Pub Date : 2025-03-19DOI: 10.1016/j.ijotn.2025.101176
Anders Ringnér , Malin Ljung , Anna-Clara Rullander
{"title":"Parents' and nurses’ experiences when children undergo limb lengthening treatment","authors":"Anders Ringnér , Malin Ljung , Anna-Clara Rullander","doi":"10.1016/j.ijotn.2025.101176","DOIUrl":"10.1016/j.ijotn.2025.101176","url":null,"abstract":"","PeriodicalId":45099,"journal":{"name":"International Journal of Orthopaedic and Trauma Nursing","volume":"57 ","pages":"Article 101176"},"PeriodicalIF":1.5,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143697616","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Simultaneous bilateral total knee arthroplasty (SBTKA) can improve post-surgical outcomes and reduce complications and cost of care. This study aimed to compare: (a) pain intensity levels in patients undergoing SBTKA between and before discharge, and 6 weeks after surgery, and (b) activities of daily living (ADL) and quality of life between the pre-operative period and 6 weeks after surgery.
Material and methods
Forty patients who were scheduled for SBTKA at inpatient units in a university-affiliated hospital in Bangkok, Thailand were recruited on the first day of admission using the face-to-face method. The research instruments included a demographic questionnaire, the Numeric Rating Scale (NRS), and the Knee and Osteoarthritis Outcome Score (KOOS): ADL, and knee-related quality of life subscales. The data were analyzed using descriptive statistics, paired t-test, and Wilcoxon Signed Rank Test.
Results
The results showed that the pain intensity level at six weeks after surgery was statistically significantly reduced when comparing the pre-discharge from the hospital (p = 0.000). Patients had improvements in their ADL (p = 0.000) and their quality of life (p = 0.000) at six weeks after surgery compared to before surgery.
Conclusions
Patients who underwent SBTKA had clinical improvement in terms of pain intensity reduction and enhancement of their ADL and quality of life.
{"title":"Post-operative outcomes among knee osteoarthritis patients undergoing simultaneous bilateral total knee arthroplasty","authors":"Dalathorn Wathsuleelanond, Phichpraorn Youngcharoen, Suchira Chaiviboontham","doi":"10.1016/j.ijotn.2025.101175","DOIUrl":"10.1016/j.ijotn.2025.101175","url":null,"abstract":"<div><h3>Background and objectives</h3><div>Simultaneous bilateral total knee arthroplasty (SBTKA) can improve post-surgical outcomes and reduce complications and cost of care. This study aimed to compare: (a) pain intensity levels in patients undergoing SBTKA between and before discharge, and 6 weeks after surgery, and (b) activities of daily living (ADL) and quality of life between the pre-operative period and 6 weeks after surgery.</div></div><div><h3>Material and methods</h3><div>Forty patients who were scheduled for SBTKA at inpatient units in a university-affiliated hospital in Bangkok, Thailand were recruited on the first day of admission using the face-to-face method. The research instruments included a demographic questionnaire, the Numeric Rating Scale (NRS), and the Knee and Osteoarthritis Outcome Score (KOOS): ADL, and knee-related quality of life subscales. The data were analyzed using descriptive statistics, paired <em>t</em>-test, and Wilcoxon Signed Rank Test.</div></div><div><h3>Results</h3><div>The results showed that the pain intensity level at six weeks after surgery was statistically significantly reduced when comparing the pre-discharge from the hospital (p = 0.000). Patients had improvements in their ADL (p = 0.000) and their quality of life (p = 0.000) at six weeks after surgery compared to before surgery.</div></div><div><h3>Conclusions</h3><div>Patients who underwent SBTKA had clinical improvement in terms of pain intensity reduction and enhancement of their ADL and quality of life.</div></div>","PeriodicalId":45099,"journal":{"name":"International Journal of Orthopaedic and Trauma Nursing","volume":"57 ","pages":"Article 101175"},"PeriodicalIF":1.5,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143593304","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-27DOI: 10.1016/j.ijotn.2025.101172
Keetie Kremers-van de Hei , Bob Evers , Lotte Weijers , Diederick Duijvesz , Berend Willem Schreurs , Sander Koeter
Background
Postoperative urinary retention is a frequently seen serious complication after surgery. After orthopaedic hip or knee arthroplasty the incidence is relatively high, between 30 and 50% in previous studies. Currently, there is no consensus on the indication for urinary catheterization and a uniform guideline is lacking. This prospective cohort study examined the safety of a modified catheterization protocol with a catheterization threshold of 800 ml instead of 400 ml (usual care) after elective joint arthroplasty using ultrasound bladder scans. The hypothesis was that the incidence of catheterization will be reduced without increasing urinary complications.
