Postmobilization Plain Radiography After Lateral Compression Type 1 Pelvic Ring Injury Does Not Affect Treatment.

INTRODUCTION: The purpose of this study was to describe the practice of postmobilization radiography after lateral compression type 1 pelvis ring injury. We hypothesized that postmobilization radiographs would be more frequent over time and would not influence treatment. METHODS: Displacement of pelvis ring injury on initial and final plain radiographs was measured. Frequency of postmobilization radiography was determined, and the impact on treatment and final radiographical outcome were assessed. RESULTS: Of the 156 patients reviewed, 98 (62.8%) were women and mean age was 60.1 years. Thirty-three of 156 patients (21.2%) had a postmobilization radiograph. Over 5 years, radiographs increased to 67% of presenting patients. None of the patients who received postmobilization plain radiographs (n = 33) had any change in clinical plan afterward; all continued with nonsurgical care. Initial fracture characteristics and alignment were no different for patients with postmobilization radiographs. Final alignment was unchanged in nearly 70%. Overall, 74% of all nonsurgical patients experienced no change in alignment, with similar rates among the patients with postmobilization radiographs. DISCUSSION: Patients with an lateral compression type 1 fracture demonstrated no changes in care after receiving postmobilization radiographs. However, the frequency of postmobilization radiographs increased over time, denoting opportunities to reduce costs and to improve efficiency and safety.

Education via a mobile application improves health literacy after orthopaedic trauma.

OBJECTIVES: Health literacy is often poor among trauma patients. We introduced an educational mobile application to newly injured patients. We hypothesized that patients who utilized the app would be more informed about their injury and treatment recommendations, and that app users would demonstrate greater adherence to treatment recommendations. DESIGN: Prospective, cohort study. SETTING: Level 1 trauma centerPatients/participants: Adult patients with acute orthopaedic injury. INTERVENTION: App with educational information about injuries, treatment, and recovery. bit.ly/traumaapp. MAIN OUTCOME MEASUREMENTS: Survey regarding knowledge about injury and treatment, and adherence to recommendations. RESULTS: 339 patients were enrolled: 187 received information about the app; 105 of them used the app. Another 234 patients had no prior knowledge about the app. App users were more often female (56.2% vs. 37.6%, p=0.002). App users were more likely to have completed college (34.3% vs. 13.7%, p<0.0001). Better health literacy was noted among app users in all measurements, including knowledge of: fracture location (69% vs. 39%, p<0.0001), treatment (100% vs. 93%, p=0.002), weightbearing status (96% vs. 88%, p=0.001), estimated healing time (63% vs. 26%, p<0.0001), and DVT prophylaxis (93% vs. 81%, p=0.003). CONCLUSIONS: Patients who used the app were more likely to have accurate knowledge in all assessed categories, with over 99% reporting adherence to weightbearing recommendations. It is probable that this level of knowledge and engagement will enhance various outcomes after injury. LEVEL OF EVIDENCE: Prognostic Level II. See Instructions for Authors for a complete description of levels of evidence.