Factors associated with failure of locking plate fixation in proximal humerus fractures.

Background: Locking plate fixation remains the mainstay of surgical fixation of unstable proximal humerus fractures, however rates of failure remain high. The aim of this study was to identify risk factors that could be used to predict the likelihood of fixation failure.

Method: Patients with proximal humerus fractures managed with locking plate fixation between 2010 and 2019 at a Level 1 trauma centre were included.

Avoiding deformity in proximal tibial nailing: risk factors, deformity rules, tips, and tricks.

Unlabelled: Malalignment is one of the most common problems linked to nailing of proximal tibial fractures. This review will cover technical aspects of intramedullary nailing and will help explain the various risk factors. Deformity rules aid in identifying the likely deformity and help to develop management strategies.

Primary and Periprosthetic Distal Femur Fractures in Older Adults: No Difference in 12-Month Mortality and Patient-Reported Outcomes.

Objectives: To compare fracture incidence, mortality, and patient-reported health outcomes at 6 and 12 months postinjury between primary and periprosthetic distal femur fractures in older adults.

Methods: A registry-based cohort study was conducted including all adults 70 years of age or older registered by the Victorian Orthopaedic Trauma Outcomes Registry who experienced a primary or periprosthetic distal femur fracture between 2007 and 2017. Outcomes included mortality and health status (Three-Level European Quality of Life-Five Dimensions Scale [EQ-5D-3L]) collected at 6 and 12 months postinjury.

Orthopaedic injuries due to electric scooter trauma presenting to a level 1 trauma centre before and after introduction of a scooter-sharing scheme.

Background: Epidemiological data from various jurisdictions has shown that electric scooters are associated with significant trauma. The Victorian state government introduced a trial scooter sharing scheme on February 1, 2022 in inner city Melbourne. This is a descriptive study from the largest trauma centre in Victoria, geographically at the heart of the government sharing scheme, investigating the "scope of the problem" before and after introduction of the ride sharing scheme.

The Translated Proximal Humerus Fracture: A Comparison of Operative and Nonoperative Management.

Objectives: To report on the long-term outcomes of the management of translated proximal humerus fractures.

Design: A prospective cohort study was conducted from January 2010 to December 2018.

Setting: Academic Level 1 trauma center.

Electric scooter-related trauma, alcohol and other drugs.

Objective: To report the frequency of electric scooter-related trauma and association with alcohol and other drug (AOD) use.

Methods: A retrospective cohort study was conducted, including presentations from 1 January 2017 to 31 May 2022 to a metropolitan health service.

Results: There were 272 cases included, with increasing frequency, of which 65 (24%) had AOD exposure.

Comparison of state-of-the-art machine and deep learning algorithms to classify proximal humeral fractures using radiology text.

Introduction: Proximal humeral fractures account for a significant proportion of all fractures. Detailed accurate classification of the type and severity of the fracture is a key component of clinical decision making, treatment and plays an important role in orthopaedic trauma research. This research aimed to assess the performance of Machine Learning (ML) multiclass classification algorithms to classify proximal humeral fractures using radiology text data.

Comparison of the quality of documentation between electronic and paper medical records in orthopaedic trauma patients.

Objective The medical record is critical for documentation and communication between healthcare professionals. This study compared the completeness of orthopaedic documentation between the electronic medical record (EMR) and paper medical record (PMR). Methods A review was undertaken of 400 medical records (200 EMR, 200 PMR) of patients with operatively managed traumatic lower limb injury.

Predicting fracture outcomes from clinical registry data using artificial intelligence supplemented models for evidence-informed treatment (PRAISE) study protocol.

Background: Distal radius (wrist) fractures are the second most common fracture admitted to hospital. The anatomical pattern of these types of injuries is diverse, with variation in clinical management, guidelines for management remain inconclusive, and the uptake of findings from clinical trials into routine practice limited. Robust predictive modelling, which considers both the characteristics of the fracture and patient, provides the best opportunity to reduce variation in care and improve patient outcomes.

