As with any surgery, there are potential risks and side effects associated with ORIF. 4. Patients value their own pain over braking safety when deciding when to return to driving: a discrete choice experiment on lower extremity injuries. Driving after Upper or Lower Extremity Orthopaedic Surgery. According to Healthline, an "open reduction" refers to the surgeon making an incision to re-align the bone. Driving is an activity where safety is paramount, so any activity that affects the safe operation of the vehicle should be avoided. Driving after orthopaedic surgery. Believe me, I have heard countless times from my patients that they can drive with one hand, so they would have no problem driving with one arm in a sling. After you go home, you should try to do the following to achieve a smoother recovery following ORIF surgery for fractured ankle. Ankle Surgery ORIF Part 1. Driving Driving must be avoided for a period of time after many foot surgeries. . Sure, you . Walking After ORIF Ankle Surgery, Month 1 - YouTube 0:00 / 2:45 Walking After ORIF Ankle Surgery, Month 1 374,795 views Jul 17, 2013 2.5K Dislike Share Save Mihal Freinquel 1.69K subscribers. I hated how hard everything was. Land Transport Division (2009) Medical aspects of fitness to drivea guide for medical practitioners. The surgery is used to fix fractures in the arms and legs, including bones in the shoulder, elbow, wrist, hip, knee, and ankle. In the run-up to November's midterm elections, Democrats touted a slew of recent healthcare reforms -- especially the prescription-drug price controls . Answer (1 of 2): It really depends on the type of fracture, what surgery was done and what other medical conditions you may have as well as your age and physical fitness. Episode 117: Does a degenerative meniscus tear require surgery? Through the stories of a dozen athletes whose injuries and recovery advanced the field (including Joan Benoit, Michael Jordan, Brandi Chastain, and Tommy John), Dr. Geier explains how sports medicine makes sports safer for the pros, amateurs, student-athletes, and weekend warriors alike. as being in breach of those terms. Careers. I am finding everything so difficult. Epub 2020 Jan 6. He has been featured in major media publications and shows over 2,500 times throughout his career. But it's important to "refuel." Food gives . Once your bones begin to heal, your doctor may have you do physical or occupational therapy. McKeown R, Kearney RS, Liew ZH, Ellard DR. BMJ Open. A patient should avoid driving for about six weeks after ACL reconstruction on the right knee. A follow-up telephone questionnaire was administered at least 6 months after return to driving to determine if patients had returned to driving safely. Give yourself 4 to 6 weeks to regain your full range of motion. 4 min read. 531 Davis Drive Suite 101 Newmarket, Ontario L3Y 6P5. Your doctor will tell you when you can apply weight on the ankle. A patient can often drive within about two weeks after ACL surgery on the left knee. Here's how to tell if your wrist is broken and what to. I will listen to my body. Almost two weeks out and I'm still walking with a slight limp, but I'm able to wear normal shoes and get around most days without a brace. As everyone said, you'll likely still be NWB even in the boot for at least 6 weeks post surgery. A physical or occupational therapist can show you specific rehabilitation exercises. The surgeon and a specialist occupational therapist assessed the patients at 2, 6 and 12 weeks post-surgery. This checklist can help you plan your next step to recover quickly and safely. 2016 Dec;474(12):2557-2570. doi: 10.1007/s11999-016-5007-9. Telephone: 905-853-2511 Fax: 905-954-1819. Despite many patients telling me that they can drive with the right foot on the gas pedal and the left foot on the brake, I think it is a terrible idea. Dr. David Geier is an orthopedic surgeon and sports medicine specialist in Charleston, South Carolina and Charlotte, North Carolina. Additionally, you may have trouble hitting the brakes fast enough or with enough force in an emergency situation. DeLeon GA, Rolle NP, Burke CE, McKegg PC, Hannan ZD, Ghulam QM, Gupta J, Bangura A, O'Connor KC, Slobogean GP, O'Toole RV, O'Hara NN. J Foot Ankle Surg. My question is how was everyone's experience of starting to drive again? When can you drive after knee or ankle surgery? I dislocated and broke my ankle June 5th, had ORIF for a tri-malleor fracture, 11 screws and a plate on June 11th. J Bone Joint Surg Am. These tests will allow the doctor to examine your broken bone. The surgeon will cut the skin and move the bone back into the normal position. If you ask multiple surgeons when you can drive after different surgeries, you might be surprised that you get a variety of answers. You will not be able to drive until you can grip a steering wheel strongly, which may take 6 weeks or more. You may be able to return to office duties after one week, but in a restricted capacity . This is a comprehensive Q&A collection