Health literacy in physical trauma patients : Evaluation of the general understanding of patients in an outpatient clinic using the German Short Test of Functional Health Literacy.

BACKGROUND: Health literacy (HL) refers to the ability to understand and process information provided by the healthcare system and depends on various factors, such as language comprehension, education, and social environment. Low HL was recently associated with increased readmission, morbidity, and mortality. Little is known about HL levels in physical trauma patients. The aim of this study was to determine general HL in physical trauma patients in an outpatient setting and to evaluate possible differences based on demographic characteristics. MATERIAL AND METHODS: A total of 100 physical trauma patients were recruited in the outpatient trauma facility of the Medical University of Vienna. All recruited patients completed the German Short Test of Functional Health Literacy (S-TOFHLA). RESULTS: The evaluated HL index ranged between 20 and 36 points (highest achievable score: 36 points), with the mean value calculated at 34.3 (adequate). Out of 100 participants, 97 patients (97%) showed adequate HL and 3 patients (3%) reached a score corresponding to a marginal understanding. No patient showed inadequate HL utilizing the S­TOFHLA tool. No significant differences were found between different demographic categories, including age, education level, native language, and injury location. CONCLUSION: In this study, included outpatient trauma patients demonstrated an overall adequate understanding of healthcare related information. Age, sociodemographic background, and/or educational status did not influence performance, which leads to the question as to whether the German version of the S­TOFHLA is valid to representatively measure HL in these patients. Furthermore, regarding the obvious shortcomings of the S­TOFHLA, the education standard of the respective population should be taken into consideration when choosing an appropriate testing tool.

Complications and Outcomes of Surgically Treated Pediatric Supracondylar Humerus Fractures.

This study describes the outcome of supracondylar humerus fractures in children using crossed K-wires after closed or open reduction with the medial, lateral or bilateral approach. Patients treated between January 2000 and December 2019 were classified according to the Von Laer classification, complications were classified according to the Sink classification and clinical outcomes were classified according to modified Flynn criteria. In total, 364 patients with a mean age of 5.23 ± 2.45 years were included. The majority were type IV fractures (156; 42.9%) and 94 (60.3%) needed an open reduction for which the medial approach (53; 56.4%) was predominantly used. Overall, of 50 complications (31 using closed reduction, 19 open reduction), 17/50 (34%) needed revision surgery. An excellent clinical outcome was achieved in 348/364 (95.6%) patients. The approach used for open reduction as such had no influence on the complication rate or clinical outcome. For severely displaced fractures, the data showed that an open approach for crossed K-wires tended to result in fewer complications and better clinical outcomes than a closed reduction. If an open reduction is indicated, the required approach (medial, lateral or bilateral) should be primarily selected according to the requirements of the fracture pattern and eventual cosmetic considerations.

Radiological Influencing Factors in the Diagnosis of Painful Habitual Instability of the Thumb Basal Joint as a Precursor of Carpometacarpal Arthritis of the Thumb-A Retrospective Study.

BACKGROUND: Painful habitual instability of the thumb basal joint (PHIT) is a rarely diagnosed condition that can severely impair hand function. Furthermore, it can increase the risk of developing carpometacarpal arthritis of the thumb (CMAOT). Clinical examination and radiographic imaging provide the foundation for a correct diagnosis, but early detection is still challenging. We investigated two objective, radiographically obtainable parameters as potential risk factors for PHIT. METHODS: Clinical data and radiographic images of 33 patients suffering from PHIT were collected and compared to those of 35 people serving as the control group. The two main objectives, the slope angle and the bony offset of the thumb joint, were gathered from the X-rays and statistically analyzed. RESULTS: The analysis showed no differences between the study and the control group concerning the slope angle. Gender and the bony offset, on the other hand, had a significant influence. Female sex and higher offset values were associated with an increased risk of PHIT. CONCLUSIONS: The results of this study prove a connection between a high bony offset and PHIT. We believe this information can be valuable in early detection and will allow more efficient treatment of this condition in the future.