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Musculoskeletal Trauma

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1. Current Concepts in Rehabilitation Protocols to Optimize Patient Function Following Musculoskeletal Trauma. Full Text available with Trip Pro

Current Concepts in Rehabilitation Protocols to Optimize Patient Function Following Musculoskeletal Trauma. Musculoskeletal (MSK) trauma is a major cause of disability and pain worldwide. Despite surgical advances following MSK injuries, poor functional outcomes following surgery remain a major public health concern. Traditional methods of rehabilitation involving bed rest and immobilization led to muscle weakness, joint stiffness, and an inability to return to previous levels of activity (...) . Recent research has provided evidence that early rehabilitation with a multidisciplinary team can prevent these negative outcomes and improve functional outcomes following MSK trauma. In order to continue to optimize recovery, standardized rehabilitation protocols and technological advances are required.Copyright © 2020. Published by Elsevier Ltd.

2020 Injury

2. How soon can we identify at-risk patients: examining initial depressive symptomology and opioid use in musculoskeletal trauma survivors? (Abstract)

How soon can we identify at-risk patients: examining initial depressive symptomology and opioid use in musculoskeletal trauma survivors? This study evaluates the associations between post injury depressive symptomology and opioid use from the initial time of injury in orthopedic trauma patients without pre-existing psychiatric conditions.This is a prospective study following the development of symptoms after orthopedic trauma injury conducted at a Level-1 trauma center.Orthopedic trauma (...) suggests that depressive symptomology immediately following musculoskeletal trauma is predictive for persistent depressive symptomology in a subset of our patient population. Inpatient BDI-II depressive symptom severity levels in the hospital were significantly related to BDI-II at 2-weeks, 6-weeks, and 3-months, and persistent opioid use, past 6-weeks, was independently associated with prolonged depressive symptomology as well. Further study into effective treatment and monitoring of mental health

2020 Injury

3. Reliability, Discriminative and Prognostic Validity of the MultiDimensional Symptom Index in Musculoskeletal Trauma. (Abstract)

Reliability, Discriminative and Prognostic Validity of the MultiDimensional Symptom Index in Musculoskeletal Trauma. The MultiDimensional Symptom Index (MSI) is a 10-item parallel score frequency x interference patient reported outcome for use in clinical pain research. This manuscript describes the results of evaluations related to measurement stability, discriminative accuracy when screening for major depressive disorder (MDD), and prognostic validity when predicting recovery trajectories (...) following acute musculoskeletal (MSK) trauma.Data were drawn from a longitudinal cohort study of adults with acute MSK trauma, supplemented by a secondary sample of adults with chronic pain.In a sample of n=23 stable participants over a 1-month period, reliability metrics indicated good stability for all 5 subscales (ICC3,1 0.70 to 0.91). In a mixed acute/chronic sample (n=148) the Number of Symptoms and Non-Somatic Symptoms subscales showed clinically useful discriminative accuracy for MDD screening

2020 Clinical Journal of Pain

4. A Mediational Analysis of Stress, Inflammation, Sleep, and Pain in Acute Musculoskeletal Trauma. (Abstract)

A Mediational Analysis of Stress, Inflammation, Sleep, and Pain in Acute Musculoskeletal Trauma. Differences in pain severity among acutely injured people may be related to the perceived stress of the event and pre-existing vulnerabilities. In this study, we test the hypotheses that pretrauma life stress influences posttrauma pain severity, and 2 potential mediating pathways, 1 biological (C-reactive protein, CRP) and 1 contextual (sleep quality).Data collected from participants within 3 weeks (...) of a noncatastrophic musculoskeletal trauma were used in this observational cross-sectional mediation analysis. The primary outcome was pain severity as measured using the Brief Pain Inventory. Predictors were posttrauma CRP assayed from plasma, sleep interference measured by the Brief Pain Inventory, and a study-specific "General Life Stressors" scale. First, the sample was split into low and high life-stress groups, and mean differences in the pain and the predictor variables were explored by t test. Next

