CURRENT CONCEPTS IN ADULTS UPPER EXTREMITY FRACTURES

21452Ugur_TiftikciCurrent_Consept_in_adults.kapak

THE IMPORTANCE OF MULTIDISCIPLINARY APPROACH IN FRACTURE TREATMENT AND REHABILITATION

Hilal Yağar

Niğde Ömer Halisdemir University, Faculty of Medicine, Department of Orthopedics and Traumatology, Niğde, Türkiye

Yağar H. The Importance of Multidisciplinary Approach in Fracture Treatment and Rehabilitation. In: Tiftikçi U, Erdoğan E, Ergün C, Güneş Z, editors. Current Concepts in Adults Upper Extremity Fractures. 1st ed. Ankara: Türkiye Klinikleri; 2025. p.371-377.

ABSTRACT

Upper extremity fractures constitute 38.7% of all fractures and constitute a significant economic and social burden. A multidisciplinary approach to the treatment of these fractures is crucial for optimum results. With multidisciplinary cooperation in fractures, it is possible to accelerate both the physical and psychosocial recovery process. Orthopedic surgeons play a central role in the diagnosis, treatment and long-term follow-up of upper extremity fractures. The hand surgeons is not only important for ensuring functional recovery, but also for advancing the application of modern surgical techniques in the treatment of complex upper extremity fractures. Anesthesiologists play an important role in the safe surgical process and in the patient’s pain management during the perioperative period. Nurses play a role in many important issues such as wound care, infection prevention and patient education during the perioperative period. Physiatrists and physiotherapists plan the rehabilitation process and ensure that joint functions are regained and muscle strength is increased. Psychiatrists support the recovery process by addressing problems related to psychosocial issues. The multidisciplinary approach significantly improves patient outcomes and treatment quality by ensuring both physical and psychosocial recovery through the collaboration of different disciplines.

Keywords: Patient care team; Nursing care; Pain management; Psychiatric rehabilitation; Orthopedic surgeons

