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Research of Orthopaedic and Traumatic Injuries and Surgical Outcomes

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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Global Health".

Deadline for manuscript submissions: 31 December 2024 | Viewed by 9510

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Special Issue Editor

Prof. Dr. Harald Kurt Widhalm

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Guest Editor

Clinical Division of Traumatology, Department of Orthopedics and Traumatology, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria
Interests: orthopedic surgery; arthroplasty; knee joint; traumatology; cartilage; orthopedic sports medicine; trauma; fracture; emergency medicine
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Special Issue Information

Dear Colleagues,

With the rapidly increasing number of cases of patients who show severe disease patterns or sustain serious injuries, an optimal quality of care may not always be guaranteed. Although we manage to treat patients and operate reasonably promptly if this is necessary, it is actually only possible to check the quality of care in exceptional cases, especially during the COVID-19 pandemic. For this reason, it is all the more important to carry out research in the field of orthopedic diseases and traumatic injuries. Due to the increasing life expectancy and the associated higher level of physical activity, even in old age, surgeons are often required to provide adequate care, especially for geriatric patients, often with osteoporotic bone situation.

Since the average life expectancy has increased over the last decades, doctors now often have to provide care for patients who suffer from several comorbidities. When treating fractures and other injuries, the greatest challenges for physicians are the appropriate preparation of the patient for an operation, which often requires special examinations, the complication-free execution of the operation, and the management of osteoporotic bone conditions, followed by the initiation of a targeted rehabilitation. To provide a high standard of care and lower mortality risks, especially in elderly patients, it is crucial to individually address each patient’s needs. One diagnostic aspect that is easily accessed but often underestimated in its importance, is correct and detailed imaging, allowing for the precise planning of treatment strategies and surgical interventions.

To lower overall risks for patients, a gold standard for this process should be established. For this purpose, I cordially invite all authors to submit original articles on this topic.

Prof. Dr. Harald Kurt Widhalm
Guest Editor

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

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Keywords

trauma
orthopedics
fractures
injuries
diagnostic
treatment
osteosynthesis
imaging
management
surgical outcomes

Published Papers (5 papers)

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Research

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14 pages, 1406 KiB

Open AccessArticle

Factors Contributing to Traffic Accidents in Hospitalized Patients in Terms of Severity and Functionality

by Alexandra Carolina Canonica, Angelica Castilho Alonso, Vanderlei Carneiro da Silva, Henrique Silva Bombana, Aurélio Alberto Muzaurieta, Vilma Leyton and Júlia Maria D’Andrea Greve

Int. J. Environ. Res. Public Health 2023, 20(1), 853; https://doi.org/10.3390/ijerph20010853 - 2 Jan 2023

Cited by 5 | Viewed by 2071

Abstract

Trauma-related injuries in traffic-accident victims can be quite serious. Evaluating the factors contributing to traffic accidents is critical for the effective design of programs aimed at reducing traffic accidents. Therefore, this study identified which factors related to traffic accidents are associated with injury severity in hospitalized victims. Factors related to traffic accidents, injury severity, disability and data collected from blood toxicology were evaluated, along with associated severity and disability indices with data collected from toxicology on victims of traffic accidents at the largest tertiary hospital in Latin America. One hundred and twenty-eight victims of traffic accidents were included, of whom the majority were young adult men, motorcyclists, and pedestrians. The most frequent injuries were traumatic brain injury and lower-limb fractures. Alcohol use, hit-and-run victims, and longer hospital stays were shown to lead to greater injury severity. Women, elderly individuals, and pedestrians tend to suffer greater disability post-injury. Therefore, traffic accidents occur more frequently among young male adults, motorcyclists, and those who are hit by a vehicle, with trauma to the head and lower limbs being the most common injury. Injury severity is greater in pedestrians, elderly individuals and inebriated individuals. Disability was higher in older individuals, in women, and in pedestrians. Full article

(This article belongs to the Special Issue Research of Orthopaedic and Traumatic Injuries and Surgical Outcomes)

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8 pages, 756 KiB

Open AccessArticle

Morphologic Alterations of the Sternoclavicular Joint following Ipsilateral Clavicle Fractures

by Malik Jessen, Marc Schnetzke, Stefan Studier-Fischer, Paul Alfred Grützner, Thorsten Gühring and Felix Porschke

