scholarly journals Conservative Care Cost Analysis of Patients of Long Bone Fracture in Emergency Room. A Review to See the Sufficiency of Health Insurance Costs

2020 ◽  
Vol 4 (2) ◽  
pp. 87-90
Author(s):  
Bayusentono Sulis ◽  
Cery Hajali
Keyword(s):  
Length Of Stay ◽  
Bone Fracture ◽  
Bone Fractures ◽  
Long Bone ◽  
Long Bones ◽  
Inclusion Criteria ◽  
Real Cost ◽  
Long Bone Fractures ◽  
Long Bone Fracture ◽  
The Cost

Long bones are bones that include the humerus, radius, ulna, femur, tibia and fibula. Aside from fibula, the main function of long bones is as the main skeleton in movement. Therefore, whenever there is a fracture in the long bone, the ability to move will be lost.The occurrence of this long bone fracture itself is still a global problem because the number of events is still quite large. This is in line with the increase in socioeconomic status and the incidence of traffic accidents which is one of the causes of fractures. METHOD This study is a prospective study to determine the magnitude of the cost of treatment conservatively in cases of long bone fractures in RSUD dr. Soetomo. The study design used was a prospective cohort. The sample size used in this study was determined by consecutive sampling, ie patients who met the inclusion criteria in the period May - August 2017. RESULTS From the observations for four months from May 2017 - August 2017 at Emergency Room Soetomo General Hospital, found 77 patients with long bone fractures that were casted. Of these patients, 38 patients were placed in a slab, 39 patients were placed in a circular cast. Among the 39 people, 17 patients were excluded according to the exclusion criteria and 22 patients were included as the study sample according to the inclusion criteria. By using a statistical test using paired sample T test with a value of α = 0.05, a significance of 0.025 was obtained. Because the significance value is 0.025 <0.05 (α). DISCUSSION From the resultsa difference between the BPJS rate of installing circular cast on long bone fractures with the real cost of installing circular cast on long bone fractures. In addition, from the value of the mean we get that the average value of the BPJS rate is greater than the real cost value, which means we can conclude that the BPJS cost can cover the cost of conservative therapy in cases of long bone fractures. CONCLUSION In the economic aspect, the longer the length of stay means the higher the costs that must be paid by the patient (the payer) and accepted by the hospital. This only applies to real tariffs, whereas to INACBG's long or short length of stay does not affect the cost.

scholarly journals 85 Parent and youth experiences of emergency department care for suspected long bone fractures in children

2020 ◽  
Vol 25 (Supplement_2) ◽  
pp. e35-e35
Author(s):  
Nathalie Gaucher ◽  
Evelyne D Trottier ◽  
Zainab Ridha ◽  
Francois Simard ◽  
Brenda Duran ◽  
...  
Keyword(s):  
Emergency Department ◽  
Length Of Stay ◽  
Bone Fracture ◽  
Bone Fractures ◽  
Tertiary Care ◽  
Long Bone ◽  
Emergency Department Care ◽  
Long Bone Fractures ◽  
Long Bone Fracture ◽  
Youth Experiences

Abstract Background Long bone fractures are a frequent reason for visits to the pediatric emergency department (ED) where patients obtain the definitive care they require. Youth are rarely involved in quality assessment and improvement initiatives. Objectives To describe parent and youth experiences of their ED care for suspected long bone fractures. Design/Methods This prospective survey study of parents/youth consulting a tertiary care pediatric ED used surveys co-constructed by ED clinicians and parent partners. English/French speaking patients aged 10 to 18 years old with suspected long-bone fracture at triage – and their parents – were eligible to complete the survey during their ED stay. Electronic surveys were developed for parents and youth and pre-tested with 12 youth and 14 parents. Descriptive data was generated using SPSS v.25 (IBM Inc.). Results Three hundred surveys were distributed to eligible participants from March 2018 to June 2019 and 249 surveys were completed (148 parents, 101 youth). At least one member from 189 families completed a survey. Parents and youth participants had median ages of 44 and 12 years old, respectively. Most patients (98%) had a radiograph as part of their work-up, usually in the ED (76%); Twenty-seven percent were referred with radiographs. Most families (61%) received a diagnosis of long-bone fracture and were referred to orthopaedics for outpatient follow-up. Families’ median length of stay was 4h08min (range 43 min-14h30min). Parents (88mm) and youth (81mm) reported high median satisfaction with their overall ED care on 100 mm visual analog scales. Most parents (81%) and youth (75%) reported receiving just enough information from ED staff, though only half (50%) of the parents received information on how to care for their child at home. More than 90% of parents believed that the ED team treated their child’s pain. Eighty-one percent of youth reported that pain was treated sufficiently although 63% believed it had been treated quickly. Most parents (56%) and youth (72%) reported their ED stay was longer than anticipated; parents’ perceptions did not correlate with ED length of stay on logistic regression (p=0.014), while youth’s did (p=0.009). Few parents (33%) or youth (32%) reported receiving regular information on ED wait times. Conclusion Parent and youth perspectives of their ED care are complementary, and both should be considered in patient-oriented quality improvement initiatives.

