Music-based interventions (MBIs), such as music therapy, are interventions in which music is used to address the physical, emotional, and social needs of individuals. The origin of music-based therapy can be traced to ancient Egypt and expanded into the United States during the mid-1900s. These interventions have shown efficacy in reducing anxiety and pain in both nonsurgical and surgical settings across various medical specialities, one of which is orthopaedic surgery. Prior studies have investigated the use of MBI in adult and paediatric patients and have shown an improvement in patient well-being following medical care and a reduction in healthcare costs across both patient populations. This standard review covers the current utility of MBI in the field of orthopaedic surgery and explores the current literature on the application and limitations of MBI in both the operative and nonoperative aspects of orthopaedic care.
Background While previous studies have investigated the association between bleeding disorders and outcomes with hip or knee surgeries, no studies have investigated the association between bleeding disorders and outcomes in upper extremity surgery.
Questions/Purposes The purpose of this study was to investigate if a past history of bleeding disorders is associated with which, if any postoperative complications for patients receiving distal radius fracture open reduction internal fixation.
Patients and Methods Patients undergoing operative treatment for distal radius fracture from 2007 to 2018 were identified in the National Surgical Quality Improvement Program database. Patients were stratified into two cohorts: patients with a bleeding disorder and patients without a bleeding disorder. In this analysis, 30-day postoperative complications were assessed, as well as mortality, extended length of stay, reoperation, and readmission. Bivariate and multivariate analyses were performed.
Results Of the 16,489 total patients undergoing operative treatment for distal radius fracture, 16,047 patients (97.3%) did not have a bleeding disorder, whereas 442 (2.7%) had a bleeding disorder. Following adjustment on multivariate analyses, an increased risk of postoperative transfusion requirement (odds ratio [OR] 17.437; p = 0.001), extended length of hospital stay more than 3 days (OR 1.564; p = 0.038), and readmission (OR 2.515; p < 0.001) were seen in patients with a bleeding disorder compared to those without a bleeding disorder.
Conclusion History of bleeding disorders is an independent risk factor for transfusions, extended length of stay, and readmission. We recommend a multidisciplinary team approach to addressing bleeding disorders before patients receive distal radius fracture open reduction internal fixation.
Level of Evidence Level III, retrospective study.
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