OTA international : the open access journal of orthopaedic trauma最新文献

{"title":"Rehabilitation after musculoskeletal injury: Israeli and South African perspectives.","authors":"Brian Bernstein, Kirsty Berry, Elior Moreh, Isabella Schwartz, Yoram A Weil, Lindsay Scott, Nomalungelo Nyathi","doi":"10.1097/OI9.0000000000000319","DOIUrl":"10.1097/OI9.0000000000000319","url":null,"abstract":"<p><p>Rehabilitation for patients sustaining isolated and multiple musculoskeletal injuries due to trauma remains a mainstay of recovery. There are a wide variety of systems in place to manage the rehabilitation process. This article describes the post-traumatic rehabilitation procedures from 2 member countries of the International Orthopaedic Trauma Association, Israel and South Africa. The systems are reflective of the clear differences between these 2 countries with vastly different economic strata and health care systems. In Israel, the rehabilitation programs and resources are most likely the result of the mature social support systems and the trauma experience. In South Africa, the programs are reflective of a two-tier health care system, with patients exposed to varying levels of rehabilitation resources.</p>","PeriodicalId":74381,"journal":{"name":"OTA international : the open access journal of orthopaedic trauma","volume":"7 5 Suppl","pages":"e319"},"PeriodicalIF":0.0,"publicationDate":"2024-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11301630/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141904148","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rehabilitation after musculoskeletal injury: an overview of systems in the United States and Canada.","authors":"Theodore A Miclau, Lisa Pascual, Silvio Ndoja, Abigail Frazer, Lauren Beaupre, Emil H Schemitsch","doi":"10.1097/OI9.0000000000000311","DOIUrl":"10.1097/OI9.0000000000000311","url":null,"abstract":"<p><p>As North America is largely industrialized with a variety of available private transportation options, trauma is a common occurrence, resulting in significant burdens of disability and costs to the health care system. To meet increasing trauma care needs, there is a robust organization of trauma and rehabilitation systems, particularly within the United States and Canada. The American and Canadian health care systems share multiple similarities, including well-equipped Level I trauma centers, specialized inpatient rehabilitation units for polytrauma patients, and thorough evaluations for recovery and post-discharge placement. However, they also have several key differences. In Canada, the criteria for admission to inpatient rehabilitation vary by location, and inpatient rehabilitation is universally accessible, whereas outpatient rehabilitation services are generally not covered by insurance. In the United States, these admission criteria for post-acute inpatient rehabilitation are standardized, and both inpatient and outpatient services are covered by private and government-funded insurance with varying durations. Overall, both health care systems face challenges in post-acute rehabilitation, including benefit limitations and limited provider access in rural areas, and must continue to evolve to meet the rehabilitation needs of injured patients as they reintegrate into their communities.</p>","PeriodicalId":74381,"journal":{"name":"OTA international : the open access journal of orthopaedic trauma","volume":"7 5 Suppl","pages":"e311"},"PeriodicalIF":0.0,"publicationDate":"2024-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11318513/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141972371","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The nonsalvageable tibia: amputation and prosthetics.","authors":"Steven Rivero, Nicole M Stevens","doi":"10.1097/OI9.0000000000000306","DOIUrl":"10.1097/OI9.0000000000000306","url":null,"abstract":"<p><p>Mangled extremities are a challenging problem for the orthopaedic surgeon. The decision for salvage versus amputation is multifactorial. Several work groups have attempted to create scoring systems to guide treatment, but each case must be regarded individually. As surgical technique and prosthetics continue to improve, amputations should be seen as a viable reconstructive option, rather than failure. This article reviews scoring systems for the mangled extremity, outcomes on salvage versus amputation, amputation surgical technique, and prosthetic options.