Prevalence of posttraumatic stress disorder in orthopedic trauma patients and a call to implement the Injured Trauma Survivor Screen as a prospective screening protocol in the United States.

Purpose: Posttraumatic stress disorder (PTSD) is prevalent and is associated with protracted recovery and worse outcomes after injury. This study compared PTSD prevalence using the PTSD checklist for DSM-5 (PCL-5) with the prevalence of PTSD risk using the Injured Trauma Survivor Screen (ITSS).

Methods: Adult trauma patients at a level I trauma center were screened with the PCL-5 (sample 1) at follow-up visits or using the ITSS as inpatients (sample 2).

Change Is Slow: Acquisition of Disability-Accessible Medical Diagnostic Equipment in Primary Care Offices over Time.

Introduction: The lack of disability-accessible medical diagnostic equipment (MDE) in primary care impedes the receipt of quality medical care by people with mobility impairments. Cross-sectional surveys and observational studies have found <40% of medical offices have disability-accessible examination tables or weight scales. Although government agencies and advocates recommend primary care acquisition of the accessible MDE, the rate of acquisition is unknown.

Risk of Fracture and Complications After Fixation in Patients With Pre-injury Psychiatric Illness: A Propensity-Matched Cohort Study.

Objectives: The purpose was to describe the frequency of orthopaedic trauma and postsurgical complications associated with psychiatric diagnoses.

Design: Query of TriNetx Analytics Network.

Setting: Participating hospitals.

Trauma recidivism is reduced with engagement in psychosocial programming following orthopaedic trauma.

Introduction: Recidivism is common following injury. Interventions to enhance patient engagement may reduce trauma recidivism. Education, counseling, peer mentorship, and other resources are known as Trauma Recovery Services (TRS).

Recovery Services for Interpersonal Violence Victims on Healthcare Use at a Trauma Center.

Introduction: Treatment of interpersonal violence (IPV) patients is often complicated by social and mental health comorbidities. New American College of Surgeons (ACS) requirements include provision of psychosocial support services for recovery after injury. We aim to describe utilization and patient outcomes after provision of Trauma Recovery Services (TRS) at our institution for the IPV population.

Impact of novel psychosocial programming on readmission and recidivism rates among patients with violence-related trauma.

Introduction: The Victims of Crime Advocacy and Recovery Program (VOCARP) provides advocacy, mental health resources, and educational materials. This study will report complications, readmissions, and recidivism among crime victims, and who used or did not use victim services.

Materials And Methods: Patients engaged with programming from 3/1/17 until 12/31/18 were included.

Recidivism after orthopaedic trauma has diminished over time.

Purpose: The purpose was to analyze our trauma population during two periods to assess for predictors of recidivism.

Methods: Prior (2007-2011, n = 879) and recent (2014-2019, n = 954) orthopaedic trauma patients were reviewed. Recidivists were those returning with an unrelated injury.

The development of a Trauma Resiliency Scale (tRS-18).

Resiliency consists of three core components, which include presence of adversity, protective factors to overcome adversity, and positive outcomes or growth. Therefore, resiliency aligns with the trauma recovery process. This paper describes development of the Trauma Resiliency Scale (tRS) to quantify the resiliency of trauma patients upon presentation and during recovery.

Accessible medical diagnostic equipment in primary care: Assessing its geographic distribution for disability equity.

Background: Height adjustable examination tables, accessible weight scales, and lifts for transferring individuals on/off examination equipment enable delivery of equitable health care to persons with mobility impairment. Because most Medicaid-covered patients must utilize a managed care network, network providers with accessible medical diagnostic equipment (MDE) at proximate locations for travel time and distance are necessary. Network density and distribution of accessible MDE has not been studied.

Social Determinants of Health and Patients With Traumatic Injuries: Is There a Relationship Between Social Health and Orthopaedic Trauma?

Background: Although economic stability, social context, and healthcare access are well-known social determinants of health associated with more challenging recovery after traumatic injury, little is known about how these factors differ by mechanism of injury. Our team sought to use the results of social determinants of health screenings to better understand the population that engaged with psychosocial support services after traumatic musculoskeletal injury and fill a gap in our understanding of patient-reported social health needs.

Question/purpose: What is the relationship between social determinants of health and traumatic musculoskeletal injury?

