Injury
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While the importance of timely surgery and early mobilization are understood in geriatric fracture populations, the relationship between timing of initiation of physical therapy (PT) postoperatively on length of stay (LOS) and mortality has not been well delineated. The purpose of this investigation was to determine the effect of PT initiated on postoperative day zero (POD0) on LOS and mortality in geriatric hip fracture patients. ⋯ Earlier initiation of PT postoperatively is associated with significantly shorter total and postoperative LOS and initiation of PT before POD2 is associated with decreased 30-day mortality. Each day that initiation of PT is delayed is associated with a two- to three-day increase in LOS.
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Observational Study
Implementation of an enhanced recovery after surgery program including a patient school: Impact on quality of life results.
Enhanced Recovery After Surgery (ERAS) protocols and educational programmes have been shown to accelerate orthopaedic surgery recovery with fewer complications, and improve patient-reported outcomes (PROs) for different types of surgery. The objective was to evaluate the impact of an ERAS programme including a patient school on health outcomes and PROs for Total Knee Replacement (TKR) surgery. ⋯ The ERAS programme including a patient school was highly successful with a fast recovery, a short hospital stay length, no surgery cancellations, and improved PROs.
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(1) To analyze three-dimensional (3D) morphologic features of atypical femur fracture at actual size without projection error; and (2) to provide clinical implications of cephalomedullary nail (CMN) fixation by separating the medullary canal and the cortex. ⋯ Asian atypical femur had three morphologic features: (1) straightened medullary canal, (2) positive values of lateral bowing, and (3) significantly increased ante-curvature of medullary canal. Considering that conventional CMN had about 4° of mediolateral angle, the disparity between implant and medullary canal might be clear. Thus, new nail design for Asian atypical femur that could increase the radius of curve (ROC) but decrease the mediolateral angle needs to be introduced.
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Despite the plausibility that diabetes may increase the risk of motor vehicle crashes (MVCs) due to various diabetes related complications and co-morbidity, findings from epidemiological studies on the relationship between diabetes and MVCs remained inclusive mainly due to heterogeneity in the study design and failure to complete consideration of potential confounders. This study re-visited this putative association with an improved study design. ⋯ T2D diagnosis was associated with a moderate but significant increase in the risk of MVCs among scooter drivers, but not among car drivers.