Int. J. Environ. Res. Public Health 2022, 19(22), 15011; https://doi.org/10.3390/ijerph192215011 - 15 Nov 2022

Viewed by 1228

Abstract

Rationale: To our knowledge, no study has investigated concomitant injuries of the sternoclavicular joint (SCJ) in acute clavicle fractures. The purpose of this study was to determine the effect of an ipsilateral clavicle fracture on the SCJ in a systematic computer tomography (CT) morphologic evaluation. Methods: CT scans in the axial and coronal plane of 45 consecutive patients with clavicle fractures were retrospectively analyzed. The scans were assessed regarding anatomic congruence of bilateral SCJs—joint space width (JSW); the position of bilateral medial clavicles (PC); and the non-fusion of epiphyses, arthritis, calcifications, and intra-articular gas. Results: The mean SCJ JSW was significantly different in the coronal (cJSW; 8.70 mm ± 2.61 mm in affected vs. 7.63 mm ± 2.58 mm in non-affected side; p = 0.001) and axial plane (aJSW; 9.40 mm ± 2.76 mm in affected vs. 9.02 ± 2.99 in non-affected SCJs; p = 0.044). The position of the medial clavicle showed a significant difference in the coronal plane (cPC; 14.31 mm ± 3.66 mm in the affected vs. 13.49 ± 3.34 in the non-affected side; p = 0.011), indicating a superior shift. Conclusion: Acute clavicle fractures may be associated with an enlargement of the ipsilateral SCJ space width and a superior shift of the proximal clavicle. Both morphologic alterations could indicate concomitant injuries of the SCJ as well as a potential increase in the risk of SCJ instability. Full article

(This article belongs to the Special Issue Research of Orthopaedic and Traumatic Injuries and Surgical Outcomes)

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11 pages, 1339 KiB

Open AccessArticle

Clinical Assessment of Functional Recovery Following Nerve Transfer for Traumatic Brachial Plexus Injuries

by Yi-Jung Tsai, Chih-Kun Hsiao, Fong-Chin Su and Yuan-Kun Tu

Int. J. Environ. Res. Public Health 2022, 19(19), 12416; https://doi.org/10.3390/ijerph191912416 - 29 Sep 2022

Cited by 1 | Viewed by 1460

Abstract

Surgical reconstruction and postoperative rehabilitation are both important for restoring function in patients with traumatic brachial plexus injuries (BPIs). The current study aimed to understand variations in recovery progression among patients with different injury levels after receiving the nerve transfer methods. A total of 26 patients with BPIs participated in a rehabilitation training program over 6 months after nerve reconstruction. The differences between the first and second evaluations and between C5–C6 and C5–C7 BPIs were compared. Results showed significant improvements in elbow flexion range (p = 0.001), British Medical Research Council’s score of shoulder flexion (p = 0.046), shoulder abduction (p = 0.013), shoulder external rotation (p = 0.020), quantitative muscle strength, and grip strength at the second evaluation for both groups. C5–C6 BPIs patients showed a larger shoulder flexion range (p = 0.022) and greater strength of the shoulder rotator (p = 0.004), elbow flexor (p = 0.028), elbow extensor (p = 0.041), wrist extensor (p = 0.001), and grip force (p = 0.045) than C5–C7 BPIs patients at the second evaluation. Our results indicated different improvements among patients according to injury levels, with quantitative values assisting in establishing goals for interventions. Full article

(This article belongs to the Special Issue Research of Orthopaedic and Traumatic Injuries and Surgical Outcomes)

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7 pages, 477 KiB

Open AccessArticle

General versus Brachial Plexus Block Anesthesia in Pain Management after Internal Fixation in Patients with Distal Radius Fracture: A Randomized Controlled Trial

by Jae-Hwi Nho, Byung-Woong Jang, Chi Young An, Jae Hwa Yoo, Sanghoon Song, Ho Bum Cho, Sang Ho Kim, Soon Im Kim, Ki Jin Jung and Byungsung Kim

