Letter Regarding: Intraoperative Effect of 2D vs 3D Fluoroscopy on Quality of Reduction and Patient-Related Outcome in Calcaneal Fracture Surgery

2021 ◽  
Vol 42 (2) ◽  
pp. 245-245
Author(s):  
Martinus Richter
Keyword(s):  
Calcaneal Fracture ◽  
3D Fluoroscopy ◽  
Patient Related Outcome ◽  
Fracture Surgery

Factors Influencing Functional Outcomes of Subtalar Fusion for Posttraumatic Arthritis After Calcaneal Fracture

2018 ◽  
Vol 39 (9) ◽  
pp. 1062-1069 ◽  
Author(s):  
Quirine M.J. van der Vliet ◽  
Falco Hietbrink ◽  
Fabio Casari ◽  
Luke P.H. Leenen ◽  
Marilyn Heng
Keyword(s):  
Quality Of Life ◽  
Functional Outcomes ◽  
Calcaneal Fracture ◽  
High Energy ◽  
Posttraumatic Arthritis ◽  
High Energy Trauma ◽  
Subtalar Arthrodesis ◽  
Subtalar Fusion ◽  
Subtalar Arthritis

Background: Subtalar arthrodesis is a common salvage operation for posttraumatic subtalar arthritis. This study aimed to identify factors associated with functional outcomes and quality of life after subtalar fusion for posttraumatic subtalar arthritis after calcaneal fracture. Methods: This is a retrospective study with follow-up by questionnaire in two level 1 trauma centers. Patients who underwent subtalar arthrodesis for posttraumatic arthritis after a calcaneal fracture between 2001 and 2016 were identified and contacted for completion of a survey consisting of the Foot and Ankle Ability Measure (FAAM), Maryland Foot Score (MFS), Patient-Reported Outcomes Measurement System Physical Function (PROMIS PF, Short Form 10a) questionnaire, EuroQol 5-dimensional (EQ-5D) questionnaire, and EuroQol visual analog scale (EQ-VAS). Exclusion criteria were initial subtalar arthrodesis at an outside facility, primary arthrodesis for fracture, initial arthrodesis earlier than 2001, amputation of the fused foot or leg, younger than 18 years at time of fusion, and inability to communicate in English. A total of 159 patients met our inclusion criteria. Eighty-four patients completed the questionnaires, resulting in a response rate of 59%. Results: Median FAAM score was 79 (interquartile range [IQR], 48-90), median MFS was 74 (IQR, 56-86), and median PROMIS PF was 45 (IQR, 38-51). Quality of life was significantly lower when compared to a reference population ( P = .001). Smoking was independently associated with worse outcomes. Complications after fusion (such as nonunion, implant failure, and infectious complications), high-energy trauma, and ipsilateral injury were also predictors for poorer outcomes. Conclusion: Acceptable functional outcomes and quality of life were observed after subtalar fusion. Smoking, complications after subtalar fusion, high-energy trauma, and presence of ipsilateral injuries were independently associated with worse functionality and quality of life. Level of Evidence: Prognostic level III, comparative series.

Threatening Fracture of Intraosseous Lipoma Treated by Internal Fixation

2019 ◽  
Vol 109 (1) ◽  
pp. 75-79
Author(s):  
Igor Frangež ◽  
Tea Nizič-Kos ◽  
Matej Cimerman
Keyword(s):  
Internal Fixation ◽  
Surgical Techniques ◽  
Bone Neoplasms ◽  
Pathologic Fracture ◽  
Calcaneal Fracture ◽  
Lateral Side ◽  
Intraosseous Lipoma ◽  
Internal Stabilization ◽  
Appropriate Treatment ◽  
Fracture Surgery

Intraosseous lipomas are rare benign bone neoplasms with an incidence of less than 0.1%; origin in the calcaneus has been reported in only a few patients. First-line treatment remains conservative, but several surgical techniques have also been described. We describe a 44-year-old woman with increasing pain in her left heel for a year and a half, who noticed swelling on the lateral side of the calcaneus. The patient underwent radiography, magnetic resonance imaging, and computed tomography of her left foot, which was suspicious for an intraosseous lipoma with a threatening calcaneal fracture. We performed a surgical procedure, curettage of the tumor, spongioplastics (by autologous bone transplant and β-tricalcium phosphate), and internal stabilization with a calcaneal plate considering the goal of immediate postoperative weightbearing. Histologic examination confirmed an intraosseous lipoma of the calcaneus. The patient's pain was relieved immediately after surgery. Internal stabilization of the calcaneus allowed the patient to immediately fully weightbear and to return to usual daily activities. Although a benign bone tumor, intraosseous lipoma can cause many complications, such as persistent pain, decreased function, or even pathologic fracture as a result of calcaneal bone weakening. Choosing an appropriate treatment is still controversial. Conservative treatment is the first option, but for patients with severe problems and threatening fracture, surgery is necessary. Internal fixation for stabilization enables immediate postoperative weightbearing and shortens recovery time.

