International Journal of Orthopaedic and Trauma Nursing最新文献_第2页

Exploring patient perspectives of younger adults with complications after internal fixation of femoral neck fractures: A qualitative study 探讨年轻成人股骨颈骨折内固定术后并发症的患者观点：一项定性研究

IF 2.1 Q3 NURSING

International Journal of Orthopaedic and Trauma Nursing

Pub Date : 2026-02-01 Epub Date: 2025-11-26 DOI: 10.1016/j.ijotn.2025.101252

Michaela Manalili Hansen , Per Hviid Gundtoft , Maiken Stilling , Ming Ding , Bjarke Viberg , Charlotte Abrahamsen

Introduction

Internal fixation is the recommended treatment for femoral neck fractures in younger adults, as it preserves the native hip joint. However, high failure rates and suboptimal outcomes following internal fixation persist. While there is substantial research on the experiences of older adults with femoral neck fractures, the perspectives of younger adults with complications following internal fixation remain largely underexplored. This study aims to examine the lived experiences of younger adults who underwent secondary surgery after internal fixation of a femoral neck fracture, with focus on the period between the initial fixation and the subsequent operation.

Methods

This qualitative, exploratory study utilizes semi-structured interviews with younger adults who underwent secondary surgery due to complications following internal fixation of a femoral neck fracture. Participants were purposively sampled from three hospitals in Denmark. Interviews were conducted 2–4 weeks post-secondary surgery, transcribed verbatim, and analyzed using Malterud's Systematic Text Condensation.

Results

Eight participants (median age 61, range 38–69 years) were included. Analysis identified four overarching themes: (1) physical impact, (2) psychosocial and identity disruption, (3) healthcare and information gaps, and (4) coping and future outlook. Alarmingly, more participants reported losing the will to live, even expressing suicidal thoughts during this period.

Conclusion

This study highlights the profound physical, psychological, and social consequences of complications following femoral neck fractures in younger adults. The findings emphasize the need for clear communication and individualized, age-appropriate, and long-term rehabilitation that integrates physical and psychological support. Tailored care pathways are essential to improve recovery and quality of life.

内固定是年轻人股骨颈骨折的推荐治疗方法，因为它保留了原有的髋关节。然而，高失败率和内固定后的次优结果仍然存在。虽然对老年人股骨颈骨折的经验进行了大量研究，但对年轻人内固定术后并发症的研究仍在很大程度上不足。本研究旨在探讨年轻成人股骨颈骨折内固定后接受二次手术的生活经历，重点关注首次固定和后续手术之间的时间。方法：本定性、探索性研究采用半结构化访谈，对因股骨颈骨折内固定术后并发症而接受二次手术的年轻人进行访谈。参与者有目的地从丹麦的三家医院取样。访谈在二次手术后2-4周进行，逐字转录，并使用Malterud的系统性文本浓缩进行分析。结果纳入8例受试者，中位年龄61岁，年龄范围38 ~ 69岁。分析确定了四个总体主题：(1)身体影响；(2)社会心理和身份破坏；(3)医疗保健和信息差距；(4)应对和未来展望。令人担忧的是，更多的参与者报告说，在这段时间里，他们失去了活下去的意愿，甚至表达了自杀的想法。结论：本研究强调了年轻人股骨颈骨折并发症对身体、心理和社会的深远影响。研究结果强调需要明确的沟通和个性化的、适合年龄的、长期的康复，包括身体和心理支持。量身定制的护理途径对于改善康复和生活质量至关重要。

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引用次数: 0

Occupational noise induced hearing loss in orthopaedic theatre nurses: Exposing the silent threat and outlining interventions to prevent it 骨科手术室护士职业性噪音引起的听力损失：揭示无声的威胁并概述预防措施

