Frontiers in Surgery最新文献

{"title":"Impact of anatomical factors on surgical planning and outcomes in high-risk patients undergoing prophylactic mastectomy.","authors":"Tomas Maciulaitis, Daiva Gudavicienė, Nerijus Jakutis","doi":"10.3389/fsurg.2025.1651775","DOIUrl":"10.3389/fsurg.2025.1651775","url":null,"abstract":"<p><strong>Background: </strong>Nipple-sparing mastectomy (NSM) with immediate implant-based reconstruction is widely accepted and effective prophylactic surgical approach for women with high-risk of hereditary BC. However, anatomical factors-advanced breast ptosis and increased sternal notch-to-nipple (SN-N) distance-can increase technical difficulty and complication risk. Preshaping procedures may optimize anatomy and broaden NSM eligibility. This study evaluates the role of preshaping in facilitating safe NSM with implant-based reconstruction.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of 84 patients who underwent prophylactic mastectomy at Vilnius University Hospital Santaros Klinikos between 2018 and 2024. All had confirmed pathogenic mutations associated with hereditary BC risk. At the time of analysis, 76 patients had completed mastectomy, while 8 had undergone only the preshaping procedure. Patients were divided into two cohorts: single-stage NSM with direct-to-implant reconstruction, and a two-stage approach involving initial preshaping surgery followed by delayed NSM. Anatomical features, surgical timing, complications were analyzed.</p><p><strong>Results: </strong>Among 76 patients, 63.2% underwent single-stage and 36.8% two-stage reconstruction. Two-stage patients had significantly greater SN-N distances (26.4 ± 3.1 cm vs. 21.6 ± 3.2 cm, <i>p</i> < 0.001). The overall complication rate was 7.9%, higher in the single-stage group (10.4%) than the two-stage group (3.6%). In the single-stage cohort, complications correlated with higher ptosis grades (<i>p</i> = 0.0021). Ductal carcinoma <i>in situ</i> was found in one patient from each group.</p><p><strong>Conclusions: </strong>Preshaping surgery effectively optimizes anatomy for NSM, reducing complications in patients with ptosis or extended SN-N distances. The two-stage approach offers safe and favorable outcomes in anatomically challenging cases.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"12 ","pages":"1651775"},"PeriodicalIF":1.6,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12504362/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145257891","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of factors on treatment outcomes in cervical degenerative disc disease: a logistic regression analysis of anterior decompression and interbody fusion with BAK/C technique.","authors":"Liang Hao, Aobo Zhang, Fengming Zhao, Honglei Liu, Xiaoli Sun","doi":"10.3389/fsurg.2025.1637376","DOIUrl":"10.3389/fsurg.2025.1637376","url":null,"abstract":"<p><strong>Objectives: </strong>To identify predictive prognostic factors through logistic regression analysis in patients with cervical degenerative disc disease (CDDD) undergoing anterior cervical discectomy and fusion (ACDF) combined with the Bagby and Kuslich (BAK/C) interbody fusion technique.</p><p><strong>Methods: </strong>This retrospective study included 80 patients treated with ACDF and BAK/C between January and December 2020, with a 3-year follow-up. Patients were stratified into a control group (favorable recovery, <i>n</i> = 52) and an observation group (poor recovery, <i>n</i> = 28) based on pain relief and neurological improvement. Radiological fusion rates and Japanese Orthopaedic Association (JOA) scores were evaluated. Multivariate logistic regression was performed to assess independent predictors of outcomes.</p><p><strong>Results: </strong>The control group exhibited significant JOA score improvement at the final follow-up (14.49 ± 0.25 vs. preoperative 10.74 ± 1.16, <i>P</i> < 0.001), while the observation group showed limited recovery (12.19 ± 0.32 vs. preoperative 11.15 ± 1.45, <i>P</i> < 0.001). The overall fusion rate was significantly higher in the control group (92.3% vs. 64.3%, <i>P</i> = 0.002). Multivariate analysis identified age ≥55 years (observation group: 62.35 ± 5.41 vs. control: 51.47 ± 6.37, <i>P</i> < 0.001), reduced bone mineral density (T-score: -2.1 ± 0.8 vs. -1.3 ± 0.6, <i>P</i> < 0.001), postoperative complications (46.4% vs. 13.5%, <i>P</i> = 0.003), and baseline disease severity as independent risk factors for poor outcomes (<i>P</i> < 0.05). The observation group demonstrated significantly higher pseudoarthrosis rates (35.7% vs. 9.6%, <i>P</i> = 0.003).