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Return to work after proximal humeral fractures: a single center study comparing conservative versus operative treatment.

Adequate treatment of proximal humeral fractures (PHF) is essential for restoring shoulder function and expediting return-to-work (RTW). This study aims to assess the impact of conservative and operative treatments on RTW and PHF recovery. In a retrospective case-control study, 858 patients (aged 18-68) treated for PHF between 2018 and 2021 were included. Questionnaires were sent to 342 operatively treated patients (Operative group (OG)) and 191 conservatively treated matched controls (Conservative group (CG)). Assessments covered RTW, functional outcomes (DASH, ASES), and quality of life (EQ-5D). A Kaplan-Meier analysis explored RTW in weeks. With a 61% response rate, 73 eligible participants (40 OG, 33 CG) contributed. Of respondents, 67.1% were female, and 60% were employed pre-trauma. Almost 70% of employed patients RTW, with no significant difference between groups (log rank, p=0.36). Among those returning to work, OG tended to resume 4 weeks later than CG (OG 10.5, IQR 22 vs.CG 6.00, IQR 8 weeks, p=0.07). DASH, ASES, and quality of life VAS scores showed no statistical difference between groups (p=0.542, p=0.257, p=0.530, respectively). The RTW proportion did not differ between operatively and conservatively treated PHF patients, though the former tended to return 4 weeks later. Functional outcomes demonstrated no significant differences. Further adequately powered studies are necessary to establish a standardized aftercare protocol for PHF, enhancing patient care and minimizing work disability.

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Understanding Orthopaedic Infections: A Conceptual Approach.

Memorizing mounds of facts without having an effective conceptual framework to store them is often an unsuccessful learning style because memory frequently fails without understanding. To accomplish this goal, we offer a framework of ideas called "concept maps". Of the many strategies for metacognition (that is, thinking about thinking), concept mapping is proven to improve meaningful and independent learning. We used this approach to guide understanding of common orthopaedic infections. This paper is not meant to serve as an approach on how to treat, but rather as a storage system with the ability to assist in understanding orthopaedic infections. Concept maps are constructed using information from over 30 sources of orthopaedic or infectious disease literature. The sequential levels of each concept map are referred to as levels of hierarchy. Boxes of each level of hierarchy are designed to be a point of differentiation between a similar concept. Branches form lower levels of hierarchy to further divide specific concepts. 5 concept maps were constructed. One map is an overview of all concepts, and the key concept for each of the following map are as follows: osteomyelitis, synovial infection, myositis, and foreign material infection. A conceptual approach is a way of learning material in a manner that allows effective storage and retrieval. This approach will ultimately lead to a better understanding of orthopaedic infections.

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