IF 2.1 Q3 NURSING

International Journal of Orthopaedic and Trauma Nursing

Pub Date : 2026-02-01 Epub Date: 2025-12-09 DOI: 10.1016/j.ijotn.2025.101254

Thomas Dean , Olivia Crannage

Excessive and prolonged exposure to loud noises can lead to an irreversible reduction in hearing known as noise induced hearing loss (NIHL). Orthopaedic theatre nurses spend a significant amount of their career surrounded by noisy orthopaedic theatre equipment, yet the risks posed to them by excessive occupational noise and the rates of NIHL in this group remain relatively unknown. Sound levels in orthopaedic theatres have been shown to exceed UK Health and Safety Executive action values with surgical instruments such as saws and rasping systems all exceeding 100 dB. Theatre nurses are therefore at risk of developing NIHL and multiple other complications associated with hearing loss, such as higher rates of loneliness and depression. Noisy theatre environments have also been shown to degrade communication, increase total errors and result in longer times to complete tasks, all leading to reductions in patient safety.

This practice development article aims to raise awareness of occupational NIHL and empower theatre nurses to implement protective interventions for their hearing. The article outlines a range of measures to reduce excessive noise exposure to theatre staff and proposes the implementation of a nurse-led ‘noise-safe theatre’. These recommendations encourage the use of engineering and administrative controls in combination with NIHL education and PPE within theatres to improve safety for both staff and patients.

过度和长时间暴露在嘈杂的噪音中会导致听力的不可逆转的下降，称为噪音性听力损失（NIHL）。骨科手术室护士在其职业生涯中大部分时间都被嘈杂的骨科手术室设备所包围，然而过度的职业噪音给他们带来的风险以及这一群体中NIHL的发生率仍然相对未知。骨科手术室的声音水平已被证明超过英国健康与安全执行局的行动值，手术器械如锯和磨砂系统均超过100分贝。因此，手术室护士面临着患NIHL和与听力损失相关的多种其他并发症的风险，例如更高的孤独感和抑郁率。嘈杂的手术室环境也被证明会降低沟通，增加总错误，并导致完成任务的时间更长，所有这些都会降低患者的安全性。这篇实践发展文章旨在提高对职业NIHL的认识，并授权剧院护士实施听力保护干预措施。文章概述了一系列措施，以减少对剧院工作人员的过度噪音，并建议实施护士领导的“噪音安全剧院”。这些建议鼓励在手术室内结合NIHL教育和个人防护装备使用工程和行政控制措施，以提高工作人员和患者的安全性。

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引用次数: 0

The family caregiver of the older person with hip fracture: perceptions about the transition to home 髋部骨折老年人的家庭照顾者：对家庭过渡的看法。

IF 2.1 Q3 NURSING

International Journal of Orthopaedic and Trauma Nursing

Pub Date : 2026-02-01 Epub Date: 2026-02-09 DOI: 10.1016/j.ijotn.2026.101264

Paula Rocha , Carlos Albuquerque , Susana Batista , Maria Adriana Henriques , Cristina Lavareda Baixinho

Background

Fractures resulting from falls constitute a problem of great magnitude for the older person, as they cause functional decline and difficulty in returning to the state prior to the fracture, and for the family caregiver, as they require care support to face the compromised ability to perform daily life activities that these people experience.

Objective

To characterize the perception of difficulties and needs felt by family caregivers in supporting older person with hip fractures in the transition home.

Methods

A descriptive, exploratory, qualitative study was developed, based on semi-structured interviews with family caregivers of patients with hip fractures undergoing surgical treatment, belonging to a hospital in the central region of Portugal. To analyze the data obtained, Bardin's content analysis was used, with the support of the MAXQDA Analytic pro 2022 software.

Results

From the analysis of the 15 interviews carried out, two categories emerged related to the difficulties perceived by family caregivers in supporting older person with hip fractures in the transition home: Care Support and Responsiveness. In relation to felt needs, the following categories emerged: Continuity of care and Training to provide care.

