Indian Journal of Orthopaedics最新文献

{"title":"Do Reduction Maneuvers Affect Recurrence in Pediatric Radial Head Subluxation? A Ten-Year Retrospective Analysis.","authors":"Mehmet Boz, Gülseda Boz, Tarik Altunkılıç, Bünyamin Arı, İsmail Güzel, Ümit Yasin Barbak","doi":"10.1007/s43465-026-01785-3","DOIUrl":"10.1007/s43465-026-01785-3","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to determine whether the choice of reduction maneuver in patients presenting to the emergency department with nursemaid's elbow influences the likelihood of recurrent dislocation. Additionally, the study sought to describe the epidemiological characteristics of these cases.</p><p><strong>Methods: </strong>This retrospective study included 1359 patients diagnosed with nursemaid's elbow who presented to the Emergency Department of Malatya Training and Research Hospital from January 2015 to June 2025. Data on demographics, side affected, radiographic evaluation, reduction maneuver, and recurrence were analyzed. The chi-square test was used for statistical analysis, with p < 0.05 considered significant.</p><p><strong>Results: </strong>The median age was 2 years, with 61.2% female. Most cases (88.1%) were in the 0-3-year age group. Left-sided involvement accounted for 63.0%, right-sided involvement 37.0%. Hyperpronation was used in 68.4%, supination-flexion in 31.6%. Recurrence rate was 4.8%, higher with right elbows and supination-flexion (p < 0.05).</p><p><strong>Conclusion: </strong>Nursemaid's elbow was more common in children under three, particularly girls, and affected the left arm. Recurrence was lower after hyperpronation than after supination-flexion.</p><p><strong>Level of evidence: </strong>Retrospective analysis study.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"60 8","pages":"2022-2027"},"PeriodicalIF":1.3,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13437855/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148678540","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":"Bony Path Assisted Suturing and Tendon-to-Tendon Suturing Technique for External Rotator Repair After Hip Arthroplasty: A Randomized-Controlled Trial.","authors":"Zuzhou Wen, Yun Ye, Hongqiang Chen, Junzhao Qiao, Xizhi Wu, Ang Luo","doi":"10.1007/s43465-026-01748-8","DOIUrl":"10.1007/s43465-026-01748-8","url":null,"abstract":"<p><strong>Objective: </strong>To compare and verify the effectiveness of tendon-to-bone suture technique for the repair of external rotator injuries after hip arthroplasty.</p><p><strong>Methods: </strong>This was a prospective, randomized, controlled study including 178 patients that were divided into two groups. Clinical outcomes, joint dislocation rates, and external rotation angles were compared between patients who underwent the tendon-to-bone suture technique (group I) and those who underwent the tendon-to-tendon suture technique (group II).</p><p><strong>Results: </strong>There were no statistically significant differences between the two groups in terms of sex, age, operative side, body mass index, diagnosis, visual analog scale (VAS) score, operation time, blood loss, or incision length (<i>P</i> > 0.05). The hip Harris scores of the two groups were significantly higher in group I than in group II at 1 and 3 months after surgery (<i>P</i> < 0.05); however, the difference was not statistically significant at 6 months after surgery (<i>P</i> > 0.05). The difference in postoperative VAS scores of the two groups was not statistically significant (<i>P</i> > 0.05). The incidence of postoperative joint dislocation in group I was significantly lower than in group II (<i>P</i> < 0.05). The external rotation angles of the two groups were higher in group I than in group II at 1, 3, and 6 months after surgery (<i>P</i> < 0.05); however, after 12 months of rehabilitation, the external rotation angles were close to normal, and the difference between the two groups was not statistically significant (<i>P</i> > 0.05).</p><p><strong>Conclusion: </strong>Tendon-to-bone repair is superior to tendon-to-tendon repair. Crucially, this technique enhances therapeutic outcomes without increasing operative time, incision length, or blood loss.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"60 6","pages":"1510-1518"},"PeriodicalIF":1.3,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13242320/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148204830","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":"Harmonizing Law and Ethics in Orthopaedics.","authors":"Naresh Shetty","doi":"10.1007/s43465-026-01778-2","DOIUrl":"https://doi.org/10.1007/s43465-026-01778-2","url":null,"abstract":"","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"60 5","pages":"1171"},"PeriodicalIF":1.1,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13219563/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148137832","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":"Femoral Neck Antirotation and Support System: A Novel