</p><p><strong>Conclusion: </strong>Advanced age, low bone density, and postoperative complications critically compromise outcomes of ACDF with BAK/C fusion. Preoperative bone density optimization, judicious use of augmented multi-level fixation, and precision patient selection are pivotal for improving prognosis. These findings provide evidence-based insights for individualized clinical decision-making.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"12 ","pages":"1637376"},"PeriodicalIF":1.6,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12504306/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145257913","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Complete laparoscopic ileal augmentation cystoplasty with modified ureteral reimplantation using an extra peritoneal approach for neurogenic bladder with vesicoureteral reflux in patient: a case report.","authors":"Qingfei Xing, Li He, Peiyan Jin, Dongxu Tian, Ke Wang, Feng Guo","doi":"10.3389/fsurg.2025.1496767","DOIUrl":"10.3389/fsurg.2025.1496767","url":null,"abstract":"<p><strong>Background: </strong>Neurogenic bladder (NGB) is defined as bladder dysfunction. Patients with NGB often have issues with high-pressure storage of urine in the bladder and/or coordinated emptying of urine. Neurogenic bladders with high pressure may lead to vesicoureteral reflux (VUR).High-grade VUR leads to recurrent urinary tract infections (UTIs), and thus causes severe renal failure. Augmentation cystoplasty (AC) can reduce bladder pressure, increase bladder compliance, reduce vesicoureteral reflux, reduce the incidence of urinary incontinence, and improve the quality of life of patients. In recent years, with the maturity of laparoscopic technology, laparoscopic ileal augmentation cystoplasty has been widely used in clinical practice. However, through searching the database, we did not find any medical records of AC performed under complete laparoscopic via extraperitoneal approach. We report today a case of complete laparoscopic ileal augmentation cystoplasty with modified ureteral reimplantation using an extraperitoneal approach for neurogenic bladder with vesicoureteral reflux in a patient.</p><p><strong>Case presentation: </strong>A 61-year-old women was hospitalized with symptoms of recurrent frequent urination. The patient had a urine volume of about 50 ml each time, no symptoms of dysuria, and no previous history of tuberculosis, diabetes and lumbar disc herniation. After admission, in addition to routine examinations, we also conducted abdominal CT, retrograde cystography, cystoscopy and urodynamic examination for the patient. Eventually, the patient was diagnosed with neurogenic bladder and bilateral ureteral reflux. The patient underwent a complete laparoscopic ileal augmentation cystoplasty with modified ureteral reimplantation using an extraperitoneal approach. Six months after the operation, the bladder volume expanded to 400 ml, and acute pyelonephritis did not occur. We ordered a CT scan of the patient, which showed no dilated ureter.</p><p><strong>Conclusion: </strong>Complete laparoscopic ileal augmentation cystoplasty with modified ureteral reimplantation using an extraperitoneal approach is difcult due to the complex operation procedure and technical difculties. This investigation demonstrated that the extraperitoneal technique of enterocystoplasty that we describe is safe and feasible and has the advantages of less trauma, less bleeding, faster return of intestinal function, and fewer postoperative complications.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"12 ","pages":"1496767"},"PeriodicalIF":1.6,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12504308/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145257886","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Minimally invasive surgical correction technique of Pectus Arcuatum, case report of an innovative method for a rare chest wall malformation (Jerusalem technique).","authors":"Daniella Moshe, Anas Salhab, Mordechai Shimonov, Firas Abu Akar","doi":"10.3389/fsurg.2025.1641213","DOIUrl":"10.3389/fsurg.2025.1641213","url":null,"abstract":"<p><p>Pectus Arcuatum (PA) is a rare anterior chest wall deformity characterized by a deformation with potential psychological impact on patients and combining features of both pectus carinatum and pectus excavatum. Traditional corrective methods involve open surgical techniques, such as sternotomy, which often result in significant surgical scars. This case report presents two patients who underwent successful minimally invasive correction of PA using a modified sandwich method, referred to as the Jerusalem Technique. The innovative approach involved bilateral thoracoscopic-guided osteotomies and placement of one or more support bars, all performed through lateral incisions without midline exposure. Both patients demonstrated excellent cosmetic and functional outcomes, minimal postoperative pain, and no complications. As many patients seek surgery for cosmetic concerns, there is a growing interest in minimally invasive approaches, this technique offers an effective alternative to traditional open surgery, representing fully minimally invasive surgical correction for PA.