2020 Clinical Journal of Pain

5. Patient Perceptions of the Use of Medical Marijuana in the Treatment of Pain After Musculoskeletal Trauma: A Survey of Patients at 2 Trauma Centers in Massachusetts. (Abstract)

Patient Perceptions of the Use of Medical Marijuana in the Treatment of Pain After Musculoskeletal Trauma: A Survey of Patients at 2 Trauma Centers in Massachusetts. To evaluate musculoskeletal trauma patients' beliefs regarding the usefulness of marijuana as a valid medical treatment for postinjury and postoperative pain and anxiety.Prospective survey.Two academic Level 1 trauma centers.Five hundred patients in an orthopedic outpatient clinic.Survey.(1) Do patients believe that marijuana can (...) that it reduced symptoms of pain, and 81% (57/70) believed that it reduced the amount of opioid pain medication they used.The majority of patients in this study believed that medical marijuana is a valid treatment and that it does have a role in reducing postinjury and postoperative pain. Those patients who used marijuana during their recovery felt that it alleviated symptoms of pain and reduced their opioid intake. Our results help inform clinicians regarding the perceptions of patients with trauma regarding

2018 Journal of Orthopaedic Trauma

6. Topical Rifampin Powder for Orthopaedic Trauma Part I: Rifampin powder reduces recalcitrant infection in a delayed treatment musculoskeletal trauma model. Full Text available with Trip Pro

Topical Rifampin Powder for Orthopaedic Trauma Part I: Rifampin powder reduces recalcitrant infection in a delayed treatment musculoskeletal trauma model. Open fractures become infected despite meticulous debridement and care. Locally applied antibiotics, commonly embedded in polymethylmethacrylate, deliver high doses of drug directly to the fracture site. Direct application of antibiotic powder, which is being applied prophylactically in spine surgery, is a recent interest in the trauma sector (...) , where bacterial biofilms are more prevalent. Traditional antibiotics, such as vancomycin, are poor performers against bacterial biofilms thus are ineffective in delayed treatment. Rifampin is an effective eradicator of Staphylococcal biofilms. Here, a rat model of musculoskeletal trauma was used to evaluate the utility of locally applied rifampin powder for reducing established orthopedic Staphylococcal infections in a delayed treatment scenario that previously indicated the limited use of local

2018 Journal of Orthopaedic Research

7. Physical Activity and Sedentary Behavior 6 Months After Musculoskeletal Trauma: What Factors Predict Recovery? Full Text available with Trip Pro

Physical Activity and Sedentary Behavior 6 Months After Musculoskeletal Trauma: What Factors Predict Recovery? Physical activity is increasingly recognized as an important marker of functional recovery following fracture.The objectives of this study were to measure sedentary behavior and physical activity 2 weeks and 6 months following fracture and to determine associated demographic and injury factors.This was an observational study.Two weeks and 6 months following fracture, 83 adults who were (...) for middle-aged participants and those with LL fractures.Although this study was sufficiently powered for the analysis of major categories, a convenience sample that may not be representative of all people with musculoskeletal trauma was used.Working-age adults with LL fractures had lower levels of physical activity 6 months after fracture than those with UL fractures. Older adults showed less improvement over time, suggesting that they are an important target group for interventions aimed at regaining

2019 Physical therapy

8. The Personal Financial Burden Associated with Musculoskeletal Trauma. (Abstract)

The Personal Financial Burden Associated with Musculoskeletal Trauma. Little is known about the effect of orthopaedic trauma on the financial health of patients. We hypothesized that some patients who sustain musculoskeletal trauma experience considerable financial hardship during treatment, and we also assessed for factors associated with increased personal financial burden.We surveyed 236 of 393 consecutive patients who were approached at 1 of 2 American College of Surgeons level-I trauma (...) centers between 2016 and 2017 following the completion of treatment for a musculoskeletal injury (60% response rate). Two validated measures (financial burden composite score and dichotomized worry score) were used to assess the financial hardship that patients experienced with the injury.There were 236 participants in the study, the mean age was 56.3 years (range, 19 to 94 years), and 48.7% of patients were male. Of the 236 patients, 97.9% had medical insurance, yet the mean financial burden

