Extremity Fractures In Patients Research Articles

Enhancing the Evaluation of Physical Function Following Orthopaedic Trauma Care: Comparison of PROMIS Computerized Adaptive Testing and Short Musculoskeletal Function Assessment.

To compare measurement properties of Patient-Reported Outcomes Measurement Information System (PROMIS) (physical function [PF] and pain interference [PI]) computerized adaptive testing to traditional Short Musculoskeletal Function Assessment (SMFA) (dysfunction index [DI] and bother index [BI]). To explore factors associated with PROMIS scores. Cross-sectional study. Level I Trauma Center. Isolated upper/lower extremity fracture patients were recruited from the orthopaedic trauma outpatient clinic (October 1, 2021 to January 1, 2023). Correlations (Pearson), reliability (standard error [SE] [T score]), efficiency (amount of information per item [1 - SE2/Nitems]), and floor/ceiling effects were assessed. An r > 0.7 represented high correlation, and SE ≤ 2.2 represented sufficient reliability. Factors associated with worse PROMIS scores were also identified. In total, 202 patients completed PROMs at median 98 days follow-up. Correlations between PROMIS-PF and SMFA-DI, and PROMIS-PI and SMFA-BI were -0.84 and 0.65. Reliability was very high for both instruments (mean SE 2.0 [PROMIS-PF], SE 2.1 [PROMIS-PI], and SE 1.2 [SMFA-DI], SE 1.8 [SMFA-BI]). Relative efficiency for PROMIS-PF versus SMFA-DI, and PROMIS-PI versus SMFA-BI was 7.8 (SD 2.5) and 4.1 (SD 1.7), respectively. Neither PROMIS nor SMFA exhibited floor/ceiling effects. In the multivariable regression analyses, elevated levels of depression, among other factors, showed an (independent) association with worse PROMIS-PF and PROMIS-PI scores. PROMIS-PF and PROMIS-PI CATs showed a (high and moderate) correlation with SMFA and hence measure a comparable construct of physical function and discomfort. As computerized adaptive tests are much more efficient to administer, they present a compelling alternative to SMFA for evaluating impact of fracture treatment. The relation between symptoms of depression and PROMIS scores emphasizes the importance of psychosocial aspects of health in orthopaedic trauma patients. Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.

Outcomes Following Surgical Fixation of Upper Extremity Fractures in Patients with Chronic Kidney Disease

Moderate to severe (stage III-IV) chronic kidney disease (CKD) and end stage renal disease (ESRD) have been shown to be independent risk factors for sustaining a fragility fracture. High rates of complications and mortality are associated with fracture fixation in patients with CKD, but existing literature is limited. It is unknown how CKD stage III-IV or ESRD affects outcomes in upper-extremity fractures. We hypothesize that patients with CKD stage III-IV or ESRD will have high complication rates after surgical fixation of upper extremity fractures. We identified all patients between 2008 and 2018 who underwent operative fixation of an upper extremity fracture proximal to the distal radius with a diagnosis of CKD stage III-IV or ESRD at the time of injury. Those with an acute kidney injury at the time of injury or a history of a kidney transplant were excluded. Demographics, medical complications, and surgical complications were collected retrospectively. Data on readmissions within 90 days and mortality within 1 year were also collected. Thirty-five patients were identified. Three patients had ESRD. Fractures included two clavicle, twelve proximal humerus, one humeral shaft, ten distal humerus, five olecranon, two ulnar shaft, one radial shaft, and two both-bone forearm fractures. In total, 91.4% of fractures were closed injuries. Surgical complications occurred in 40% of patients. The reoperation rate was 11.4%, and all cases of reoperation involved hardware removal. The all-cause 90-day readmission rate was 34.3%. The 1-year mortality rate was 8.6%. Surgical complications occurred in 40% of patients with CKD stage III-IV or ESRD who underwent fixation for an upper extremity fracture. It is important to counsel these patients regarding their high risk for complications. Further research is needed to investigate and identify how to mitigate risk. Prognostic IV.

