a role in future surgical training and skills assessment.

Does More Invasive Surgery Result in Higher Patient Satisfaction? A Long-Term Follow-Up of 136 Zygomaticomaxillary Complex Fractures

Study Design Retrospective with follow-up. Objective To evaluate the long-term satisfaction of surgically treated patients with zygomaticomaxillary complex (ZMC) fractures in relation to the use of internal fixation, number of fixation points, and orbital floor (OF) reconstruction. Secondary objectives were to describe the use of antibiotics and post-operative infections. Methods Patients with unilateral ZMC fractures between 2007-2018 and treatment with either open reduction and internal fixation (ORIF) or closed reduction (CR) were identified from medical records and invited to follow-ups between 2018-2020. Patients were examined, photographed, and completed a questionnaire. A review panel of 3 experienced surgeons evaluated photographs and computed tomography (CT) scans pre- and post-surgery. Results The study sample consisted of 136 patients (108 ORIF, 28 CR) with a median follow-up time of 76 months. Patient satisfaction of surgical outcome was high (97.8%), with no significant differences in relation to the use of internal fixation, number of fixation points, or OF reconstruction. Dissatisfaction was primarily related to hypoesthesia. On post-operative CT scans, malar asymmetry was more often predicted in patients with 1-point fixations. On questionnaires and photographs, malar asymmetry was more common in patients with 3-point fixations. Prophylactic antibiotics had no effect on the rate of post-operative infections. Conclusions Patient satisfaction was not influenced by internal fixation, number of fixation points, or OF reconstruction. Selected ZMC fractures can be treated with less invasive approaches. Caution should be observed when predicting long-term malar asymmetry on post-operative CT scans. The findings of this study highlight the importance of a rational and ethical use of surgery.

Visual Field Patterns in Optic Neuropathy

The optic nerve is susceptible to a wide variety of pathological processes. In optic neuropathy, quantitative visual field analysis using standard automated perimetry is critical in initial diagnosis, monitoring disease progression, and guiding treatment plans. While acquired visual field defects may progress rapidly, congenital visual field defects may not progress or may progress slowly. Although the most common defect in congenital or acquired optic neuropathy is the central defect, many defect types that are not pathognomonic to the disease can be seen. In ischemic optic neuropathy, which is common among optic neuropathies, arcuate defect and central defect are usually seen. In disc disorders with localized nerve damage, such as optic disc coloboma or optic pit, localized defects such as arcuate scotoma or cecocentral scotoma in which the fixation point is preserved may be observed. Papilledema causes peripapillary fluid accumulation and an enlarged blind spot in the perimetry. In compressive optic neuropathies, non-specific defects such as central and subtudinal defects may be observed, as well as quadrant defects such as hemianopsia and quadrionopsia. Studies show that the combined use of optical coherence tomography and standard automated perimetry to determine structure-function relationships improves clinical care in neuro-ophthalmic disorders.

Automotive powertrain electrification: system methodology to guarantee acoustic comfort

For the past few years, electrification has disrupted the automotive industry. Surprisingly, Noise Vibration and Harshness (NVH) became a major issue as it is located in high frequencies (1 to 5 kHz). The noise has 2 origins: the electromagnetic forces in the electric motor and the gear mesh forces in the reducer. The first part focuses on the methodology developed in collaboration with car-makers in order to integrate the powertrain in a satisfying way in the vehicle. First, this process is focused on the structure-borne noise. Attention is paid on rubber mounts and on their fixation points. Second, the airborne transfer may become an issue. Despite the acoustic power requirement provided, the final vehicle performance is not guaranteed. Examples will illustrate these important topics. The second part pays attention to the prediction of reducer noise. Automotive stakeholders are approaching the gear mesh source by approximate linear tools. Recent works have shown that this methodology has limitations and leads to inaccurate results. This may be a major concern. A few examples will illustrate this risk and show that further simulation developments are necessary.

Bony Dorsal Preservation.

Rhinoplasty is undergoing a transformation with the re-emergence of Dorsal Preservation Rhinoplasty (DPR) techniques. This article introduces a novel addition to the DPR repertoire, "Bony Dorsal Preservation" (BDP), which has particular application for the correction of crooked noses. In this comprehensive overview, we summarize current DPR concepts and techniques, the intricate considerations that go into the dorsal osseocartilaginous vault and septal management, and how these are modified to treat the crooked nose. However, current DPR techniques, particularly the Low Septal Strip (LSS), have drawbacks, and the desire to address such issues led to the development of BDP. BDP is ideal for cases where there is no septal base pathology. It maintains the core principle of DPR by lowering dorsal humps without creating open roof deformities. Its unique feature lies in the temporary separation of the upper lateral cartilages from the septum while leaving the septal base attachment intact, thus allowing the entire osseocartilaginous vault to be adjusted independently before reconnecting the preserved upper lateral cartilages. This technique offers direct visualization during septal excision and fixation and enables cartilaginous vault movement without sacrificing stability. Compared to LSS, there is more septal cartilage available for harvesting, the risks of a single point of septal fixation are eliminated, and there is the potential to transition to component reduction techniques if needed. With shared indications and contraindications with other DPR methods, BDP emerges as a valuable addition to the evolving field of rhinoplasty, particularly in addressing the challenges of the crooked nose.