2019 The Journal of Bone and Joint Surgery. American Volume

9. Acetaminophen or Nonsteroidal Anti-Inflammatory Drugs in Acute Musculoskeletal Trauma: A Multicenter, Double-Blind, Randomized, Clinical Trial (Abstract)

Acetaminophen or Nonsteroidal Anti-Inflammatory Drugs in Acute Musculoskeletal Trauma: A Multicenter, Double-Blind, Randomized, Clinical Trial We determine whether pain treatment with acetaminophen was not inferior to nonsteroidal anti-inflammatory drugs or the combination of both in minor musculoskeletal trauma.The Paracetamol or NSAIDs in Acute Musculoskeletal Trauma Study was a double-blind, randomized, clinical trial conducted in 2 general practices and 2 emergency departments (...) in the Netherlands. A total of 547 adults, aged 18 years and older, with acute blunt minor musculoskeletal extremity trauma were randomly assigned in a 1:1:1 ratio to acetaminophen 4,000 mg/day, diclofenac 150 mg/day, or acetaminophen 4,000 mg/day+diclofenac 150 mg/day during 3 consecutive days. Patients, health care staff, and outcome assessors were blinded for treatment allocation. Follow-up for each patient was 30 days. Primary outcome measures were between-group differences in mean numeric rating scale (NRS

2017 EvidenceUpdates

10. Current Status of Musculoskeletal Trauma Care Systems Worldwide. Full Text available with Trip Pro

Current Status of Musculoskeletal Trauma Care Systems Worldwide. Although general trauma care systems and their effects on mortality reduction have been studied, little is known of the current state of musculoskeletal trauma delivery globally, particularly in low-income (LI) and low middle-income (LMI) countries. The goal of this study is to assess and describe the development and availability of musculoskeletal trauma care delivery worldwide.A questionnaire was developed to evaluate different (...) characteristics of general and musculoskeletal trauma care systems, including general aspects of systems, education, access to care and pre- and posthospital care. Surgical leaders involved with musculoskeletal trauma care were contacted to participate in the survey.Of the 170 surveys sent, 95 were returned for use for the study. Nearly 30 percent of surgeons reported a formalized and coordinated trauma system in their countries. Estimates for the number of surgeons providing musculoskeletal trauma per one

2018 Journal of Orthopaedic Trauma

11. The Burden of High-Energy Musculoskeletal Trauma in High-Income Countries. (Abstract)

The Burden of High-Energy Musculoskeletal Trauma in High-Income Countries. Though declining in the recent decades, high-energy musculoskeletal trauma remains a major contributor to the burden of disease in high-income countries (HICs). However, due to limitations in the available body of the literature, evaluation of this burden is challenging. The purpose of this review is to assess: (1) the current epidemiologic data on the surgical burden of high-energy musculoskeletal trauma in HICs; (2 (...) ) the current data on the economic impact of high-energy musculoskeletal trauma; and (3) potential strategies for addressing gaps in musculoskeletal trauma care for the future.In 2016, mortality from road traffic injuries (RTIs) between the ages of 15-49 was reported to be 9.5% (9.0-9.9) in high-income countries, accounting for approximately 255 million DALYs. While RTIs do not fully capture the extent of high-energy musculoskeletal trauma, as the most common mechanism, they serve as a useful indicator

2018 World Journal of Surgery

12. Intravenous paracetamol versus dexketoprofen in acute musculoskeletal trauma in the emergency department: A randomised clinical trial. (Abstract)