Conclusions

The family caregiver perceives multiple needs and difficulties experienced in the support provided to older person with hip fractures in the transition home. As this phenomenon is somewhat complex due to the involvement of numerous factors, the analysis of the aspects associated with this care process is essential, contributing to a favorable evolution and a safe transition.

背景：跌倒导致的骨折对老年人来说是一个很大的问题，因为它们会导致功能下降和难以恢复到骨折前的状态，对家庭照顾者来说，因为他们需要护理支持来面对这些人经历的日常生活活动能力受损。目的：描述家庭照顾者在过渡家庭中支持髋部骨折老年人的困难和需求的感知。方法：在半结构化访谈的基础上，对葡萄牙中部地区一家医院接受手术治疗的髋部骨折患者的家庭护理人员进行了描述性、探索性、定性研究。在MAXQDA Analytic pro 2022软件的支持下，采用Bardin含量分析法对所得数据进行分析。结果：从15次访谈的分析中，出现了两类与家庭照顾者在过渡家庭中支持髋部骨折老年人所感知到的困难相关的问题：护理支持和响应性。关于感觉到的需要，出现了以下类别：持续护理和提供护理的培训。结论：家庭照顾者感知到在过渡家庭中为髋部骨折的老年人提供支持的多重需求和困难。由于涉及许多因素，这种现象有些复杂，因此分析与此护理过程相关的各个方面至关重要，有助于有利的演变和安全过渡。

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引用次数: 0

Recovery during the first year after femoral neck fracture is a complex and non-linear journey: a longitudinal qualitative study 股骨颈骨折后第一年的康复是一个复杂的非线性过程：一项纵向定性研究

IF 2.1 Q3 NURSING

International Journal of Orthopaedic and Trauma Nursing

Pub Date : 2026-02-01 Epub Date: 2026-01-20 DOI: 10.1016/j.ijotn.2026.101256

Erika Olofsson , Sebastian Mukka , Olof Wolf , Nils P. Hailer , Eva Tengman , Lenita Lindgren , Birgitta Olofsson , Åsa Audulv

Background

Femoral neck fractures (FNF) are a severe and common injury that affect older adults physically, psychologically, and socially. Variation in the trajectory of recovery remains underexplored. This study was conducted to investigate older adults’ recovery experiences during the first year after FNF.

Method

This longitudinal interview-based study was conducted with 13 participants aged ≥75 years with FNF who were admitted to the orthopedics wards of two hospitals in Sweden. Semi-structured interviews were conducted with participants at 1, 4, and 12 months after fracture. Reflexive thematic analysis of the interview transcripts was performed.

Results

Participants described their recovery after FNF as a complex and non-linear journey. Four interrelated themes were identified as key aspects influencing recovery during the first year after FNF: engagement in daily activities, fear of falling, family members’ bridging of the support gap, and striving for independence. Recovery was represented as a fluctuating personal experience that evolves over time.

Conclusion

Recovery after FNF extends beyond physical healing, encompassing emotional adjustment and social reintegration. The understanding of recovery as an evolving and individualized process highlights the need for follow-up and rehabilitation strategies that address not only functional outcomes, but also patients’ confidence, motivation, and support in daily life.

股骨颈骨折（FNF）是一种严重和常见的损伤，影响老年人的身体、心理和社会。恢复轨迹的变化仍未得到充分探索。本研究旨在调查老年人FNF术后第一年的恢复情况。方法本研究采用纵向访谈法，选取13名年龄≥75岁的瑞典两家医院骨科病房收治的FNF患者。在骨折后1、4和12个月对参与者进行半结构化访谈。对访谈笔录进行反身性专题分析。结果参与者将FNF后的恢复描述为一个复杂的非线性过程。确定了四个相互关联的主题是影响家庭基金后第一年恢复的关键方面：参与日常活动、担心跌倒、家庭成员弥补支助差距以及争取独立。恢复被描述为一种随时间演变的波动的个人经历。结论FNF术后的康复不仅包括身体的康复，还包括情绪的调整和社会的重新融入。将康复理解为一个不断发展和个性化的过程，强调了对随访和康复策略的需求，这些策略不仅要解决功能结果，还要解决患者在日常生活中的信心、动机和支持。

