Injury
-
Access to specialised trauma care is an important measure of trauma system efficiency. However, few data are available on access to integrated trauma systems. We aimed to describe access to trauma centres (TCs) in an integrated Canadian trauma system and identify its determinants. ⋯ In an integrated, mature trauma system, we observed high access to TCs. However, problems in access were observed for the elderly, women and in urban areas where there are many non-designated hospitals. Access to trauma care should be monitored as part of quality of care improvement activities and pre-hospital guidelines for trauma patients should be applied uniformly throughout the province.
-
Randomized Controlled Trial
A preliminary RCT of a mind body skills based intervention addressing mood and coping strategies in patients with acute orthopaedic trauma.
To test the acceptability and feasibility of a mind body skills-based intervention (RRCB) and estimate its preliminary effect in reducing disability and pain intensity as compared to standard care (SC) in patients with acute musculoskeletal trauma. ⋯ Level 1 prognostic.
-
The purpose of this study was to identify risk factors present at the time of injury that predict poor functional outcomes and heterotopic ossification (HO) in open periarticular elbow fractures. ⋯ Prognostic level IV.
-
Proximal fractures of femur represent an important cause of hospitalization, morbidity and mortality for elderly patients. Femoral intramedullary nailing is an option to achieve a stable osteosynthesis but the breakage is a rare complication. The aim was to determinate the prevalence, causes, management and functional outcomes of this patients in our hands. ⋯ To the best of our knowledge, this study represents the largest series of cases of trochanteric nail breakage due to material fatigue. This complication is rare (0.88%) that can foresee in unstable fractures with delayed union. The type of salvage should be individualized showing acceptable functional outcome in our series.
-
An interpositional wedge bone graft is a procedure performed to restore carpal height and scaphoid length for displaced scaphoid nonunions with carpal instability. The purpose of this study was to investigate which headless screw design (threadless central shaft screw or fully threaded variable pitch compression screw) is biomechanically preferred when an interpositional bone graft is needed. ⋯ The threadless central shaft screw design is biomechanically preferred over the fully threaded variable pitch screw design because it achieves higher and identical compression forces at different interfragmentary gaps with similar stiffness and load to failure.