Int. J. Environ. Res. Public Health 2022, 19(15), 9155; https://doi.org/10.3390/ijerph19159155 - 27 Jul 2022

Cited by 2 | Viewed by 2131

Abstract

Distal radius fractures (DRFs) are very common injuries associated with aging, and the number of fractures is increasing with the increase in the elderly population. General anesthesia or brachial plexus block (BPB) is required for fracture fixation, and acute postoperative pain control is necessary after operation. Early pain control can improve patient satisfaction and functional outcomes. In this study, we report the clinical differences in postoperative pain, according to the method of anesthesia (general anesthesia versus brachial plexus block). Volar plating was used to treat 72 patients older than 60 years who had comminuted DRF. Patients were randomized to either group A (36 patients), who underwent general anesthesia, or group B (36 patients), who underwent BPB. We compared these two groups prospectively for acute postoperative pain using a visual analog scale (VAS) at 2, 4, 6, 12, and 24 h after surgery. The VAS scores of each group were: 6.8 ± 2.5 in general anesthesia and 0.5 ± 2.3 in BPB at 2 h, postoperatively; 6.5 ± 2.4 in general anesthesia and 0.5 ± 2.4 in BPB anesthesia at 4 h, postoperatively; 5.2 ± 2.4 in general anesthesia and 1.5 ± 2.4 in BPB anesthesia at 6 h, postoperatively; 4.5 ± 2.5 in general anesthesia and 3.4 ± 2.7 in BPB anesthesia at 12 h, postoperatively; and 3.5 ± 2.5 in general anesthesia and 3.2 ± 2.7 in BPB anesthesia at 24 h, postoperatively. DRF patients with BPB anesthesia showed a lower VAS score than those subjected to general anesthesia in early postoperative period. As a result, the effect of BPB anesthesia on acute pain management after surgery was excellent, which resulted in a lower pain score compared with general anesthesia in DRF patients undergoing volar plating. Full article

(This article belongs to the Special Issue Research of Orthopaedic and Traumatic Injuries and Surgical Outcomes)

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Other

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16 pages, 1602 KiB

Open AccessSystematic Review

Effectiveness and Safety of Different Treatment Modalities for Patients Older Than 60 Years with Distal Radius Fracture: A Network Meta-Analysis of Clinical Trials

by Héctor Gutiérrez-Espinoza, Felipe Araya-Quintanilla, Iván Cuyul-Vásquez, Rodrigo Gutiérrez-Monclus, Sara Reina-Gutiérrez, Iván Cavero-Redondo and Sergio Núñez de Arenas-Arroyo

Int. J. Environ. Res. Public Health 2023, 20(4), 3697; https://doi.org/10.3390/ijerph20043697 - 19 Feb 2023

Cited by 2 | Viewed by 2064

Abstract

The aim of this study was to compare the clinical effectiveness and complications of different treatment modalities for elderly patients with distal radius fracture (DRF). Methods: We performed a network meta-analysis (NMA) of randomized clinical trials (RCTs). Eight databases were searched. The eligibility criteria for selecting studies were RCTs that compared different treatment modalities (surgical or nonoperative) in patients older than 60 years with displaced or unstable intra-articular and/or extra-articular DRFs. Results: Twenty-three RCTs met the eligibility criteria (2020 patients). For indirect comparisons, the main findings of the NMA were in volar locking plate (VLP) versus cast immobilization, with the mean differences for the patient-rated wrist evaluation (PRWE) questionnaire at −4.45 points (p < 0.05) and grip strength at 6.11% (p < 0.05). Additionally, VLP showed a lower risk ratio (RR) of minor complications than dorsal plate fixation (RR: 0.02) and bridging external fixation (RR: 0.25). Conversely, VLP and dorsal plate fixation showed higher rates of major complications. Conclusions: Compared with other treatment modalities, VLP showed statistically significant differences for some functional outcomes; however, most differences were not clinically relevant. For complications, although most differences were not statistically significant, VLP was the treatment modality that reported the lowest rate of minor and overall complications but also showed one of the highest rates of major complications in these patients. PROSPERO Registration: CRD42022315562. Full article

(This article belongs to the Special Issue Research of Orthopaedic and Traumatic Injuries and Surgical Outcomes)

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