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引用次数: 0

A retrospective case series study evaluating the use of synthetic dermal matrix for complex wounds: the Hong Kong experience 评价合成真皮基质用于复杂伤口的回顾性病例系列研究：香港的经验。

IF 2.1 Q3 NURSING

International Journal of Orthopaedic and Trauma Nursing

Pub Date : 2026-02-01 Epub Date: 2025-12-12 DOI: 10.1016/j.ijotn.2025.101253

Wing Wah Chau , Pok Man Fung , Wai Fung Kwong

Background

Partial-thickness skin grafts (PTSG) are the conventional method for definite wound closure in orthopaedics; however, synthetic dermal matrix have emerged as an alternative for complex wounds, particularly when vital structures, like tendon and bone, are exposed.

Objective

This case series evaluates the clinical outcomes, cost implications, and granulation capacity of synthetic dermal matrix compared to PTSG using case-based observations and literature comparisons.

Methods

Seven patients with complex wounds treated with synthetic dermal matrix at a public hospital in Hong Kong between December 2023 and May 2024 were followed until complete wound healing. Outcomes included healing time, 30-day wound size reduction, matrix integration after delamination, hospitalization duration, and vital structure coverage.

Results

Synthetic dermal matrix showed successful granulation in all cases with variable healing times (51–205 days). Granulation over bone, tendon, and joint was observed in 71.4 % of patients. No readmissions or hematoma formation occurred.

Conclusion

Synthetic dermal matrix is a safe and effective method for managing wounds with exposed vital structures and shows potential cost benefits over traditional PTSG. Further studies with larger samples are needed.

背景：部分厚度皮肤移植（PTSG）是骨科伤口愈合的常规方法；然而，合成真皮基质已经成为复杂伤口的替代品，特别是当重要结构，如肌腱和骨骼暴露时。目的：本病例系列通过病例观察和文献比较，评估合成真皮基质与PTSG的临床结果、成本影响和造粒能力。方法：于2023年12月至2024年5月在香港某公立医院接受人工真皮基质治疗的7例复杂创面患者，随访至创面完全愈合。结果包括愈合时间、30天创面缩小、脱层后基质整合、住院时间和重要结构覆盖。结果：合成真皮基质在不同愈合时间（51 ~ 205天）下均能成功形成肉芽。71.4%的患者出现骨、肌腱和关节肉芽肿。无再入院或血肿形成。结论：合成真皮基质是一种安全有效的治疗重要结构暴露创面的方法，与传统PTSG相比具有潜在的成本优势。需要更大样本的进一步研究。

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引用次数: 0

Safety and satisfaction of urinary catheter use in the perioperative period amongst hip fracture patients: a prospective cohort 髋部骨折患者围手术期导尿管使用的安全性和满意度：一项前瞻性队列研究。

IF 2.1 Q3 NURSING

International Journal of Orthopaedic and Trauma Nursing

Pub Date : 2026-02-01 Epub Date: 2026-01-30 DOI: 10.1016/j.ijotn.2026.101259

Steven Papp , Melanie Dodd-Moher , Bradley Meulenkamp , Jérémie Thibault , Chantal Backman , Nicole Whitley , Dita Chamoun , George Grammatopoulos

Introduction

Foley catheterization is often performed at time of admission in patients suffering a hip fracture. Guidelines for catheter management are inconsistent and lack consideration of the patient experience. We aimed to compare pain and convenience with voiding, as well as complication rates (urinary tract infection (UTI), postoperative urinary retention (POUR), and surgical site infection (SSI)) of catheterized versus non-catheterized patients awaiting hip fracture surgery.