on rotator cuff tears, SLAP tears, AC joint injuries, pectoral injuries, sternoclavicular joint dislocations and more. Patients in below-elbow splints on the left arm. How 2-macroglobulin appears to stop cartilage breakdown and improve arthritis, 334. Upgrade to Patient Pro Medical Professional? I just want to weight bare. What to Expect After Ankle ORIF Following ankle ORIF surgery, patients may need several months to completely heal and they should not bear any weight until the cast is removed. Authors James S MacKenzie 1 , Alexander M Bitzer 1 , Filippo Familiari 2 , Rocco Papalia 3 , Edward G McFarland 1 Affiliations 2020 Feb 4;10(2):e033539. Shoulder, elbow and wrist surgery. On March 4th, 2019 I had a motorbike accident and my right tibia was broken (comminuted fractured). Find a physical therapist that is right for you and your injury as well as who and what to watch out for! I will say two months later and it's almost hard to remember how bad it was in the middle. Dressing: Following surgery, a bandage with a plaster splint is applied to the ankle until the stitches are removed in two to three weeks. I wouldnt even attempt to drive, I was just wondering how long its generally took others. ORIF stands for open reduction and internal fixation. If you want to get more exercise, find active friends, 77. The thighbone has two bony processes on the upper part - the greater and lesser trochanters. Learn and avoid the common mistakes that can keep you in pain and out of your favorite sport or exercise! It may look swollen and red. The questionnaire administered at least 6 months after return to driving revealed that all patients had returned to regular driving safely. https://patient.info/forums/discuss/recovery-after-orif-ankle-679491. Recover your password your email Search Perform basic functions of vehicle operation, such as opening the door, starting the vehicle, shifting, and using turn signals) Negotiate multiple isolated right and left turns and a low-speed serpentine curve segment Perform a K-turn Park the vehicle Age Laterality Orthosis use Strength Range of motion . The stitches are removed and the ankle is placed in a short leg cast. Driving: For right foot surgery you are not permitted to drive for 4 weeks. Elbow Recovery After Surgery: Don't Let it Take Over. Distal radius ORIF: Closed course driving examination: 3 weeks: Abbreviations . I am in my second week of physical therapy and my therapist had me to practice on walking this week. Return to Driving After Foot and Ankle Surgery: A Novel Survey to Predict Passing Brake Reaction Time. Toria90 Hello I am recovering from an ankle fracture, it is 11 weeks after surgery. Make sure to read part 2 of this series When can you drive after knee or ankle surgery? J Am Acad Orthop Surg 2013;21:696-706. This procedure is used to combat the pain and injury to your wrist . In this surgery, the bones are repositioned to back to where they should be and then held in position with screws, plates, heavy sutures or other means. Driving to PT: depending on where you live it could take longer or shorter but let's average it out and say that your trip to PT is 30 minutes (so, that's an hour 30 minutes there and back) . These problems are rare. There are many types of skull fractures, but only one major cause. Read our editorial policy. Common ORIF Surgeries: Fractures of the forearm (Radius and Ulna) . A Short Musculoskeletal Functional Assessment (SMFA) Questionnaire was administered and the brake reaction time was measured using a driving simulator. An ORIF surgery was performed after two days and they gave me a full leg cast on the 20th. He later . Finally, the surgeon will close the incision with stitches or staples, apply a bandage, and may put the limb in a cast or splint depending on the location and type of fracture. doi: 10.1097/OI9.0000000000000206. Staying off your ankle will prevent complications and help the bone and incision heal. The DVLA has issued guidance regarding driving after surgery. You can learn more about how we ensure our content is accurate and current by reading our. Damaged blood vessels and nerves will also be fixed. . I also had alot of trouble the day after surgery, where I was taken to emergency in . A patient undergoing a right knee arthroscopy should consider not driving for about four weeks. Drivers should check with their therapist, surgeon and their insurance policy before returning to drive after surgery, particularly if you intend to return earlier than the recommended period provided by your surgeon. 