Injury
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To clinically validate a recently proposed classification scheme of post-traumatic bone defects. ⋯ III.
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Observational Study
Acute stress disorder in trauma patients discharged in 72 h or less.
Acute Stress Disorder (ASD) is a psychiatric condition affecting individuals exposed to trauma and requires the presence of symptoms 72 h following trauma. Patients evaluated for trauma related injury are often discharged prior to 72 h, but the risk of ASD remains. The aim of this study was to quantify the rate of acute stress disorder in trauma patients admitted for fewer than 72 h. ⋯ Our study found 12% of trauma patients discharged prior to 72 h developed ASD. These data point to possible benefit in reassessment of injured patients following hospital discharge and the importance of developing pathways for trauma patients to access mental health resources.
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The objective of this study was to identify demographic, injury-related, and treatment-related characteristics of patients who underwent decompressive fasciotomies for acute thigh compartment syndrome. ⋯ Delays to fasciotomy are frequent in the treatment of acute thigh compartment syndrome. The demographics of acute thigh compartment syndrome demonstrate a strong male predominance. Treating providers should recognize spontaneous hematoma and motor vehicle accidents as the most common causes of acute thigh compartment syndrome.
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We herein report on a series of 21 patients with traumatic patellar osteomyelitis treated by single-stage surgery, and discuss the specific application of single-stage procedures for traumatic patellar osteomyelitis. ⋯ Single-stage wound treatment was successful in 20 of 21 patients. Treatments included radical debridement together with tissue flap for repair of soft tissue and extensor mechanism defects, and internal refixation of patellar fractures. 14 patients were treated with gastrocnemius flaps. One patient developed recurrent wound infection, which healed after reoperation. At a mean follow-up of 8 ± 2.63 years (range, 3.2-11.4 years), none had developed recurrence. Six patients had nearly full knee ROM (0°-105° to 0°-146°), whereas 11 patients had impaired knee mobility (ROM, 0°-90° to 0°-65°), 3 patients had knee joint stiffness with a ROM of 0°, and 1 patient had knee flexion contracture with a ROM of 78°-130° CONCLUSIONS: Single-stage surgical treatment consisting of various surgical techniques was an acceptable treatment for traumatic patellar osteomyelitis, allowing early exercise of the knee joint. The osteomyelitis did not recur, and most patients' knee ROM was restored to a certain extent, excluding patients with severe damage to the patellar articular surface and inactive functional exercise.
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Probability analysis with reporting of P values is often used to determine the statistical significance of study findings in the orthopedic literature. The fragility index (FI) has been used to evaluate the robustness of a significant result. The purpose of this study was to determine the utility of applying a fragility analysis to randomized controlled trials (RCTs) evaluating distal radius fractures (DRFs). ⋯ Level I.