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"12 ","pages":"1641213"},"PeriodicalIF":1.6,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12504485/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145257979","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of clinical efficacy of two approaches for endoscopic lumbar fusion surgery in the treatment of single-segment lumbar spondylolisthesis.","authors":"Kun Li, Hang Lin, Zhibin Zhang, Xiangyu Meng","doi":"10.3389/fsurg.2025.1588997","DOIUrl":"10.3389/fsurg.2025.1588997","url":null,"abstract":"<p><strong>Objectives: </strong>Lumbar Spondylolisthesis (LSP) is a frequently encountered degenerative disorder of the spine. Unilateral biportal endoscopy (UBE) and percutaneous endoscopy (PE) have each shown promising initial results in managing this condition. This study aimed to compare the clinical efficacy of unilateral biportal endoscopic lumbar interbody fusion (UBE-LIF) and percutaneous endoscopic lumbar interbody fusion (PE-LIF) in treating single-level LSP, with the objective of providing high-quality evidence to support clinical decision-making.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on clinical records from 118 patients diagnosed with single-segment LSP who were treated at the Sixth Affiliated Hospital of Xinjiang Medical University between June 2021 and August 2023. Participants were categorized into two groups: UBE-LIF (<i>n</i> = 61) and PE-LIF (<i>n</i> = 57). Parameters assessed included operative duration, intraoperative blood loss, and postoperative levels of serum biomarkers, creatine kinase (CK) and C-reactive protein (CRP), measured on the third day following surgery. Furthermore, evaluations were made using the visual analog scale (VAS) for back and leg pain, and the Oswestry Disability Index (ODI), at baseline, as well as at 3 days, 3 months, 6 months, and 1 year postoperatively. Radiographic fusion rates and incidences of postoperative complications were also compared.</p><p><strong>Results: </strong>All procedures were successfully completed. Intraoperative blood loss was slightly higher in the PE-LIF group, without significant difference (<i>P</i> = 0.568). The UBE-LIF group had a shorter operative duration (<i>P</i> < 0.001). On postoperative day 3, the UBE-LIF group exhibited significantly lower CRP levels compared to the PE-LIF group (<i>P</i> = 0.009). Both treatment groups demonstrated marked improvement in VAS and ODI scores across all follow-up periods, with no statistically significant intergroup differences at any time point (<i>P</i> > 0.05). Fusion rates and the incidence of postoperative complications were similar between the two cohorts (<i>P</i> = 0.852; <i>P</i> = 0.527, respectively).</p><p><strong>Conclusions: </strong>Large randomized controlled trials are needed to robustly examine the comparative efficacy of these surgical options for lumbar spondylolisthesis. UBE-LIF appears advantageous in reducing operative time and improving surgical field exposure, which may potentially lower anesthesia-related risks and decrease anesthesia complications. Future large randomized controlled trials are needed to robustly examine the comparative efficacy of these techniques.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"12 ","pages":"1588997"},"PeriodicalIF":1.6,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12500643/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145250793","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of morphological and psychological outcomes after sub-brow blepharoplasty.","authors":"Tengfei Wang, Yunke Li, Mengru Pang","doi":"10.3389/fsurg.2025.1658806","DOIUrl":"10.3389/fsurg.2025.1658806","url":null,"abstract":"<p><strong>Purpose: </strong>Periorbital aging commonly presents with upper eyelid laxity and brow descent. Sub-brow blepharoplasty is a promising surgical intervention to address these concerns. This study aimed to evaluate both morphological and psychological outcomes of sub-brow blepharoplasty in a Chinese population.