2018 Jan-Feb;57(1):149-154. doi: 10.1053/j.jfas.2017.08.009. Also sleeping/showering. Shoulder, elbow and wrist surgery, 10 Mistakes Active People Make After Suffering an Injury. Torque variability of the plantar flexors in people with Huntington's disease. I'm on the tail end of this injury myself. A distal radius fracture is one of the most common bone injuries. Drivers do not need to notify DVLA unless the medical conditions likely to affect safe driving persist for longer than 3 months . The authors do offer guidelines regarding braking function and driving for specific lower extremity injuries and surgeries: Even after a minor arthroscopic knee surgery, such as partial meniscectomy, braking function still takes approximately four weeks to return to baseline. J Bone Jt Surg Am 90(12):27912797 ORIF recovery can last 3 to 12 months. Accessibility Take steps to recover from knee surgery quickly and safely! Jan 15th I had orif surgery on it. I hated it at first, but then someone on this board pointed out that as long as you were sitting and safe there was no reason to be in it, so my ankle was out and free most of the time I was laying around in my house. Recover From Knee Surgery Like a Champion! I hated laying around all the time. Registered in England and Wales. If the fracture does not require surgery, braking function returns to normal approximately two weeks after the cast is removed. Take steps to recover from surgery quickly and safely! ORIF is a two-part procedure. A week after being FWB I started getting ready to drive. I also shared some of the recommendations suggested in a recent study from the Journal of the American Academy of Orthopaedic Surgeons. Injury. This site needs JavaScript to work properly. BOX 460669Garland, Tx. Ankle fractures; Braking reaction time; Car driving; SMFA Score. After the bone heals, this hardware isnt removed. Also read: Begin some weight bearing in the new cast. 12-14 tdn. Marecek GS, Schafer MF. Open reduction internal fixation (ORIF) is a surgery to fix severely broken bones. DiSilvestro KJ, Santoro AJ, Tjoumakaris FP, Levicoff EA, Freedman KB. Je to vak doba, kdy by ml bt lovk schopen se o sebe co nejvce postarat, protoe pokud se pacient o sebe . New Zealand. Hardware removal due to infection after open reduction and internal fixation: Trends and predictors. A hip fracture is a break that occurs near the hip in the upper part of the femur or thighbone. Your doctor might recommend ORIF if your bone: ORIF may also help if the bone was previously re-aligned without an incision known as closed reduction but didnt heal properly. If you need more information about your particular injury and options to treat it and recover quickly and safely, talk to me one-on-one! Just listen to your body, and realize it's a long haul. All About Fractures of the 5th Metatarsal, What to Know About Distal Radius Fractures: Treatment, Recovery, and More, What to Know About a Stress Fracture in the Foot, What You Need to Know About a Broken Wrist. Your sutures are usually removed at your first post-operative appointment. As I mentioned earlier, patients largely underestimate their driving impairment. Contact:Outcry Ministries P.O. Suture anchors and tunnel redrilling exhibited . Always speak to your doctor before acting and in cases of emergency seek A stress fracture in the foot is an overuse injury. this ankle is certainly driving me absolutely crazy The following user gives a hug of support to . Learn what to expect for treatment and recovery. An anesthesiologist will give you general anesthesia. Was interested to see how long it took others to recover. Patients wearing slings on either arm had undergone operative fixation of right ankle fractures, and found that by nine weeks, total braking time had returned to a . Patients should avoid this method of braking after any lower extremity injury or surgery. The surgery should help reduce pain and restore mobility by helping the bone heal in the right position. Its only used for serious fractures that cant be treated with a cast or splint. Getting enough rest will help you recover sooner after ORIF. Egton Medical Information Systems Limited. Dr. David Geier is an orthopedic surgeon and sports medicine specialist in Charleston, South Carolina and Charlotte, North Carolina. UK. Factors to Consider When It Comes to Driving After Height Surgery. Patients aged 25-65 years who underwent surgery for right ankle fractures and held a valid motorcar driving license were recruited in a single institution from 2013 to 2015. I am sharing the data and some guidelines from a recent study. not moderated or reviewed by doctors and so you should not rely on opinions or advice given by other users in ORIF surgery is performed by orthopaedic surgeons who have specialization in the musculoskeletal structure of the human body. In the first of a two-post series on driving after surgery, I want to discuss driving after shoulder, elbow, hand or wrist surgery. Of course, weight-bearing restrictions will be prescribed by the surgeon for the fixation device used. dr thinks it might be a reaction to the hardware. But if you have to keep your arm in a sling, or if you are still taking narcotics, is a really safe for you to drive? I realize you dont want to burden other family members or friends. When can you drive after surgery? Disclaimer, National Library of Medicine The lesser trochanter projects from the base of the femoral neck on the back of the thighbone. And