Injury
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Honduras is one of the most violent countries in the world and it has limited epidemiological data that describes the extent of intentional and unintentional injuries. This research is needed to develop and inform prevention programs in Honduras, as well as to spread international awareness. ⋯ The description of injuries provides the basis for prevention. The disproportionate number of unintentional injuries (4:1) seen in Honduras' referral hospital calls for further research in: 1) trauma care logistics and emergency systems, 2) mortality and lethality of intentional injuries, and 3) analysis of the types of unintentional injuries. Further research is necessary to evaluate interventions and identify the socioeconomic effects of injuries in the region.
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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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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.
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Comparative Study
A comparison of the bipedicled nerve flap with the Littler flap for reconstructing a neurocutaneous defect of digits.
Complex digital injuries involving soft-tissue loss and digital nerve defect continues to pose a reconstructive challenge. This study reports the repair of such neurocutaneous defect with the bipedicled nerve flap or the Littler flap and compares the results of the two techniques. ⋯ When reconstructing a complex neurocutaneous defect in the digit, choosing the bipedicled nerve flap rather than the Littler flap attains lower incidence of pain and cold intolerance, and higher patient satisfaction. Our results suggest that repair of the transected digital nerves can reduce neuroma incidence.