Socioeconomic status is associated with greater hazard of post-discharge mortality than race, gender, and ballistic injury mechanism in a young, healthy, orthopedic trauma population

ObjectivesTo explore the utility of legacy demographic factors and ballistic injury mechanism relative to popular markers of socioeconomic status as prognostic indicators of 10-year mortality following hospital discharge in a young, healthy patient population with isolated orthopedic trauma injuries. MethodsA retrospective cohort study was performed to evaluate patients treated at an urban Level I trauma center from January 1, 2003, through December 31, 2016. Current Procedure Terminology (CPT) codes were used to identify upper and lower extremity fracture patients undergoing operative fixation. Exclusion criteria were selected to yield a patient population of isolated extremity trauma in young, otherwise healthy individuals between the ages of 18 and 65 years. Variables collected included injury mechanism, age, race, gender, behavior risk factors, Area Deprivation Index (ADI), and insurance status. The primary outcome was post-discharge mortality, occurring at any point during the study period. ResultsWe identified 2539 patients with operatively treated isolated extremity fractures. The lowest two quartiles of socioeconomic status (SES) were associated with higher hazard of mortality than the highest SES quartile in multivariable analysis (Quartile 3 HR: 2.2, 95% CI: 1.2–4.1, p = 0.01; Quartile 4 HR: 2.2, 95% CI: 1.1–4.3, p = 0.02). Not having private insurance was associated with higher mortality hazard in multivariable analysis (HR 2.0, 95% CI: 1.3–3.2, p = 0.002). The presence of any behavioral risk factor was associated with higher mortality hazard in univariable analysis (HR: 1.8, p < 0.05), but this difference did not reach statistical significance in multivariable analysis (HR: 1.4, 95%: 0.8–2.3, p = 0.20). Injury mechanism (ballistic versus blunt), gender, and race were not associated with increased hazard of mortality (p > 0.20). ConclusionLow SES is associated with a greater hazard of long-term mortality than ballistic injury mechanism, race, gender, and medically diagnosable behavioral risk factors in a young, healthy orthopedic trauma population with isolated extremity injury.

The Effect of Benson's Relaxation on Pain in Patients Post Open Reduction Internal Fixation (orif) Extremity Fractures

The most common complaint felt by patients due to fractures and the main complaint of patients after surgery is pain. Pain that is felt continuously can result in clinical and psychological changes. Benson's relaxation can be an alternative intervention in patients with Post Open Reduction Internal Fixation (ORIF) limb fractures to reduce pain by stimulating the pituitary gland to release endorphins and inhibit pain impulses from the cerebral cortex and thalamus. Benson Relaxation is safe and easy to do, has no risk of injury/side effects. The purpose of this study was to determine the effect of Benson relaxation on pain in patients with Post Open Reduction Internal Fixation (ORIF) limb fractures in the Dahlia Room at Mardi Waluyo General Hospital, Blitar. The research design uses a quasi-experimental pre-post test design. The population was all post ORIF patients with extremity fractures in the Dahlia (surgical) room at Mardi Waluyo Blitar Hospital with a total of 35 patients. The sample was post ORIF extremity fracture patients in the Dahlia Room of Mardi Waluyo General Hospital Blitar with a total sample of 13 respondents in each group using the Consecutive Sampling technique. Pain measurement data uses a Numerical Rating Scale. Statistical test using independent t-test. The results showed that the mean decrease in pain score in the Benson relaxation intervention group was 1.10, while the mean decrease in pain score in the control group was 0.44 with a pvalue of 0.00 &lt;��� 0.05. It was concluded that there was an effect of Benson relaxation on pain in patients with Post Open Reduction Internal Fixation (ORIF) limb fractures. Benson relaxation is effective in reducing pain in patients with post open reduction internal fixation (ORIF) limb fractures. There needs to be a standard operating procedure regarding Benson's relaxation, so that later it can be implemented by all nurses.Keywords: Benson Relaxation, Pain, Fracture, Post ORIF