Health-related quality of life in trauma patients who sustained a calcaneal fracture

Injury ◽  
2016 ◽  
Vol 47 (7) ◽  
pp. 1586-1591 ◽  
Author(s):  
G. Alexandridis ◽  
A.C. Gunning ◽  
L.P.H. Leenen
Keyword(s):  
Quality Of Life ◽  
Calcaneal Fracture ◽  
Trauma Patients ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related

scholarly journals Prognostic factors of depression and depressive symptoms after hip fracture surgery: systematic review

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
R. Milton-Cole ◽  
S. Ayis ◽  
K. Lambe ◽  
M. D. L. O’Connell ◽  
C. Sackley ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Depressive Symptoms ◽  
Hip Fracture ◽  
Data Extraction ◽  
High Quality Research ◽  
Hip Fracture Surgery ◽  
Modelling Studies ◽  
Underlying Mechanisms ◽  
Fracture Surgery

Abstract Background Patients with hip fracture and depression are less likely to recover functional ability. This review sought to identify prognostic factors of depression or depressive symptoms up to 1 year after hip fracture surgery in adults. This review also sought to describe proposed underlying mechanisms for their association with depression or depressive symptoms. Methods We searched for published (MEDLINE, Embase, PsychInfo, CINAHL and Web of Science Core Collection) and unpublished (OpenGrey, Greynet, BASE, conference proceedings) studies. We did not impose any date, geographical, or language limitations. Screening (Covidence), extraction (Checklist for critical Appraisal and data extraction for systematic Reviews of prediction Modelling Studies, adapted for use with prognostic factors studies Checklist), and quality appraisal (Quality in Prognosis Studies tool) were completed in duplicate. Results were summarised narratively. Results In total, 37 prognostic factors were identified from 12 studies included in this review. The quality of the underlying evidence was poor, with all studies at high risk of bias in at least one domain. Most factors did not have a proposed mechanism for the association. Where factors were investigated by more than one study, the evidence was often conflicting. Conclusion Due to conflicting and low quality of available evidence it is not possible to make clinical recommendations based on factors prognostic of depression or depressive symptoms after hip fracture. Further high-quality research investigating prognostic factors is warranted to inform future intervention and/or stratified approaches to care after hip fracture. Trial registration Prospero registration: CRD42019138690.

scholarly journals Prognostic Factors for Mortality, Activity of Daily Living and Quality of Life in Taiwanese Older Patients within 1 Year following Hip Fracture Surgery

2022 ◽  
Vol 12 (1) ◽  
pp. 102
Author(s):  
Ming-Hsiu Chiang ◽  
Yu-Yun Huang ◽  
Yi-Jie Kuo ◽  
Shu-Wei Huang ◽  
Yeu-Chai Jang ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
Hip Fracture ◽  
Daily Living ◽  
Estimating Equation ◽  
Generalized Estimating Equation ◽  
Hip Fracture Surgery ◽  
Fracture Surgery

Background. Hip fractures among older adults are a major public health concern worldwide. This study investigated the potential clinical factors that predict postoperative 1-year activities of daily living (ADL), quality of life (QoL), and mortality in Taiwanese older adults following hip fracture. Methods. This is a prospective cohort study enrolling older adults (≥60 years) who had undergone hip fracture surgery in a single medical center. The comprehensive clinical history of each patient was examined. QoL, ADL, and mortality events were recorded consecutively at 3, 6, and 12 months after operation. The multiple logistic regression model and the generalized estimating equation (GEE) were adopted to identify contributing factors for mortality and postoperative ADL and QoL prognosis, respectively. Results. Among 377 participants with hip fracture, 48 died within 1 year of the index operation. ADL and QoL considerably decreased at 3 months following hip surgery. Old age, high Charlson Comorbidity Index, and American Society of Anesthesiologists grading were crucial predictors for mortality at the 1-year follow-up. The generalized estimating equation analysis indicated that the length of postoperative follow-up time, serum albumin level, patient cognitive status, and handgrip strength were considerably associated with QoL and ADL recovery prognosis in the Taiwanese older adults following hip fracture. Conclusions. Hip fractures have long-lasting effects on the older adults. Our data imply several prognosis predicting parameters that may assist clinicians in accounting for an individual’s personalized risks in order to improve functional outcomes and reduce mortality.

scholarly journals Learning Curve for Open Reduction and Internal Fixation of Displaced Intra-Articular Calcaneal Fracture by Extensile Lateral Approach Using the Cumulative Summation Control Chart

2019 ◽  
Vol 4 (4) ◽  
pp. 2473011419S0008
Author(s):  
Jungtae Ahn ◽  
Tae Yong Kim ◽  
Tae Wook Kim ◽  
Bi O Jeong
Keyword(s):  
Learning Curve ◽  
Moving Average ◽  
Operating Time ◽  
Calcaneal Fracture ◽  
Lateral Approach ◽  
Phase 2 ◽  
Extensile Lateral Approach ◽  
Cumulative Summation ◽  
The Mean

