Browsing by Subject "Fracture"

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    Measurement properties and responsiveness of the EQ-5D-Y-5L compared to the EQ-5D-Y-3L in children and adolescents receiving acute orthopaedic care
    (2022-02-17) Verstraete, Janine; Marthinus, Zara; Dix-Peek, Stewart; Scott, Des
    Objective The aim of this study is a head-to-head comparison of the instrument performance and responsiveness of the EQ-5D-Y-3L and the expanded English version of the EQ-5D-Y-5L in children/adolescents receiving acute orthopaedic management in South Africa. Methods Children/adolescents aged 8–15 years completed the EQ-5D-Y-5L, EQ-5D-Y-3L, self-rated health (SRH) question and PedsQL at baseline. The EQ-5D-Y-5L, EQ-5D-Y-3L and SRH question were repeated after 24 and 48 h. Performance of the EQ-5D-Y-5L and EQ-5D-Y-3L was determined by comparing feasibility (missing responses), redistribution of dimensions responses, discriminatory power, concurrent validity, and responsiveness. Results Eighty-three children/adolescents completed baseline measures and seventy-one at all three time-points. Reporting of 11111 decreased by 20% from the EQ-5D-Y-3L to the EQ-5D-Y-5L. Informativity of dimensions improved on average by 0.267 on the EQ-5D-Y-5L with similar evenness. There was a range of 11–27% inconsistent responses when moving from the EQ-5D-Y-3L to the EQ-5D-Y-5L. There was a low to moderate and significant association on the EQ-5D-Y-3L and EQ-5D-Y-5L to similar items on the PedsQL and SRH scores. Percentage change over time was greater for the EQ-5D-Y-5L (range 0–182%) than EQ-5D-Y-3L (range 0–100%) with the largest reduction for both measures between 0 and 48 h. For those who respondents who showed an improved SRH the EQ-5D-Y-5L and EQ-5D-Y-3L showed significant paired differences. Conclusion The English version of the EQ-5D-Y-5L appears to be a valid and responsive extension of the EQ-5D-Y-3L for children receiving acute orthopaedic management. The expanded levels notably reduce the ceiling effect and has greater discriminatory power. Concurrent validity of the EQ-5D-Y-3L and EQ-5D-Y-5L was low to moderate with similar PedsQL items and SRH. The EQ-5D-Y-5L generally showed greater change than the EQ-5D-Y-3L across all dimensions with the greatest change observed for 0–48 h. Responsiveness was comparable across the EQ-5D-Y-3L and EQ-5D-Y-5L for those with improved SRH. Greater sensitivity to change may be observed on comparison of utility scores, once preference-based value sets are available for the EQ-5D-Y-5L.
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    Surgical Management of Frontal Sinus Fractures
    (2025-05-06) Standford-Moore, Gaelen; Shaye, David
    The frontal sinus is a centrally located structure of functional and aesthetic importance. Fractures of the frontal sinus may occur by either blunt or penetrating trauma. The frontocranial bones have a greater thickness than their neighbouring parietal and temporal bones, as they are often subject to more forceful mechanisms of injury. For this reason frontal sinus injuries account for only 5-15% of maxillofacial injuries, and are predominantly caused by highspeed motor vehicle accidents, assaults or direct contact sports. Settings with road traffic safety laws, seatbelts, airbags, and helmet laws have significantly reduced rates of high-impact injuries. In regions with few traffic safety measures (e.g. helmet laws, seatbelt laws) frontal sinus fractures are frequently seen. Without proper treatment, frontal sinus fractures may lead to a wide array of complications including facial deformity, CSF leak, mucocoele and death. For these reasons, proper diagnosis and treatment of acute frontal sinus injuries remains an important part of treating head and neck trauma.