Indian Journal of Orthopaedics最新文献

{"title":"Comments on \"Do Reduction Maneuvers Affect Recurrence in Pediatric Radial Head Subluxation? A Ten-Year Retrospective Analysis\".","authors":"Ahmet Harma","doi":"10.1007/s43465-026-01987-9","DOIUrl":"https://doi.org/10.1007/s43465-026-01987-9","url":null,"abstract":"","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"60 10","pages":"2914-2915"},"PeriodicalIF":1.3,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13658759/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149181635","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":"Commentary: Gadekar et al., \"Jumbo Acetabular Cup in the Indian Population: Is it Time to Reconsider Existing Thresholds?\"","authors":"Rajesh Malhotra","doi":"10.1007/s43465-026-01902-2","DOIUrl":"https://doi.org/10.1007/s43465-026-01902-2","url":null,"abstract":"","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"60 9","pages":"2302-2303"},"PeriodicalIF":1.3,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13627476/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149108965","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":"India's Draft National Health Research Policy 2026: A Visionary Framework for Transforming the National Health Research Ecosystem.","authors":"Vaishya Raju, Kambhampati B S Srinivas, Vaish Abhishek, Iyengar P Karthikeyan","doi":"10.1007/s43465-026-01949-1","DOIUrl":"https://doi.org/10.1007/s43465-026-01949-1","url":null,"abstract":"<p><p>The National Health Research Policy (NHRP) 2026 presents a forward-looking framework to strengthen India's health research ecosystem. It addresses emerging priorities in biomedical sciences, clinical and public health research, digital health, artificial intelligence, genomics, and implementation science while aligning with national initiatives, such as Universal Health Coverage, Ayushman Bharat Digital Mission, Atmanirbhar Bharat, and Viksit Bharat 2047. The policy emphasises multidisciplinary research, innovation, equitable capacity building, ethical governance, translational research, and stronger public-private partnerships, marking a substantial advance over previous frameworks. Its success will depend on sustained funding, effective institutional governance, a skilled clinician-scientist workforce, interoperable digital infrastructure, responsible AI regulation, and robust monitoring through measurable outcomes. This viewpoint highlights the policy's key strengths, discusses potential implementation challenges, and offers practical recommendations to facilitate successful execution. Effective implementation could establish India as a global leader in high-quality, ethical, innovative, and patient-centred health research while improving healthcare delivery and population health.</p><p><strong>Graphical abstract: </strong></p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"60 10","pages":"2613-2617"},"PeriodicalIF":1.3,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13658658/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149181223","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":"Timing and Causes of Systemic Readmissions After Hip Fracture Surgery: An 8-Year Retrospective Cohort Study.","authors":"Faizan Iqbal, Ahmed Taha Musabeh AlSuwaidi, Husam Eddin Ghazal, Sarthy Velayutham, Aswin Cheriyan, Emad ElSayed ElMorshdy","doi":"10.1007/s43465-026-01929-5","DOIUrl":"https://doi.org/10.1007/s43465-026-01929-5","url":null,"abstract":"<p><strong>Background: </strong>Systemic readmissions after hip fracture surgery impose a substantial clinical and economic burden. Hip fracture represents a sentinel orthopedic injury with prolonged postoperative vulnerability extending beyond the index admission. Evidence from the Middle East remains scarce, particularly regarding the incidence, causes, and timing of systemic readmissions in multiethnic populations. This study aimed to determine the one-year incidence, etiologies, and temporal distribution of systemic readmissions following proximal hip fracture surgery, and to explore whether commonly documented comorbidities showed any association with systemic readmission.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted at a tertiary-care hospital in the Middle East from January 2017 to January 2025. Kaplan-Meier analysis was the primary method used to describe one-year systemic readmission-free survival, while logistic regression was performed on an exploratory basis.</p><p><strong>Results: </strong>Among 284 patients, 35 experienced systemic readmissions within one year (12.3%). Infectious (31.4%), cardiovascular (20.0%), and pulmonary (20.0%) complications were the most frequent etiologies. Kaplan-Meier analysis demonstrated a one-year systemic readmission-free survival of 87.7%, with most readmissions clustering between 90 and 180 postoperative days. No comorbidity-including American Society of Anesthesiologists (ASA) class-was significantly associated with systemic readmission. Stratified survival curves showed no significant difference by ASA classification (log-rank p = 0.54).