Internal Fixation for Pauwels III Femoral Neck Fractures: A Finite Element Analysis.","authors":"Taiyou Wang, Shuquan Guo, Hongyu Lin, Fukang Zhu, Guangjian Wang, Bo Qiao","doi":"10.1007/s43465-026-01779-1","DOIUrl":"https://doi.org/10.1007/s43465-026-01779-1","url":null,"abstract":"<p><strong>Background: </strong>Pauwels III femoral neck fractures are challenging for orthopedic surgeons due to the high shear force and frequent complications. The best treatment approach for this type of fracture remains an undetermined issue. The Femoral Neck Antirotation and Support System (FNAS) was designed to withstand increased shear and torsional forces while minimizing implant cut-out. This study aims to compare the biomechanical outcomes of the FNAS with the Femoral Neck System (FNS) and three cannulated screws (3CS) in the treatment of Pauwels III femoral neck fractures.</p><p><strong>Methods: </strong>A finite element model of 70° Pauwels III femoral neck fracture was established. Three different fixation models were constructed: FNAS model, FNS model, and 3CS model. Each model was subjected to a 2100 N load and the stress distribution and displacement of each model were recorded.</p><p><strong>Results: </strong>Under 2100 N loading, the peak stress at the fracture end was 25.844 MPa for the FNAS model and 27.516 MPa for the FNS model, respectively, while the 3CS model exhibited a significantly higher peak stress of 139.14 MPa. The maximum femoral displacement was 4.8764 mm for the FNAS model, 4.8423 mm for the FNS model, and 5.0079 mm for the 3CS model, indicating greater stiffness and stability in the FNAS and FNS models. The maximum displacement of internal fixation observed was 4.7541 mm for the FNAS model, 4.7359 mm for the FNS model, and 4.9265 mm for the 3CS model. Internally, the peak stress in the FNS model was 496.26 MPa, significantly higher than 338.94 MPa in the FNAS model and 229.85 MPa in the 3CS model.</p><p><strong>Conclusion: </strong>Within the specific context and assumptions of this static finite element model, the FNAS demonstrated biomechanical performance comparable to the FNS in terms of construct stiffness, while exhibiting significantly lower peak implant stress. This suggests that the FNAS may offer a potential advantage in reducing implant failure risk for Pauwels III femoral neck fractures.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"60 9","pages":"2421-2430"},"PeriodicalIF":1.3,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13627492/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149109109","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":"Bipolar Hemiarthroplasty Versus Proximal Femoral Nailing in Elderly Patients with Unstable Intertrochanteric Fractures: A Systematic Review and Meta-analysis.","authors":"Parveez Rahman Rabik Rahuman, Nazmul Huda Syed, Khaled Elsayed Mohamed Ebid, Muhammad Rajaei Ahmad Mohd Zain","doi":"10.1007/s43465-026-01717-1","DOIUrl":"https://doi.org/10.1007/s43465-026-01717-1","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background and aim: &lt;/strong&gt;Bipolar hemiarthroplasty (BHA) and proximal femoral nail (PFN) represent the two predominant interventions in contemporary clinical practice. This review was conducted to address the lack of consensus regarding the superiority of these two interventions. This study aims to perform a systematic review and meta-analysis to assess the superiority of PFN compared to BHA by evaluating postoperative outcomes, including mortality rates and Harris Hip Scores (HHS). Furthermore, secondary outcomes such as injury to surgery time, revision surgery rates, intra-operative blood loss, duration of immobilization, and length of hospitalization were evaluated.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methodology: &lt;/strong&gt;Four electronic databases (PubMed, Scopus, Web of Science, and the Cochrane Library) were searched for relevant articles published. Inclusion criteria included human studies with randomized controlled trial (RCT) or observational cohort designs (prospective or retrospective) that directly compared bipolar hemiarthroplasty (BHA) with proximal femoral nail (PFN) for unstable intertrochanteric femoral fractures in elderly patients (aged ≥ 60 years). Exclusion criteria included animal studies, articles not available in English, and studies comparing non-relevant outcomes. Two independent reviewers performed data extraction using standardized forms. Review Manager 5.4 (RevMan) software was employed for meta-analysis using random-effects models with assessment of heterogeneity using &lt;i&gt;I&lt;/i&gt; &lt;sup&gt;2&lt;/sup&gt; statistics and subgroup analyses by study design and surgical approach. This study is registered with PROSPERO (ID: CRD42022322759).