A spotter's guide to endovascular endograft recognition

Since the first endovascular aneurysm repair of abdominal aortic aneurysms in the 1980s, there has not only been exponential growth of procedures performed per year, but also rapid proliferation of stent grafts. With the resultant growth in revision and explant procedures on these grafts, we developed this guide to aid trainees in surgery and radiology in identifying these grafts. Our goal with this spotter's guide is to allow the identification of key features from commonly implanted devices radiographically, such as points of fixation, radiopaque markers, and stent patterns. The operative approach for the treatment of endograft complications, including endoleak embolization, aortic cuff extension, laser fenestration, limb extension, and endograft explant is often dramatically impacted by the type of endograft and its individual device characteristics. The intent of this guide is to aid practitioners in identifying endovascular aneurysm repair endografts of all ages, even those that have not been implanted in years.

Use of the pectoralis minor and coracoacromial ligament for a biplanar coracoclavicular and acromioclavicular reconstruction: A cadaveric feasibility study.

The aim of this study was to evaluate the feasibility of a novel technique that focuses on vertical and horizontal stabilization of the acromioclavicular joint using two local autologous grafts, the pectoralis minor (Pm) and the coracoacromial ligament (CAL). Ten fresh-frozen shoulder cadaveric pieces were dissected. Length and width of the Pm and CAL were measured in their anatomical position and anatomical variants were noted. The Pm tendon was harvested at the myothendinous junction keeping the insertion at the coracoid process. The CAL was detached from the coracoid process keeping the acromial insertion. The free limbs of both grafts were prepared with the Krackow technique and the Arthrex SpeedWhip technique, respectively. The primary coracoclavicular reduction and fixation were with the button system or with two subcoracoid ultrahigh-strength suture cerclage through and around the clavicle. The Pm graft was fixed inside a clavicular tunnel by a cortical button and the CAL was transferred and fixed to the lateral clavicle using a knotless anchor or intramedullary when lateral clavicle resection was performed. The median length of the Pm was 50 mm (interquartile range [IQR]: 50-54), and the median length of the CAL was 36.5 mm (IQR 34-40) which decreased by 15% and 23% once were prepared with the Krackow and Arthrex SpeedWhip techniques to 44.5 mm (IQR: 30-65) and 30 mm (IQR: 22-32), respectively. The diameter of the prepared Pm graft was 5 mm (IQR: 4.5-6) and the CAL graft 5.5 mm (5-6). All grafts were able to reach the fixation points. The procedure was feasible in 100% of the cases. A biplanar reconstruction using autologous Pm and CAL appears feasible in restoring the acromioclavicular joint stability. Level IV. Basic science, anatomy, cadaveric dissection.

Using Eye Movement to Determine Whether Closed-Frame Shots Attract Viewers’ Attention

There is a large variety of photographic composition, and these compositions can illicit different visual and psychological responses in the audience. However, there is limited knowledge of the key factors in these compositions in photography that actually affect the viewing process, and also no empirical support for the relationship between emotional responses and visual cognition. This research applied eye-tracking to calculate the degree of fixation distribution in the process of viewing photographic works through the quantitative characteristics of fixation trajectory in the investigation of the influence of eye-movement information on closed and open image compositions. This research attempts to understand the psychological differences in viewing framed and unframed images and identify the crucial factors that affect the composition of photographic images. Results from the eye movement data found that closed text and photos displayed traits of the principle of closure, and that different compositions can significantly affect the fixation point and sightline distribution. Image compositions with property of closure tend to be more attractive, generating higher number of fixation and longer fixation duration, indicative of easier focus on the primary object in the picture frame and regulating the viewer’s field of view. Photographers try to make good use of frame composition to herd viewer focus as well as increase their interest, making their image composition as complete, concise, pleasant, and pleasurable to the eye, typically applied to landscape, still life or portrait photography. This study has the potential to become a reference that contributes to photography educational and visual communication.

Aesthetic Approaches to Zygomatic Fracture Management: Achieving Optimal Outcomes With Minimal Scarring.

The zygomaticomaxillary complex is integral to facial aesthetics and is frequently involved in facial fractures. These injuries often necessitate surgical intervention, with open reduction and internal fixation being the standard treatment. This article presents a novel philosophy for managing zygomatic fractures, emphasizing the "Scarless Surgery" technique. The authors' approach prioritizes minimal osteosynthesis material and fixation points while utilizing the least visible surgical access. For isolated zygomatic arch fractures, an intraoral technique is preferred, whereas the frontozygomatic suture is approached through an upper eyelid crease for optimal aesthetic outcomes. The zygomaticomaxillary buttress is accessed through a vestibular mucosal incision and the infraorbital rim benefits from a transconjunctival approach. The findings suggest that fewer fixation points can still yield satisfactory stability and cosmetic results, aligning with literature supporting the efficacy of 1 and 2-point fixations. This modern technique not only minimizes visible scarring but also conforms to the contemporary push for minimally invasive surgical methods. The authors' experience and the existing literature support the efficacy of this approach, reinforcing its viability as a standard practice in the surgical management of facial trauma.

