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Oberlohr V, Giordano V, Hungria JOS, Caiero M, Pires RE, da Silva LHP, Pallottino A, Sanchez GT, Labronici PJ, MacKechnie M, Miclau T. LEADERSHIP DEVELOPMENT TRAINING FOR BRAZILIAN ORTHOPEDIC SURGEONS. Acta Ortop Bras 2024; 32:e272375. [PMID: 38532865 PMCID: PMC10962097 DOI: 10.1590/1413-785220243201e272375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Accepted: 03/30/2023] [Indexed: 03/28/2024]
Abstract
Objective To report on the experience and impressions of the Brazilian orthopedic trauma surgeons attending the Leadership Development Program (LDP) hosted by the Sociedade Brasileira do Trauma Ortopédico (SBTO) in Sao Paulo, Brazil on November 4, 2022. Methods Forty-eight orthopedic trauma surgeons from five different regions throughout Brazil were provided a link to complete The Big Five Test, a validated online personality assessment. The questionnaire was available in Portuguese and was intended to provide a background on individual personality traits and their influence on interpersonal interactions. The LDP integrated content from literature reviews specific to Latin America, established leadership programs from leading business schools, and various subject matter experts. Prior to the start of the LDP, participants received a pre-course survey evaluating demographic information, a needs assessment, and the prioritization of leadership topics utilizing a 5-point Likert-scale. Attendees participated in the one-day, interactive LDP focusing on the fundamental principles of leadership development, communication, personal development, emotional intelligence and negotiation. Following the LDP, a post-course evaluation was administered to determine the participants' overall experience, and suggestions for LDP improvement. Results Forty-one of the forty-eight course participants completed the pre-course evaluation, whereas forty-six of the forty-eight participants completed the post-course evaluations. Overwhelmingly, the lack of opportunity was most prevalently reported as the main obstacle to attending a leadership course, as cited by 56% of respondents. Conclusion Expanding the accessibility, diversity, and customizability of leadership programs can facilitate the development of personal tools needed to move healthcare forward. Critical topics include emotional intelligence and other differentiating leadership qualities that distinguish true transformational and servant leaders. Advancing leadership skills can stimulate networking, expose learners to experiential learning styles, inspire others to create positive change, and engender creative solutions for systematic improvements and health outcomes. Level of Evidence III; Individual Case-Control Studies.
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Affiliation(s)
- Verena Oberlohr
- University of California, Orthopaedic Trauma Institute, Department of Orthopaedic Surgery, San Francisco, School of Medicine, Zuckerberg San Francisco General Hospital, San Francisco, California, USA
| | - Vincenzo Giordano
- Hospital Municipal Miguel Couto, Prof. Nova Monteiro Orthopedics and Traumatology Department, Rio de Janeiro, RJ, Brazil
- Rede D’or São Luiz, Clínica São Vicente, Rio de Janeiro, RJ, Brazil
| | | | - Marcelo Caiero
- Hospital das Clínicas da Faculdade de Medicina da USP, Institute of Orthopedics and Traumatology, São Paulo, SP, Brazil
| | - Robinson Esteves Pires
- Universidade Federal de Minas Gerais (UFMG), Department of the Locomotor System, Belo Horizonte, MG, Brazil
| | | | - Alexandre Pallottino
- Hospital Central Aristarcho Pessoa - CBMERJ, Orthopedics Department, Rio de Janeiro, RJ, Brazil
| | - Gustavo Tadeu Sanchez
- UNIFESP (Universidade Federal de São Paulo), Paulista School of Medicine, Department of Orthopedics and Traumatology, São Paulo, SP, Brazil
| | - Pedro José Labronici
- Hospital Santa Teresa, Prof. Donato D’Ângelo Orthopedics and Traumatology Department, Petrópolis, Rio de Janeiro, RJ, Brazil
| | - Madeline MacKechnie
- University of California, Orthopaedic Trauma Institute, Department of Orthopaedic Surgery, San Francisco, School of Medicine, Zuckerberg San Francisco General Hospital, San Francisco, California, USA
| | - Theodore Miclau
- University of California, Orthopaedic Trauma Institute, Department of Orthopaedic Surgery, San Francisco, School of Medicine, Zuckerberg San Francisco General Hospital, San Francisco, California, USA
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Albuquerque RPE, Giordano V, Pallottino A, Sassine T, Canedo R, Pina J, do Amaral NP. ANALYSIS OF THE REPRODUCIBILITY OF TIBIAL PLATEAU FRACTURES' CLASSIFICATION. Rev Bras Ortop 2015; 44:225-9. [PMID: 27004176 PMCID: PMC4783692 DOI: 10.1016/s2255-4971(15)30072-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To assess the inter-observer agreement of three tibial plateau fracture classifications: Schatzker, AO Group, and Hohl. METHODS Nine physicians of different levels of expertise (six Orthopaedic Residents - OR - and three Orthopaedic Attendings - OA) classified 50 tibial plateau fractures. RESULTS There was a low to moderate agreement between OR and OA on the three classification systems. A straight correlation was found between the year of Residence and an increase on the level of agreement on the AO group and Hohl classifications. This was partially seen on the Schatzker classification. Kappa ranged from 0.344 to 0.577, 0.36 to 0.499, and 0.278 to 0.465 for the Hohl, AO group, and Schatzker systems, respectively. CONCLUSION With a level of 0.1, there was a significant agreement on the three classifications among the physicians. When comparing ORs to OAs, the three studied classifications show low to moderate consistency, with the Hohl classification showing the highest level of agreement between OR.