</p><p><strong>Conclusion: </strong>Although no stable association between individual comorbidities and systemic readmission was identified in exploratory analyses, a distinct late postoperative vulnerability window (3-6 months) was identified. These findings provide important region-specific evidence and support the need for structured mid-term follow-up and multidisciplinary care pathways to reduce late systemic complications after hip fracture surgery. From an orthopedic perspective, these findings emphasize hip fracture surgery as the beginning of a prolonged recovery trajectory rather than an isolated surgical event.</p><p><strong>Graphical abstract: </strong></p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"60 10","pages":"2795-2802"},"PeriodicalIF":1.3,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13658646/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149181612","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":"The Fragile Field: Cartilage Repair in the Professional Football Player.","authors":"Riccardo D'Ambrosi, Srinivas B S Kambhampati, Gino Kerkhoffs, Jari Dahmen","doi":"10.1007/s43465-026-01935-7","DOIUrl":"https://doi.org/10.1007/s43465-026-01935-7","url":null,"abstract":"","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"60 9","pages":"2171-2176"},"PeriodicalIF":1.3,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13627587/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149109008","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":"Body Mass Index-Related Changes in Tibial Morphology: Considerations for Intramedullary Nailing.","authors":"Muhammed Yasir Altunışık, Burak Aydın, Ömer Faruk Aydoğdu","doi":"10.1007/s43465-026-01921-z","DOIUrl":"https://doi.org/10.1007/s43465-026-01921-z","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the association between body mass index (BMI) and tibial morphological parameters, specifically focusing on medullary and cortical geometry.</p><p><strong>Methods: </strong>This single-center retrospective observational study included adults aged 18-65 years with full-length AP and lateral tibial radiographs obtained within the prior 6 months. The participants were grouped as nonobese (BMI < 30 kg/m²) or obese (BMI ≥ 30 kg/m²). The outer tibial diameter (TD) and medullary canal diameter (MCD) were measured in both the anteroposterior (AP) and lateral planes at the level of the narrowest visible medullary canal within the middle third of the diaphysis, and the cortical thickness index (CTI) and canal-bone ratio (CBR) were calculated. Group comparisons, correlation analyses, and multivariable linear regression models (BMI, age, sex, and height) were performed for the AP and lateral CBRs.</p><p><strong>Results: </strong>Seventy-four individuals were analyzed (42 nonobese, 32 obese). The obese group demonstrated a significantly smaller MCD in both planes, a higher CTI, and a lower CBR. BMI was negatively correlated with the AP CBR and lateral CBR and with the AP and lateral MCD but was positively correlated with the AP CTI and lateral CTI. In the regression analysis, BMI remained an independent negative predictor of the AP CBR and lateral CBR.</p><p><strong>Conclusions: </strong>A high BMI is associated with tibial medullary canal narrowing and a low CBR, accompanied by a high CTI, in both the AP and lateral planes. These findings support careful preoperative evaluation of internal tibial morphology in obese patients to optimize intramedullary implant planning.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"60 10","pages":"2803-2809"},"PeriodicalIF":1.3,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13658742/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149181664","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":"Clinical and Functional Outcomes of Bone Defect Reconstruction Using the Masquelet Technique: Experience with Rare Talus and Metatarsal Cases.","authors":"Ahmet Temiz, Okkes Bilal, Duran Topak, Fatih Dogar, Mustafa Abdullah Ozdemir, Kadir Ismail Dere","doi":"10.1007/s43465-026-01891-2","DOIUrl":"https://doi.org/10.1007/s43465-026-01891-2","url":null,"abstract":"<p><strong>Background: </strong>Segmental bone defects remain a major challenge in orthopedic surgery. The Masquelet's induced membrane technique (MIMT) is a two-stage reconstructive approach used for limb salvage in complex defects. This study evaluated radiographic healing and patient-reported outcomes after MIMT in a single tertiary center, including rare talus and metatarsal applications.