Injury
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Ankle fractures frequently occur and must be treated with open reduction for long-term stability. The existing anaesthesia methods include general anaesthesia, spinal and epidural anaesthesia, peripheral nerve block and local anaesthesia with IV sedation. However, each method has its inherent risks and potential costs, and the use of a tourniquet is inevitable. Therefore, the wide-awake local anaesthesia no tourniquet (WALANT) technique provides an alternative method for equivalent haemostasis and pain control without the use of a tourniquet. ⋯ WALANT simplified surgical preparations and provided a safe and reliable method for ankle fracture management. Because the use of a tourniquet was not required, reduced postsurgical pain was observed. Moreover, the use of local anaesthesia resulted in more satisfied patients and facilitated easier recovery.
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Observational Study
Short-term morbidity factors associated with length of hospital stay (LOS): Development and validation of a Hip Fracture specific postoperative morbidity survey (HF-POMS).
We aimed to describe and quantify postoperative complications in the older hip fracture population, develop and validate a hip fracture postoperative morbidity survey tool (HF-POMS). ⋯ Many patients remained in hospital for non-medical reasons. HF-POMS may be a useful tool to assist in discharge planning and randomised control trial outcome definitions.
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Early discharge of some in-patients is the effective measure to create hospital surge capacity in disasters. However, some of these patients may need to post-discharge continuity of care. The aim of the current study then is to explore the barriers of continuity of care, and to provide suitable solutions for potentially dischargeable patients during disasters. ⋯ Understanding the barriers to continuity of care for discharged patients for adopting policies based on experiences of health care providers can help planners to design and implement effective programs, which will enhance patients' access to necessary care.
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Comparative Study
A comparative study for the usage of Fidji cervical cages after multilevel anterior cervical discectomy and fusion.
Postoperative dysphagia is one major concern in the treatment for patients with cervical spine spondylosis by using anterior cervical discectomy and fusion (ACDF) with plating and cage system. ⋯ Fidji cervical cages could relieve postoperative dysphagia in the treatment of multilevel CSM with ACDF, especially at the first several months postoperatively.
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Tibial shaft fracture is common, accounting for 2% of all adult fractures. Large epidemiological follow ups are lacking and previous studies have shown great variation in incidence rates and trends. The aim of this population-based nationwide study was to analyze all tibial shaft fractures in Finland in 1997-2014 and to provide an update on current epidemiological data. ⋯ The incidence of tibial shaft fractures has markedly decreased in Finland between 1997 and 2014, mainly because of a declining trend in the incidence of fall-induced low-energy fractures. Reasons for this development are uncertain and therefore more comprehensive population-based epidemiological studies are needed to reveal the factual reasons behind the decrease.