Injury
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To evaluate functional and radiological outcomes in distal femoral fracture patients (distal femoral shaft fractures or metaphyseal fractures) receiving indirect reduction and internal fixation with the minimally invasive percutaneous plate osteosynthesis (MIPPO) assisted by 3D printing navigation templates. ⋯ MIPPO assisted by 3D printing navigation templates could practically improve surgical accuracy and eliminate postoperative rotational deformity in patients with distal femoral fractures.
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Acute physiologic compartment syndrome (ACS) is a disorder of increased intra-compartmental pressure leading to decreased tissue perfusion and muscle necrosis. Tissue ischemia can result in irreversible muscle and nerve injury and requires urgent fasciotomy. The aim of this study was to determine the factors associated with the presence of necrotic muscle in patients undergoing leg fasciotomy. ⋯ ACS is a potentially limb threatening condition often associated with poor outcomes, particularly when the diagnosis is delayed. Patients with open fracture have a three-fold increase in odds of necrotic muscle at the time of fasciotomy.
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Pre-injury health status is an important determining factor of long-term outcomes after orthopaedic major trauma. Determining pre-injury health status of major trauma patients with orthopaedic injuries is also important for evaluating the change from pre to post-injury health status. ⋯ People with orthopaedic major trauma have better pre-injury health compared to the general Australian population. Therefore, population-specific values should be used as baseline measures to evaluate orthopaedic trauma outcomes. Pre-injury health status values reported at three different post-injury time points were comparable. If conducting a retrospective pre-injury health evaluation, researchers need be aware of factors that influence self-reporting of pre-injury health status and the response shift that may happen due to encountering injury.
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Factors associated with adverse outcomes following surgery for syndesmotic instability with associated closed fibula fracture are incompletely understood. The purpose of this study was to determine the pathoetiology and incidence of adverse events after stabilization of syndesmotic instability. In addition, we aimed to identify any patient or surgeon related factors that might be associated with unanticipated outcomes. ⋯ Certain patient groups have an increased risk of adverse events following the use of current surgical fixation methods for stabilizing the syndesmosis. Patients undergoing surgery for syndesmotic instability with associated fibula fracture without open wound should be counseled that up to 1 in 10 suffer an infectious complication and that 1 in 5 require unplanned hardware removal.
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A patient-relevant, focused Core Outcome Set (COS) is essential to the design of clinical trials dealing with chest wall trauma, in order to maximise quality of evidence regarding impact of interventions and to reduce research waste. ⋯ Collecting serious adverse outcomes was important to all stakeholders as were life impact outcomes such as quality of life, physical function and return to activities. Resource use outcomes were considered less important. We recommend this Core Outcome Set, developed with multiple relevant stakeholders, for use in future clinical trials, following further work on the most appropriate methods and instruments for measurement.