Category: Trauma Introduction/Purpose: Open reduction and internal fixation (ORIF) of displaced intra-articular calcaneal fracture (DIACF) by extensile lateral approach is widely used but is technically challenging. In this study, the learning curve for ORIF of DIACF by extensile lateral approach was investigated. Methods: Between March 2014 and July 2018, 45 cases consisting of 40 patients underwent operative treatment for DIACF by the extensile lateral approach performed in all instances by a single surgeon. A moving average and cumulative summation control chart (CUSUM) were used for learning curve analyses. Operative failure was defined when at least one of the following parameters were unsatisfactory: reduction of Gissane angle and Böhler angle, posterior facet congruency, calcaneal width, subfibular impingement, axial alignment, or calcaneocuboid joint congruency. Results: The mean operating time was 117.4 min. Regarding the quality of reduction, the mean preoperative sum of the 7 parameters was 5.1 and improved to 0.6 postoperatively. The CUSUM for operative success peaked in the 20th case. The CUSUM and moving average graphics of operating time peaked at the 9th case and registered nadirs at the 34th case, with slight ascent and decent. The operating time for twenty cases in phase 1 (1–20) and for twenty-five cases in phase 2 (21–45) of the learning curve did not differ significantly. There was no statistical difference in the severity of fracture pattern. By comparison, significant differences in phase 2 patients showed a better postoperative reduction quality. Conclusion: As indicated by multidimensional statistical analyses, primary technical competence in improving the reduction quality of DIACF was achieved after the initial learning period with 20 cases. After the learning curve for ORIF of DIACF, a better reduction quality in the sum of reduction parameters was observed.

Emotional well-being and quality of life in patients undergoing radiation therapy for pancreatic and hepatobiliary malignancies.

2011 ◽  
Vol 29 (4_suppl) ◽  
pp. 297-297
Author(s):  
B. T. Samuelson ◽  
E. K. Fromme ◽  
J. Waller ◽  
C. R. Thomas
Keyword(s):  
Quality Of Life ◽  
Radiation Therapy ◽  
Positive Response ◽  
Well Being ◽  
Definitive Treatment ◽  
Hepatobiliary Malignancies ◽  
Before And After ◽  
Patient Related Outcome ◽  
The Impact

297 Background: Therapy for GI malignancies has long been known to have a marked impact on quality of life, yet this relationship remains poorly understood. The specific aim of this analysis was to evaluate the impact of radiation therapy (RT) on emotional well-being and QOL in patients receiving RT for pancreatic and hepatobiliary malignancies. Methods: A retrospective, IRB-approved chart review was performed of 722 patients receiving RT for any cancer diagnosis between 1/1/2006 and 12/31/2008. Subjects completed the Functional Assessment of Cancer Therapy General (FACT-G) questionnaire before and after RT. Pre- and immediately post-RT course scores were compared using student t-tests with Bonferroni correction for multiple comparisons (7 comparisons, alpha =.007). Results: 722 of 1369 (52.7%) patients participated in the Patient Related Outcome database. Complete pre and post RT spirituality data were available for 73 (64.6%) patients with GI malignancies, including 24 (33%) with pancreatic or hepatobiliary disease. Average age was 61, 15 (63%) were male and 14 (58%) received definitive treatment. A decrease in both functional and physical well-being was demonstrated in post-RT scores as compared to pre-RT. Emotional well-being, however, increased (17.60 to 18.72, p=0.051), a trend not replicated in any of the other GI malignancies. Further analysis demonstrated this improvement was largely due to a decrease in positive response to the statements “I feel nervous” (1.21 to 0.67, p=0.009) and “I worry my condition will get worse” (1.58 to 1.25, p=0.043). A decrease in positive response to “I feel sad” and an increase in positive response to “I am satisfied with how I am coping with my illness” were also noted, but differences were not significant. Conclusions: Emotional well-being of those receiving RT for pancreatic and hepatobiliary malignancies appears to improve over the course of therapy, even while other measures of QOL decline. Additional investigations in larger populations are warranted to further elucidate this relationship. Documentation of PROs may have potential for impact on QOL for patients with these and other malignancies. No significant financial relationships to disclose.

Post Operative Cognitive Dysfunction: A Literature Review

2021 ◽  
Vol 1 (1) ◽  
pp. 8-11
Author(s):  
Irfan Ferdinand Tambunan
Keyword(s):  
Quality Of Life ◽  
Cognitive Dysfunction ◽  
Postoperative Cognitive Dysfunction ◽  
Cognitive Disorders ◽  
Education Level ◽  
Pharmacological Management ◽  
Hip Fracture Surgery ◽  
Fracture Surgery ◽  
Ventilated Patients

Along with ages, elderly patients with comorbid who undergoing surgical procedures are more likely to experience cognitive disorders such as decreased quality of life and loss of independence. This is known as postoperative cognitive dysfunction. The percentage is quite significant for old age to experience cognitive disorders. Ages, education level, health and mental status can be a factor causing cognitive disorders. Comprehensive assessment of objective mental, social and functional status can increase patient preoperative. Perioperative pharmacological management can reduce the incidence of POCD. For example, minimal use of propofol in spinal anesthesia may reduce POCD in hip fracture surgery. The use of dexmedetomidine in ventilated patients in the ICU may also reduce POCD. The etiology is still unclear, but there is a suspicion that the use of neurotoxic anesthetics can trigger the occurrence of POCD, but this has not been further proven.

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