scholarly journals Discharge destination and patient‐reported outcomes after inpatient treatment for isolated lower limb fractures

2021 ◽  
Author(s):  
Lara A Kimmel ◽  
Jessica Kasza ◽  
Belinda J Gabbe
Keyword(s):  
Lower Limb ◽  
Inpatient Treatment ◽  
Patient Reported Outcomes ◽  
Discharge Destination ◽  
Lower Limb Fractures ◽  
Patient Reported ◽  
Limb Fractures

scholarly journals Discharge destination and patient‐reported outcomes after inpatient treatment for isolated lower limb fractures

2020 ◽  
Vol 212 (6) ◽  
pp. 263-270 ◽  
Author(s):  
Lara A Kimmel ◽  
Pamela M Simpson ◽  
Anne E Holland ◽  
Elton R Edwards ◽  
Peter A Cameron ◽  
...  
Keyword(s):  
Lower Limb ◽  
Inpatient Treatment ◽  
Patient Reported Outcomes ◽  
Discharge Destination ◽  
Lower Limb Fractures ◽  
Patient Reported ◽  
Limb Fractures

scholarly journals Local flaps vs. free flaps for complex lower limb fractures: Effect of flap choice on patient-reported outcomes

2020 ◽  
Vol 17 ◽  
pp. 91-96 ◽  
Author(s):  
Dilraj Singh Bhullar ◽  
Saravana Vail Karuppiah ◽  
Ahmed Aljawadi ◽  
Tess Gillham ◽  
Omar Fakih ◽  
...  
Keyword(s):  
Lower Limb ◽  
Patient Reported Outcomes ◽  
Free Flaps ◽  
Local Flaps ◽  
Lower Limb Fractures ◽  
Patient Reported ◽  
Limb Fractures

scholarly journals Validating a Simple Discharge Planning Tool Following Hospital Admission for an Isolated Lower Limb Fracture

2014 ◽  
Vol 94 (7) ◽  
pp. 1005-1013 ◽  
Author(s):  
Lara A. Kimmel ◽  
Anne E. Holland ◽  
Pam M. Simpson ◽  
Elton R. Edwards ◽  
Belinda J. Gabbe
Keyword(s):  
Lower Limb ◽  
Discharge Planning ◽  
Demographic Data ◽  
Weight Bearing ◽  
Inpatient Rehabilitation ◽  
Discharge Destination ◽  
Hospital System ◽  
Predictive Values ◽  
Lower Limb Fractures ◽  
Limb Fractures

Background Early, accurate prediction of discharge destination from the acute hospital assists individual patients and the wider hospital system. The Trauma Rehabilitation and Prediction Tool (TRaPT), developed using registry data, determines probability of inpatient rehabilitation discharge for patients with isolated lower limb fractures. Objective The aims of this study were: (1) to prospectively validatate the TRaPT, (2) to assess whether its performance could be improved by adding additional demographic data, and (3) to simplify it for use as a bedside tool. Design This was a cohort, measurement-focused study. Methods Patients with isolated lower limb fractures (N=114) who were admitted to a major trauma center in Melbourne, Australia, were included. The participants' TRaPT scores were calculated from admission data. Performance of the TRaPT score alone, and in combination with frailty, weight-bearing status, and home supports, was assessed using measures of discrimination and calibration. A simplified TRaPT was developed by rounding the coefficients of variables in the original model and grouping age into 8 categories. Simplified TRaPT performance measures, including specificity, sensitivity, and positive and negative predictive values, were evaluated. Results Prospective validation of the TRaPT showed excellent discrimination (C-statistic=0.90 [95% confidence interval=0.82, 0.97]), a sensitivity of 80%, and specificity of 94%. All participants able to weight bear were discharged directly home. Simplified TRaPT scores had a sensitivity of 80% and a specificity of 88%. Limitations Generalizability may be limited given the compensation system that exists in Australia, but the methods used will assist in designing a similar tool in any population. Conclusions The TRaPT accurately predicted discharge destination for 80% of patients and may form a useful aid for discharge decision making, with the simplified version facilitating its use as a bedside tool.