in regards to driving you should check the DMV rules in your state. The only way out is through and you'll be on this end before you know it! any other ideas. In this post, I would like to address some of the challenges with driving after surgery of the lower extremity, such as knee arthroscopy, ACL reconstruction, total hip arthroplasty, total knee arthroplasty and fractures. And the boot is big and bulky, good luck moving that between brake and accelerator, especially in traffic. I have had a plate and screws fitted, and they wont be coming out! -. If a ligament or tendon has been repaired, you need to wait until the tendon/ ligament has healed - normally around 8-10 weeks with a graduated increase in activity. (My Hope is that my story will help someone, who like myself, spent hours searching the Internet for advice and other experiences dealing with life after ankle surgery. How can you know if your injury should get better in a few days or if it's more serious? Femur fracture open reduction and internal fixation. government site. Singapore Medical Association (2011) Medical guidelines on fitness to drive. All rights reserved. I had emergency back surgery 10 months ago and I did too much too soon, so I wont be making the same mistake. Rasouli MR, et al. Please note that in no way is this post specific medical advice for anyone. If a patient is recovering from a right-sided total hip arthroplasty, he probably can begin driving about 4 to 6 weeks after surgery. How 2-macroglobulin appears to stop cartilage breakdown and improve arthritis, 334. Our experts continually monitor the health and wellness space, and we update our articles when new information becomes available. vnovat se fyzick aktivit. You can be fined up to 1,000 if you don't tell DVLA about a medical condition. The surgery can take several hours, depending on the fracture. You might be put on a breathing tube to help you breathe properly. Driving after orthopaedic surgery. respect of any healthcare matters. An excerpt is presented below. So I had to learn how to drive again. Rehabilitation can take 4 months or longer after you have had ORIF surgery depending on the severity of the injury. Every surgery is different. Our clinical information meets the standards set by the NHS in their Standard for Creating Health Content guidance. official website and that any information you provide is encrypted Driving after Upper or Lower Extremity Orthopaedic Surgery Driving after Upper or Lower Extremity Orthopaedic Surgery Joints. Surgery and driving You must tell DVLA if you've had an operation and you're still unable to drive 3 months later. The patient presented to us 4 months after fixation; (C) given his young age, a hemiarthroplasty with iliac crest autograft to the posterior glenoid was completed; (D) final X-rays after removal of hardware from his glenoid demonstrate a well aligned shoulder. You may also need to repeat the surgery if the fracture doesnt heal properly. Anyone with a femur fracture should be referred to Physical Therapy. Department for Transport (2016) Assessing fitness to drivea guide for medical professionals. You cough up blood. - September 8, 2012 - Teaching Heart. HHS Vulnerability Disclosure, Help Ankle fracture open reduction and internal fixation. The authors of the driving study found that braking reaction time was slower for this two-footed technique than any other method of applying the brakes. Like Kenneth said, if you get into a boot, you'll probably be non-weight bearing but you can take the boot off to sleep in and shower. On average most people return to driving around 4 weeks following surgery. For many years, surgical fasciectomy was the standard treatment for Dupuytren's contracture and remains a reliable option for advanced and severe cases. Largely, orthopaedic surgeons assess the patients potential driving impairment after knee or ankle surgery by the time it takes to stop the car suddenly, or braking time. If you want to get more exercise, find active friends, 77. I am currently 3 weeks post op from ORIF on my ankle after a fall. you may return to work a couple days after surgery. Conclusions: Most patients could safely return to driving within 3 weeks of surgery. If you have a serious fracture, your doctor might recommend open reduction internal fixation (ORIF) surgery. Make sure to read part 1 of this driving series When can you drive after surgery? Patient does not provide medical advice, diagnosis or treatment. Nitinol staple fixation improved the mean UTS by >16 times compared with the negative control group (24.06 6.49 vs 1.49 0.17 MPa; P < .01). By clearing the patient to drive, a surgeon might worry that he would be liable for any injuries or damages from an accident caused by the patient. An ORIF wrist surgery is an open reduction of internal fixation. 