The Effect of Benson's Relaxation on Pain in Patients Post Open Reduction Internal Fixation (orif) Extremity Fractures

The most common complaint felt by patients due to fractures and the main complaint of patients after surgery is pain. Pain that is felt continuously can result in clinical and psychological changes. Benson's relaxation can be an alternative intervention in patients with Post Open Reduction Internal Fixation (ORIF) limb fractures to reduce pain by stimulating the pituitary gland to release endorphins and inhibit pain impulses from the cerebral cortex and thalamus. Benson Relaxation is safe and easy to do, has no risk of injury/side effects. The purpose of this study was to determine the effect of Benson relaxation on pain in patients with Post Open Reduction Internal Fixation (ORIF) limb fractures in the Dahlia Room at Mardi Waluyo General Hospital, Blitar. The research design uses a quasi-experimental pre-post test design. The population was all post ORIF patients with extremity fractures in the Dahlia (surgical) room at Mardi Waluyo Blitar Hospital with a total of 35 patients. The sample was post ORIF extremity fracture patients in the Dahlia Room of Mardi Waluyo General Hospital Blitar with a total sample of 13 respondents in each group using the Consecutive Sampling technique. Pain measurement data uses a Numerical Rating Scale. Statistical test using independent t-test. The results showed that the mean decrease in pain score in the Benson relaxation intervention group was 1.10, while the mean decrease in pain score in the control group was 0.44 with a pvalue of 0.00 &lt;��� 0.05. It was concluded that there was an effect of Benson relaxation on pain in patients with Post Open Reduction Internal Fixation (ORIF) limb fractures. Benson relaxation is effective in reducing pain in patients with post open reduction internal fixation (ORIF) limb fractures. There needs to be a standard operating procedure regarding Benson's relaxation, so that later it can be implemented by all nurses.Keywords: Benson Relaxation, Pain, Fracture, Post ORIF

Particularities of upper extremity fractures in patients with COVID-19

Background. Treatment of the fractures in patients with COVID-19, given the novelty of this problem, is one of the most difficult tasks of modern traumatology and orthopedics. The purpose of this study was to determine the peculiarities of the course of the traumatic process in victims with fractures of the upper limbs against the background of COVID-19. Materials and methods. To carry out our research, we retrospectively analyzed the treatment of 136 trauma patients who underwent inpatient treatment in one of the city hospitals of Kyiv from 2019 to 2021. In our study, we used the generally accepted AO/ASIF classification of fractures to determine the clinical and nosological characteristics of injuries in patients with COVID-19. Results. During the COVID-19 epidemic, fractures to the distal part of the forearm (28.8 %), clavicle (17.8%) and proximal part of the shoulder (15.1 %) were most often detected. Among segmental injuries in patients with COVID-19, forearm (in 42.5 % of cases) and shoulder (in 35.6 % of cases) fractures predominated. Also, simple fractures of type A (72.6 %) were more common, and much less fragmentary fractures of type B (21.9 %) and multifragmentary type C fractures (5.5 %) were present. It is worth noting a significant decrease in the number of hand injuries during the COVID-19 pandemic by almost 7 times. In our opinion, this is due to the lockdown introduced by the authorities of Ukraine, which significantly reduced the number of industrial injuries among the research sample. Conclusions. We concluded that the COVID-19 pande­mic significantly affected the clinical and nosological structure and characteristics of bone fractures of the upper limb girdle, the analysis of cases proved that such changes in the clinical and nosological structure of fractures of the upper limb girdle are associated with changes in life activities during the pandemic and more typical for domestic trauma.