</p><p><strong>Methods: </strong>Sixty-four patients undergoing sub-brow blepharoplasty at the Plastic Surgery Department of Guizhou Medical University (January 2022-October 2023) were enrolled. All surgeries were performed by the same surgeon. Standardized follow-ups occurred postoperatively at T1 (immediately), T2 (1 month), and T3 (6 months), with preoperative evaluation at T0. Morphological changes were assessed through standardized photography, measuring brow, eyelid, and canthal positions. Psychological outcomes were assessed using the Social Appearance Anxiety Scale (SAAS). Patient satisfaction was recorded at final follow-up.</p><p><strong>Results: </strong>Of the 64 patients, 49 (98 eyes) completed all follow-ups (mean follow-up: 7.5 months; follow-up rate: 76.56%). Significant improvements were observed in all morphological indices and SAAS scores postoperatively (<i>P</i> < 0.05). No postoperative complications occurred. At final follow-up, 71.43% of patients were extremely satisfied, 22.45% satisfied, and 6.12% neutral-yielding a 93.88% overall satisfaction rate.</p><p><strong>Conclusion: </strong>Sub-brow blepharoplasty significantly improves eyebrow position, facial aesthetics, and reduces social appearance anxiety with high patient satisfaction and minimal risk.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"12 ","pages":"1658806"},"PeriodicalIF":1.6,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12500621/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145250715","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prediction of the impact of anxiety on atrial fibrillation recurrence after radiofrequency catheter ablation based on heart rate variability.","authors":"Yufei Ren, Hua Zhang, Yingji Tian","doi":"10.3389/fsurg.2025.1653123","DOIUrl":"10.3389/fsurg.2025.1653123","url":null,"abstract":"<p><strong>Background: </strong>Radiofrequency catheter ablation (RFCA) can significantly improve the prognosis of patients with atrial fibrillation (AF); however, the postoperative recurrence rate remains high. Therefore, identifying accurate predictors of recurrence after RFCA holds important clinical value.</p><p><strong>Methods: </strong>This retrospective study included 180 patients with AF who underwent RFCA. Patients were grouped by one-year recurrence status. Univariate analysis was conducted to compare demographic and clinical characteristics between the two groups. Cox proportional hazards models and Kaplan-Meier survival curves were used to assess the impact of heart rate variability (HRV), anxiety, and their interaction on recurrence. Predictive performance was evaluated with receiver operating characteristic (ROC) curves. Stratified analyses were performed to explore whether the effect of anxiety on recurrence varied by HRV levels.</p><p><strong>Results: </strong>Compared with the non-recurrence group, the recurrence group had higher prevalence of persistent AF and heart failure, longer AF duration, and more severe left atrial structural burden (i.e., higher EFT, LAD, and LAVI values). Multivariate Cox analysis identified that both HRV and anxiety were independent risk factors for recurrence, and their interaction term also had significant predictive value (HR > 1, <i>P</i> < 0.05). Kaplan-Meier analysis indicated that patients with low HRV and high anxiety had the lowest recurrence-free survival rate. ROC curve analysis revealed that the combined HRV-anxiety interaction model yielded an AUC of 0.745, indicating a certain predictive advantage over individual indicators. Stratified analysis further confirmed that the recurrence risk associated with high anxiety was more pronounced in the low HRV group.</p><p><strong>Conclusion: </strong>HRV and anxiety were identified as independent predictors of AF recurrence following RFCA, with a significant synergistic interaction observed between the two. Their combined assessment may enhance the accuracy of recurrence risk prediction and provide a foundation for the development of individualized intervention strategies.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"12 ","pages":"1653123"},"PeriodicalIF":1.6,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12500613/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145250758","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postoperative secondary contralateral arachnoid cyst following rupture and bleeding of intracranial aneurysm: a case report.","authors":"Kun Hu, Yanyan Yu, Yancong Yang, Huichen Li, Jinyuan Liao, Huanglian Zhong, Qiuhua Jiang, Jun Liu, Shuiying Zeng, Nan Yang, Wenjun Zhang","doi":"10.3389/fsurg.2025.1672623","DOIUrl":"10.3389/fsurg.2025.1672623","url":null,"abstract":"<p><p>The simultaneous occurrence of intracranial aneurysms and intracranial arachnoid cysts is a rare clinical observation, with the majority of documented instances demonstrating ipsilateral presentation. In this report, we describe an atypical case involving the development of a secondary arachnoid cyst subsequent to the rupture