Methods

Patients admitted to a single tertiary care hospital with a hip fracture completed a 3-item questionnaire about their preoperative bladder management experience. The primary outcome was pain associated with catheterization versus non-catheterization. Secondary outcomes included rates of postoperative UTI, POUR and SSI.

Results

A total of 119 patients were included. Fifty-five (93.2%) catheterized patients found the catheter to be convenient and only 6 (10.2%) reported pain with catheter use. Conversely, 28 (46.7%) non-catheterized patients found it painful to move to the bathroom and 17 (28.3%) reported pain with urination. Catheterized patients had significantly less pain related to emptying their bladder than non-catheterized patients (0.90/10 vs 3.59/10, respectively; p < 0.001). The rate of UTI (18.6% catheterized vs 13.3% non-catheterized), POUR (6.8% catheterized vs 11.1% non-catheterized) and SSI (3.4% catheterized vs 1.7% non-catheterized) were similar between groups.

Conclusions

Preoperative catheter use was associated with less pain with voiding and greater satisfaction for patients awaiting hip fracture surgery, without increasing rates of postoperative UTI, POUR, or SSI. Guidelines for catheter use should consider the patient experience.

Level of evidence

II.

简介：Foley导尿术通常在髋部骨折患者入院时进行。导管管理指南不一致，缺乏对患者经验的考虑。我们的目的是比较留置导尿与非留置导尿患者等待髋部骨折手术时的疼痛和便利性，以及并发症发生率（尿路感染（UTI）、术后尿潴留（POUR）和手术部位感染（SSI））。方法：在一家三级医院住院的髋部骨折患者完成了一份关于术前膀胱管理经验的3项问卷。主要结局是与导尿和非导尿相关的疼痛。次要结局包括术后UTI、POUR和SSI的发生率。结果：共纳入119例患者。55例（93.2%）患者认为导管使用方便，只有6例（10.2%）患者报告导管使用时疼痛。相反，28名（46.7%）未置管的患者发现上厕所时疼痛，17名（28.3%）报告排尿时疼痛。与未置管患者相比，置管患者排尿时的疼痛明显减轻（分别为0.90/10 vs 3.59/10）； p结论：术前使用导尿管与等待髋部骨折手术的患者排尿时的疼痛减轻和更高的满意度相关，且不会增加术后UTI、POUR或SSI的发生率。导管使用指南应考虑患者的经验。证据水平：II。

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引用次数: 0

The Patient Continuity of Care Questionnaire: Translation and cultural adaptation to a Danish context 病人护理问卷的连续性：翻译和文化适应丹麦语境。

IF 2.1 Q3 NURSING

International Journal of Orthopaedic and Trauma Nursing

Pub Date : 2026-02-01 Epub Date: 2026-02-18 DOI: 10.1016/j.ijotn.2026.101267

Lili Worre Høpfner Jensen , Søren Kold , Heather D. Hadjistavropoulos , Ole Rahbek

引用次数: 0

Bone health in an upper Midwestern health system: Years 2008–2015 中西部北部健康系统中的骨骼健康：2008-2015年。

IF 2.1 Q3 NURSING

International Journal of Orthopaedic and Trauma Nursing

Pub Date : 2026-02-01 Epub Date: 2025-12-15 DOI: 10.1016/j.ijotn.2025.101255

Ana M. Fernandez , Claudia C. Ramjattan , Colleen M. Renier , Kristy K. Lundberg , Samantha Nelson , Erica Lake , Theo A. Woehrle , Morgan Brenholdt , Paul K. Kosmatka , Chodisha Chakrapani , Megan A. Schwalbe , Melissa L. Harry

Introduction

Osteoporosis, osteopenia, and low impact fractures have documented effects on morbidity and mortality. This study explores the prevalence of osteoporosis and osteopenia among United States patients referred for a DXA scan and profiles patients experiencing low impact hip fractures (LIHFs) in an Upper Midwestern program to improve treatment and prevent secondary fractures in these patients.

