Abstract:
OBJECTIVES:To evaluate the relationship between mechanism of injury and mortality in geriatric trauma patients and the ability of existing injury severity indices (ISIs) to assess mortality. DESIGN:Retrospective review. SETTING:Urban level 1 trauma center. PARTICIPANTS:Four thousand five hundred forty-five trauma patients age ≥55 presenting between 2008 and 2011. INTERVENTION:Low-energy (LE-GTP) and high-energy (HE-GTP) geriatric trauma patient cohorts were created based on ICD-9 injury codes. Existing ISIs were evaluated for their ability to predict in-hospital mortality using the area under the receiver-operating characteristic curve (AUROC). MAIN OUTCOME MEASURES:Mortality. RESULTS:The Trauma Score-Injury Severity Score (TRISS) was the most predictive ISI for both cohorts and was deemed to have moderate predictive capacity (AUROC: 0.82) in LE-GTP and excellent predictive capacity (AUROC: 0.91) in the HE-GTP. For, HE-GTP each 1-year increase in age was associated with a 12% increase risk of mortality versus 6% for LE-GTP. Preexisting conditions (PECs) were distributed differently between the cohorts with significantly more PECs in the LE-GTP (P < 0.01). CONCLUSIONS:Existing ISIs have fair-to-moderate predictive capacity for in-hospital morality in LE-GTPs and moderate-to-excellent predictive capacity in HE-GTPs. LE-GTPs and HE-GTPs are distinct cohorts that should be evaluated separately. Combining the cohorts underestimates both the effect of age on HE-GTPs and the effect of PECs on LE-GTPs while overestimating the effect of PECs on HE-GTPs. LEVEL OF EVIDENCE:Prognostic Level II. See Instructions for Authors for a complete description of levels of evidence.
journal_name
J Orthop Traumajournal_title
Journal of orthopaedic traumaauthors
Konda SR,Lack WD,Seymour RB,Karunakar MAdoi
10.1097/BOT.0000000000000281subject
Has Abstractpub_date
2015-07-01 00:00:00pages
331-6issue
7eissn
0890-5339issn
1531-2291pii
00005131-201507000-00009journal_volume
29pub_type
杂志文章abstract::Theoretically, fissures and minor fractures of the pelvis sustained by the elderly after low-energy trauma may lead to thromboembolic complications. Few studies exist, but clinically, these injuries had been considered to have an excellent prognosis until a recent study reported a 10% fatality rate from pulmonary embo...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章,评审
doi:10.1097/00005131-198906000-00005
更新日期:1989-01-01 00:00:00
abstract:OBJECTIVES:The stiffness of locking plates provide increased stability for early fracture healing but may limit late interfragmentary motion (IFM) necessary for secondary bone healing. An ideal plating construct would provide early rigidity and late flexibility to optimize bone healing. A novel screw plate construct ut...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000001664
更新日期:2020-03-01 00:00:00
abstract::Femoral neck nonunions are a difficult complication in the treatment of femoral neck fractures and have traditionally been managed using an intertrochanteric valgus osteotomy and blade plate. We propose an alternative method, a proximal femoral valgus osteotomy using a sliding hip screw instead of a blade plate. This ...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章,评审
doi:10.1097/00005131-200608000-00006
更新日期:2006-07-01 00:00:00
abstract:OBJECTIVES:Hand dominance has been reported to be an important factor affecting outcomes after upper extremity trauma but remains unstudied after hemiarthroplasty for fracture. This study determined whether dominance affected outcomes after hemiarthroplasty for proximal humerus fractures. DESIGN:Retrospective cohort s...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000000294
更新日期:2015-08-01 00:00:00
abstract::Recent studies on ankle syndesmosis injuries have shown that a significant amount of rotational malediction of the distal fibula are missed and may lead to poor functional outcome. A new set of radiographic criteria were developed to help detect distal fibula internal and external rotation using conventional fluorosco...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e31828f89a9
更新日期:2013-12-01 00:00:00
abstract:OBJECTIVE:Risk for bleeding complications during and after early hip fracture surgery for patients taking clopidogrel and other anticoagulants have not been defined. The purpose of this study is to assess the perioperative bleeding risks and clinical outcome after early hip fracture surgery performed on patients taking...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e318240d70f
更新日期:2012-10-01 00:00:00
abstract:OBJECTIVE:To examine the impact of number and position of locking screws in the diaphyseal portion of an osteoporotic distal femoral fracture model with hybrid fixation. METHODS:Four groups containing 5 osteoporotic bone models were used with varying combinations of diaphyseal screw fixation: 4 nonlocking screws (cont...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e318238c086