Method
We prospectively included 305 patients who were treated according to the local fast track arthroplasty protocol in which a modified catheterization protocol was used. Catheterization was only performed at a scan volume of 800 ml or more. Bladder contents were monitored preoperatively, immediately postoperatively and at outpatient follow-up. Urological scores and complications were monitored. The usual care control group was treated according to the usual care protocol with a threshold for catheterization of 400 ml, these results were published in a previous study.
Results
The incidence of catheterization for urinary retention was significantly lower in patients who were treated with the less invasive protocol than the usual care control group (11.1% versus 48.8%, p < 0.001). The rate of urologic complications was low using the new protocol (4% urinary tract infection and 0.3% pharmacological interventions).
Conclusion
The results of our study provide strong empirical support for modifying catheterization protocols after orthopaedic surgery. A less invasive protocol is safe, provides reduction in workload for nurses, is patient-friendly and reduces costs.
背景术后尿潴留是术后常见的严重并发症。在骨科髋关节或膝关节置换术后，发病率相对较高，在先前的研究中为30 - 50%。目前，关于导尿的指征没有共识，缺乏统一的指南。这项前瞻性队列研究检查了选择性关节置换术后使用超声膀胱扫描将置管阈值改为800ml而不是400ml（常规护理）的改进置管方案的安全性。假设导尿的发生率会降低，而不会增加泌尿系统并发症。方法前瞻性纳入305例采用局部快速通道关节置换术的患者，其中采用改良的置管方案。仅在扫描容积为800毫升或更多时进行导管插入。术前、术后及门诊随访监测膀胱内容物。监测泌尿系统评分和并发症。常规护理对照组按常规护理方案治疗，置管阈值为400ml，这些结果已在既往研究中发表。结果微创治疗组尿潴留导尿发生率明显低于常规治疗组(11.1% vs 48.8%, p <；0.001)。使用新方案的泌尿系统并发症发生率较低（4%尿路感染和0.3%药物干预）。结论本研究结果为骨科术后置管方案的修改提供了有力的实证支持。侵入性较小的方案是安全的，减少了护士的工作量，对患者友好，并降低了成本。
{"title":"A less invasive catheterization protocol for managing urinary retention in patients undergoing hip and knee arthroplasty: A prospective cohort study","authors":"Keetie Kremers-van de Hei , Bob Evers , Lotte Weijers , Diederick Duijvesz , Berend Willem Schreurs , Sander Koeter","doi":"10.1016/j.ijotn.2025.101172","DOIUrl":"10.1016/j.ijotn.2025.101172","url":null,"abstract":"<div><h3>Background</h3><div>Postoperative urinary retention is a frequently seen serious complication after surgery. After orthopaedic hip or knee arthroplasty the incidence is relatively high, between 30 and 50% in previous studies. Currently, there is no consensus on the indication for urinary catheterization and a uniform guideline is lacking. This prospective cohort study examined the safety of a modified catheterization protocol with a catheterization threshold of 800 ml instead of 400 ml (usual care) after elective joint arthroplasty using ultrasound bladder scans. The hypothesis was that the incidence of catheterization will be reduced without increasing urinary complications.</div></div><div><h3>Method</h3><div>We prospectively included 305 patients who were treated according to the local fast track arthroplasty protocol in which a modified catheterization protocol was used. Catheterization was only performed at a scan volume of 800 ml or more. Bladder contents were monitored preoperatively, immediately postoperatively and at outpatient follow-up. Urological scores and complications were monitored. The usual care control group was treated according to the usual care protocol with a threshold for catheterization of 400 ml, these results were published in a previous study.