INTENSITAS NYERI BERKORELASI DENGAN KEBUTUHAN TIDUR PADA PASIEN POST OPERASI FRAKTUR EKSTREMITAS BAWAH

Around 80% of postoperative patients complain about pain on the surgical area, the impact of postoperative pain can disrupt a person's sleep needs. This study aims to determine the relationship between pain intensity and the need for sleep in the postoperative of lower extremity fracture patients at Meuraxa Hospital in Banda Aceh. Data were collected for 30 days in the Al-Bayyan 2 and 3 of Surgical Inpatient Rooms at Meuraxa Hospital in Banda Aceh. The research used a correlation method with a cross sectional approach with 43 total respondents. The Numeric Rating Scale (NRS) and the Pittsburgh Sleep Quality Index (PSQI)questionnaires were used to measure pain scale and sleep needs. Then the data was processed using a computer device. The results of this study showed that pain intensity from 27 respondents (62.8%) of postoperative patients with lower extremity fractures at Meuraxa Hospital Banda Aceh 2022 was at severe and the need for sleep from 31 respondents (72, 1%) was in a bad category. The bivariate analysis showed that the value of p = 0.004 and ɑ = 0.05 (p value &lt; ɑ) meaning that Ha is accepted. There is a relationship between pain intensity and the need for sleep in postoperative lower extremity fracture patients at Meuraxa Hospital in Banda Aceh.

STRATEGI MANAJEMEN NYERI BERKORELASI DENGAN INTENSITAS NYERI PADA PASIEN POST OPERASI FRAKTUR EKTREMITAS BAWAH

Surgery can cause very severe pain in patients due to surgical incisions. To treat pain in fracture patients, effective pain management is needed. The pain management provided must be able to meet the patient's needs, one of which is the need for comfort. namely pharmacology and non-pharmacology. This study aims to identify the relationship between pain intensity and pain management strategies in post lower extremity fracture patients. This research is quantitative analytic in nature with a cross sectional approach. The sampling technique used purposive sampling with a total sample of 43 postoperative lower extremity fracture respondents. The instrument in this study used a pain scale for pain intensity, while the pain management strategy used the American pain society patient outcome questionnaire revised, with interview collection techniques. The results of the study showed that there was a relationship between pain intensity and pain management strategies in postoperative lower extremity fracture patients. 15 people (60.0%) experienced severe pain with good pain management strategies, 10 people (40.0%) had severe pain with sufficient pain management strategies, while 17 people had moderate pain with good pain management strategies (94.4%), and moderate pain with sufficient pain management strategies in 1 person (5.6%). This is based on the results of the calculation of the chi-square statistical test obtained Pvalue = 0.014 &lt;α = 0.05. There is a relationship between pain intensity felt by patients with pain management strategies in postoperative lower extremity fracture patients at Meuraxa Hospital Banda Aceh.

The Effectiveness of Distraction Techniques for Pain in Fracture Patients in Sundari General Hospital, Medan

&lt;div&gt;&lt;table cellspacing="0" cellpadding="0" align="left"&gt;&lt;tbody&gt;&lt;tr&gt;&lt;td align="left" valign="top"&gt;&lt;p&gt;&lt;em&gt;The impact of fracture is discontinuity and tissue damage. If not treated immediately will cause complications. There needs to be management that can prevent complications. Pain experienced by patients can be known by measuring using a pain scale.&lt;/em&gt; If not treated immediately will cause complications. There needs to be management that can prevent complications. Surgical management includes closed reduction, fixation, open reduction, Open Reduction External Fixation (OREF), and Open Reduction Internal Fixation (ORIF). &lt;em&gt;Distractions have the best effect for short periods of time, for example during invasive procedures or while waiting for analgesics to work. Distraction techniques can be applied to patients with acute pain, chronic pain and anxiety patients. The role of the nurse is to provide physical health services to the patient, namely as a care giver and to the patient's psychological health, namely as an educator. Nurses must be able to provide comfort so that patients avoid pain. So, nurses should combine pharmacological and non-pharmacological management such as providing distraction techniques according to SOP to reduce pain. This research is a quantitative research with a quasi-experimental research type. With the treatment group by measuring the level of pain before the distraction technique was carried out with the control group by measuring the level of pain after the distraction technique was carried out. Statistical test results showed that there were differences in pain levels before and after the distraction technique was performed with a p value of 0,017 (0.15). &lt;/em&gt;&lt;em&gt;Distraction technique is effective for reducing the pain level of post ORIF extremity fracture patients at Sundari General Hospital in Medan. Should be able to apply more distraction techniques as non-pharmacological therapy to reduce pain in accordance with established operational standards.&lt;/em&gt;&lt;em&gt;&lt;/em&gt;&lt;/p&gt;&lt;p&gt;&lt;em&gt; &lt;/em&gt;&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;/tbody&gt;&lt;/table&gt;&lt;/div&gt;&lt;strong&gt;&lt;em&gt;Keywords : Distraction technique, Fracture, Pain&lt;/em&gt;&lt;/strong&gt;