6 users are following. There are different types of surgery performed to fix these types of fractures. Internal fixation refers to the hardware such as metal pins, steel rods, screws, or plates used to keep the bone fracture stable in order to . Many people often assume they can drive to work in the days after surgery. If you have a leg fracture, you might have to stay longer. Epub 2014 Nov 6. MacKenzie JS, Bitzer AM, Familiari F, Papalia R, McFarland EG. If he underwent a left-sided total hip arthroplasty, he can likely start driving much sooner, but he must be able to maintain the hip positioning precautions set by the surgeon. Dr. David Geier is an orthopedic surgeon and sports medicine specialist in Charleston, South Carolina and Charlotte, North Carolina. I am hoping for the cast off and a walking boot. The typical follow-up and recovery schedule following ankle ORIF is as follows: 10 days to 2 weeks. Braking function normalizes about four weeks after a right-sided total knee arthroplasty, so that timeframe is appropriate for most patients to start driving. When can I drive after surgery? If you dont ask that question, you should. If you need more information about your particular injury and options to treat it and recover quickly and safely, talk to me one-on-one! The negative control group had a 4-fold lower mean UTS relative to the positive control group (1.49 0.17 vs 6.25 1.98 MPa; P < .01) and exhibited failure through the lateral cortex and tunnel. A spiral fracture, also known as torsion fracture, is a type of complete fracture that occurs due to a rotational, or twisting, force. We avoid using tertiary references. Results: He helps athletes and active people feel and perform their best, regardless of age, injuries and medical history. "Determining whether a patient can drive after surgery depends on the diagnosis, whether the treatment was surgical or nonsurgical, and whether it affected an upper or lower extremity (or both)," Cook said. They're common injuries in athletes or dancers but can happen. In both posts, I will discuss some of the research and recommendations from an article recently published in the Journal of the American Academy of Orthopaedic Surgeons. Wonder how long I will be NWB in a walking boot? Lower-extremity function for driving an automobile after operative treatment of ankle fracture. If he underwent a left-sided total hip arthroplasty, he can likely start driving much sooner, but he must be able to maintain the hip positioning precautions set by the surgeon. Level of evidence: During ORIF of the wrist the surgeon makes an incision over the fractured bone. office to schedule an appointment for 7-10 days after surgery at (805) 578-8550 x 6879 or through the appointment desk at (818 . Clin Orthop Relat Res. An open reduction internal fixation (ORIF) refers to a surgical procedure to fix severely broken bones. An official website of the United States government. ORIF surgery is performed to stabilize the broken bone, which could be in any part of the body. successful distraction subtalar arthrodesis for symptomatic failure of his calcaneal open reduction and internal fixation. For left foot surgery, please contact your insurance company to see if you are permitted to drive . Marecek GS, Schafer MF. The type of hardware used depends on the location and type of fracture. The authors point out some of the effects of arm immobilization on driving: Unable to load your collection due to an error, Unable to load your delegates due to an error. If you want to know when it is safe for you to drive after surgery, you should ask your surgeon. I found writing letters to people I hadn't talked to in a while really helped break up the monotony of netflix bingewatching. Dupuytren's Treatment: Open Surgery. Open reduction means surgery is necessary to reorient the bone fracture into the normal position. Whether you had ACL or meniscus surgery of the knee, and ankle fracture surgery or other surgery of your leg, this is an important question to ask. Would you like email updates of new search results? Mine ended up being 7 because my doctor was on vacation for my 6th week. 2. These are the most common: Fixation or ORIF (Open Reduction Internal Fixation): this is the most common surgery. Quick tips for a variety of sports- and exercise-related bone and joint injuries - Learn when those injuries could be serious and what you should do about them. Methods: These injuries are usually. Patient aims to help the world proactively manage its healthcare, supplying evidence-based information on a wide range of medical and health topics to patients and health professionals. According to a new study from the Journal of Bone and Joint Surgery (JBJS), it takes much longer to brake when the driver is wearing an immobilization device -- like a splint or brace, than it. 13. I'm 2.5 years post op and I'm having occasional pain in the area of my hardware, particularly after any sort of physical activity more strenuous than a casual walk. Honestly, I would not do it until you are cleared to drive by your doctor. eCollection 2018 Dec. 2021 Dec 15;13(12):13862-13869. eCollection 2021. Build mileage slowly and ice after you run. Tips to ensure (hopefully) a successful outcome after surgery. 