Intravenous paracetamol versus dexketoprofen in acute musculoskeletal trauma in the emergency department: A randomised clinical trial. Musculoskeletal system traumas are among the most common presentations in the emergency departments. In the treatment of traumatic musculoskeletal pain, paracetamol and non-steroidal anti-inflammatory analgesics (NSAID) are frequently used. Our aim in this study is to compare the efficacy of intravenous dexketoprofen and paracetamol in the treatment of traumatic (...) in terms of VAS reductions (p = 0.613).Intravenous paracetamol and dexketoprofen seem to produce equivalent pain relief for acute musculoskeletal trauma in the emergency department. CLINICALTRIALS.NCT03428503.Copyright © 2018 Elsevier Inc. All rights reserved.

2018 American Journal of Emergency Medicine Controlled trial quality: predicted high

13. Development of a screening tool to predict the risk of chronic pain and disability following musculoskeletal trauma: protocol for a prospective observational study in the United Kingdom. Full Text available with Trip Pro

Development of a screening tool to predict the risk of chronic pain and disability following musculoskeletal trauma: protocol for a prospective observational study in the United Kingdom. Pain is an expected and appropriate experience following traumatic musculoskeletal injury. By contrast, chronic pain and disability are unhelpful yet common sequelae of trauma-related injuries. Presently, the mechanisms that underlie the transition from acute to chronic disabling post-traumatic pain (...) are not fully understood. Such knowledge would facilitate the development and implementation of precision rehabilitation approaches that match interventions to projected risk of recovery, with the aim of preventing poor long-term outcomes. The aim of this study is to identify a set of predictive factors to identify patients at risk of developing ongoing post-traumatic pain and disability following acute musculoskeletal trauma. To achieve this, we will use a unique and comprehensive combination of patient

2018 BMJ open

14. Overview of musculoskeletal pain

Overview of musculoskeletal pain Overview of musculoskeletal pain - Summary of relevant conditions | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Overview of musculoskeletal pain Last reviewed: February 2019 Last updated: July 2018 Introduction Musculoskeletal pain is very common, may be acute or chronic, and is a major cause of morbidity and occupational sickness absence. Studies have found a prevalence of chronic musculoskeletal pain (...) in approximately 13% of the adult Danish population, Sjogren P, Ekholm O, Peuckmann V, et al. Epidemiology of chronic pain in Denmark: an update. Eur J Pain. 2009;13:287-292. http://www.ncbi.nlm.nih.gov/pubmed/18547844?tool=bestpractice.com 16% of adults in the UK, Elliott AM, Smith BH, Penny KI, et al. The epidemiology of chronic pain in the community. Lancet. 1999;354:1248-1252. http://www.ncbi.nlm.nih.gov/pubmed/10520633?tool=bestpractice.com and 40% to 67% of women in New Zealand. Taylor W. Musculoskeletal

2018 BMJ Best Practice

15. Musculoskeletal sprains and strains

Musculoskeletal sprains and strains Musculoskeletal sprains and strains - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Musculoskeletal sprains and strains Last reviewed: February 2019 Last updated: April 2018 Summary Muscle injuries occur from either direct or indirect trauma. Predisposing factors include type of muscle architecture (i.e., pennate muscle, type II fast twitch muscle fibres, and muscle-tendon units (...) that he has no competing interests. Peer reviewers Assistant Professor Department of Orthopaedics University of Virginia Charlottesville VA Disclosures QC declares that he has no competing interests. Professor of Trauma and Orthopaedic Surgery University Hospital of North Staffordshire Keele University School of Medicine Stoke on Trent UK Disclosures NM is an author of a study referenced in this monograph. Use of this content is subject to our Services Legal © BMJ Publishing Group 2018 ISSN 2515-9615

2018 BMJ Best Practice

16. Autologous minced muscle grafts improve endogenous fracture healing and muscle strength after musculoskeletal trauma Full Text available with Trip Pro