更新日期:2012-09-01 00:00:00
abstract::We reviewed 21 cases of humeral nonunion following the failure of "locking" humeral nails. The nails had been inserted as the primary operative procedure following humeral fracture in fifteen cases or after the failure of closed treatment in six cases. Reconstruction after the failure of these implants was complicated...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199610000-00008
更新日期:1996-01-01 00:00:00
abstract:OBJECTIVES:To develop an accurate machine learning (ML) predictive model incorporating patient, fracture, and trauma characteristics to identify individual patients at risk of an (occult) PMF. METHODS:Databases of 2 studies including patients with TSFs from 2 Level 1 trauma centers were combined for analysis. Using te...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000001663
更新日期:2020-03-01 00:00:00
abstract::This technique article presents a small-incision, gluteal-splitting approach for the treatment of select fractures involving the posterior acetabulum. The approach essentially involves the proximal portion of the Kocher-Langenbeck incision, and it can be extended to a larger exposure if needed. It is ideally suited fo...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/01.bot.0000211143.70424.f7
更新日期:2006-09-01 00:00:00
abstract:OBJECTIVES:To report the complications and pitfalls in the treatment of complex injuries of the proximal tibia when locking plates are used. DESIGN, SETTING, AND PATIENTS:This was a retrospective case series conducted at a university Level I trauma center. Thirty-seven patients with complex proximal tibia fractures (4...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e318030df96
更新日期:2007-02-01 00:00:00
abstract::We present a case of a 19-year-old woman with a closed diaphyseal femur fracture and who had fixation of the fracture using a newer lateral entry nail, which resulted in an intraoperative proximal femur fracture. The patient underwent revision the following day and subsequently returned to regular activity without sig...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e3181a53790
更新日期:2010-04-01 00:00:00
abstract::Healthcare policy has changed drastically, and with the 50-year anniversary of the passage of Medicare approaching in 2015, the authors evaluate the development of the current healthcare system and its relationship to the development of modern orthopaedic trauma. With more changes in healthcare policy forthcoming, it ...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000000214
更新日期:2014-10-01 00:00:00
abstract:OBJECTIVES:The purpose of this study was to review the outcome of late revision surgery in a series of patients with posterior wall fractures having recurrent hip instability after failed initial open reduction and internal fixation. DESIGN:Retrospective analysis of consecutive patients. SETTING:Level 1 trauma center...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e31819a07cf
更新日期:2009-03-01 00:00:00
abstract:BACKGROUND:Because embalming has been demonstrated to decrease the mechanical integrity of bone, most investigators favor fresh-frozen specimens for biomechanical evaluation. However, little is known about how the integrity of fresh--frozen specimens may change during biomechanical testing or may be affected by standar...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e318225b875
更新日期:2011-08-01 00:00:00
abstract:OBJECTIVES:Evaluate the effect of the COVID-19 pandemic and the "shelter-in-place" order on orthopaedic trauma presenting to a community level II trauma center. It is hypothesized the overall number of orthopaedic trauma encounters (OTE), the number of OTEs related to both high and low severity injuries, as well as the...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000001860
更新日期:2020-06-08 00:00:00
abstract:OBJECTIVES:To introduce a modified operative technique for minimally invasive plate osteosynthesis (MIPO) for acute displaced humeral shaft fractures and to evaluate the clinical and radiological outcomes. DESIGN:: Prospective clinical series study. SETTING:University hospital. PATIENTS:Twenty-one patients with acut...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e318254895f
更新日期:2012-10-01 00:00:00
abstract:OBJECTIVES:The objective of this study was to evaluate donor site morbidity associated with anterior iliac crest bone graft harvesting for orthopaedic trauma reconstructions. DESIGN:Retrospective case series. SETTING:Level 1 trauma center. PATIENTS:Forty-Six consecutive patients who had undergone anterior iliac cres...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000000551
更新日期:2016-06-01 00:00:00
abstract::After completing an orthopaedic trauma fellowship, what challenges will you have as regard to maintaining balance and perspective in your new position in society? How will you view yourself, family, and your profession? These are simple suggestions on maintaining passion for your profession. ...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章,评审