The effect of lemon inhalation aromatherapy on pain, nausea, as well as vomiting and neurovascular assessment in patients for lower extremity fracture surgery: a randomized trial

BackgroundComplementary and integrative medicine may be effective for postoperative outcomes. This study aimed to determine the effect of lemon inhalation aromatherapy on pain, nausea, and vomiting and neurovascular assessment in patients for lower extremity fracture surgery.MethodsThis is a randomized clinical trial study. Ninety patients who had undergone lower extremity fracture surgery were randomly assigned to the intervention (lemon aromatherapy) and control groups. Lemon aromatherapy was started in the morning of the surgery and extended at two-hour intervals until the end of the surgery, in the recovery room, and 16 h after surgery. Numerical pain and nausea and vomiting scales, the Rhodes Index of Nausea, Vomiting, and Retching, and the WACHS Neurovascular Observation Chart were used to assess the outcomes before and after the intervention (in the recovery room and 4, 8, 12, and 16 h post-surgery). The data were analyzed using the Wilcoxon test, ANCOVA, and Repeated Measure ANCOVA.ResultsA significant difference was observed between the groups in terms of the intensity of pain (P < 0.001) and nausea and vomiting (P = 0.001) during the study period. Moreover, a significant difference was found between groups as to the frequency and severity of nausea, vomiting, and retching. The amount and duration of postoperative vomiting and nausea were significantly lower in the intervention group compared to the control group. In addition, lemon inhalation aromatherapy decreased the frequency of anti-emetic drug administration in the recovery room (P = 0.04) and 16 h post-surgery (P = 0.03).ConclusionsThis study indicated that aromatherapy reduced pain intensity, postoperative nausea, vomiting, and retching, as well as the incidence of anti-emetic drug administration. Therefore, using lemon inhalation aromatherapy to relieve pain and reduce nausea and vomiting is suggested for lower extremity fracture patients who have undergone surgery.Trial registrationThis study was registered in the Iranian Registry of Clinical Trail (Number = 57,331, IRCT20130616013690N10, approved 24/07/2021) (https://www.irct.ir/trial/57331).

Efektivitas Rom Pasif Terhadap Tonus Otot Pasien Post Opersi Fraktur Ektermitas : Evidence Based Case Report (Ebcr)

Fractures or broken bones are incidents of trauma to the bones with various causes. This condition results in damage to the bone and surrounding tissue, complications can occur in the limb bones if there is a lack of mobilization. Actions that can be taken to prevent more severe complications are by doing ROM motion exercises to check the strength of muscle tone. to determine the effectiveness of passive ROM on muscle tone in post extremity fracture patients. This type of research is a case study research. The focus in this study was the application of passive ROM training on muscle tone in extremity fracture patients. Results: there is a change in muscle tone in patients with post-extremity fracture after passive ROM. there are changes in muscle tone in patients with post-fracture extremities after passive ROM. Passive ROM can provide benefits to increase muscle strength in post-fracture patients in the extremities.

