Injury
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To assess key demographic and psychosocial variables that may be associated with non-adherence to clinic visits following orthopaedic trauma injuries to patients in an urban and rural population. ⋯ In the present study, key demographic and psychosocial factors were significantly associated with patient adherence to scheduled follow-up appointments after treatment for orthopaedic trauma. Identifying patients at higher risk for nonadherence will allow healthcare teams to educate patients, providers, and staff, link patients to resources to enhance adherence, and work with their institutions to develop and implement protocols for improving adherence to follow-up appointments.
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In damage control orthopaedics (DCO), fractures are initially stabilised with external fixation followed by delayed conversion to definitive internal fixation. The aim of this study is to determine whether the timing of the conversion influences the development of deep infection and fracture healing in a cohort of patients treated by DCO after a closed fracture of the lower limb. Furthermore, we wanted to evaluate whether the one-stage conversion procedure is always safe. ⋯ One-stage conversion to definitive internal fixation within 22 days from DCO is a safe and feasible procedure, which does not influence the incidence of infection or non-union.
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Drilling is a common technique used in orthopedic surgery procedures but causes increases in temperature that can lead to cell damage and death. The extent of this depends largely on the magnitude of the increase in temperature. The commonly accepted limit to prevent osteonecrosis is less than 47 °C for 60 s. There is controversy when it comes to the optimal drilling parameters that limit temperature increases and cell death. In addition to this, less research has been done on the drilling effects in the osteochondral area of joints. Osteochondral tissue damage can interfere with the daily lives of patients and if severe enough will need to be treated. We hypothesize that increasing tool speed and drill bit size will increase temperature that could be above the osteonecrosis limit. ⋯ All the tool speed and drill bit size combinations lead to an increase in temperature that were under the commonly accepted limit. The highest temperature reached was 44 °C with a tool speed of 1150 RPM and 3070 RPM and drill bit size 5.159 mm. It was found that increasing the tool speed increased the temperature change and increasing the drill bit size increased the temperature change.
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Few studies on early functional outcomes following acute care after traumatic brain injury (TBI) are available. The aim of this study was to develop and validate a predictive model for functional outcomes at discharge for TBI patients using machine learning methods. ⋯ We established a random forest model that performed well in predicting early functional outcomes following acute care after TBI. The model has utility for informing decision-making regarding patient management and discharge planning and for facilitating health care quality assessment and resource allocation for TBI treatment.
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Pelvic fractures are associated with high morbidity and often require surgical intervention. An Anterior Posterior Compression (APC) II injury consists of disruption at the pubic symphysis and anterior sacroiliac joint. Studies investigating specific ligamentous contributions would aid in development of novel fixation techniques. The objective of this study is to determine the level of pelvic destabilization from progressive soft tissue disruptions associated with APC II injuries. ⋯ mechanism-based reasoning.