Internal Fixation of Long Bone Fractures in Farm Animals

1993 ◽  
Vol 06 (01) ◽  
pp. 36-41 ◽  
Author(s):  
A. Steiner ◽  
U. Iselin ◽  
C. Lischer ◽  
J. A. Auer
Keyword(s):  
Internal Fixation ◽  
Bone Fracture ◽  
Bone Fractures ◽  
Farm Animals ◽  
Long Bone ◽  
Fracture Treatment ◽  
Long Bone Fractures ◽  
Long Bone Fracture

This study demonstrates that long bone fracture treatment in food and fibre producing animals is in most cases successful. The greatest disadvantage of such treatment are the costs of the surgery and implants.

PREDICTION OF LONG BONE FRACTURES VIA RECONSTRUCTION OF PEDESTRIAN ACCIDENTS USING MULTI-BODY SYSTEM AND FE MODELS

2015 ◽  
Vol 15 (01) ◽  
pp. 1550016 ◽  
Author(s):  
BINGYU WANG ◽  
JIKUANG YANG ◽  
OTTE DIETMAR ◽  
YONG PENG
Keyword(s):  
Lower Extremity ◽  
Bone Fracture ◽  
Bone Fractures ◽  
Long Bone ◽  
Fe Model ◽  
Body System ◽  
Long Bone Fractures ◽  
Long Bone Fracture ◽  
Pedestrian Accidents ◽  
Multi Body

This study aimed at prediction of long bone fractures and analysis of lower extremity injury mechanisms in real world passenger car to pedestrian collision. For this purpose, two cases of car to pedestrian accidents with detail recorded lower extremity injuries were reconstructed using Multi-body system (MBS) and Finite element (FE) models. The MBS models were used to determine lower extremity impact conditions, such as impact velocity, contact location as well as impact orientation. Furthermore, impact conditions were used to define initial boundary conditions in the simulation of lower extremity colliding with car front end using FE models. The bending moment and von Mises stress distributions of long bone were calculated in FE model to evaluate long bone fracture risks. Then, injury outcomes from simulations were compared with hospital recorded injury data. The simulation results of long bone fracture were consistent with the injury pattern and positions from hospital records. Moreover, the calculated fracture moments of tibia and fibula shaft as well as femur neck region were 310.8, 21.4 and 304.7 Nm, respectively. The FE model is capable to reproduce the dynamic injury process and is an effective tool to demonstrate the dynamic response of the injury and to predict the risk of long bone fractures.

scholarly journals Management of infected non-union of lower limb long bone fractures using ilizarov technique: a study of outcomes

2017 ◽  
Vol 3 (3) ◽  
pp. 557 ◽  
Author(s):  
Hrishikesh Pande ◽  
Chander Mohan Singh ◽  
Anjan Prabhakara ◽  
Vivek Mathew Philip ◽  
Mohd Shezan Iqbal ◽  
...  
Keyword(s):  
Lower Limb ◽  
Bone Fractures ◽  
Lower Limbs ◽  
Long Bone ◽  
Long Bones ◽  
Ilizarov Technique ◽  
Infected Nonunion ◽  
Ring Fixator ◽  
Long Bone Fractures ◽  
Ilizarov Ring Fixator

