Clinical orthopaedics and related research
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Clin. Orthop. Relat. Res. · Jun 2016
Validation of the HOOS, JR: A Short-form Hip Replacement Survey.
Patient-reported outcome measures (PROMs) are increasingly in demand for outcomes evaluation by hospitals, administrators, and policymakers. However, assessing total hip arthroplasty (THA) through such instruments is challenging because most existing measures of hip health are lengthy and/or proprietary. ⋯ Level III, diagnostic study.
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Clin. Orthop. Relat. Res. · Jun 2016
Does Surgical Stabilization of Lateral Compression-type Pelvic Ring Fractures Decrease Patients' Pain, Reduce Narcotic Use, and Improve Mobilization?
Debate remains over the role of surgical treatment in minimally displaced lateral compression (Young-Burgess, LC, OTA 61-B1/B2) pelvic ring injuries. Lateral compression type 1 (LC1) injuries are defined by an impaction fracture at the sacrum; type 2 (LC2) are defined by a fracture that extends through the posterior iliac wing at the level of the sacroiliac joint. Some believe that operative stabilization of these fractures limits pain and eases mobilization, but to our knowledge there are few controlled studies on the topic. ⋯ Level III, therapeutic study.
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Clin. Orthop. Relat. Res. · Jun 2016
Comparative StudyLarge-magnitude Pelvic and Retroperitoneal Tissue Damage Predicts Organ Failure.
Pelvic and retroperitoneal trauma is a major cause of morbidity and mortality in multiply injured patients. The Injury Severity Score (ISS) has been criticized for underrepresenting and inaccurately defining mechanical injury. The influence of pelvic injury volume on organ dysfunction and multiple organ failure (MOF) has not been described. Through the use of CT, this investigation sought to precisely define volumes of mechanical tissue damage by anatomic region and examine its impact on organ failure. ⋯ Level III, prognostic study.
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Clin. Orthop. Relat. Res. · Jun 2016
Comparative StudyVariation in Resource Utilization for Patients With Hip and Pelvic Fractures Despite Equal Medicare Reimbursement.
Medicare currently reimburses hospitals for inpatient admissions with "bundled" payments based on patient Diagnosis-related Groups (DRGs) regardless of true hospital costs. At present, DRG 536 (fractures of the hip and pelvis) includes a broad spectrum of patients with orthopaedic trauma, likely with varying inpatient resource utilization. With the growing incidence of fractures in the elderly, inadequate reimbursements from Medicare for certain patients with DRG 536 may lead to growing financial strain on healthcare institutions caring for these patients with higher costs. ⋯ Level IV, economic and decision analysis.
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Clin. Orthop. Relat. Res. · Jun 2016
Will My Tibial Fracture Heal? Predicting Nonunion at the Time of Definitive Fixation Based on Commonly Available Variables.
Accurate prediction of tibial nonunions has eluded researchers. Reliably predicting tibial nonunions at the time of fixation could change management strategies and stimulate further research. ⋯ Level III, diagnostic study.