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Affiliation(s)
- Rodrigo Pires E Albuquerque
- Orthopedist; Coordinator, Knee Surgery Department, Orthopedics and Traumatology Clinic, Hospital Municipal Miguel Couto (SOT-HMMC), Rio de Janeiro, Brazil
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Giordano V, Amaral NPD, Soares M, Pallottino A, Albuquerque RPE, Santos Neto JFD, Souza FSD, Miguel Filho GJ. Fratura da escápula: resultados do tratamento cirúrgico em 15 pacientes. Rev Bras Ortop 2011. [DOI: 10.1590/s0102-36162011000700008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Giordano V, do Amaral NP, Pallottino A, Pires e Albuquerque R, Franklin CE, Labronici PJ. Operative treatment of transverse acetabular fractures: is it really necessary to fix both columns? Int J Med Sci 2009; 6:192-9. [PMID: 19652723 PMCID: PMC2719284 DOI: 10.7150/ijms.6.192] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2009] [Accepted: 07/10/2009] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE we prospectively evaluated clinical and radiographic outcomes in patients with displaced combined transverse-posterior wall acetabular fractures managed at our Institution over a period of seven years by posterolateral single approach, direct posterior wall and posterior column reduction and plating, and indirect reduction of anterior column controlled by fluoroscopic images with or without lag-screw fixation. The aim was to identify if the obtained immediate postoperative Matta radiographic roof-arc angles after fracture reduction and fixation alters in the postoperative period when comparing posterior plating alone versus posterior plate and anterior column lag-screw fixation. PATIENTS AND METHODS 35 skeletally mature patients (31 male and four female, with mean age of 39.9 years old [range, 23.3 to 66.7 y/o]) with combined transverse-posterior wall acetabular fractures surgically treated by a posterolateral single approach were enrolled in this prospective investigation. Nineteen patients had associated orthopaedic injuries. The first part of the acetabular fracture management was similar to all patients and consisted in anatomical reduction and fixation of the transverse posterior component followed by anatomical reduction and fixation of the posterior wall component. The transverse anterior component reduction was controlled by fluoroscopic images (anteroposterior (AP), iliac oblique, and obturator oblique views) and digital palpation through the greater sciatic notch. Fifteen of the 35 patients had an additional lag-screw fixation from the posterior to the anterior columns with an extra-long small-fragment cortical screw. AP and Judet oblique radiographic views were taken at the end of the procedure and roof-arc angles were measured. Clinical results were assigned according to the grading system of Merle D'Aubigne and Postel as modified by Matta et al. Radiographic roof-arc angles were checked and compared between the two groups of patients to the same data collected both at the time of the surgical procedure and at three months postoperatively. Statistical analysis was done by either using chi-square (clinical outcome) and Mann-Whitney (roentgenographic outcome) tests, with a level of significance of alpha = 5%. RESULTS at final follow-up examination 18 to 84 months postoperatively (mean, 46.8 months), the clinical results were considered satisfactory in 31 (88.6%) patients (excellent in nine (25.7%) and good in 22 (62.9%) patients). There was no difference between patients with (n = 15) and without (n = 20) fixation of the transverse anterior component of the acetabular fracture (p = 0.67). Radiographic roof-arc angles measured at discharge, at three months postoperatively and at the last follow-up consultation didn't changed significantly (p > 0.05). There was no statistically significant difference between patients treated with (n = 15) and without (n = 20) fixation of the anterior component of the transverse acetabular fracture in terms of medial displacement of the femoral head. CONCLUSION the authors suggest that associated transverse-posterior wall acetabular fractures can be managed by a single posterior approach. Direct reduction and fixation of the posterior wall and column components is an adequate option for these injuries. If there is adequate indirect reduction of the anterior column, as checked by digital palpation and fluoroscopy, we feel that it is not necessary to fix the anterior column component of the transverse acetabular fracture.