scholarly journals Measuring recovery after open lower limb fractures: combined objective functional tests and global perceived recovery outperform narrower metrics and a standard generic patient reported outcome measure

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Ian Pallister ◽  
Gregory Jack Handley ◽  
Sharon Maggs ◽  
Ann-Marie Davies ◽  
Amanda Kyle ◽  
...  
Keyword(s):  
Functional Outcome ◽  
Outcome Measures ◽  
Lower Limb ◽  
Gait Speed ◽  
Spearman Correlation ◽  
Lower Limb Fractures ◽  
Patient Reported ◽  
Functional Outcome Measures ◽  
Limb Fractures ◽  
Objective Functional

Abstract Background Open lower limb fractures are serious injuries requiring combined ortho-plastic surgery and have significantly worse outcomes than similar closed fractures. There is little objective published data to determine which functional outcome measures best reflect progress or completeness of physical recovery. Our hypothesis was that objective measures combining strength, mobility and balance would better reflect recovery than isolated parameters (e.g. range of motion ROM) and would compare well to patients’ perceived recovery. Methods Adult open lower limb fracture patients were reviewed 6 and 12 weeks, 6, 9 and 12 months post-injury. The mechanism, injury pattern, age, gender and treatment were recorded. Isolated parameter objective functional outcome measures (OFOMs) (ROM and MRC strength grade) were compared to combined OFOMs (timed up and go, comfortable gait speed and fast gait speed, Edgren Side Step Test (TUAG, CGS, FGS, ESST) and Single Leg balance. Patient reported outcomes were recorded (Global Perceived Effect (GPE) score and Disability Rating Index (DRI)). Statistical analysis used non-parametric tests (e.g. Spearman correlation) compared each with time since injury. Results Sixty-eight patients (54 male) with a median age of 45(20–75) years. Of the 19 isolated OFOMs, only knee flexion and ankle plantar flexion ROM and strength improved with time (Spearman correlation p = 0.042, 0.008, 0.032, 0.036 respectively). TUAG, ESST, CGS, FGS and GPE scores showed significant improvement (Spearman correlation p < 0.001). Patients’ estimation of recovery paralleled these measures (Spearman correlation p < 0.001) with all but 2 patients achieving the minimum clinical important difference in DRI by 12 months compared to baseline. However, the GPE score had a higher proportion of improving responses than DRI at each time-point. Discussion Functional recovery is a key determinant in patients returning to work, providing for themselves and their family or resuming independent living for older patients. This study has demonstrated time-related improvements in combined OFOMs measuring mobility, strength, agility and balance paralleling patients’ perception of recovery in the 12 months after open lower limb fractures. Over the same time-frame, the simple GPE score compared favourably with the DRI. Such parameters could become part of a defined core outcomes set. Focussing rehabilitation towards these combined OFOMs may help hasten recovery. Trial registration South West Wales REC 06/WMW02/10).

Studying variables affecting the length of stay in patients with lower limb fractures by means of Machine Learning

2021 ◽  
Author(s):  
Ylenia Colella ◽  
Arianna Scala ◽  
Chiara De Lauri ◽  
Francesco Bruno ◽  
Giuseppe Cesarelli ◽  
...  
Keyword(s):  
Machine Learning ◽  
Length Of Stay ◽  
Lower Limb ◽  
Lower Limb Fractures ◽  
Limb Fractures

Technical aspects and complications in the surgical treatment of poliomyelitis-affected lower limb fractures

2018 ◽  
Vol 62 (4) ◽  
pp. 257-266
Author(s):  
J. Mingo-Robinet ◽  
J.A. Alonso ◽  
M. Moreno-Barrero ◽  
L. González-García ◽  
V. Garcia-Virto ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Lower Limb ◽  
Technical Aspects ◽  
Lower Limb Fractures ◽  
Limb Fractures
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