of an intracranial aneurysm. Notably the cyst was situated contralaterally to the site of the aneurysm rupture and outside the surgical field. The patient's clinical history and imaging studies confirmedcorroborated the secondary nature of the cyst, which is postulated to have resulted from inflammatory responses triggered by a subarachnoid hemorrhage (SAH). The patient underwent neuroendoscopic partial resection of the cyst wall and lateral ventriculostomy, leading to a significant improvement in neurological dysfunction symptoms associated with the secondary arachnoid cyst. Follow-up cranial MRI demonstrated a substantial reduction in the cyst's volume, with no evidence of subsequent hydrocephalus or cyst enlargement. This case enhances the comprehension of the pathophysiological mechanisms underlying the formation of contralateral arachnoid cysts subsequent to aneurysm rupture and emphasizes the necessity of acknowledging arachnoid cysts as potential delayed complications associated with aneurysmal subarachnoid hemorrhage (aSAH).</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"12 ","pages":"1672623"},"PeriodicalIF":1.6,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12500747/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145250727","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radial extracorporeal shock wave promotes the treatment of non-union of femoral shaft fractures in children: a case report.","authors":"He Shang, Tao Ma, Xueqi Liu, Tianxiang Yang, Yongzhu Luo, Jun Li, Jinpeng Liang, Desheng Chen","doi":"10.3389/fsurg.2025.1667385","DOIUrl":"10.3389/fsurg.2025.1667385","url":null,"abstract":"<p><strong>Background: </strong>Despite the minimally invasive benefits of flexible intramedullary nails (FIN) for pediatric femoral shaft fractures, nonunion may occur. Traditional surgical revisions carry high trauma and risk, while radial extracorporeal shockwave therapy (rESWT) has potential for promoting bone healing but lacks sufficient evidence in such pediatric cases.</p><p><strong>Methods: </strong>A 4-year-old male with left femoral shaft fracture (AO/OTA 32A2) and FDA-defined nonunion 9 months after FIN fixation received rESWT. Using Gymna ShockMaster 300 (Uniphy), parameters were 6-8 Hz, 2.0-3.0 bar, 1,000-1,500 pulses/week for 3-4 weeks (covering fracture and 2 cm around). Treatment included pre-procedural screening, professional operation, gamified communication, and concurrent rehabilitation.</p><p><strong>Results: </strong>Post-rESWT, fracture lines blurred then disappeared, with clinical healing achieved and no complications. At 3-month follow-up, intramedullary nail was removed; the patient had 80% weight-bearing capacity, independent walking (mild gait asymmetry), and full weight-bearing recovery later.</p><p><strong>Conclusion: </strong>rESWT effectively reverses post-FIN nonunion in pediatric femoral shaft fractures, with advantages of non-invasiveness, safety, and good compliance. It is a feasible alternative for surgery-limited cases, though long-term efficacy needs large-scale validation.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"12 ","pages":"1667385"},"PeriodicalIF":1.6,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12498227/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145244270","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biomechanical mechanism and clinical management progress of surgical wound tension.","authors":"Feiyu Gong, Bingjie Wan, Ping Qi, Zairong Wei","doi":"10.3389/fsurg.2025.1674382","DOIUrl":"10.3389/fsurg.2025.1674382","url":null,"abstract":"<p><p>Surgical wound tension, a core biomechanical factor in tissue repair, is clinically important because high tension can cause microcirculatory disturbances, leading to inhibition of cell migration and collagen deposition, and increasing complications such as wound dehiscence and incisional hernia. Therefore, the concept of \"active tension reduction\" has been emphasized, including preoperative optimization of biomechanical distribution, intraoperative layered combined subcutaneous tension-reducing suturing, and postoperative dynamic management. However, the difficulty in standardizing wound tension quantification presents clinical challenges. In summary, this study integrates the biomechanical mechanisms of surgical wound tension with clinical practice to explore a systematic strategy from tension assessment to novel intervention techniques.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"12 ","pages":"1674382"},"PeriodicalIF":1.6,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12498228/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145244169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}