HUBUNGAN MOTIVASI DENGAN PELAKSANAAN MOBILISASI DINI PADA PASIEN POST OPERASI FRAKTUR EKSTREMITAS BAWAH DI RUMAH SAKIT UMUM DAERAH MEURAXA BANDA ACEH

The incidence of fractures in Indonesia continues to increase with the highest cases being lower extremity fractures with a prevalence rate of 67.9%. Complications can occur due to one of the factors, namely the lack of patient mobilization. This study aims to determine the relationship between motivation and the implementation of early mobilization in postoperative lower extremity fracture patients at Meuraxa Hospital. The design of this study used a descriptive cross-sectional study approach. The sample in this study used purvosive sampling with a total sample of 36 lower extremity fracture patients. The univariate and bivariate data analysis used the Chi Square statistical test. The results showed that the results of the chi square test with a p value of 0.003 (p &lt;0.05). This shows that there is a relationship between patient motivation and the implementation of early mobilization in lower extremity post fracture patients at Meuraxa Hospital Banda Aceh 2021.

Duration of Antibiotic Prophylaxis for Ballistic Fractures to the Extremities.

In the U.S. there are thousands of ballistic firearm injuries to the extremities and subsequent infections, yearly. There is a lack of consensus regarding the ideal duration of antibiotic treatment to prevent infection of these wounds. Our study investigated infection rate among ballistic extremity fracture patients based on antibiotic prophylaxis duration, operative management, wound severity, and fracture location. Retrospective chart review of ballistic extremity fracture patients from a single trauma center from 01/01/2010 to 12/31/2020. Of 1611 fracture cases screened, 193 met our inclusion criteria. Infection rate was significantly higher among patients who received antibiotic prophylaxis for ≥48hours (19.4%) compared to those who received antibiotics for <48 hours (4.4%) (Chi2 = 9.89, P = .001). This trend continued among patients who underwent operative management (P < .001), patients with articular ballistic fractures (P = .014), patients with non-articular ballistic fractures (P = .03), and patients with ballistic fractures to the lower extremities (P = .003). There was no difference in the rate of infection between patients who received ≥48hours or <48hours of antibiotic prophylaxis among patients with Gustilo-Anderson grade I, grade II, or grade III injuries, patients with ballistic fracture to the upper extremities, and patients who did not undergo operative management. Across all analyses in the present study, there was not a single correlation between antibiotic prophylaxis duration for ≥48hours and lower rates of subsequent infection. For patients with ballistic fractures to the extremities, prophylactic antibiotic administration for ≥48hours is unwarranted.

EFEKTIVITAS TEKNIK RELAKSASI NAPAS DALAM KOMBINASI GUIDED IMAGERY DENGAN MUSIK TERHADAP SKALA NYERI PADA PASIEN POST OPERASI FRAKTUR DI RS. SITI KHODIJAH SEPANJANG

Objective: Fracture is bone damage caused by trauma, namely excessive pressure on the bone, surgery is one of the fracture management, the problem that often arises in postoperative fracture patients is pain. Pain is an uncomfortable or unpleasant symptom caused by tissue damage. Deep breathing relaxation and guided imagery are non-pharmacological techniques to reduce pain. The aimed of this research was to determine the effect of giving deep breathing relaxation techniques combination with guided imagery with music on pain scale in postoperative fracture patients at the Siti Khodijah hospital.Methods: This article used pre-experimental with one group pre-test post-test design. The sampling techniques was purposive sampling where a sample of 20 respondents was obtained. The data analysis techniques used a paired sample t- test program with a significance level of α=0.05.Results: showed that the deep breathing relaxation technique combination with guided imagery with music proved to be effective in reducing pain scale in postoperative extremity fracture patients at the Siti Khodijah hospital. The pain scale before the intervention was moderate pain (70%) and severe pain (30%), while the pain scale after the intervention was mild pain (45%) and moderate pain (55%) (p value=0.000 &lt; α=0.05), then H1 is accepted and H0 is rejected.Conclusion: deep breathing relaxation techniques combination with guided imagery with music can reduce pain intensity in postoperative fracture patients at the Siti Khodijah hospital. The application of these techniques can be carried out according to SOP so that nurses do not only focus on pharmacological treatment.