</div></div><div><h3>Results</h3><div>The incidence of catheterization for urinary retention was significantly lower in patients who were treated with the less invasive protocol than the usual care control group (11.1% versus 48.8%, p < 0.001). The rate of urologic complications was low using the new protocol (4% urinary tract infection and 0.3% pharmacological interventions).</div></div><div><h3>Conclusion</h3><div>The results of our study provide strong empirical support for modifying catheterization protocols after orthopaedic surgery. A less invasive protocol is safe, provides reduction in workload for nurses, is patient-friendly and reduces costs.</div></div>","PeriodicalId":45099,"journal":{"name":"International Journal of Orthopaedic and Trauma Nursing","volume":"57 ","pages":"Article 101172"},"PeriodicalIF":1.5,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143579400","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-19DOI: 10.1016/j.ijotn.2025.101165
Sonya Clarke (Dr)
{"title":"The transition of young people to adult services within orthopaedic healthcare -Editorial for May 2025 issue","authors":"Sonya Clarke (Dr)","doi":"10.1016/j.ijotn.2025.101165","DOIUrl":"10.1016/j.ijotn.2025.101165","url":null,"abstract":"","PeriodicalId":45099,"journal":{"name":"International Journal of Orthopaedic and Trauma Nursing","volume":"57 ","pages":"Article 101165"},"PeriodicalIF":1.5,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143474785","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This trial aimed to evaluate the efficacy of the “Herbal Laxative Capsule” (HLC) formulation in alleviating symptoms of postoperative constipation (POC) in patients undergoing surgeries for traumatic fractures of the hip or lower extremities. The HLC is a novel polyherbal formulation that integrates both scientifically validated botanicals, such as Cassia angustifolia and Aloe barbadensis, with traditionally employed herbs like Foeniculum vulgare, Coriandrum sativum, and Carum carvi, all of which are recognized for their laxative properties.
Materials and methods
A triple-blind, placebo-controlled, randomized clinical trial was conducted at an academic hospital in Kashan, Iran. A total of 61 orthopedic patients with POC were randomized to receive either HLC (n = 31) in the treatment group or a placebo (n = 30) in the placebo group. Both were administered as 520 mg capsules, taken twice daily for one week. The primary outcomes included assessments of constipation severity and stool consistency, while the secondary outcomes evaluated patient satisfaction using validated clinical scales.
Results
The treatment group demonstrated a statistically significant reduction in constipation severity and improvement in stool consistency compared with the placebo group (P < 0.001). No significant adverse effects were reported. Additionally, patient satisfaction was notably higher in the treatment group (P < 0.001).
Conclusion
The HLC formulation demonstrated significant efficacy in effectively managing POC, which is often opioid-induced constipation (OIC), in orthopedic patients. These findings suggest that HLC could serve as a promising alternative to conventional laxatives, warranting further investigation in larger-scale clinical trials.