</p><p><strong>Methods: </strong>We retrospectively reviewed 14 patients (10 males, 4 females) treated with MIMT for post-traumatic or osteomyelitis-related lower-extremity bone defects (tibia, femur, talus, metatarsal) between 2010 and 2023. Mean age was 35 ± 15.4 years and mean defect size was 8 ± 3.3 cm. Radiographic healing was assessed using the Lane and Sandhu scoring system. Patient-reported outcomes (SF-36 and LEFS) were collected at the final follow-up (mean 6 ± 4.5 years). Group comparisons and correlations were analyzed using t tests and Pearson correlation.</p><p><strong>Results: </strong>Union was achieved in 13/14 patients (93%), with a mean time to union of 11 ± 4.6 months. At the final follow-up, mean LEFS was 54 ± 15.7, mean MCS was 65.3 ± 6.5, and mean PCS was 35.3 ± 5.4. In exploratory analysis, male patients scored higher in SF-36 vitality and physical role limitation subdomains. No infection recurrence or amputation occurred. Longer inter-stage interval correlated with lower SF-36 mental health scores.</p><p><strong>Conclusion: </strong>In this small, retrospective, and heterogeneous cohort, MIMT was associated with a high observed union rate, durable infection control, and preserved mental health despite persistent physical limitations at the final follow-up. Rare-site talus and metatarsal reconstructions were feasible in this series, but inferences for these locations remain descriptive and hypothesis-generating given the limited case numbers.</p><p><strong>Graphical abstract: </strong>This graphical abstract illustrates the two-stage of Masquelet's induced membrane technique (MIMT) for segmental bone defects. In the first stage, debridement, external fixation and insertion of a PMMA spacer induce a vascularized membrane around the defect. In the second stage, the spacer is removed and the membrane cavity is filled with cancellous bone graft, followed by stable plate fixation. Progressive callus formation leads to graft remodeling and restoration of bone continuity.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"60 10","pages":"2774-2786"},"PeriodicalIF":1.3,"publicationDate":"2026-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13658653/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149181656","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":"Isolated Orchialgia as the Sole Manifestation of an Occult L5 Pars Defect: A Case Report.","authors":"Arvind Gopalrao Kulkarni, Priyambada Kumar, Bala Ganeshan Thangaraj Pillai","doi":"10.1007/s43465-026-01911-1","DOIUrl":"https://doi.org/10.1007/s43465-026-01911-1","url":null,"abstract":"<p><strong>Background: </strong>Chronic orchialgia is usually investigated within a urological framework. A spinal origin is uncommon and is typically associated with low back pain or radicular symptoms. Isolated orchialgia caused by an occult lumbar pars defect has not yet been reported in literature.</p><p><strong>Case description: </strong>A 52-year-old man presented with persistent right-sided orchialgia despite extensive urological evaluation and conservative treatment. He had no low back pain, radicular symptoms, or neurological deficits. Plain radiographs suggested a right L5 pars defect. Lumbar MRI demonstrated a unilateral L5 pars defect with T1 hypointensity and T2 hyperintensity, raising suspicion for an active lesion. SPECT-CT confirmed focal increased osteoblastic activity, indicating a metabolically active non-healed pars defect. In the absence of any alternative identifiable cause, the pars lesion was considered the likely pain generator. The patient underwent minimally invasive L5-S1 transforaminal lumbar interbody fusion, resulting in complete resolution of orchialgia, which was maintained at one-year follow-up.</p><p><strong>Conclusion: </strong>Occult L5 pars defects can rarely present solely as chronic orchialgia. A high index of clinical suspicion is crucial in patients with unexplained testicular pain and inconclusive urological evaluation. Functional imaging with SPECT-CT may help distinguish symptomatic pars defects from incidental lesions and guide definitive treatment.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"60 10","pages":"2722-2726"},"PeriodicalIF":1.3,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13658652/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149181301","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":"Length of Hospitalization of Patients with Spinal Trauma Caused by Motor Vehicle Accidents: Retrospective Study from a Level 1 Trauma Center.","authors":"Tulić Ivan, Vasić Milos, Novaković Uros, Perić Jovan, Marković Ksenija, Mladenović Milos, Joksimović Luka, Teodosić Valerija, Zagorac Slavisa","doi":"10.1007/s43465-026-01906-y","DOIUrl":"https://doi.org/10.1007/s43465-026-01906-y","url":null,"abstract":"<p><strong>Introduction: </strong>Traumatic spinal fractures (TSFs) resulting from motor vehicle accidents (MVAs) are a significant contributor to morbidity, often leading to prolonged hospitalization and complex clinical management. Identifying predictors of mortality and extended hospital stay is crucial for optimizing care in trauma centers worldwide.