Autologous minced muscle grafts improve endogenous fracture healing and muscle strength after musculoskeletal trauma The deleterious impact of concomitant muscle injury on fracture healing and limb function is commonly considered part of the natural sequela of orthopedic trauma. Recent reports suggest that heightened inflammation in the surrounding traumatized musculature is a primary determinant of fracture healing. Relatedly, there are emerging potential therapeutic approaches for severe (...) muscle trauma (e.g., volumetric muscle loss [VML] injury), such as autologous minced muscle grafts (1 mm3 pieces of muscle; GRAFT), that can partially prevent chronic functional deficits and appear to have an immunomodulatory effect within VML injured muscle. The primary goal of this study was to determine if repair of VML injury with GRAFT rescues impaired fracture healing and improves the strength of the traumatized muscle in a male Lewis rat model of tibia open fracture. The most salient findings

2017 Physiological reports

17. A Skills-Based Program Delivered Via Secure Live Video to Patients With Acute Musculoskeletal Trauma

A Skills-Based Program Delivered Via Secure Live Video to Patients With Acute Musculoskeletal Trauma A Skills-Based Program Delivered Via Secure Live Video to Patients With Acute Musculoskeletal Trauma - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please (...) remove one or more studies before adding more. A Skills-Based Program Delivered Via Secure Live Video to Patients With Acute Musculoskeletal Trauma The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our for details. ClinicalTrials.gov Identifier: NCT03405610 Recruitment Status : Completed First Posted : January 23, 2018 Last Update Posted : August 17

2017 Clinical Trials

18. Effectiveness of alternative therapies for post-operative and trauma-related musculoskeletal pain management: a systematic review

Effectiveness of alternative therapies for post-operative and trauma-related musculoskeletal pain management: a systematic review Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. The registrant confirms that the information supplied for this submission is accurate and complete. CRD bears no responsibility or liability for the content of this registration record

2019 PROSPERO

19. Predictors of seeking financial compensation following motor vehicle trauma: inception cohort with moderate to severe musculoskeletal injuries. Full Text available with Trip Pro

Predictors of seeking financial compensation following motor vehicle trauma: inception cohort with moderate to severe musculoskeletal injuries. Compensation related factors have been repeatedly associated with poor recovery following orthopaedic trauma. There is limited research into the factors associated with seeking financial compensation. Further understanding of these factors could facilitate injury recovery by purposeful compensation scheme design. The aim of this study was to investigate (...) the predictors of seeking financial compensation, namely making a claim and seeking legal representation, following motor vehicle related orthopaedic trauma. The study was conducted in New South Wales (NSW), Australia, in motor vehicle crash and workers' compensation schemes.Participants were patients admitted with upper or lower extremity factures following a motor vehicle crash to two trauma hospitals. Data were collected at baseline within two weeks of injury. Participants were followed up at six months

2017 BMC Musculoskeletal Disorders

20. Covid-19: Management of trauma and orthopaedic patients

of trauma and acute musculoskeletal (MSK) patients • Obligatory inpatients: Continue to require admission and surgical management, for example, hip fracture. We must expedite treatment to avoid pre-operation delay and expedite rehabilitation to minimise length of stay. • Non-operative: Patients with injuries that can reasonably be managed either operatively or non-operatively, for example, displaced wrist fracture. We must explore non-operative care first, especially if this avoids admission. • Day (...) Covid-19: Management of trauma and orthopaedic patients Publications approval reference: 001559 NHS England and NHS Improvement Specialty guides for patient management during the coronavirus pandemic Clinical guide for the management of trauma and orthopaedic patients during the coronavirus pandemic 14 April 2020 Version 2 “…and there are no more surgeons, urologists, orthopaedists, we are only doctors who suddenly become part of a single team to face this tsunami that has overwhelmed us…” Dr

2020 Covid-19 Ad hoc guidelines

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