{"title":"Efficacy of an Iranian herbal medicine formula for postoperative constipation in trauma patients with hip and lower limb fractures: A triple-blind, placebo-controlled randomized clinical trial","authors":"Rezvan Ghafarzadegan , Mohammadreza Zarei , Nahid Norouzi , Neda Mirbagher Ajorpaz , Seyedeh Mahsa Lotfi , Sayyed Mehdi Rasooli Manesh , Hossein Akbari , AliReza Abedi","doi":"10.1016/j.ijotn.2025.101163","DOIUrl":"10.1016/j.ijotn.2025.101163","url":null,"abstract":"<div><h3>Aim of the study</h3><div>This trial aimed to evaluate the efficacy of the “Herbal Laxative Capsule” (HLC) formulation in alleviating symptoms of postoperative constipation (POC) in patients undergoing surgeries for traumatic fractures of the hip or lower extremities. The HLC is a novel polyherbal formulation that integrates both scientifically validated botanicals, such as <em>Cassia angustifolia</em> and <em>Aloe barbadensis</em>, with traditionally employed herbs like <em>Foeniculum vulgare</em>, <em>Coriandrum sativum</em>, and <em>Carum carvi</em>, all of which are recognized for their laxative properties.</div></div><div><h3>Materials and methods</h3><div>A triple-blind, placebo-controlled, randomized clinical trial was conducted at an academic hospital in Kashan, Iran. A total of 61 orthopedic patients with POC were randomized to receive either HLC (n = 31) in the treatment group or a placebo (n = 30) in the placebo group. Both were administered as 520 mg capsules, taken twice daily for one week. The primary outcomes included assessments of constipation severity and stool consistency, while the secondary outcomes evaluated patient satisfaction using validated clinical scales.</div></div><div><h3>Results</h3><div>The treatment group demonstrated a statistically significant reduction in constipation severity and improvement in stool consistency compared with the placebo group (P < 0.001). No significant adverse effects were reported. Additionally, patient satisfaction was notably higher in the treatment group (P < 0.001).</div></div><div><h3>Conclusion</h3><div>The HLC formulation demonstrated significant efficacy in effectively managing POC, which is often opioid-induced constipation (OIC), in orthopedic patients. These findings suggest that HLC could serve as a promising alternative to conventional laxatives, warranting further investigation in larger-scale clinical trials.</div></div>","PeriodicalId":45099,"journal":{"name":"International Journal of Orthopaedic and Trauma Nursing","volume":"57 ","pages":"Article 101163"},"PeriodicalIF":1.5,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143402829","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-07DOI: 10.1016/j.ijotn.2025.101162
Chun Huang , Jian Song , Lingli Peng , Zirong Tao
Background
Unmet nursing needs during hospital discharge for elderly patients with hip fractures may lead to increased readmission rates and mortality.
Objective
To investigate the discharge transition experience and nursing needs of elderly patients with hip fracture.
Methods
Five electronic databases (PubMed, Web of science, Ovid, CINAHL, Embase) were searched from Jan. 1st, 2014 to Nov. 1st, 2024. Qualitative studies that reported the experiences, perceptions, and needs of elderly patients with hip fractures during the discharge transition were included. Two authors independently screened, and extracted themes. The Joanna Briggs Institute Critical Appraisal Checklist for Qualitative Research was used to evaluate the quality of literature. Themes were generated by the thematic analysis method of data from the original study.
Results
A total of 11 qualitative studies were included. And three themes were identified: (1) challenges of transition and rehabilitation, (2) adaptation and coping, (3) ensuring patient-centered rehabilitation and discharge care.
Conclusion
It is crucial for healthcare staff to address the discharge transition experiences and nursing needs of elderly patients with hip fracture. Additionally, the findings of this review offer valuable insights for healthcare policymakers and administrators to enhance support for patients during the discharge process.