<p class="abstract"><strong>Background:</strong> Nonunion of long bone fractures is a common condition treated by an orthopaedic surgeon. Many nonunions can be treated effectively by internal fixation with or without bone grafting but, an infected nonunion can prove to be a tough challenge. The Ilizarov method is effective in managing infected nonunion of long bones. This study aims to assess the outcome of management of infected nonunions of long bones of lower limb with Ilizarov Ring fixator using bone and functional results as per Association for the Study and Application of Methods of Ilizarov (ASAMI) Scoring System.</p><p class="abstract"><strong>Methods:</strong> We retrospectively analysed 18 patients (16 Male: 2 Female; Mean age 43.2 years) managed with Ilizarov technique for an infected tibial or femoral nonunion between 01 January 2013 and 31 December 2014. They were followed up for an average of 25.4 months after removal of fixator. They were assessed for functional and Bone (radiological) outcomes using the Association for the Study and Application of Methods of Ilizarov (ASAMI) criteria.<strong></strong></p><p class="abstract"><strong>Results:</strong> 17 limbs were salvaged and union could be achieved. One limb required amputation due to severe persistent intractable infection. None required any additional skeletal stabilisation after removal of fixator frame except casting in a few patients for a period of 6 weeks. Mean time to union was 211.83 days (range 136 - 320days/median 184) or 7.01 months. As per the ASAMI score, Bone results were excellent in 10, good in 5, fair in 2 and poor in 1. Functionally 7 were graded as excellent, 6 as good, 3 as fair and 1 as poor and 1 patient underwent amputation.</p><p><strong>Conclusions:</strong> The Ilizarov’s method remains one of the most versatile and successful means of achieving bone healing in infected nonunions of long bones of lower limbs with additional benefits of correcting bone defects, deformities and limb length inequalities. </p>

The Wide-Open Three-Legged Parallel Robot for Long-Bone Fracture Reduction

2017 ◽  
Vol 9 (1) ◽  
Author(s):  
Mohammad H. Abedinnasab ◽  
Farzam Farahmand ◽  
Jaime Gallardo-Alvarado
Keyword(s):  
Bone Fracture ◽  
Degrees Of Freedom ◽  
Experimental Tests ◽  
Parallel Robot ◽  
High Accuracy ◽  
Fracture Reduction ◽  
Long Bone ◽  
Long Bones ◽  
Six Degrees Of Freedom ◽  
Long Bone Fracture

Robotic reduction of long bones is associated with the need for considerable force and high precision. To balance the accuracy, payload, and workspace, we have designed a new six degrees-of-freedom three-legged wide-open robotic system for long-bone fracture reduction. Thanks to the low number of legs and their nonsymmetrical configuration, the mechanism enjoys a unique architecture with a frontally open half-plane. This facilitates positioning the leg inside the mechanism and provides a large workspace for surgical maneuvers, as shown and compared to the well-known Gough–Stewart platform. The experimental tests on a phantom reveal that the mechanism is well capable of applying the desired reduction steps against the large muscular payloads with high accuracy.

scholarly journals Prospective study of managing long bone fracture nonunion: is bone graft needed in every case?

2018 ◽  
Vol 4 (4) ◽  
pp. 556
Author(s):  
Srinivas Balagani
Keyword(s):  
Prospective Study ◽  
Bone Graft ◽  
Bone Fracture ◽  
Fracture Site ◽  
Long Bone ◽  
Segmental Defect ◽  
Long Bones ◽  
Non Union ◽  
Number Of Patients ◽  
Long Bone Fracture

<p class="abstract"><strong>Background:</strong> Increased road traffic accidents lead to increased incidence of fracture of long bones. It has a tendency of non-union. Infection is very common in these cases which are an important cause of nonunion of long bone fractures. The objective of the study was to study the incidence and patterns of non-union of long bone fracture.</p><p class="abstract"><strong>Methods:</strong> Hospital based prospective study was carried out at Department of Orthopedics, from June 2017 to March 2018. Patients admitted to wards of Department of Orthopedics with nonunion of long bones were included. During the study period a total of 20 cases were eligible for the present study as per the inclusion and exclusion criteria.<strong></strong></p><p class="abstract"><strong>Results:</strong> Males were more affected than females. Most commonly affected age group was 41-50 years and 61-70 years (25% each). Most commonly affected long bone was femur in 35% of the cases. Most common type of non-union was hypertrophic (50%). Most common cause of non-union was broken implant in 35% of the cases. Maximum number of patients had union in 4-6 months in 60% of the cases after surgery of previous non-union of long bones. Only four patients developed complications like shortening of the limb or persistent non-union.</p><p class="abstract"><strong>Conclusions:</strong> Hypertrophic non unions doesn’t require bone graft, they require only stable fixation. For removal of broken implant in hypertrophic non-union if we open the fracture site, then even the gap after debridement of fracture site shows partial segmental defect it doesn’t require bone grafting.</p>

scholarly journals Association of bone fracture type and degree of callus formation with leptin concentration in children with long bone fractures

2019 ◽  
pp. 62-62
Author(s):  
Zoran Paunovic ◽  
Ivan Stanojevic ◽  
Dzihan Abazovic ◽  
Mia Rakic ◽  
Nikola Stankovic ◽  
...  
Keyword(s):  
Bone Fracture ◽  
Bone Fractures ◽  
Callus Formation ◽  
Long Bone ◽  
Fracture Type ◽  
Long Bone Fractures

scholarly journals DOES THE TERM OF DEFINITIVE OSTEOSYNTHESIS OF MULTIPLE LONG BONE FRACTURES OF LOWER EXTREMITIES IMPACT ON TREATMENT OUTCOMES IN POLYTRAUMA PATIENTS