Methods: Trauma recovery services is a psychosocial support program at our institution that offers patients and their family members resources such as professional coaching, peer mentorship, post-traumatic stress disorder screening and treatment, educational resources, and more.

Are trauma surgical societies adequately addressing mental health after injury?

Background: Survivors of physical trauma, their home caregivers, and their medical providers all have an increased risk of developing psychological distress and trauma-related psychiatric disease. The purpose of this study was to describe the frequency and change over time of trauma society research presentations regarding mental health to identify opportunities for growth.

Methods: Archives from 2018 to 2020 from the American Association for the Surgery of Trauma, the Eastern Association for the Surgery of Trauma, and the Western Trauma Association were reviewed.

Functional outcomes more than 5 years following acetabulum fracture.

Objectives: The purposes of this project were to evaluate functional outcomes more than 5 years after acetabulum fracture and to determine factors related to function.

Methods: This retrospective study consisted of 205 adult patients treated for acetabulum fracture who completed the Musculoskeletal Function Assessment (MFA) a minimum of 5 years following injury. The MFA includes survey of daily activities, gross and fine mobility, social and work function, sleeping, and mood.

Are we missing the mark? Relationships of psychosocial issues to outcomes after injury: A review of OTA annual meeting presentations.

Objectives: To observe the availability of information about social, emotional, and psychological factors in abstracts presented at the Orthopaedic Trauma Association (OTA) annual meeting.

Data Source: OTA website (https://ota.org/education/meetings-and-courses/meeting-archive/).

Risk Factors for Posttraumatic Stress Disorder in Acute Trauma Patients.

Objective: To identify risk factors for posttraumatic stress disorder (PTSD) after traumatic injury.

Setting: Single urban Level I trauma center.

Design: Prospective.

Factors influencing management of bilateral femur fractures: A multicenter retrospective cohort of early versus delayed definitive Fixation.

Introduction: The purpose of our study was to evaluate the factors that influence the timing of definitive fixation in the management of bilateral femoral shaft fractures and the outcomes for patients with these injuries.

Methods: Patients with bilateral femur fractures treated between 1998 to 2019 at ten level-1 trauma centers were retrospectively reviewed. Patients were grouped into early or delayed fixation, which was defined as definitive fixation of both femurs within or greater than 24 hours from injury, respectively.

New versus old: 95 degree angled blade plate versus distal femoral locking plate. A randomized clinical trial.

Introduction: The purpose was to compare the locking condylar plate (LCP) with the 95° angled blade plate (ABP) for distal femoral fracture patterns amenable to either device. Our hypothesis was that LCP would outperform ABP with primary outcome of nonunion and secondary outcomes of reoperation and malunion.

Methods: 78 adult patients with 79 eligible fractures and mean age of 60 years were prospectively randomized to LCP (n = 45) or ABP (n = 34).

Can disability accommodation needs stored in electronic health records help providers prepare for patient visits? A qualitative study.

Background: Embedding patient accommodation need in the electronic health record (EHR) has been proposed as one means to improve health care delivery to patients with disabilities. Accommodation need is not a standard field in commercial EHR software. However, some medical practices ask about accommodation need and store it in the EHR.

The Impact of Nurse Delegation Regulations on the Provision of Home Care Services: A Four-State Case Study.

The objective of this study was to explore how home care workers and the agencies that employ them interact with their state's nurse practice act in the provision of care. Using a qualitative case study approach, we selected four states with varying levels of restrictiveness in their nurse delegation regulations. We conducted interviews ( = 45) with state leaders, agency leaders, and home care workers to learn how these policies affect the home care workforce's ability to perform care tasks for their clients in order to allow clients to remain in their own homes.

What Is the Financial Impact of Orthopaedic Sequelae of Intravenous Drug Use on Urban Tertiary-care Centers?

Background: Orthopaedic sequelae such as skin and soft-tissue abscesses are frequent complications of intravenous drug use (IVDU) and comprise many of the most common indications for emergency room visits and hospitalizations within this population. Urban tertiary-care and safety-net hospitals frequently operate in challenging economic healthcare environments and are disproportionately tasked with providing care to this largely underinsured patient demographic. Although many public health initiatives have been instituted in recent years to understand the health impacts of IVDU and the spreading opioid epidemic, few efforts have been made to investigate its economic impact on healthcare systems.