Benedikt Braun
Update from the Smart Digital Solutions Task Force Having identified how current digital solutions can meet the demands of orthopedic trauma surgery and further the development of the NEEMO approach to guide the use of new digital technologies (Fig 1), the Smart Digital Solutions Task Force (SDSTF) is continuing to assess available technologies and their potential applications in orthopedic trauma surgery. Although limited to digital meetings and restricted research capabilities with our affiliated hospitals during the Covid-19 pandemic, the initial aim of the SDSTF was to provide a systematic review of all studies on wearable activity monitors for fracture management published in the last decade. From more than 2000 identified studies, 136 reports were analyzed focusing on technology, treatment, assessed outcome, and general usability
Ease
Modularity
Need
Ownership
Environment
features. The study was accepted at the DKOU and SICOT annual meetings and is currently under review for publication (PROSPERO ID:210344). As soon as an accepted version of the manuscript is available it will be published on the AO website. To provide a clinical perspective on the current state of wearable technology and determine future needs relating to this field, SDSTF and AO Trauma conducted a survey analysis derived from more than 400 respondents (Fig 2). Not only were we able to determine the current characteristics of these tools but we were also able to assess the additional developmental needs of trauma surgeons. The analysis is now finalized and will be prepared for publication. In addition to these projects and alongside the collaboration with DePuy Synthes on emerging digital projects SDSTF members are presently overseeing an investigator-initiated clinical study to assess the direct impact of new wearable monitors on clinical trauma treatment and determine how digital technologies can enhance the patient journey. The first patients are already enrolled in this new trial to track the healing progress and subsequently provide objective patient outcome data. Together with the systematic review, survey, and study, the ambitious goal is to provide comprehensive recommendations on the best evidence-based practices for using wearable devices to measure activity, and then advise on clinically relevant outcome parameters. Fig 1 Need Ease Environment Modularity Ownership (NEEMO) is a guiding framework to aid developers, researchers, and clinicians when using digital solutions to address their needs (Finding NEEMO).
Technology Strain / Bending Sensor 2% Other 2% HR / Pulse Oxymeter 25%
Outcome used Fall Detection 3%
Temporal Spatial Parameters 3%
Accelerometry Interial Sensor 13%
Other 3%
None 8%
HR / Oxygen Sat 24% Pressure Sensor 8% Gen Activity 32% Kinematic Parameters 4%
Pedometer 8%
Smartphone 39%
a
Kinetic Parameters 6% Gen Galt Analysis 7%
b
Energy Expenditure 8%
Raw Accelerometry 3%
Fig 2a–b Preliminary survey analysis. Technologies (a) and outcomes (b) used by surgeons already utilizing wearable technologies.
76
Innovations 2021