2020 ◽  
Vol 4 ◽  
pp. 24-31
Author(s):  
Olexandr Burianov ◽  
Sergii Dubrov ◽  
Taras Omelchenko ◽  
Volodymyr Lianskorunskyi ◽  
Viktor Lykhodii ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Bone Fractures ◽  
Damage Control ◽  
Lower Extremities ◽  
Hospital Length Of Stay ◽  
Long Bone ◽  
Long Bone Fractures ◽  
Group I ◽  
Fracture Osteosynthesis ◽  
Group Ii

The aim: to determine the timing impact of definitive multiple long bone fracture osteosynthesis of lower extremities on complications development, duration of Mechanical Ventilation (MV), Length of Stay in Intensive Care Unit (LOS-ICU), Hospital length of Stay (H-LOS) in patients with polytrauma treated according to Damage Control Orthopedics (DCO). Materials and methods: a prospective controlled non-randomized trial in parallel groups conducted in polytrauma department of Kyiv City Clinical Hospital No. 17 from February 2016 to January 2020, which included 107 adult patients with polytrauma, multiple long bone fractures of lower extremities, one of which femur treated according to DCO. The patients were divided into two groups: Group I included 51 patients who underwent definitive osteosynthesis of long bone fractures of lower extremities after patient condition stabilization ≥24 hours ≤5 days; Group II included 56 patients who underwent definitive osteosynthesis of long bone fractures of lower extremities during the period >5 days after injury. Results: there were no statistically significant differences between Group I and Group II patients in demographics, injury mechanism, trauma severity and general patient condition. Group I patients who underwent osteosynthesis from 2nd to 5th days after injury had lower pneumonia incidence, compared to Group II patients (17.6 % vs. 26.8 %, p=0.047), shorter MV duration (9.3±6.9 vs. 14.9±9.1, p=0.048), ICU-LOS (13.5±8.3 vs. 19.1±11.0, p=0.037), and H-LOS (30.3±13.9 vs. 38.9±15.5, p=0.046). Conclusion: performing definitive multiple fracture osteosynthesis of lower extremity long bones after polytrauma patient stabilization from 2nd to 5th days after injury allowed to reduce the frequency of pneumonia, shorten the duration of MV, LOS-ICU and H-LOS, compared with its implementation after 5th days

scholarly journals Risk factors for long-bone fractures in children up to 5 years of age: a nested case–control study

2014 ◽  
Vol 100 (5) ◽  
pp. 432-437 ◽  
Author(s):  
Ruth Baker ◽  
Elizabeth Orton ◽  
Laila J Tata ◽  
Denise Kendrick
Keyword(s):  
Risk Factors ◽  
Case Control Study ◽  
Bone Fractures ◽  
Long Bone ◽  
Long Bone Fractures ◽  
Fractures In Children ◽  
Long Bone Fracture ◽  
Prevention Interventions ◽  
Nested Case Control ◽  
Control Study

AimTo investigate risk factors for first long-bone fractures in children up to 5 years old in order to provide evidence about which families could benefit from injury prevention interventions.MethodsPopulation-based matched nested case–control study using The Health Improvement Network, a UK primary care research database, 1988–2004.Maternal, household and child risk factors for injury were assessed among 2456 children with long-bone fractures (cases). 23 661controls were matched to cases on general practice. Adjusted ORs and 95% CIs were estimated using conditional logistic regression.ResultsFractures of long-bones were independently associated with younger maternal age and higher birth order, with children who were the fourth-born in the family, or later, having a threefold greater odds of fracture compared to first-born children (adjusted OR 3.12, 95% CI 2.08 to 4.68). Children over the age of 1 year had a fourfold (13–24 months, adjusted OR 4.09 95% CI 3.51 to 4.76) to fivefold (37+ months, adjusted OR 4.88 95% CI 4.21 to 5.66) increase in the odds of a long-bone fracture compared to children aged 0–12 months. Children in families with a history of maternal alcohol misuse had a raised odds of long-bone fracture (adjusted OR 2.33, 95% CI 1.13 to 4.82) compared to those with no documented history.ConclusionsRisk factors for long-bone fractures in children less than 5 years old included age above 1 year, increasing birth order, younger maternal age and maternal alcohol misuse. These risk factors should be used to prioritise families and communities for injury prevention interventions.

Sign in / Sign up

Export Citation Format

Share Document