</p>","PeriodicalId":74381,"journal":{"name":"OTA international : the open access journal of orthopaedic trauma","volume":"7 4 Suppl","pages":"e306"},"PeriodicalIF":0.0,"publicationDate":"2024-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11149746/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141263543","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Open tibial shaft fracture fixation strategies: intramedullary nailing, external fixation, and plating.","authors":"Michelle Shen, Nirmal Tejwani","doi":"10.1097/OI9.0000000000000316","DOIUrl":"10.1097/OI9.0000000000000316","url":null,"abstract":"<p><p>Tibial shaft fractures are one of the most common orthopaedic injuries. Open tibial shaft fractures are relatively common because of the paucity of soft tissue surrounding the bone. Despite the prevalence of these injuries, the optimal fixation strategy is still a topic of debate. The purpose of this article was to review the current literature on open tibial shaft fracture fixation strategies including intramedullary nailing, external fixation, and plating.</p>","PeriodicalId":74381,"journal":{"name":"OTA international : the open access journal of orthopaedic trauma","volume":"7 4 Suppl","pages":"e316"},"PeriodicalIF":0.0,"publicationDate":"2024-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11149753/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141263536","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Classification of open tibia fractures: the rationale for a new classification system.","authors":"Sehar Resad Ferati, Abhishek Ganta","doi":"10.1097/OI9.0000000000000318","DOIUrl":"10.1097/OI9.0000000000000318","url":null,"abstract":"<p><p>Open tibial shaft fractures are one of the most common long bone injuries encountered. Current existing classifications are designed to characterize the nature of the injury and guide clinical decision making. However, despite these advancements, there are areas in our current classification system that can be improved to not only make reliability more producible but also create prognostic factors that can help guide treatment.</p>","PeriodicalId":74381,"journal":{"name":"OTA international : the open access journal of orthopaedic trauma","volume":"7 4 Suppl","pages":"e318"},"PeriodicalIF":0.0,"publicationDate":"2024-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11149748/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141263532","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevention and treatment of osteomyelitis after open tibia fractures.","authors":"Devan D Mehta, Philipp Leucht","doi":"10.1097/OI9.0000000000000309","DOIUrl":"10.1097/OI9.0000000000000309","url":null,"abstract":"<p><p>Infection and chronic post-traumatic osteomyelitis of the tibia after open fracture are complex problems that cause significant morbidity and threaten the viability of a limb. Therefore, it is of utmost importance for the orthopaedic surgeon to understand both patient and treatment factors that modify the risk of developing these disastrous complications. Infection risk is largely based on severity of open injury in addition to inherent patient factors. Orthopaedic surgeons can work to mitigate this risk with prompt antibiotic administration, thorough and complete debridement, expedient fracture stabilization, and early wound closure. In the case osteomyelitis does occur, the surgeon should use a systematic multidisciplinary approach for eradication.</p>","PeriodicalId":74381,"journal":{"name":"OTA international : the open access journal of orthopaedic trauma","volume":"7 4 Suppl","pages":"e309"},"PeriodicalIF":0.0,"publicationDate":"2024-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11149744/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141263537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Soft tissue coverage for IIIB fractures: from timing to coverage options.","authors":"Ali Azad, Jacques H Hacquebord","doi":"10.1097/OI9.0000000000000317","DOIUrl":"10.1097/OI9.0000000000000317","url":null,"abstract":"<p><p>Open tibia fractures are the most common open long bone injury. Most of these injuries involve a high-energy mechanism. Many standards for management have been created to provide guidance and a baseline for quality. There are several factors that must be considered when determining the timing of coverage for an open fracture with soft tissue compromise. Understanding the available options for soft tissue coverage, including local/rotational flaps and free tissue transfer, will allow for a tailored approach based on the personality of the injury. The aim of this review was to characterize the critical window of treatment based on the current literature and to provide a review of the available soft tissue coverage options.</p>","PeriodicalId":74381,"journal":{"name":"OTA international : the open access journal of orthopaedic trauma","volume":"7 4 Suppl","pages":"e317"},"PeriodicalIF":0.0,"publicationDate":"2024-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11149747/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141263540","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tibial bone loss.","authors":"Benjamin C Schaffler, Sanjit R Konda","doi":"10.1097/OI9.0000000000000315","DOIUrl":"10.1097/OI9.0000000000000315","url":null,"abstract":"<p><p>Critical bone loss after open fractures, while relatively uncommon, occurs most frequently in high-energy injuries. Fractures of the tibia account for the majority of open fractures with significant bone loss. A number of different surgical strategies exist for treatment of tibial bone loss, all with different advantages and disadvantages. Care should be taken by the surgeon to review appropriate indications and all relevant evidence before selecting a strategy.