Outcomes of severe lower limb injury with Mangled Extremity Severity Score ≥ 7.

Aims: Complex fractures of the femur and tibia with associated severe soft tissue injury are often devastating for the individual. The aim of this study was to describe the two-year patient-reported outcomes of patients in a civilian population who sustained a complex fracture of the femur or tibia with a Mangled Extremity Severity Score (MESS) of ≥ 7, whereby the score ranges from 2 (lowest severity) to 11 (highest severity).

Methods: Patients aged ≥ 16 years with a fractured femur or tibia and a MESS of ≥ 7 were extracted from the Victorian Orthopaedic Trauma Outcomes Registry (January 2007 to December 2018).

Outcomes following operatively managed acetabular fractures in patients aged 60 years and older.

Aims: Acetabular fractures in older adults lead to a high risk of mortality and morbidity. However, only limited data have been published documenting functional outcomes in such patients. The aims of this study were to describe outcomes in patients aged 60 years and older with operatively managed acetabular fractures, and to establish predictors of conversion to total hip arthroplasty (THA).

PRECICE intramedullary nail in the treatment of adult leg length discrepancy.

Background: Limb length discrepancy in adults is not an uncommon occurrence following trauma and limited literature exists on limb lengthening in skeletally mature populations using modern techniques. This study aimed to evaluate outcomes of limb lengthening surgery using the PRECICE magnetic limb lengthening intramedullary nail in an adult population.

Method: From 2013 to 2018, 21 adult patients were operated by a single surgeon, using the PRECICE nail, for lower limb length discrepancies.

Discharge destination and patient-reported outcomes after inpatient treatment for isolated lower limb fractures.

Objectives: To examine the association between discharge destination (home or inpatient rehabilitation) for adult patients treated in hospital for isolated lower limb fractures and patient-reported outcomes.

Design: Review of prospectively collected Victorian Orthopaedic Trauma Outcomes Registry (VOTOR) data.

Setting, Participants: Adults (18-64 years old) treated for isolated lower limb fractures at four Melbourne trauma hospitals that contribute data to the VOTOR, 1 March 2007 - 31 March 2016.

Twelve month mortality rates and independent living in people aged 65 years or older after isolated hip fracture: A prospective registry-based study.

Introduction: This study investigated which patient and injury characteristics are associated with 12-month mortality rates and living independently after isolated hip fracture.

Methods: Older adults aged ≥65 years were included if they had an isolated hip fracture, were admitted to hospital between July 2009 and June 2016, inclusive, and were registered to the Victorian Orthopaedic Trauma Outcomes Registry. Mortality up to 12 months (365 days) post-injury, and functional outcomes (Glasgow Outcome Scale-Extended; GOS-E) at 12 months post-injury were examined.

The road to recovery for vulnerable road users hospitalised for orthopaedic injury following an on-road crash.

Background: Pedestrians, cyclists and motorcyclists are vulnerable to serious injury due to limited external protective devices. Understanding the level of recovery, and differences between these road user groups, is an important step towards improved understanding of the burden of road trauma, and prioritisation of prevention efforts. This study aimed to characterise and describe patient-reported outcomes of vulnerable road users at 6 and 12 months following orthopaedic trauma.

Patient Comprehension of Common Orthopedic Terminology.

Background: Medical terminology is often complex and confusing to lay people. Even common terms used by health care professionals often have other meanings and can easily be misinterpreted.

Objective: This study aimed to identify patient comprehension of common orthopedic terminology across multiple hospital settings.

Using Patient-Reported Outcomes to Predict Revision Arthroplasty Following Femoral Neck Fracture: Enhancing the Value of Clinical Registries through Data Linkage.

