Sidel (Italy)

Introduction:Pelvic fractures are severe injuries that can drastically affect a woman's quality of life through sexual dysfunction (SD), genitourinary dysfunction (GD), and increasing the potential need for future cesarean section (C-section). Limited research has captured long-term outcomes after pelvic fractures in women of childbearing age. This study aimed to determine the association between pelvic fractures and rates of C-section, SD, and GD.Methods:All women of childbearing age who sustained a pelvic fracture were identified in a national insurance database. A comparison group of patients with lower extremity long-bone fractures was selected. Patients who gave birth after injury were additionally identified. A minimum of 5 years of follow-up was required for inclusion. Rates of C-section, SD, and GD were compared between cohorts. Multivariate logistic regression analysis was conducted with the inclusion of diabetes, tobacco, hypertension, obesity, and advanced maternal age.Results:A total of 6,174 patients with pelvic fracture and 27,154 control fracture patients were identified. 434 patients with pelvic fracture (7.0%) and 1,258 control fracture patients (4.6%) gave birth after fracture. Patients with pelvic fracture had a significantly higher rate of C-section (50.0% versus 38.8%, P < 0.001), SD diagnosis (10.9% versus 8.8%, P < 0.001), and urinary retention diagnosis (3.5% versus 2.8%, P < 0.001). No significant difference in global GD diagnosis was identified. Multivariate analyses showed that pelvic fracture was associated with C-section (odds ratio [OR]: 1.78; 95% confidence interval [95% CI]: 1.42 to 2.23, P < 0.001), SD diagnosis (OR: 1.23; 95% CI: 1.12 to 1.35, P < 0.001), and urinary retention diagnosis (OR: 1.35; 95% CI: 1.15 to 1.57, P < 0.001).Discussion:Pelvic fractures confer an intrinsic level of risk of C-section, SD, and urinary retention that is elevated beyond what would be expected from a traumatic lower extremity injury alone. Treating orthopaedic surgeons should actively counsel women regarding increased risks, openly discuss postinjury sequelae, and coordinate interspecialty care beyond initial treatment of acute trauma.

The present paper presents the hands-on results of the use of a large screen stereoscopic installation to train technicians on maintenance tasks of large machineries for a leading mechanical industry. Such machinery, deployed from the company in remote locations around the world, need complex and lengthy maintenance procedures, to be performed periodically by teams of highly trained technicians. The firm organize continuous training classes to a large number of its technicians, using qualified trainers and continuously updating machinery documentation, resulting in long and expensive periods of time of technicians inactivity. Classes involve training on assembly and disassembly operations of the company complex mechanical products and were traditionally based on the use of video documentation, 2D mechanical drawings and live demonstrations on real equipment. In an attempt to improve this process, the firm equipped some of the training centers with large stereoscopic projection facilities and dedicated software, introducing the use of real-time stereo rendering of CAD models for virtual disassembly/assembly sequences. The firm investigated then potential benefits of the new methodology compared to the traditional one. The present article presents an overview of the technological framework used, and outlines the results of such comparison performed over a period of 6 months.