Influence of Psychological Supervision on Athletes’ Compliance, Mental Elasticity Characteristics and Acute Stress Disorder in Traumatic Fracture Rehabilitation Training

Background: We aimed to explore the effect of psychological supervision on rehabilitation training compliance, mental elasticity characteristics, and acute stress disorder. Methods: From March 2018 to March 2020, 128 athletes with traumatic fractures in Zhoukou Sports Club in China were divided into two groups using the random number table method, The intervention group (64 athletes) received psychological supervision during the rehabilitation training, while the control group (64 athletes) without psychological supervision. The rehabilitation training compliance in the two groups was observed, and the mental elasticity characteristics and acute stress disorder changes were compared between the two groups before and post-intervention. Results: The compliance rate during postoperative rehabilitation training in the intervention group is 92.19%, which was significantly higher than 73.44% in the control group (P<0.05). Compared with the scores before intervention, the CD-RISC score and SASRD score of the two groups were significantly lower than the scores post-intervention. The SMFA function and vexation indexes of the intervention group in three months after operation were significantly lower than those of the control group (P<0.05). The QOL scores of the intervention group in social, environmental, psychological, and physiological fields were significantly higher than those of the control group in three months after operation (P<0.05). Conclusion: The implementation of psychological supervision for athletes with traumatic fractures could improve rehabilitation training compliance, increase the level of mental elasticity, and relieve acute stress disorder.

Restoration of neglected fracture dislocation hip in elderly: a case report

<p class="abstract">Neglected traumatic fracture dislocation of the hip is a challenging problem due to soft tissue contractures, adhesions, fibro fatty tissue filling acetabulum, avascular necrosis, arthritis and myositis ossificans. These types of injury often get missed at initial evaluation in the presence of distracting injuries and in poly trauma patients. Femoral head fractures account for only 7-16% of all hip fracture dislocations, with combined femoral head and acetabular fractures in elderly being even lower. Literature favours primary hip replacement as compared to hip salvage in age above 60 years and in patients with neglected hip fracture dislocations of more than 3 months duration due to high chances of afore mentioned complications. Here, we report a case of 69 years old male with neglected hip fracture dislocation associated with posterior acetabular wall and femoral head fracture for the challenges in management with a total hip replacement.</p>

Post-traumatic temporal bone pneumatocele presenting after aggressive Valsalva

We report a case of a temporal bone pneumatocele with full-thickness erosion of the cranium associated with aggressive nose blowing. This condition presented 9 years after traumatic fracture of the temporal bone. There are 17 reported cases of mastoid sinus hyperpneumatisation in the literature. Eleven of the 17 are associated with Valsalva manoeuvres or elevated middle ear pressure. However, no other cases of full-thickness erosion at the site of a former fracture have been reported. We propose that the fracture, in combination with elevated mastoid sinus pressure from aggressive nose blowing, led to escape and trapping of pressurised air in the epidural and subcutaneous spaces, which resulted in bone erosion.

Divergent patterns of anti-fracture medication use following fracture on therapy: A population-based cohort study

Context Fracture-on-therapy should motivate better anti-fracture medication adherence. Objective Describe osteoporosis medication adherence in women before and following a fracture. Design Retrospective cohort study. Setting Manitoba BMD Registry (1996-2013). Patients Women who started anti-fracture drug therapy after a DXA-BMD with follow-up for 5 years during which a non-traumatic fracture occurred at least one year after starting treatment. Main Outcome Linked prescription records determined medication adherence (estimated by medication possession ratios, MPR) in one-year intervals. The variable of interest was MPR in the year before and after the year in which the fracture occurred with subgroup analyses according to duration of treatment pre-fracture. We chose an MPR of ≥0.50 to indicate minimum adherence needed for drug efficacy. Results There were 585 women with fracture-on-therapy, 193(33%) had hip or vertebral fracture. Bisphosphonates accounted for 82.2% of therapies. Median MPR the year prior to fracture was 0.89(IQR 0.49-1.0) and 0.69(IQR 0.07-0.96) the year following the year of fracture(p&lt; 0.0001). The percentage of women with MPR ≥ 0.5 pre-fracture was 73.8%, dropping to 57.3% post-fracture(p&lt;0.0001); restricted to hip/vertebral fracture results were similar (58.2% to 33.3%, p &lt;0.002). Among those with pre-fracture MPR &lt;0.5, only 21.7% achieved a post-fracture MPR ≥ 0.5. Conclusions Although fracture-on-therapy may motivate sustained/improved adherence, MPR remains low or even declines after fracture in many. This could reflect natural decline in MPR with time but is paradoxical to expectations. Fracture-on-therapy represents an important opportunity for clinicians to re-emphasize treatment adherence.

Meta-Analysis of 3D Printing Applications in Traumatic Fractures

Background: Traumatic fracture is a common orthopaedic disease, and application of 3D printing technology in fracture treatment, which entails utilisation of pre-operative printed anatomic fracture model, is increasingly gaining popularity. However, effectiveness of 3D printing-assisted surgery lacks evidence-based findings to support its application.Materials and Methods: Embase, PubMed and Cochrane Library databases were systematically searched until October, 2020 to identify relevant studies. All randomised controlled trials (RCTs) comparing efficacy of 3D printing-assisted surgery vs. conventional surgery for traumatic fractures were reviewed. RevMan V.5.3 software was used to conduct meta-analysis.Results: A total of 12 RCTs involving 641 patients were included. Pooled findings showed that 3D printing-assisted surgery had shorter operation duration [standardised mean difference (SMD) = −1.52, 95% confidence interval (CI) – 1.70 ~ −1.34, P &lt; 0.00001], less intraoperative blood loss (SMD = 1.34, 95% CI 1.74 ~ 0.94, P &lt; 0.00001), fewer intraoperative fluoroscopies (SMD = 1.25, 95% CI 1.64 ~ 0.87, P &lt; 0.00001), shorter fracture union time (SMD = −0.15, 95% CI −0.25 ~ −0.05, P = 0.003), and higher rate of excellent outcomes (OR = 2.40, 95% CI 1.07 ~ 5.37, P = 0.03) compared with conventional surgery. No significant differences in complication rates were observed between the two types of surgery (OR = 0.69, 95% CI 0.69 ~ 1.42, P = 0.32).Conclusions: Indicators including operation duration, intraoperative blood loss, number of intraoperative fluoroscopies, fracture union time, and rates of excellent outcomes showed that 3D printing-assisted surgery is a superior alternative in treatment of traumatic fractures compared with conventional surgery. Moreover, the current study did not report significant differences in incidence of complications between the two approaches.Systematic Review Registration: CRD42021239507.