Injury
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Multicenter Study
Psychological health status after major trauma across different levels of trauma care: A multicentre secondary analysis.
Concentration of trauma care in trauma network has resulted in different trauma populations across designated levels of trauma care. ⋯ Major trauma patients admitted to a level I trauma centre have more depressive, anxious, and post-traumatic stress symptoms than when admitted to a non-level I trauma centre. These symptoms differed across trauma regions, indicating populations differences. Level of trauma care and trauma region are important when analysing psychological health status.
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Fragility fractures of the pelvis are becoming increasingly important in an ageing society. However, they are under-represented in the current research literature. In particular, unstable bilateral fragility fractures of the sacrum (FFP IVb) benefit from surgical treatment, but individual fracture patterns need to be considered in the surgical decision. This study describes the sacral anatomy in patients with FFP IVb pelvic fractures, with particular emphasis on the identification and evaluation of possible trans-sacral screw corridors, with particular emphasis on the transverse fracture components. ⋯ III.
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Severe metaphyseal comminution and sizable bone defect of the distal femur are high risks of fixation failure. To date, no exact magnitude of comminution and bone loss is determined as an indication for augmentation of fixation construct. The present study aimed to investigate the influence of metaphyseal gap width, working length, and screw distribution on the stability of the fixation construct. ⋯ The 30-mm and wider metaphyseal gap width with a long working length presented a risk of varus collapse and fixation failure. Short working length with spreading screw provided low EQV stress, low bone stress, and high fracture stability.
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Collecting patient-reported outcomes in a systematic fashion is important to understand recovery trajectories and compare performance between different services and fields of care. These outcomes can be collected through a variety of means, but studies comparing different follow-up methods in patients with a variety of injury types are scarce. This study aimed to compare follow-up data from three injury registries to quantify patient preference for telephone versus online follow-up, determine factors associated with choosing online follow-up, and compare response rates based on the patient's preferred follow-up method. ⋯ While follow-up preference and completion were higher for telephone-based follow-ups, the findings suggest a patient's preference for completing post-injury follow-ups differs according to the type of injury they sustained, and that allowing patients a choice of their preferred follow-up method is important. The variety of follow-up methods offered should therefore reflect the needs of different patient groups, which may allow for the development of algorithms or workflow processes. Directing certain patients towards a particular follow-up method could deliver higher and more efficient follow-up rates.
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Patients with chronic lateral ankle instability (CLAI) can be managed with arthroscopic Broström repair and inferior extensor retinaculum augmentation or arthroscopic assisted lateral ligament reconstruction using ipsilateral semitendinosus autograft, with good functional outcomes in patients. It is unclear whether one offers better outcome that the other. This retrospective analysis of prospectively collected data compared the outcomes of repair and reconstruction. ⋯ In CLAI patients, arthroscopic reconstruction yields better outcomes in terms of ATT, AOFAS, and KAFS in the mid-term; however, it is associated with a longer intraoperative time, delayed return to sports, and an extended duration to resume normal ankle function compared to the arthroscopic Broström repair and inferior extensor retinaculum augmentation procedure.