Referanslar

  1. Wenzinger E, Rivera-Barrios A, Gonzalez G, Herrera F. Trends in upper extremity injuries presenting to US emergency departments. Hand. 2019;14(3):408-12. [Crossref]  [PubMed]  [PMC]
  2. Wu AM, Bisignano C, James SL, Abady GG, Abedi A, Abu-Gharbieh E, et al. Global, regional, and national burden of bone fractures in 204 countries and territories, 1990-2019: a systematic analysis from the Global Burden of Disease Study 2019. The Lancet Healthy Longevity. 2021;2(9):e580-92. [Crossref]  [PubMed]
  3. Zdero R, Brzozowski P, Schemitsch EH. Biomechanical Design Optimization of Distal Humerus Fracture Plates: A Review. BioMed Research International. 2024;2024(1):6015794. [Crossref]  [PubMed]  [PMC]
  4. Hoveidaei AH, Nakhostin-Ansari A, Namdari S, Hosseini-Asl SH, Khonji MS, Selk-Ghaffari M, et al. Increasing burden of upper-extremity fractures in the Middle East and North Africa (MENA): a 30-year analysis of the epidemiology and causes of injuries. JBJS. 2024;106(4):323-36. [Crossref]  [PubMed]
  5. Bousfield K, Cheon JY, Harley S, Lampiris-Tremba A, Loseby J, Bianchi N, et al. What are the predictors of return to work for people with elbow, wrist, and hand conditions? A systematic review. Journal of Occupational Rehabilitation. 2022:1-34.
  6. Tong HC, Haig AJ, Theisen ME, Smith C, Miller Q. Multidisciplinary team evaluation of upper extremity injuries in a single visit: the UPPER Program. Occupational Medicine. 2001;51(4):278-86. [Crossref]  [PubMed]
  7. Rijsdijk M, Tuffaha S, Coert JH. Multidisciplinary strategies to treat painful mononeuropathies in the upper extremity: from lab to bedside. Journal of Hand Surgery (European Volume). 2024;49(6):792-801. [Crossref]  [PubMed]  [PMC]
  8. Neuhaus V, Bot AG, Guitton TG, Ring DC. Influence of surgeon, patient and radiographic factors on distal radius fracture treatment. Journal of Hand Surgery (European Volume). 2015;40(8):796-804. [Crossref]  [PubMed]
  9. Ranade SC, Allen AK, Deutsch SA. The role of the orthopaedic surgeon in the identification and management of nonaccidental trauma. JAAOS-Journal of the American Academy of Orthopaedic Surgeons. 2020;28(2):53-65. [Crossref]  [PubMed]
  10. Wolf JM, Athwal GS, Shin AY, Dennison DG. Acute trauma to the upper extremity: what to do and when to do it. JBJS. 2009;91(5):1240-52.
  11. Tong HC, Haig AJ, Theisen ME, Smith C, Miller Q. Multidisciplinary team evaluation of upper extremity injuries in a single visit: the UPPER Program. Occupational Medicine. 2001;51(4):278-86. [Crossref]  [PubMed]
  12. Gebregiorgis D, Nega B, Seyoum N. A perspective of extremity vascular trauma epidemiology and its management in a resource limited set up. Clinical Surgery Research Communications. 2021;5(3):27-34. [Crossref]
  13. Kuşcu B, Gurbuz K, Dogar F. Reconstruction techniques for upper extremity crush injuries with massive tissue loss and open fractures: a prospective study. European Review for Medical & Pharmacological Sciences. 2024;28(12).
  14. Dasari CR, Sandhu M, Wisner DH, Wong MS. Approaches to distal upper-extremity trauma: a comparison of plastic, orthopedic, and hand surgeons in academic practice. Annals of Yağar The Importance of Multidisciplinary Approach in Fracture Treatment and Rehabilitation Plastic Surgery. 2016;76:S162-4. [Crossref]  [PubMed]
  15. Smeraglia F, Del Buono A, Maffulli N. Wrist arthroscopy in the management of articular distal radius fractures. British medical bulletin. 2016;119(1). [Crossref]  [PubMed]
  16. Labrum IV JT, Ilyas AM. Perioperative pain control in upper extremity surgery: prescribing patterns, recent developments, and opioid-sparing treatment strategies. Hand. 2019;(4):439-44. [Crossref]  [PubMed]  [PMC]
  17. Kehlet H. Postoperative pain relief--what is the issue? Br J Anaesth. 1994;72(4):375-8. [Crossref]  [PubMed]
  18. Roh YH, Park SG, Lee SH. Regional versus General Anesthesia in Postoperative Pain Management after Distal Radius Fracture Surgery: Meta-Analysis of Randomized Controlled Trials. Journal of Personalized Medicine. 2023;13(11):1543. [Crossref]  [PubMed]  [PMC]
  19. Lee R, Lee D, Ramamurti P, Fassihi S, Heyer JH, Stadecker M, Webber M, Hughes A, et al. Complications following regional anesthesia versus general anesthesia for the treatment of distal radius fractures. European Journal of Trauma and Emergency Surgery. 2022;48(6):4569-76. [Crossref]  [PubMed]  [PMC]