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Albuquerque RPE, Giordano V, Pallottino A, Sassine T, Canedo R, Pina J, Amaral NPD. Análise da reprodutibilidade das classificações das fraturas do platô tibial. Rev Bras Ortop 2009. [DOI: 10.1590/s0102-36162009000300008] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Labronici PJ, Galeno L, Teixeira TM, Franco JS, Hoffmann R, Lourenço PRBDT, Giordano V, Pallottino A, Amaral NPD. Ponto de entrada para as hastes intramedulares anterógradas do fêmur: estudo em cadáver. Rev Bras Ortop 2009. [DOI: 10.1590/s0102-36162009000600005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Labronici PJ, Galeno L, Teixeira TM, Franco JS, Hoffmann R, de Toledo Lourenço PRB, Giordano V, Pallottino A, do Amaral NP. ENTRY POINT FOR THE ANTEGRADE FEMORAL INTRAMEDULLARY NAIL: A CADAVER STUDY. Revista Brasileira de Ortopedia (English Edition) 2009; 44:487-90. [PMID: 27077057 PMCID: PMC4816820 DOI: 10.1016/s2255-4971(15)30145-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Objective: To analyze the natural exit of the wire guides in major trochanter through retrograde femoral approach, in cadaver specimens. Material and Method: 100 femurs had been perforated between the femoral condyles, at 1.2 cm of the intercondylar region. A 3-mm straight wire guide was introduced, through retrograde approach, until the proximal extremity of femur was reached. Femurs were assessed for posterosuperior and anterosuperior portions of major trochanter, pear-shaped cavity, and upper median line between the head-neck and the major trochanter. Results: in 62%, the straight wire guides exited at the anterior surface of major trochanter. In the pear-shaped cavity, the median distance found was 1.0 cm and the interquartile range was 0.5 cm, initially expressing, in relation to pear-shaped cavity, better accuracy. Conclusion: the central axis of the medullar canal, at coronal plane, projected better accuracy in the region of the pear-shaped cavity.
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Giordano V, Amaral NPD, Rios H, Franklin CE, Pallottino A. Fraturas ipsilaterais de fêmur e pelve (quadril flutuante): análise prospectiva de 16 casos. Rev Bras Ortop 2007. [DOI: 10.1590/s0102-36162007000900006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Giordano V, Pecegueiro do Amaral N, Franklin CE, Pallottino A, Pires E Albuquerque R, Giordano M. Functional Outcome after Operative Treatment of Displaced Fractures of the Acetabulum: A 12-month to 5-year Follow-up Investigation. Eur J Trauma Emerg Surg 2007; 33:520-7. [PMID: 26814937 DOI: 10.1007/s00068-007-6092-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2006] [Accepted: 02/26/2007] [Indexed: 11/28/2022]
Abstract
PURPOSE To review our experience with 82 surgically treated displaced acetabular fractures over a 4-year period. PATIENTS AND METHODS Ninety-three consecutive displaced acetabular fractures were consecutively operated on at Level I Trauma Center from January 1, 2000 through December 31, 2003, and 82 were available for review with a minimum of 12-month follow-up. Clinical (Merle D'Aubigné modified by Matta et al.) and radiographic (Matta) outcomes were evaluated. Complications and secondary operative procedures were documented. RESULTS Anatomical reduction was achieved in 89% of the patients. At follow-up examination 12-60 months postoperatively (mean 32 months), clinical results were satisfactory in 65 patients (79.2% of the cases), with 14 excellent and 51 good results, and roentgenographic results were satisfactory in 70 patients (85.4% of the cases). Complications included a 12.2% incidence of sciatic nerve palsy (10 patients, two postoperative and eight posttraumatic), a 2.4% incidence of intraoperative vascular lesion (one external iliac artery and one external iliac vein), a 1.2% incidence of postoperative loss of reduction, a 1.2% incidence of infection, a 1.2% incidence of Brooker et al. class IV heterotopic ossification, a 2.4% incidence of posttraumatic osteoarthritis, and a 2.4% incidence of osteonecrosis of the femoral head. CONCLUSIONS Operative treatment is an effective method for the management of displaced acetabular fractures. Clinical and roentgenographic results correlate closely with an anatomic reduction. Low complication rate can be expected if adequate preoperative assessment and planning is performed. Strategies to minimize the risk of thromboembolism and heterotopic ossification on the basis of mechanical pneumatic compression and antiinflammatory nonsteroidal drugs, respectively, are reliable techniques for these injuries.
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Affiliation(s)
- Vincenzo Giordano
- Hospital Municipal Miguel Couto, Ortopedia e Traumatologia, Rio de Janeiro, Brazil.
- Hospital Municipal Miguel Couto, Ortopedia e Traumatologia, Leblon Rio de Janeiro, Brazil.
| | | | | | - Alexandre Pallottino
- Hospital Municipal Miguel Couto, Ortopedia e Traumatologia, Rio de Janeiro, Brazil
| | | | - Marcos Giordano
- Hospital de Força Aérea do Galeáo, Ortopedia e Traumatologia, Rio de Janeiro, Brazil
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Giordano V, Rios H, Moreirão M, Giordano M, Amaral NPD, Pallottino A, Oliveira SD. Ensaio mecânico da resistência ao impacto do cimento ósseo puro e associado a duas drogas anestésicas locais. Rev Bras Ortop 2007. [DOI: 10.1590/s0102-36162007000700007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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