The aim of this study was to determine the association between patient-reported outcome measures (PROMs) six months following femoral neck fracture after a low fall and future arthroplasty, and the factors associated with this. Six-month post-fracture PROMs were collected from the Victorian Orthopaedic Trauma Outcomes Registry (VOTOR) for patients aged >55 years who were admitted for a femoral neck fracture after a low fall between March 2007 and June 2015. These cases were linked with those registered by Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR) up to October 2016.

Incidence, Costs and Predictors of Non-Union, Delayed Union and Mal-Union Following Long Bone Fracture.

Fracture healing complications are common and result in significant healthcare burden. The aim of this study was to determine the rate, costs and predictors of two-year readmission for surgical management of healing complications (delayed, mal, non-union) following fracture of the humerus, tibia or femur. Humeral, tibial and femoral (excluding proximal) fractures registered by the Victorian Orthopaedic Trauma Outcomes Registry over five years ( = 3962) were linked with population-level hospital admissions data to identify two-year readmissions for delayed, mal or non-union.

Epidemiology and outcomes of traumatic knee dislocations: Isolated vs multi-trauma injuries.

Background And Purpose: Traumatic dislocation of the knee (TKD) is a rare injury, accounting for approximately 0.02% of orthopaedic injuries. They are a challenging entity for orthopaedic surgeons to manage, and can have devastating consequences.

Nail Fit: Does Nail Diameter to Canal Ratio Predict the Need for Exchange Nailing in the Setting of Aseptic, Hypertrophic Femoral Nonunions?

Objectives: To evaluate patient-independent risk factors for aseptic femoral hypertrophic nonunion requiring exchange nailing, with particular reference to the fit of the nail at the isthmus within the canal.

Design: Retrospective case control study.

Setting: Level 1 trauma center.

Predictors of recovery in cyclists hospitalised for orthopaedic trauma following an on-road crash.

Background: As cycling-related injury rates are on the rise, there is a need to understand the long term outcomes of these patients in order to quantify the burden of injury and to inform injury prevention strategies. This study aimed to investigate predictors of return to work and functional recovery in a cohort of cyclists hospitalised for orthopaedic trauma from crashes occurring on-road.

Methods: A retrospective analysis of data from the Victorian Orthopaedic Trauma Outcomes Registry (VOTOR) was conducted for patients who were hospitalised for orthopaedic trauma following a cycling crash that occurred on-road between July 2007 and June 2015.

Patient reported health related quality of life early outcomes at 12 months after surgically managed tibial plafond fracture.

Introduction: Tibial plafond fractures represent a small but complex subset of fractures of the lower limb. The aim of this study was to describe the health related quality of life, pain and return to work outcomes 12 months following surgically managed tibial plafond fracture.

Methods: The Victorian Orthopaedic Trauma Outcomes Registry (VOTOR) database was used to identify patients with tibial plafond fractures.

Health Literacy in Orthopaedic Trauma Patients.

Objective: This study aimed to determine the level of health literacy in a postoperative orthopaedic trauma population and to evaluate the efficacy of a simple predischarge discussion strategy, targeted at improving health literacy.

Design: A pre-post intervention study was conducted from April 2014 to January 2015.

Setting: Academic Level 1 trauma center.

Comparing ICD-10 external cause codes for pedal cyclists with self-reported crash details.

Accurate coding of injury event information is critical in developing targeted injury prevention strategies. However, little is known about the validity of the most universally used coding system, the International Classification of Diseases (ICD-10), in characterising crash counterparts in pedal cycling events. This study aimed to determine the agreement between hospital-coded ICD-10-AM (Australian modification) external cause codes with self-reported crash characteristics in a sample of pedal cyclists admitted to hospital following bicycle crashes.

Twelve-month work-related outcomes following hip fracture in patients under 65 years of age.

Introduction: Recent research has highlighted the need for improved outcome reporting in younger hip fracture patients. For this population, return to work (RTW) is a particularly important measure against which to evaluate treatment outcomes. However, to date, only two small studies have reported RTW outcomes in young hip fracture patients and neither investigated factors predictive of RTW.