Injury
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Hip fractures rank in the top ten disabling conditions worldwide. With an ageing population, this public health problem is expected to increase. ⋯ However, we need first to fully understand the factors contributing to recovery after hip fractures, including psycho-cognitive and social factors. The purpose of this study was to identify future research priorities for understanding the role of psycho-cognitive and social factors in the recovery process for community-dwelling older adults after hip fracture and to survey world experts to confirm the identified priorities.
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Physiotherapy can play a vital role in the pathway of care of people after fragility fracture and includes interventions of early mobilisation and prescription of structured exercise programmes for maximising functional recovery and reducing the risk of falls and further fractures. Although the optimal nature of physiotherapist interventions after hip and vertebral fracture requires further investigation in large-scale trials, evidence supports the prescription of high-intensity and extended exercise interventions. This article will overview interventions in the acute and chronic phases after hip fractures, interventions after vertebral fracture and the role of physiotherapy in the prevention of further fractures.
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Randomized Controlled Trial
Functional bracing treatment for stable type B ankle fractures.
In general, stable type B ankle fractures are treated conservatively with cast immobilization or a walking boot during six weeks. Some disadvantages of casting are joint stiffness, muscle wasting and lack of comfort. This study was designed to evaluate whether functional treatment with a removable brace is a safe and more comfortable alternative. ⋯ Functional bracing showed significant differences for the VAS comfort score and range of motion at 6 weeks compared to casting. After a year no significant differences were found. Treatment with a brace is a safe and more comfortable option for stable type B ankle fractures.
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Diaphyseal fractures with proximal humeral extension can be treated using a helical model, so it is lateral on the proximal aspect and on the diaphyseal segment in the anterior surface. ⋯ In all patients, there was a difference in the humeral head retroversion compared to the contralateral limb, but with little clinical repercussion and good or excellent functional scores.
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Pediatric pelvic injuries are rare. Due to anatomic differences of the immature pelvis, different injury patterns may occur as compared to adults. The purpose was to analyze the effect of skeletal maturity on pediatric pelvic injury pattern, associated injuries, and treatment intervention. ⋯ Retrospective comparative study, Level III.