Optimizing Patient Function After Musculoskeletal Trauma: An Introduction
Theodore Miclau, MDa, Esther M.M. Van Lieshout, MSc PhDb
a Orthopaedic Trauma Institute, Department of Orthopaedic Surgery, University of California, San Francisco, Zuckerberg San Francisco General Hospital, San Francisco, CA, USA
b Trauma Research Unit Department of Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
Corresponding author:
Theodore Miclau, MD
Orthopaedic Trauma Institute
Department of Orthopaedic Surgery, University of California, San Francisco, Zuckerberg San Francisco General Hospital, San Francisco, CA, USA
Email: theodore.miclau@ucsf.edu
Phone: (628) 206-8812
Abstract:
Trauma is a leading cause of morbidity and mortality worldwide. Post-traumatic conditions frequently result in long-term disabilities and represent significant socioeconomic challenges. Determining and addressing factors that influence function are essential for improving patient outcomes. This supplement seeks to highlight topical issues related to optimizing patient outcomes in order to better understand and improve post-injury care.
Introduction:
Trauma is the leading cause of death globally under the age of 40, exceeded only by
cardiovascular disease and cancer in all age groups (1,2). For every death due to injury, however, three individuals survive with permanent disabilities (3,4). The Global Burden of Disease Study 2013 Collaborators estimated that there were 22 million years lived with disability (YLD) due to fractures worldwide, accounting for over one-fifth of the global YLD burden in 2013, rising disability rates per person, and crucially significant health expenditures (5). Other reports estimate that surgical diseases account for approximately 11% of global disability-adjusted life years (DALYs) (6). Economic losses extend far beyond health care costs, as many individuals are unable to return to work due to physical and mental disabilities (7,8). Increases in injury-related disability are further being driven by an aging population and exacerbated by increased populations’ co-morbid conditions and physical inactivity (9,10).
Identifying and addressing elements that influence patient outcomes are critical to maximize patient recovery. While many factors are non-modifiable patient- and injury-related conditions, others can be significantly influenced by pre-operative, intraoperative, and post-operative
management. To this end, treatment guidelines, pathways, and systems have been developed to standardize care and facilitate post-injury recovery (11-13). Further, methods to more reliably establish physical and psychological outcomes, which are critical for assessing and improving interventions, continue to advance with research and technology.
This supplement provides a review of topical issues related to optimizing patient function following musculoskeletal trauma. The work represents a summary discussion of those areas weighed during a recent international symposium hosted by the Osteosynthesis and Trauma Care Foundation in Toronto, Canada in November, 2019. The information presented in this
supplement will contribute towards greater efforts to understand and improve post-injury care worldwide.
Acknowledgement
The guest editors and all authors of this supplement thank the Osteosynthesis and Trauma Care Foundation (OTCF) for sponsorship of the symposium “Optimizing Patient Care Following Musculoskeletal Trauma” in Toronto, Canada, 2019 and of this supplement in Injury.
References
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