背景：老年髋部骨折患者出院时护理需求不满足可能导致再入院率和死亡率增加。目的探讨老年髋部骨折患者出院过渡经验及护理需求。方法检索2014年1月1日至2024年11月1日的5个电子数据库（PubMed、Web of science、Ovid、CINAHL、Embase）。定性研究报告了老年髋部骨折患者在出院过渡期间的经历、认知和需求。两位作者独立筛选和提取主题。采用乔安娜布里格斯研究所定性研究关键评价清单来评估文献的质量。主题是通过对原始研究数据的主题分析方法生成的。结果共纳入11项定性研究。并确定了三个主题：(1)过渡和康复的挑战；(2)适应和应对；(3)确保以患者为中心的康复和出院护理。结论了解老年髋部骨折患者的出院过渡期经历及护理需求对医护人员至关重要。此外，本综述的研究结果为医疗保健政策制定者和管理者提供了宝贵的见解，以加强对出院过程中的患者的支持。
{"title":"Discharge transition experience and nursing needs of elderly patients with hip fracture: A qualitative systematic review","authors":"Chun Huang , Jian Song , Lingli Peng , Zirong Tao","doi":"10.1016/j.ijotn.2025.101162","DOIUrl":"10.1016/j.ijotn.2025.101162","url":null,"abstract":"<div><h3>Background</h3><div>Unmet nursing needs during hospital discharge for elderly patients with hip fractures may lead to increased readmission rates and mortality.</div></div><div><h3>Objective</h3><div>To investigate the discharge transition experience and nursing needs of elderly patients with hip fracture.</div></div><div><h3>Methods</h3><div>Five electronic databases (PubMed, Web of science, Ovid, CINAHL, Embase) were searched from Jan. 1st, 2014 to Nov. 1st, 2024. Qualitative studies that reported the experiences, perceptions, and needs of elderly patients with hip fractures during the discharge transition were included. Two authors independently screened, and extracted themes. The Joanna Briggs Institute Critical Appraisal Checklist for Qualitative Research was used to evaluate the quality of literature. Themes were generated by the thematic analysis method of data from the original study.</div></div><div><h3>Results</h3><div>A total of 11 qualitative studies were included. And three themes were identified: (1) challenges of transition and rehabilitation, (2) adaptation and coping, (3) ensuring patient-centered rehabilitation and discharge care.</div></div><div><h3>Conclusion</h3><div>It is crucial for healthcare staff to address the discharge transition experiences and nursing needs of elderly patients with hip fracture. Additionally, the findings of this review offer valuable insights for healthcare policymakers and administrators to enhance support for patients during the discharge process.</div></div>","PeriodicalId":45099,"journal":{"name":"International Journal of Orthopaedic and Trauma Nursing","volume":"57 ","pages":"Article 101162"},"PeriodicalIF":1.5,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143387765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-07DOI: 10.1016/j.ijotn.2025.101160
Sonya Clarke, Shareena Bibi Mohd Arif, Carmen Queiros
{"title":"LITERATURE REVIEWS – Skin traction in orthopaedic care: Efficacy, management and clinical practices across the life course","authors":"Sonya Clarke, Shareena Bibi Mohd Arif, Carmen Queiros","doi":"10.1016/j.ijotn.2025.101160","DOIUrl":"10.1016/j.ijotn.2025.101160","url":null,"abstract":"","PeriodicalId":45099,"journal":{"name":"International Journal of Orthopaedic and Trauma Nursing","volume":"57 ","pages":"Article 101160"},"PeriodicalIF":1.5,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143349346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.ijotn.2024.101156
{"title":"Editorial February 2025 issue – Authors Prof Rebecca Jester and Paul McLiesh","authors":"","doi":"10.1016/j.ijotn.2024.101156","DOIUrl":"10.1016/j.ijotn.2024.101156","url":null,"abstract":"","PeriodicalId":45099,"journal":{"name":"International Journal of Orthopaedic and Trauma Nursing","volume":"56 ","pages":"Article 101156"},"PeriodicalIF":1.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142928191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.ijotn.2025.101161
Qinglu Li , Wenting Shi , Nan Wang , Guorong Wang
Background
Arthritis is a common chronic disease among middle-aged and older adults and is strongly related to functional decline.
Methods
The research sample and data were derived from the China Health and Retirement Longitudinal Study (CHARLS) 2015. We employed the least absolute shrinkage and selection operator (LASSO) and multifactor logistic regression analysis to identify features for model construction. We proposed six machine learning (ML) predictive models. The optimal model was selected using various learning metrics and was further interpreted using the SHapley Additive exPlanations (SHAP) method.
Results
A total of 5111 subjects were included in the analysis, of which 1955 developed functional disability. Among the six models, XGBoost showed the best performance, achieving a test set area under the curve (AUC) of 0.74. SHAP analysis ranked the features by their contribution as follows: waist circumference, handgrip strength, self-reported health status, age, body pains, depression, history of falls, sleeping duration, and availability of care resources. SHAP dependence plots indicated that individuals over 60 with increased waist circumference (>85 cm), short sleeping duration (<5 h), and lower handgrip strength (<25 kg) had a higher probability of functional disability.