The Effect of Rehabilitation Intervention on Pain, Strength, Range of Motion, Hand Function and Quality of Life Patients with Upper Extremity Fracture - A Systematic Review

BACKGROUND&#x0D; The rehabilitation intervention for upper extremity fracture varies from shoulder to finger, obtained from physical modalities and exercise. Physical modality and exercise rehabilitation intervention effectively reduce pain, increase range of motion (ROM), hand function and improve quality of life. This systematic review aims to synthesize current scientific knowledge on rehabilitative interventions with a specific focus on upper extremity fractures and the effect of all interventions on the patient.&#x0D; METHODS&#x0D; Three scholarly databases (PubMed, Google Scholar, Science Direct) were systematically searched. Literature published before 10 January 2022 focused on upper extremity fracture and rehabilitation treatment patients. Quality assessment was completed with CEBM tools by Oxford University. For PICO, The Population was upper extremity fractures, and the intervention was rehabilitation intervention, both physical modality and exercise. The comparation was other rehabilitation interventions or without rehabilitation, and the outcome in this study were measured with the visual analogue scale (VAS), ROM, hand function, and quality of life (QoL).&#x0D; RESULTS&#x0D; Eight studies were included in this review among 18.326 reference titles founded and screened. All of the studies had various sample sizes followed by bias analysis with CEBM tools. Rehabilitation for elbow fracture was dynamic fixation using rigid tape and proprioceptive neuromuscular facilitation stretching. Rehabilitation for distal radius fracture was scapular exercise, graded motor imagery, hot pack on hand volume, illusory kinesthesia, and wrist exercise. These interventions can reduce the pain, improve strength, range of motion, hand function and quality of life in upper extremity fracture patients.&#x0D; CONCLUSIONS&#x0D; Exercise and physical modality rehabilitation intervention have proven to reduce pain, improve strength, range of motion, hand function and quality of life in upper extremity fracture patients.

Regional anesthesia for acute and subacute orthopedic trauma: A review

• Multimodal pain control has become the standard of care for management of orthopedic trauma. • This paper describes use of regional aesthesia for surgical intervention of extremity fractures in patients who present following traumatic injury as part of a multimodal pain management protocol. • Types of, indications for, and outcomes of both upper and lower extremity peripheral nerve blocks will be reviewed. Pain management in the setting of acute and subacute orthopedic trauma can be challenging. Due to the recent focus on the rising opioid epidemic, as well as the adverse side of effects of opioid pain medication, multimodal pain control has become the standard of care for management of orthopedic trauma, particularly during operative fixation. The purpose of this paper is to report on the use of regional anesthesia for surgical intervention of extremity fractures in patients who present following traumatic injury as part of a multimodal pain management protocol. Types of, indications for, and outcomes of both upper and lower extremity peripheral nerve blocks will be reviewed.

Outcomes After Orthopedic Trauma Surgery - What is the Role of the Anesthesia Choice?

The body of literature concerning the influence of anesthetic type on many perioperative outcomes has grown considerably in recent years. Most studies have suggested that particularly in orthopedic patients, regional anesthesia may be associated with improved perioperative outcomes. Orthopedic trauma presents itself as a field that might benefit from increased utilization of regional techniques with the goal to improve outcomes. This narrative review concludes that, indeed, regional anesthesia seems to provide benefits for morbidity, pain control, and improved return to function in hip fracture, rib fracture, and isolated extremity fracture patients.