  20. Sunderland S, Yarnold CH, Head SJ, Osborn JA, Purssell A, Peel JK, et al. Regional versus general anesthesia and the incidence of unplanned health care resource utilization for postoperative pain after wrist fracture surgery: results from a retrospective quality improvement project. Regional Anesthesia & Pain Medicine. 2016;41(1):22-7. [Crossref]  [PubMed]
  21. Hodgson SA, Mawson SJ, Stanley D. Rehabilitation after two-part fractures of the neck of the humerus. The Journal of Bone & Joint Surgery British Volume. 2003;85(3):419-22. [Crossref]  [PubMed]
  22. Helmerhorst GT, Zwiers R, Ring D, Kloen P. Pain relief after operative treatment of an extremity fracture: a noninferiority randomized controlled trial. JBJS. 2017;99(22):1908-15. [Crossref]  [PubMed]
  23. Bell KL, Shohat N, Goswami K, Tan TL, Kalbian I, Parvizi J. Preoperative opioids increase the risk of periprosthetic joint infection after total joint arthroplasty. The Journal of Arthroplasty. 2018;33(10):3246-51. [Crossref]  [PubMed]
  24. Wheeler M, Oderda GM, Ashburn MA, Lipman AG. Adverse events associated with postoperative opioid analgesia: a systematic review. The journal of pain. 2002;3(3):159-80. [Crossref]  [PubMed]
  25. Kandarian BS, Elkassabany NM, Tamboli M, Mariano ER. Updates on multimodal analgesia and regional anesthesia for total knee arthroplasty patients. Best Practice & Research Clinical Anaesthesiology. 2019;33(1):111-23. [Crossref]  [PubMed]
  26. Lee SK, Lee JW, Choy WS. Is multimodal analgesia as effective as postoperative patient-controlled analgesia following upper extremity surgery?. Orthopaedics & Traumatology: Surgery & Research. 2013;99(8):895-901. [Crossref]  [PubMed]
  27. Zhu Y, Yang B, Wang Y. Effects of comfort nursing combined with rehabilitation training on joint function, pain level and quality of life in patients with lower extremity fractures. Archives of Clinical Psychiatry. 2023;50(6).
  28. Brent L, Hommel A, Maher AB, Hertz K, Meehan AJ, Santy-Tomlinson J. Nursing care of fragility fracture patients. Injury. 2018;49(8):1409-12. [Crossref]  [PubMed]
  29. Boga SM. Nursing practices in the prevention of post-operative wound infection in accordance with evidence-based approach. International Journal of Caring Sciences. 2019;12(2):1228.
  30. Pang Z, Shan M, Li Y, Zhang H, Huang A, Liu Y,et al. The efficacy of rehabilitation nursing interventions on patients with open lower limb fractures. Journal of Healthcare Engineering. 2022;2022(1):1859747. [Crossref]  [PubMed]  [PMC]
  31. Lv H, Yang N. Clinical effect of application of nursing concept of rehabilitation surgery for improvement of quality of postoperative recovery in orthopedics. Journal of Orthopaedic Surgery and Research. 2021;16:1-7. [Crossref]  [PubMed]  [PMC]
  32. Bruder A, Taylor NF, Dodd KJ, Shields N. Exercise reduces impairment and improves activity in people after some upper limb fractures: a systematic review. Journal of physiotherapy. 2011;57(2):71-82. [Crossref]  [PubMed]
  33. Dawson PU. A new discipline in medicine, physiatry: physical medicine and rehabilitation. West Indian Medical Journal. 2009;58(6):497.
  34. Wakefield AE, McQueen MM. The role of physiotherapy and clinical predictors of outcome after fracture of the distal radius. The Journal of Bone & Joint Surgery British Volume. 2000;82(7):972-6. [Crossref]
  35. Adıyeke L, Aydoğmuş S, Sabuncuoğlu M, Bilgin E, Duymuş TM. Effects of psychological factors on the clinical outcomes of fifth metacarpal neck fractures and their relation to injury etiology. Turkish Journal of Trauma & Emergency Surgery/Ulusal Travma ve Acil Cerrahi Dergisi. 2019;25(4). [Crossref]  [PubMed]
  36. Duramaz A, Koluman A, Duramaz A, Kural C. The relationship between impulsivity and anxiety and recurrent metacarpal fractures due to punch injury. International Orthopaedics. 2021;45:1315-28. [Crossref]  [PubMed]
  37. McQuillan TJ, Franco JR, Sorg EM, Baller E, Quijije N, Rozental TD. Understanding and addressing psychiatric comorbidities and upper-extremity trauma: surgeons in a multidisciplinary care model. The Journal of Hand Surgery. 2021;46(4):328-34. [Crossref]  [PubMed]
  38. Yeoh JC, Pike JM, Slobogean GP, O'Brien PJ, Broekhuyse HM, Lefaivre KA. Role of depression in outcomes of low-energy distal radius fractures in patients older than 55 years. Journal of Orthopaedic Trauma. 2016;30(5):228-33. [Crossref]  [PubMed]
  39. Buller LT, Best MJ, Alam M, Sabeh K, Lawrie C, Quinnan SM. The influence of psychiatric comorbidity on inpatient outcomes following distal humerus fractures. Advances in Orthopedic Surgery. 2016;2016(1):4913808. [Crossref]