Conclusion
This study presents an interpretable machine learning-based model for the early detection of functional disability in patients with arthritis and informs the development of care strategies aimed at delaying functional disability in this population.
{"title":"Risk prediction of functional disability among middle-aged and older adults with arthritis: A nationwide cross-sectional study using interpretable machine learning","authors":"Qinglu Li , Wenting Shi , Nan Wang , Guorong Wang","doi":"10.1016/j.ijotn.2025.101161","DOIUrl":"10.1016/j.ijotn.2025.101161","url":null,"abstract":"<div><h3>Background</h3><div>Arthritis is a common chronic disease among middle-aged and older adults and is strongly related to functional decline.</div></div><div><h3>Methods</h3><div>The research sample and data were derived from the China Health and Retirement Longitudinal Study (CHARLS) 2015. We employed the least absolute shrinkage and selection operator (LASSO) and multifactor logistic regression analysis to identify features for model construction. We proposed six machine learning (ML) predictive models. The optimal model was selected using various learning metrics and was further interpreted using the SHapley Additive exPlanations (SHAP) method.</div></div><div><h3>Results</h3><div>A total of 5111 subjects were included in the analysis, of which 1955 developed functional disability. Among the six models, XGBoost showed the best performance, achieving a test set area under the curve (AUC) of 0.74. SHAP analysis ranked the features by their contribution as follows: waist circumference, handgrip strength, self-reported health status, age, body pains, depression, history of falls, sleeping duration, and availability of care resources. SHAP dependence plots indicated that individuals over 60 with increased waist circumference (>85 cm), short sleeping duration (<5 h), and lower handgrip strength (<25 kg) had a higher probability of functional disability.</div></div><div><h3>Conclusion</h3><div>This study presents an interpretable machine learning-based model for the early detection of functional disability in patients with arthritis and informs the development of care strategies aimed at delaying functional disability in this population.</div></div>","PeriodicalId":45099,"journal":{"name":"International Journal of Orthopaedic and Trauma Nursing","volume":"56 ","pages":"Article 101161"},"PeriodicalIF":1.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143312461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.ijotn.2025.101158
Andrea Cosentino , Gianni Odorizzi , Wilhelm Berger
Finger amputations, commonly resulting from trauma, require effective management to restore function, prevent infection, and expedite healing. Surgical interventions, such as replantation and flap reconstruction, are often the standard treatment but can be costly and unnecessary for certain injuries, especially distal amputations. Semi-occlusive bandages (SOBs) offer a cost-efficient, effective alternative for managing distal fingertip amputations. This review introduces the classifications of finger amputations using Tamai and Allen systems, discusses their applicability to SOBs, and highlights benefits such as faster healing, reduced pain, and lower infection risks. Recent studies have validated SOBs’ efficacy, affordability, and high patient satisfaction in various clinical contexts. While evidence supports SOBs as a first-line treatment in appropriate cases, further research is needed to evaluate their cost-effectiveness across diverse healthcare settings.
手指截肢通常由外伤造成，需要有效的治疗来恢复功能、预防感染并加快愈合。外科手术通常是标准的治疗方法，如再植和皮瓣重建，但对于某些损伤，尤其是远端截肢，手术费用昂贵且没有必要。半闭塞性绷带（SOB）为治疗指尖远端截肢提供了一种经济、有效的替代方法。这篇综述介绍了使用 Tamai 和 Allen 系统对手指截肢进行的分类，讨论了它们对 SOB 的适用性，并强调了其优点，如愈合更快、减少疼痛和降低感染风险。最近的研究证实，在各种临床情况下，SOB 具有疗效好、经济实惠和患者满意度高等优点。虽然有证据支持在适当的情况下将 SOB 作为一线治疗方法，但还需要进一步的研究来评估其在不同医疗环境下的成本效益。
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