</p>","PeriodicalId":74381,"journal":{"name":"OTA international : the open access journal of orthopaedic trauma","volume":"7 4 Suppl","pages":"e315"},"PeriodicalIF":0.0,"publicationDate":"2024-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11149745/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141263545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ankle fracture surgery in patients experiencing homelessness: a national evaluation of one-year rates of reoperation.","authors":"Fielding S Fischer, Hania Shahzad, Safdar N Khan, Carmen E Quatman","doi":"10.1097/OI9.0000000000000335","DOIUrl":"10.1097/OI9.0000000000000335","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the impact of homelessness on surgical outcomes following ankle fracture surgery.</p><p><strong>Design: </strong>Retrospective cohort study.</p><p><strong>Setting: </strong>Mariner claims database.</p><p><strong>Patients/participants: </strong>Patients older than 18 years who underwent open reduction and internal fixation (ORIF) of ankle fractures between 2010 and 2021. A total of 345,759 patients were included in the study.</p><p><strong>Intervention: </strong>Study patients were divided into two cohorts (homeless and nonhomeless) based on whether their patient record contained International Classification of Disease (ICD)-9 or ICD-10 codes for homelessness/inadequate housing.</p><p><strong>Main outcome measures: </strong>One-year rates of reoperation for amputation, irrigation and debridement, repeat ORIF, repair of nonunion/malunion, and implant removal in isolation.</p><p><strong>Results: </strong>Homeless patients had significantly higher odds of undergoing amputation (adjusted odds ratio [aOR] 1.59, 95% confidence interval [CI] 1.08-2.27, <i>P</i> = 0.014), irrigation and debridement (aOR 1.22, 95% CI 1.08-1.37, <i>P</i> < 0.001), and repeat ORIF (aOR 1.16, 95% CI 1.00-1.35, <i>P</i> = 0.045). Implant removal was less common in homeless patients (aOR 0.65, 95% CI 0.59-0.72, <i>P</i> < 0.001). There was no significant difference between homeless and nonhomeless patients in the rate of nonunion/malunion repair (aOR 0.87, 95% CI 0.63-1.18, <i>P</i> = 0.41).</p><p><strong>Conclusions: </strong>Homelessness is a significant risk factor for worse surgical outcomes following ankle fracture surgery. The findings of this study warrant future research to identify gaps in surgical fracture care for patients with housing insecurity and underscore the importance of developing interventions to advance health equity for this vulnerable patient population.</p><p><strong>Level of evidence: </strong>Prognostic Level III.</p>","PeriodicalId":74381,"journal":{"name":"OTA international : the open access journal of orthopaedic trauma","volume":"7 2","pages":"e335"},"PeriodicalIF":0.0,"publicationDate":"2024-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11098169/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140961123","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of open fracture and related complications: the Japanese way.","authors":"Hiroaki Minehara, Yukichi Zenke, Akihiro Maruo, Takashi Matsushita, Theodore Miclau","doi":"10.1097/OI9.0000000000000325","DOIUrl":"https://doi.org/10.1097/OI9.0000000000000325","url":null,"abstract":"<p><p>Open fractures continue to be a challenging clinical problem throughout the world, and Japan is no exception. Surgeons are faced with critical decisions throughout the care of these injuries that can have significant effects in clinical outcome, ranging from the type and timing of antibiotic administration, fixation, soft-tissue management, and interventions for postfracture complications. In October 2022, the Japanese Society for Fracture Repair (JSFR) was invited to represent Japan as the Guest Nation society at the 38th Annual Meeting of the Orthopaedic Trauma Society held in Tampa, Florida. The JSFR organized a symposium, entitled \"Management of Open Fracture and related complications-the Japanese way,\" that featured cutting-edge approaches to open fractures in their country, including presentations on the \"fix-and-flap\" approach, local antibiotics perfusion delivery, and a \"chipping\" method for the stimulation of bone healing. This article summarizes the content of these 3 presentations from that symposium.</p>","PeriodicalId":74381,"journal":{"name":"OTA international : the open access journal of orthopaedic trauma","volume":"7 3 Suppl","pages":"e325"},"PeriodicalIF":0.0,"publicationDate":"2024-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11064782/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140868319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}