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;We analysed a total of 13 studies published between 2012 and 2025. There were 11 retrospective cohort and two randomized controlled studies. The number of patients in these studies ranged from 44 to 308. There was a significant difference in HHS between the two groups with a standard mean difference (MD) of  - 7.60 (range - 10.83 to - 4.36), favouring the PFN group. The BHA group had a greater mortality rate with odds ratio (OR) of 1.47 (range 1.14 to 1.90). Moreover, intraoperative blood loss (MD: 206.86) and period of immobilization (MD: 0.35) were lower in the PFN group. There were no difference in the rate of revision surgery (OR- 0.76), period of hospitalisation and injury to surgery time (MD:  - 1.35).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Proximal femoral nailing demonstrates advantages in intraoperative blood loss, transfusion requirements, and long-term Harris Hip Score compared with bipolar hemiarthroplasty for unstable intertrochanteric femoral fractures in the elderly. However, bipolar hemiarthroplasty offers important advantages in early mobilization, immediate weight-bearing, and simplified rehabilitation protocols. Patient-specific factors, including age, estimated life expectancy, cognitive status, comorbidity burden, and functional reserve, should guide the choic","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"60 6","pages":"1429-1442"},"PeriodicalIF":1.1,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13242318/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148204860","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":"Editorial: Complications of Lower Limb Trauma: The Persistent Challenge in Modern Trauma Care.","authors":"Mandeep S Dhillon","doi":"10.1007/s43465-026-01783-5","DOIUrl":"https://doi.org/10.1007/s43465-026-01783-5","url":null,"abstract":"","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"60 5","pages":"1037-1038"},"PeriodicalIF":1.1,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13219674/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148137883","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":"Paediatric Flexible Flatfeet: A Narrative Review of Conflicting Perspectives in Clinical Practice.","authors":"Saraswati Viswanathan, Nirali Mehta, Prapurna Pothukuchi","doi":"10.1007/s43465-026-01769-3","DOIUrl":"10.1007/s43465-026-01769-3","url":null,"abstract":"<p><strong>Background: </strong>Paediatric flexible flatfoot (PFF), though common, lacks universally accepted diagnostic and management protocols. There is ongoing debate regarding whether it represents a pathological condition or a physiological variant. Whilst many children remain asymptomatic, evidence suggests that even those without overt symptoms may experience reduced functional capacity.</p><p><strong>Objective: </strong>This narrative review aims to summarise the current understanding of paediatric flexible flatfoot, focusing on factors influencing arch development and the various clinical approaches used in managing symptomatic children.</p><p><strong>Review of literature: </strong>Many treatment strategies have been described in literature for symptomatic children, including non-operative measures such as orthotic support and functional re-education, as well as surgical procedures such as lateral column lengthening and subtalar arthroereisis (SA).Obesity has been identified as a significant contributing factor to paediatric flexible flatfoot. With the expected rise in childhood obesity, the prevalence of flatfoot is likely to increase, highlighting the need for clear and standardised management guidelines.</p><p><strong>Conclusion: </strong>Paediatric flexible flatfoot remains a debated condition with no clear consensus regarding its clinical significance or optimal management. While most children remain asymptomatic, symptomatic cases should initially be managed with activity modification and functional re-education. Surgical procedures such as subtalar arthroereisis show promising short-term outcomes in selected patients, though further long-term studies are required to establish clear treatment guidelines.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"60 4","pages":"846-853"},"PeriodicalIF":1.3,"publicationDate":"2026-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13100088/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147770241","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":"Surgeries Performed in Professional Australian Cricketers 2015-2024.","authors":"John W Orchard, Anna Saw, Philippa Inge, Kate Beerworth, Leigh Golding, Nick Jones","doi":"10.1007/s43465-026-01762-w","DOIUrl":"https://doi.org/10.1007/s43465-026-01762-w","url":null,"abstract":"<p><strong>Aim: </strong>A study describing the distribution and rate of surgical operations performed in professional Australian cricketers, both male and female, over a decade.</p><p><strong>Methods: </strong>Cricket Australia Athlete Management System was searched for consultations including terms that might reference whether surgery had been performed. Surgeries were any procedure performed in a hospital or day care facility, including non-orthopaedic surgeries.