Injury
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An early postoperative mobilization shows beneficial effects in terms of complications and long-term mobilization scores in elderly adult fracture patients. The primary objective of this study was to evaluate the overall mobilization of orthogeriatric patients during the postoperative hospital stay based on a continuous accelerometry measurement. Secondly, the collected data was analyzed to detect fracture related differences. We hypothesized that upper extremity fractures come along with higher levels of physical activity compared to fractures of the lower extremity. ⋯ Our data demonstrates that it is feasible and accepted by the patient to continuously measure the mobility including gait speed and characteristics of orthogeriatric patients using waist worn accelerometry based wearables. Postoperative mobility and gait speed was generally low in both groups. Actions to improve postoperative mobility of orthogeriatric patients are urgently needed. Level Of Evidence Prospective cohort study, Level of Evidence 2.
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Heterotopic ossification (HO) is a common complication in patients who have sustained high-energy trauma to the hip region. Traditionally, resection is performed after ectopic bone maturation. We hypothesized that early HO resection in patients with hip ankylosis after trauma can be performed with little chance of recurrence. ⋯ This is a Level IV retrospective case series.
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The aim of the study is to evaluate the clinical outcome and complications from the initial cohort of blast injured bilateral lower limb, above knee amputees who underwent Direct Skeletal Fixation (DSF). ⋯ DSF is an option for amputees who, due to the nature of their injuries, may not be able to tolerate traditional suspension socket prostheses and have exhausted all other treatment options. At a minimum of 2 year follow up, the absence of significant infective complications suggests DSF may be utilised in the blast injured despite chronic polymicrobial colonisation. Longer term surveillance of these patients is required to assess the long-term suitability of this technique in this cohort of patients.
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Interventions to reduce subsequent injuries among already-injured people presenting to healthcare providers may reduce the overall burden of injury. However, in order to develop such interventions it is necessary to understand what predicts subsequent injuries. This knowledge is currently limited for general injury populations. This prospective Subsequent Injury Study aims to determine pre-injury sociodemographic and heath factors, and injury-related factors, that predict subsequent injury claims reported to Accident Compensation Corporation (ACC, New Zealand's universal injury insurer) in the 24 months following an ACC entitlement claim injury ('sentinel' injury). Two separate outcome variables were used to identify subsequent injuries of interest: having (1) at least one high severity injury claim (New Injury Severity Scores ≥4), or (2) two or more claims (injuries of any severity). ⋯ Factors identified in this study may provide useful flags to help healthcare providers and policy makers identify people at increased risk of severe or multiple subsequent injuries who may benefit from targeted injury prevention strategies or interventions.
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The purpose of this study was to evaluate the safety and efficacy of using lower profile 2.4/2.4 mm and 2.0/2.4 mm dual mini-fragment plate constructs for fixation of diaphyseal clavicle fractures. ⋯ Dual mini-fragment plating of diaphyseal clavicle fractures, using 2.4/2.4 mm and 2.0/2.4 mm plate combinations, creates a lower profile construct that reliably maintains fracture reduction to healing, and has a low rate of reoperation for symptomatic implant removal.