A modified passive-dynamic ankle-foot orthosis: can it prevent amputation and arthrodesis in patients with ankle-foot trauma?

Introduction: High-energy lower extremity trauma (HELET) may cause severe damage within the foot-ankle complex. Occasionally, arthrodesis or amputation are the only remaining options to increase activity levels. The modified passive dynamic ankle-foot orthosis (PDAFO) may prove to be a nonsurgical alternative.

Real-time visual biofeedback during weight bearing improves therapy compliance in patients following lower extremity fractures.

Background: Individuals with lower extremity fractures are often instructed on how much weight to bear on the affected extremity. Previous studies have shown limited therapy compliance in weight bearing during rehabilitation. In this study we investigated the effect of real-time visual biofeedback on weight bearing in individuals with lower extremity fractures in two conditions: full weight bearing and touch-down weight bearing.

Technical Aspects and Validation of a New Biofeedback System for Measuring Lower Limb Loading in the Dynamic Situation.

Background: A variety of techniques for measuring lower limb loading exists, each with their own limitations. A new ambulatory biofeedback system was developed to overcome these limitations. In this study, we described the technical aspects and validated the accuracy of this system.

Degloved foot sole successfully reconstructed with split thickness skin grafts.

Introduction: The current opinion is that split thickness skin grafts are not suitable to reconstruct a degloved foot sole. The tissue is too fragile to carry full bodyweight; and therefore, stress lesions frequently occur. The treatment of choice is the reuse of the avulsed skin whenever possible, or else the use of a full thickness fascio-cutaneus flap.

Acute phase complications following traumatic spinal cord injury in Dutch level 1 trauma centres.

Objective: To assess the number and nature of complications during the acute phase following traumatic spinal cord injury and to explore the relationship between number of complications and length of hospital stay.

Design: Multi-centre prospective cohort study.

Patients: A total of 54 patients with traumatic spinal cord injury, referred to 3 level 1 trauma centres in The Netherlands.

Trends in moderate to severe paediatric trauma in Central Netherlands.

Introduction: Trend analyses of hospital discharge data can raise signals for prevention policies, but are often flawed by changes in health care consumption. This is a trend analysis of the clinical incidence of paediatric trauma that used international criteria to overcome this bias. The objective is to describe trends in clinical incidence of moderate to severe paediatric trauma, and to identify target groups for prevention activities.

Dynamic weight loading in older people with hip fracture.

Objective: Hip fractures have a high morbidity and mortality in elderly patients. Improving mobility outcomes is crucial in order to decrease the burden of this injury. The objective of this study was to investigate dynamic weight loading in older people with hip fractures using a new device.

Determinants of limitations in unpaid work after major trauma: a prospective cohort study with 15 months follow-up.

Objective: To identify determinants of limitations in unpaid work (household work, shopping, caring for children and odd jobs around the house) in patients who had suffered major trauma (ISS≥16) and who were in full-time employment (≥80%) at the time of injury.

Design: Prospective cohort study.

Setting: University Medical Centre Utrecht, a level 1 trauma centre in the Netherlands.

Keep moving forward: a new energy returning prosthetic device with low installation height after Syme or Pirogoff amputation.

Background: The incidence of foot amputations increased in the Netherlands to 3.3/100,000 people up to 1994. Despite these numbers, only a few basic prosthetic and orthotic devices are available, and all lack functionality to restore ankle and foot mobility.

The effects of regionalization of pediatric trauma care in the Netherlands: a surveillance-based before-after study.

Background: System changes in pediatric trauma care may reduce childhood injury mortality. The Dutch system of trauma care has been regionalized in 1999/2000. We evaluated changes in referral behavior and in-hospital mortality before and after regionalization of trauma care in the Netherlands.

Are existing outcome instruments suitable for assessment of spinal trauma patients?

Object: Valid outcome assessment tools specific for spinal trauma patients are necessary to establish the efficacy of different treatment options. So far, no validated specific outcome measures are available for this patient population. The purpose of this study was to assess the current state of outcome measurement in spinal trauma patients and to address the question of whether this group is adequately served by current disease-specific and generic health-related quality-of-life instruments.

Psychometric properties of questionnaires evaluating health-related quality of life and functional status in polytrauma patients with lower extremity injury.

Background: Long term disability is common among polytrauma patients. However, as yet little information exists on how to adequately measure functional status and health-related quality of life following polytrauma.

Aims: To establish the unidimensionality, internal consistency and validity of two health-related quality of life measures and one functional status questionnaire among polytrauma patients.

Long-Term Health-Related Quality of Life in Major Pediatric Trauma: A Pilot Study.

Background: Major trauma is the leading cause of mortality and morbidity in children of developed countries. Little research has been done about the health-related quality of life (HRQL) in these children. The aim of the current research is to describe the HRQL of children in the long term after major trauma and to compare it with healthy peers.

Long-term health condition in major pediatric trauma: a pilot study.

Purpose: Major trauma is the leading cause of death in children of developed countries. However, little is known about its long-term health consequences in survivors. Our aim was to describe the health condition in children at long-term after major trauma.

Health-related quality-of-life measures for long-term follow-up in children after major trauma.

Objective: Our objective was to review measures of health-related quality of life (HRQL) for long-term follow up in children after major trauma and to determine the measures that are suitable for a large age range, reliable and valid, and cover a substantial amount of the domains of functioning using the International Classification of Functioning, Disability, and Health (ICF) of the World Health Organization (WHO).

Methods: The Medline and EMBASE databases were searched in all years up to October 2007 for generic HRQL measures suitable for children aged 5-18 years old and validated in English or Dutch. Measures were reviewed with respect to the age range for which the measure was suitable and reliability, validity, and content related to the ICF.

Individual and population burdens of major trauma in the Netherlands.

Objective: To assess the impact of major trauma on individual and population health.

Methods: Data from a regional trauma registry were used, including all trauma fatalities and nonfatal severely injured patients (injury severity score >15) in 1999 and 2000. The impact of fatalities was expressed in terms of years of life lost (YLL).

Return to work after major trauma.

Objective: To quantify the prevalence of return to work after major trauma, and to investigate the determinants of postinjury work status.

Design: Prospective cohort study.

Setting: University Medical Centre Utrecht, a level 1 trauma centre in the Netherlands.

Determinants of long-term functional consequences after major trauma.

Objective: The purpose of this study was to describe the long-term functional consequences from major trauma and to quantify the effect of sociodemographic, injury-related, and physical determinants of its outcome.

Methods: A prospective cohort study was performed at the University Medical Center Utrecht (Level I trauma center) in the Netherlands during 1999 and 2000. All severely (injury severity score [ISS] >or=16) injured adult (age >or=16) trauma survivors (n = 359) were selected for follow-up.