Notice bibliographique
Résumé
Commentary Tibial fracture nonunion is expensive in terms of health-care and personal costs1. Compared with patients with a healed tibial fracture, those with a nonunion have poorer physical and mental function and more posttraumatic psychological distress2. Reliance on walking aids and opioids is commonly associated with tibial nonunion1,2. In the present study, quality of life was measured in a heterogeneous cohort of patients with tibial shaft nonunion at three to 244 months after injury; these patients had undergone zero to twenty-three operations. Although there was no matched cohort of patients with a healed tibial shaft fracture for comparison, the authors compared their outcomes with the normal population and patients with other health conditions such as chronic cardiovascular disease and arthritis. They found that patients with nonunion, on average, reported physical health worse than 90% of the normal population and mental health worse than 75% of the normal population. This is below the quality of life experienced by many individuals living with diabetes and those who have survived myocardial infarction. Patients with tibial shaft nonunion who also had depression, obesity, and diabetes (especially in combination) reported particularly poor function and high levels of chronic pain. Although smoking has been well established as a risk factor for the development of nonunion3, the current study revealed that patients with nonunion who smoked had similar function to those with nonunion who did not smoke. Given the profound deficits in quality of life experienced by individuals with tibial nonunion, attempts should be focused on prevention and timely, effective treatment. Zlowodzki et al. showed that, one year after successful treatment of tibial nonunion, Short Form (SF)-36 physical and social function scores had improved significantly from the values before treatment4, although others found less improvement in SF-36 scores despite eventual fracture-healing1. The best evidence to date suggests that statically locked, reamed intramedullary nailing of both open and closed tibial shaft fractures is associated with the best outcomes, including minimizing the risk of nonunion5. For those with delayed union following tibial shaft fracture, smoking cessation and avoidance of chronic nonsteroidal anti-inflammatory drug use may be helpful in maximizing the likelihood of achieving union with well-planned and well-executed surgical treatment3-5. For established tibial nonunions, nonsurgical treatment alone (such as pulsed ultrasound or interferential current) is not likely to succeed5. Despite ultimate union, patients may continue to report persistent pain and psychological difficulties. Future studies are needed to establish the best way to avoid and to treat tibial nonunion and the accompanying psychological problems.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,002 | 0,001 |
| Bibliométrie | 0,001 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,001 | 0,002 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».