</p><p><strong>Results: </strong>There were 3419 player years studied between 2015 and 2024, yielding 447 surgeries, a rate of 13.1 surgeries per 100 player years, the majority of which were musculoskeletal (orthopaedic) procedures. The most common procedures were: knee arthroscopy (1.61/100 player years), wrist hand/finger fracture fixations (1.52), shoulder reconstruction (0.91), ankle posterior impingement procedures (0.44) and knee ACL reconstructions (0.41). The rates of surgery in male (12.7) and female (13.5) players were similar. The rate of surgery in male players was lower than a previous audit a decade ago (19.6 which excluded non-musculoskeletal procedures, <i>P</i> < 0.001) with the surgeries being performed less often including knee arthroscopy, ankle posterior impingement procedures and shoulder arthroscopy (all <i>P</i> < 0.001).</p><p><strong>Discussion/conclusions: </strong>There is a general consistency in the rate of surgical procedures in professional Australian cricketers, although rates for the recent decade have dropped compared to the one prior in male players. Rates of surgery between male and female cricketers are very similar, and rates are lower than in the football codes in Australia but higher than the general population.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"60 9","pages":"2555-2560"},"PeriodicalIF":1.3,"publicationDate":"2026-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13627475/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149108973","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 Effect of Patient Education on Function, Quality of Life, and Activities of Daily Living After Total Hip Arthroplasty: A Pilot Study.","authors":"Sinem Yenil Kocabay, Nevriye Ünal Süzer, Muhammet Emin Can, Nihal Büker, Akın Süzer","doi":"10.1007/s43465-026-01772-8","DOIUrl":"https://doi.org/10.1007/s43465-026-01772-8","url":null,"abstract":"<p><strong>Background: </strong>Postoperative education is crucial for improving physical function, daily activity participation, and quality of life after total hip arthroplasty (THA). The aim of our study was to examine the effects of patient education on function, quality of life, and activities of daily living after THA.</p><p><strong>Methods: </strong>Patients who underwent primary THA were randomized into three groups: online education, brochure, and control. Pain (Visual Analog Scale-VAS), function (The Western Ontario and McMaster Universities Arthritis Index-WOMAC), quality of life (World Health Organization Quality of Life Scale-Short Form-WHOQOL-BREF), and activities of daily living (The Lawton-Brody Instrumental Activities of Daily Living-IADL) were evaluated online before education and 4 weeks after discharge. Changes and between-group differences were analyzed (<i>p</i> < 0.05).</p><p><strong>Results: </strong>Thirty-nine participants (25 female, 14 male; mean age 61.23 ± 12.57 years) were included. All groups showed significant within-group improvements in pain and WOMAC scores (<i>p</i> < 0.05). Significant improvements were observed in the WHOQOL-BREF physical health domain in the training and control groups, and in general and physical health in the brochure group (<i>p</i> < 0.05). Between-group comparisons showed greater reductions in pain during sleep and rest in the control group than in the brochure group (<i>p</i> < 0.01). The control and education group had better improvements in WOMAC pain, stiffness, function, and total scores than the brochure group. For physical and environmental health, the education group showed better improvement than the brochure group (<i>p</i> < 0.05).</p><p><strong>Conclusion: </strong>Online patient education after THA was more effective than an information brochure alone in managing pain and improving functional outcomes. However, the small sample size and the baseline gender imbalance between the groups represent key limitations of the study and should be carefully considered when interpreting the findings.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s43465-026-01772-8.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"60 6","pages":"1500-1509"},"PeriodicalIF":1.1,"publicationDate":"2026-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13242523/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148204634","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":"Preserving Our Legacy: Call for a National Series on the Evolution of Orthopaedics from Individual States of India.","authors":"Srinivas B S Kambhampati, Murali Poduval, Navin Thakkar, Lalit Maini, R H Govardhan, Rajeev Raman","doi":"10.1007/s43465-026-01753-x","DOIUrl":"10.1007/s43465-026-01753-x","url":null,"abstract":"","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"60 4","pages":"807-808"},"PeriodicalIF":1.3,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13100190/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147770213","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}