Information sampling differences supporting superior face identity processing ability.

Face recognition in humans is often cited as a model example of perceptual expertise that is characterized by an increased tendency to process faces as holistic percepts. However emerging evidence across different domains of expertise points to a critical role of feature-based processing strategies during the initial encoding of information. Here, we examined the eye-movement patterns of super-recognisers-individuals with extremely high faceidentification ability compared with the average person-using gaze-contingent "spotlight" apertures that restrict visual face information in real time around their point of fixation. As an additional contrast, we also compared their performance with that of facial examiners-highly trained individuals whose superiority has been shown to rely heavily on featural processing. Super-recognisers and facial examiners showed equivalent facematching accuracy in both spotlight aperture and natural viewing conditions, suggesting that they were equally adept at using featural information for faceidentity processing. Further, both groups sampled more information across the face than controls. Together, these results show that the active exploration of facial features is an important determinant of facerecognition ability that generalizes across different types of experts.

The effect of sports expertise on the performance of orienteering athletes’ real scene image recognition and their visual search characteristics

As a sport conducted in dynamically changing natural environments, orienteering places high demands on athletes' cognitive processing abilities and visual search efficiency. However, previous studies on orienteering have been primarily limited by the use of fixed stimulus materials on computer screens, which are unable to fully simulate authentic sports scenarios. To better understand the sports expertise of orienteering athletes in terms of their real scene image recognition performance and visual search characteristics, this study recruited 40 orienteering athletes, both experts and novices, as participants. By utilizing eye-tracking technology and setting observation points in real-world scenarios to conduct image recognition task tests, the ecological validity of the experiment was further enhanced. The results showed that the experts demonstrated a high level of accuracy and a short response time, with visual search characteristics including few saccade counts, low fixation frequency, concentrated fixation points, simple and clear fixation paths, and higher visual search efficiency. This study further reveals that long-term specialized training will lead to the formation of a unique cognitive structure related to the specific knowledge and long-term memory required by expert orienteering athletes, thereby promoting the development of expert advantage.

WP6.9 - Essential Surgery Skills Course: A One Week Training Program to Prepare Surgeons for Humanitarian Deployment

Abstract Background Medical students, surgical trainees, and surgical faculty are increasingly interested in incorporating global surgery into their clinical practices and professional careers. However, many concerns remain about the preparation of surgeons for operating in resource-limited settings and their exposure to critical procedures such as cesarean sections, hysterectomies, or fracture reductions. In an attempt to address these concerns, academic institutions have developed advanced professional training programs for the global surgeon. Methods A six-day essential surgery skills conference was created at a large academic institution that provides trainees and surgeons with an overview of common surgical scenarios across orthopedics, urology, obstetrics, gynecology, general surgery, anesthesia and ultrasound in the form of didactics, simulations, and wet labs. Results 11 surgical trainees from four large academic institutions attended the essential surgery skills conference. Trainees attended sessions on point of care ultrasound, regional anesthesia, general anesthesia, hysterectomies, cesarean sections, post-partum hemorrhage, fracture reduction and fixation, ureteral injuries, and humanitarian deployment. A pre and post-test was administered. Improvement was noted in the trainees scores on the post-test in their knowledge of surgical subspecialty care. Trainees also reported feeling better prepared for humanitarian deployment. Conclusion Global surgery conferences can be designed to provide a networking and collaboration forum for improving access to surgical services worldwide. One-week predeparture conferences that discuss essential technical skills and relevant global surgery knowledge may better prepare surgeons to operate in resource-limited settings.

Medial augmentation of distal femur fractures using the contralateral distal femur locking plate: A technical note.

Lateral locking plates are commonly employed for the fixation of distal femur fractures. However, scenarios involving medial comminution, extremely distal fractures, periprosthetic fractures, or nonunion could necessitate medial augmentation. This study explores the possibility of using lateral distal femoral locking plate systems for medial fixation by employing the contralateral plate. This study presents a technical note on the application of lateral distal femur locking systems for medial augmentation in patients as indicated by current literature findings. Postoperative imaging modalities, including radiography and computed tomography (CT), were used to assess the plates' fit to the distal femur. Three cases following the specified technical note are presented. The various plate systems, all comprising distal femur locking systems, demonstrated adaptability to the medial femur anatomy as confirmed by intraoperative visualization and postoperative radiographs, including two-dimensional and three-dimensional CT scans. It has also been possible to achieve at least 3 independent fixation points regardless of the size of the medial condyle. Locking distal femoral plates can be a viable option for medial augmentation in indicated cases, achieving anatomical adaptation to the distal femur. This provides robust augmentation without the need for additional instruments beyond those used for the lateral cortex.