doi:10.1097/BOT.0000000000000431
更新日期:2015-11-01 00:00:00
abstract:OBJECTIVES:To compare failure rates between short and long cephalomedullary nails used for the treatment of intertrochanteric hip fractures in patients over 65 years of age. DESIGN:Retrospective cohort study. Data were collected from medical records and radiographs. SETTING:Three level 1 trauma centers. PATIENTS/PAR...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000000036
更新日期:2014-07-01 00:00:00
abstract::A case of an angulated, greenstick fracture of the scapula mimicking scapular winging in a skeletally immature 12-year-old boy is described. The bony deformity was visualized with plain radiography. CT was helpful in exclusion of a thoracic injury or an underlying neoplasm. Closed reduction yielded satisfactory result...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/01.bot.0000174707.10980.f4
更新日期:2006-02-01 00:00:00
abstract:OBJECTIVES:To determine whether bundled payments are feasible in the orthopaedic fracture setting, and the potential economic implications of this reimbursement structure. DESIGN:Prospective. SETTING:Multicenter. PATIENTS/PARTICIPANTS:Between 2004 and 2014, a total of 23,643 operatively treated patients with fractur...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000000742
更新日期:2017-03-01 00:00:00
abstract:OBJECTIVE:To determine whether the practice of overlapping surgery influenced patient safety after open reduction internal fixation (ORIF) for ankle fractures. DESIGN:Retrospective case-control. SETTING:Level 1 Academic Midwest trauma center. PATIENTS:All patients who underwent ankle fracture ORIF by a single surgeo...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000001757
更新日期:2020-08-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to compare the relative stiffness of four common external fixation (XF) configurations used to span and stabilize the knee after knee dislocation. METHODS:Synthetic composite femora and tibiae connected with cords were used to simulate a knee. Four configurations of external fix...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e3181e3cd4b
更新日期:2010-11-01 00:00:00
abstract::Fracture compression can be achieved in many ways intraoperatively using either screws in compression plates, compression devices, or using intramedullary nails. The use of locked intramedullary nails combines the advantages of indirect fracture fixation and compression with minimal soft tissue disruption. This articl...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章,评审
doi:10.1097/BOT.0b013e31819f2779
更新日期:2009-05-01 00:00:00
abstract:OBJECTIVE:To determine humeral diaphyseal fractures at risk for nonunion with functional brace treatment. DESIGN:Retrospective case series. SETTING:A single surgeon's practice. PATIENTS:Forty-nine of 52 consecutive patients treated nonoperatively for an isolated diaphyseal fracture of the humerus during a 6-year per...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/01.bot.0000249423.48074.82
更新日期:2006-10-01 00:00:00
abstract:OBJECTIVES:Iliosacral screw pathways in the first (S1) and second (S2) sacral segments are commonly used for adult pelvic ring stabilization. We hypothesize that radiographically "safe" pathways exist in pediatric patients. SETTING:Academic level I Trauma Center. PATIENTS:All patients between ages 2 and 16 years with...
journal_title:Journal of orthopaedic trauma
pub_type: 临床试验,杂志文章
doi:10.1097/BOT.0000000000000421
更新日期:2016-01-01 00:00:00
abstract:OBJECTIVES:Improved patient outcomes after plating of displaced clavicle fractures have been demonstrated by recent clinical studies. Many of these patients, however, complain of anterior chest wall numbness after this procedure; we hypothesize that numbness likely persists long term for many patients, but without effe...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000000095
更新日期:2014-11-01 00:00:00
abstract::In the current health care environment, cost containment is more important than ever. Most physicians currently are unaware of the cost of operating room supplies. A large amount of waste occurs secondary to lack of knowledge and absence of physician incentives for cost saving. Many of the decisions for supply use can...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000000718
更新日期:2016-12-01 00:00:00
abstract:OBJECTIVES:External fixator pins are thought to have improved pullout strength if inserted into both cortices and if pilot holes are drilled. We tested these hypotheses and investigated effects of osteoporosis and pin location on pin pullout strength. METHODS:Self-drilling external fixator pins were inserted using 4 t...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e3182511ed7
更新日期:2013-02-01 00:00:00