Methodology

This retrospective observational study analyzed data from an in-house osteoporosis program database, trauma registry, and electronic health records. A DXA scan cohort included patients aged ≥50 years with completed DXA scans from 1/1/2008-9/30/2015. A LIHF cohort included patients aged ≥65 years receiving LIHF care from 1/1/2008-6/30/2015. Analyses included descriptive statistics, binary logit-linked generalized estimating equations, and survival analyses comparing mortality outcomes.

Results

In total, 11,725 patients received a DXA scan during the study period, of whom 21.3 % had osteoporosis and 33.9 % had osteopenia. Of those with osteoporosis, 46.3 % were on osteoporosis medication six months after a DXA scan. Mortality rates were low in the DXA scan cohort. Of 1207 patients aged ≥65 years with LIHFs, 12.8 % received osteoporosis medication six months following the LIHF. The one-year mortality rate post-LIHF was 29.6 % across females and males. Mortality odds and hazards were significantly lower in those with DXA scans versus those with no DXA scan documented.

Conclusions

Opportunities to improve bone health management are achievable by enhancing recognition and treatment of patients at high risk for LIHFs, including those without prior DXA scans. Ongoing collaborative care supporting initiation of medication treatment following LIHFs is necessary.

骨质疏松、骨质减少和低冲击骨折对发病率和死亡率有文献记载。本研究探讨了在美国接受DXA扫描的患者中骨质疏松和骨质减少的患病率，并分析了中西部上部项目中经历低冲击髋部骨折（LIHFs）的患者，以改善治疗并预防这些患者的继发性骨折。方法：这项回顾性观察性研究分析了来自内部骨质疏松项目数据库、创伤登记和电子健康记录的数据。DXA扫描队列包括2008年1月1日至2015年9月30日完成DXA扫描的年龄≥50岁的患者。LIHF队列纳入2008年1月1日至2015年6月30日期间接受LIHF治疗的年龄≥65岁的患者。分析包括描述性统计、二元逻辑关联的广义估计方程和比较死亡率结果的生存分析。结果：在研究期间，总共有11725名患者接受了DXA扫描，其中21.3%患有骨质疏松症，33.9%患有骨质减少症。在骨质疏松患者中，46.3%的患者在DXA扫描后6个月接受了骨质疏松药物治疗。DXA扫描队列的死亡率较低。1207例年龄≥65岁的LIHF患者中，12.8%的患者在LIHF发生6个月后接受了骨质疏松药物治疗。在女性和男性中，lihf后一年的死亡率为29.6%。与未记录DXA扫描的患者相比，进行DXA扫描的患者的死亡率和风险显著降低。结论：通过加强对LIHFs高风险患者的识别和治疗，包括未进行DXA扫描的患者，可以实现改善骨健康管理的机会。持续的协作护理支持在LIHFs后开始药物治疗是必要的。

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引用次数: 0

Nurses' knowledge about palliative care needs of people with fragility hip fractures: a cross-sectional study 护士对脆性髋部骨折患者姑息治疗需求的了解：一项横断面研究

IF 2.1 Q3 NURSING

International Journal of Orthopaedic and Trauma Nursing

Pub Date : 2025-11-01 Epub Date: 2025-11-12 DOI: 10.1016/j.ijotn.2025.101242

Sara Gomes , Ivo Paiva , Isabel Moreira , Andréa Marques

引用次数: 0

Literature reviews – Impact of multidisciplinary teams on fracture care in older people 文献综述-多学科团队对老年人骨折护理的影响

IF 2.1 Q3 NURSING

International Journal of Orthopaedic and Trauma Nursing

Pub Date : 2025-11-01 Epub Date: 2025-09-11 DOI: 10.1016/j.ijotn.2025.101231

Sonya Clarke, Shareena Bibi Mohd Arif, Carmen Queiros

引用次数: 0