</p><p><strong>Methods: </strong>This retrospective, single-center cohort study analyzed 136 patients with TSFs following MVAs, admitted to a Level 1 trauma center between January 2024 and January 2025. Demographic, clinical, and epidemiological variables were collected. Statistical analyses included logistic regression to determine mortality predictors and Poisson regression for factors influencing length of stay (LoS).</p><p><strong>Results: </strong>The median age was 42 years, and 67.6% of patients were male. The majority of injuries involved car occupants, with pedestrians exhibiting the highest in-hospital mortality (24%). Advanced age and polytrauma emerged as significant independent predictors of mortality (OR 1.04 per year, <i>p</i> = 0.008; OR 3.35, <i>p</i> = 0.033). Prolonged hospitalization was associated with older age (<i>p</i> < 0.001), presence of polytrauma (<i>p</i> < 0.001), thoracic spine injury (<i>p</i> < 0.001), and multisite spinal involvement (<i>p</i> = 0.014). While neurological deficits and treatment modality (surgical vs. conservative) were not significantly associated with outcomes, longer hospital stays among pedestrians suggest injury severity related to unprotected trauma.</p><p><strong>Conclusion: </strong>Advanced age, polytrauma, and injury to thoracic or multiple spinal regions are significant predictors of mortality and extended hospitalization in TSF patients post-MVA. The findings highlight the importance of early risk stratification and individualized management strategies in trauma patients, particularly those of advanced age or with multiple injuries. Further multicenter studies incorporating long-term functional outcomes are warranted to inform comprehensive trauma care models.</p><p><strong>Level of evidence: </strong>Level III.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"60 10","pages":"2767-2773"},"PeriodicalIF":1.3,"publicationDate":"2026-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13658727/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149181229","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":"Heterotopic Ossification: A Rare Complication of Lateral Condyle Humerus Fracture Treatment in Children.","authors":"Premal Naik","doi":"10.1007/s43465-026-01814-1","DOIUrl":"https://doi.org/10.1007/s43465-026-01814-1","url":null,"abstract":"<p><strong>Purpose: </strong>Heterotopic ossification (HO) following elbow injury in children is quite rare. Multiple articles on the outcomes and complications after a lateral condyle humerus fracture in children have not mentioned heterotopic ossification as a complication. We report a short series of three cases of heterotopic ossification following surgical treatment of lateral condyle humerus fractures.</p><p><strong>Methods: </strong>Two children with lateral condyle humerus fractures with elbow dislocation, and one child with a Song stage 5 lateral condyle humerus fracture, presented to us with heterotopic ossification after surgical treatment. One had bony ankylosis, while another experienced malunion of the lateral condyle fragment. One child who presented early was managed conservatively, whereas the other two presented later with mature heterotopic ossification and required excision to improve elbow motion. All children received oral indomethacin to prevent progression or recurrence.</p><p><strong>Results: </strong>According to Hardacre's criteria, the child treated conservatively had an excellent outcome. The children who underwent HO excision demonstrated improvements of 125⁰ and 108⁰ in elbow motion, and according to Hardacre's criteria, both achieved good results; neither had recurrence of heterotopic ossification. Improvement in elbow motion following excision of heterotopic ossification took several years.</p><p><strong>Conclusion: </strong>Heterotopic ossification following treatment of lateral condyle humerus fractures is rare; associated elbow dislocation may increase the risk. Awareness of this complication allows earlier diagnosis and management. Early conservative treatment with rest and indomethacin may prevent the need for surgical excision. Although excision can improve elbow motion over time, full recovery of motion may not occur. Therefore, heterotopic ossification should be recognized as a potential complication of lateral condyle humerus fracture treatment in medical textbooks.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"60 10","pages":"2831-2839"},"PeriodicalIF":1.3,"publicationDate":"2026-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13658677/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149181020","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}