Management algorithm of external fixation in lower leg arterial injury for limb salvages

PurposeThe aim of this study is to investigate the outcome of these limb-threatening injuries through external fixation treatment and to discuss the case of patients’ functional recovery after external fixation.MethodsDemographics, surgical treatment and outcomes in 88 patients with lower leg arterial injuries treated by external fixation at two trauma centers from 2009 to 2018 were reviewed. The primary outcome was the rate of successful lower leg salvage, while secondary outcomes were complications and functional recovery.ResultsEighty-eight patients were identified and 80 patients (90 legs) maintained a successful lower leg salvage. The mean age was 32.7 ± 10.8 years, and 81.8% were male. The primary outcomes included the following complications: pin-tract infection (8 legs), pins loosening (4 pins), wound superficial infection (7 legs), deep infection developed osteomyelitis (3 legs), bone nonunion or bone defect (17 legs) and amputation (8 legs). The average healing time of fracture was 5.6 ± 4.3 months. The maintain of external fixation average time was 5.8 ± 3.6 months. The improvement of scores of the pain, function and quality of life in our follow-up was statistically significant.ConclusionFor the lower extremity fracture patients with vascular injuries, using external fixation correctly can improve clinical outcomes and produce the improvement of pain, function and the quality of life.Level of evidenceRetrospective cohort, level IV.

PEMBERIAN ROM AKTIF TERHADAP TINGKAT KEMAMPUAN ADL DASAR PADA PASIEN POST OPERASI FRAKTUR EKSTREMITAS BAWAH DENGAN TINDAKAN ORIF DI RSUD DR. ZAINOEL ABIDIN BANDA ACEH

Based on data from the WHO, in 2013 there were 1.3 million people suffering from fractures due to traffic accidents. Fracture patients have limitations in carrying out their daily activities and active ROM exercises need to be done. The purpose of the study was to determine the effect of giving active ROM on the level of basic ADL ability in postoperative lower extremity fracture patients with ORIF action at RSUDZA Banda Aceh in 2018. The research design used in this study was Quasi Experiment with Static Group Comparison, Sampling in this study conducted by purposive sampling technique totaling 20 respondents. Data was collected using the basic ADL observation sheet. The results showed that the basic ADL ability scores in the intervention group were mostly in the mild dependency category, as much as 60%, while in the control group many were in the moderate dependency category, as much as 40%. Basic ADL in postoperative lower extremity fracture patients with ORIF action in Raudhah 6 and Raudhah 7 RSUDZA Banda Aceh (p = 0.008) which means Ha is accepted and H0 is rejected. The importance of doing active ROM for postoperative lower extremity fracture patients with ORIF action to help the healing process. It is hoped that nurses will provide an explanation of active ROM exercises as a permanent activity in an effort to prevent loss of body function abilities.

THE EFFECT OF PREOPERATIVE EDUCATION ON SELF EFFICACY AND BEHAVIOR OF POST OPERATIVE PATIENTS OF LOWER EXTREMITY FRACTURES

Preoperative education is a form of education given before surgery patients, education contains things that patients will do after surgery. Preoperative education can improve self-efficacy and patient behavior. Objectives: To investigate whether there is an effect of preoperative education on self-efficacy and behavior in lower extremity fracture patients; Methods: This study used a quantitative method with a Quasi Experimental design with a pretest and posttest control group approach. The sample used was 52 respondents who were diagnosed as lower extremity fractures. Respondents were divided into 2 groups: intervention (provided education in the form of videos) and control (given verbal education); Results: after the study was completed and the score was calculated, there was an increase in the two control and intervention groups in the self-efficacy questionnaire scores but there was a significant increase in self-efficacy and exercise behavior in the intervention group who were given preoperative education via video for 15 minutes, namely 53.84 % self efficacy scores and 21 behavioral scores; Conclusion: In this study it was found that preoperative education is important in patient care, education provided through video is proven to be more effective in increasing self-efficacy and improving postoperative exercise behavior in lower extremity fracture patients compared to preoperative education given verbally.