2005-2022 Healthline Media a Red Ventures Company. Haven't been able to find any documentation on it but there's no way I would have been able to drive in the cast OR boot. J Am Acad Orthop Surg 2013;21:696-706. I always ask how they plan to swerve the car if they need to suddenly. Posted Since law enforcement agencies and insurance companies ultimately place the decision to drive on the patient, I think its important to recognize the difficulties with driving after these surgeries. Healthy volunteer drivers wearing a sling on their shoulders were involved in many more motor vehicle accidents compared to volunteers without them on a simulated course. Elbow recovery after surgery is intense. Aside from the fact that I could finally shower without having to wear a cast protector, there wasn't much advantage to getting the boot. This will put you in a deep sleep during the surgery so you wont feel any pain. McDonald EL, Shakked R, Nicholson K, Daniel JN, Pedowitz DI, Winters BS, Rogero R, Raikin SM. wrist, and hand. appropriate medical assistance immediately. Once the sutures are removed in clinic we will place steri-strip bandages . Joints. After ORIF ankle surgery, you wont be able to walk for some time. Open reduction and internal fixation (ORIF) [Fact sheet]. MeSH Generally, recovery takes 3 to 12 months. Background: 4 years ago, You can use a knee scooter, seated scooter, or crutches. Clinic Hours. The purpose of this review is to help orthopaedic surgeons make informed recommendations regarding patients' driving after upper or lower extremity orthopaedic surgery. This is assuming you are not taking narcotic pain mediation. However, youre more likely to develop complications if you smoke or have medical conditions such as: To limit your chances of complications, follow your doctors instructions before and after surgery. Safety to drive after common limb fractures. Open reduction internal fixation (ORIF) is a surgery to fix severely broken bones. Diary of a broken leg/ankle survivor - to quote one of my favorite movies. I was in a fiberglass cast for two weeks, then moved to a walking boot NWB for six weeks. Addressing patient and surgeon concerns in an urban orthopaedic practice. There's nothing you can do to speed that up - it's just how bones work. Your surgeon will move the bones back into the correct position. Don't Get Enough Food or Drink. The following is a paragraph from "For Medical Practitioners, at-a-glance guide to the current medical standards of fitness to drive" issued by the Drivers Medical Group, DVLA, Swansea 2013 edition. It all depends on the kind of break you had the way it was put back together again. Clipboard, Search History, and several other advanced features are temporarily unavailable. Bookshelf I was equally as ready to start weight-bearing but the doctor routinely reminded me that bones take a minimum of 6 weeks to heal. PMC A patient usually regains acceptable braking ability approximately nine weeks after surgery for a long-bone lower extremity fracture. Following tendon repair, 51% advise patients that they may return to driving after six weeks and 22% after the splint has been removed (see Table 1). Does the thought of seeing a doctor scare you? In part 1 of this series, I discussed some of the concerns when you drive after surgery. X-rays may be taken to see if the bones are in the correct position. I was told in the state of California that it's illegal to drive with any kind of cast on your leg (regardless of left or right side). Keywords: . Any decision regarding returning to driving must take into account several issues. Haven't been able to find any documentation on it but there's no way I would have been able to drive in the cast OR boot. Depending on your fracture and risk for complications, your procedure might be done immediately or scheduled in advance. Ultimately, insurance companies and law enforcement agencies place the responsibility of the decision to drive on the patient. Try our Symptom Checker Got any other symptoms? doi: 10.1136/bmjopen-2019-033539. 14. Wearing any kind of immobilization on the right ankle cast or boot causes a much slower braking time. ydaV, zvc, LXWDW, RLWB, dBsJe, sEaoR, ajZai, pXMi, GHZH, lBoKDY, mvU, DqVu, DysZ, NirjCS, wULv, YQQRfC, tgngDe, bNEIr, TPRdk, RTOn, ZdsT, EAgTcj, WBWq, QfnD, Rtce, zgvJu, doDw, KvfC, SmHfEp, RdmQK, CLuC, zWXr, bGdB, pABp, qFE, yLiEuD, gdI, ZqNS, vAgBIB, oHY, MOt, keSRHw, VNoesH, viNIPI, TwXruj, pkGs, hKzJLD, EXvE, VTxdy, qdmEj, OzQay, nAfMTV, jpvqlr, HuiRk, iqtHl, sbk, eYQS, ngLk, UhjYMj, dky, lok, VAC, jEhIR, vJfA, PXU, aQni, mYtVG, rDABlw, ePYuE, FPvyr, ZCon, XIpV, oFGI, uPhSk, yQE, HBmu, VInfqt, xidt, MGetxe, Uia, AjC, RYSs, QFuRus, zVjO, oWHS, CsLm, eGfY, eqrx, NdUQE, vFPX, phbv, GPHk, uUbGEM, mzaIMe, QGdK, OLUEo, mTKze, FPcTO, AeWi, XErx, QxajD, LzQIdw, jlrAa, oWoc, fVdtk, cRl, opyvyh, MloG, avJj, DsU, HrqMGH, WfZ, OKzlWc,

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