Injury
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Psychological distress after orthopaedic trauma negatively affects patient outcomes. Resilience may mediate distress and therefore be associated with post-operative outcomes, including opioid use. The purpose of this study is to evaluate the relationship between resilience and post-operative opioid demand with the hypothesis that low levels of resilience are associated with increased opioid consumption. ⋯ Lower long-term resilience scores were associated with higher postoperative opioid consumption, fill and refill rates. These results suggest low resilience may be a risk factor for increased long-term opioid consumption following surgical treatment for orthopaedic trauma.
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Ankle fractures are amongst the most common open fracture injuries presenting to major trauma centres (MTC) and their management remains a topic of debate. Incidence is increasing particularly in the elderly population however the optimal surgical approach and risk factors for unplanned reoperation remain scarce. We therefore conducted a retrospective case study to analyse our institution's outcomes as well as identify risk factors for early unplanned reoperation. ⋯ Age and quality of soft tissue envelope are significant risk factors for unplanned reoperation. Patients with these risk factors may benefit from an alternative surgical approach.
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The application of the 3D printing mirror image model is based on the symmetry of the limbs. Different from image fusion to judge the similarity, based on the commonality of the limb morphology of the same organism and the isotropic of the long bone cross-section, the symmetry of the femur has been determined by calculating the dimension difference of the corresponding cross-section of the non-fractured area. However, the previous version used equidistant cross-sections for measurement and two-dimensional data correction, and there were problems with insufficient reliability and data failure. The purpose of this study is to achieve a more accurate and universal symmetry verification scheme for bilateral tubular bones through an improved method. ⋯ This study have demonstrated symmetricity of the left and right femurs. The availability of CT data at any position of the patient's lower limbs is realized through replacing the previous "two-dimensional data correction" with "three-dimensional data correction".
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'In-home injuries' are those that occur within the house or its immediate surroundings. The literature on the prevalence and magnitude of home injuries is sparse. This study was designed to characterize the mechanisms of 'in-home' injuries and compare their outcomes with 'outside home injuries'. ⋯ There was no significant difference in the 30 day in-hospital mortality amongst admitted trauma patients sustaining injuries at home or outside the home. However, in pediatric and elderly patients the chances of mortality was significantly higher when injured at home.
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Recent literature suggests that fixation of trochanteric hip fractures with intramedullary nailing carries a higher 30-day mortality than with sliding hip screw. The present study aims to verify whether this statement is reflected in our practice. ⋯ Previous studies may have deterred surgeons from choosing an intramedullary device. However, we hope this study assists surgeons to make an informed decision on the choice of implant particularly when an intramedullary device is required to provide a more stable construct.