International Orthopaedics最新文献

{"title":"Anatomical considerations, diagnosis, and treatment of medial and posterolateral elbow rotatory instability in athletes: an arthroscopic perspective and literature review.","authors":"Michail Kotsapas, Dimitrios Giotis, Frantzeska Zampeli, Vasileios Giannatos, Christos Koutserimpas, Zinon Kokkalis, Dimitrios Karadimos, Christos Koukos","doi":"10.1007/s00264-025-06485-5","DOIUrl":"10.1007/s00264-025-06485-5","url":null,"abstract":"<p><strong>Purpose: </strong>Elbow joint instability results from the disruption of one or more stabilizing anatomical structures. The two most common forms of instability are posterolateral rotatory instability (PLRI) and medial elbow instability (MEI), particularly in athletes. This review aims to explore the anatomical foundations, diagnostic methods, and therapeutic approaches for PLRI and MEI in athletes.</p><p><strong>Methods: </strong>A comprehensive literature review was performed to investigate the study objective.</p><p><strong>Results: </strong>Regarding the anatomical background, the primary stabilizing structures of the elbow joint include the humeroulnar joint (trochlea, olecranon, and coronoid process), the medial collateral ligament (MCL), and the lateral ulnar collateral ligament (LUCL). PLRI is primarily caused by LUCL insufficiency, while MEI results from MCL dysfunction. A thorough clinical evaluation, combined with advanced imaging-magnetic resonance imaging (MRI) or MR arthrography is essential for an accurate diagnosis. For high-level athletes, surgical intervention is often required, with the timing and type of surgery tailored to the athlete's specific needs, expectations, and the chronicity of the injury.</p><p><strong>Conclusion: </strong>PLRI and MEI present diagnostic and therapeutic challenges, especially in athletes. Advanced imaging and clinical evaluation are crucial for the diagnosis. Surgical intervention, particularly arthroscopy, is often required for optimal outcomes.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":"1439-1450"},"PeriodicalIF":2.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143567145","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Body mass index matters: morbid obese patients have different microorganism profiles in the setting of periprosthetic hip joint infections.","authors":"Maximilian Budin, Nemandra A Sandiford, Thorsten Gehrke, Mustafa Citak","doi":"10.1007/s00264-025-06513-4","DOIUrl":"10.1007/s00264-025-06513-4","url":null,"abstract":"<p><strong>Purpose: </strong>This study investigated the relationship between BMI and microorganism profiles, with a particular focus on gut microorganisms in patients with PJI following total hip arthroplasty (THA). It also explored comorbidities, that may contribute to these variations.</p><p><strong>Methods: </strong>This study included all patients treated at our institution for a PJI of a THA between 1996 and 2021. Patients were categorized into four distinct BMI groups: <30; 30-34.9; 35-39.9; ≥ 40. Bivariate and logistic regression analysis were conducted, with presentation of odds ratio (OR) and 95% confidence interval (CI).</p><p><strong>Results: </strong>A total of 3645 hip PJI cases were recruited for the final analysis. Patients with a BMI ≥ 40 had approximately a ten fold higher risk for Streptococcus dysgalactiae (p < 0.001; OR = 9.92; 95% CI 3.87-25.44) and a seven fold higher risk for Proteus mirabilis (p < 0.001; OR = 7.43; 95% CI 3.13-17.67) and Klebsiella pneumoniae (p < 0.001; OR = 6.9; 95% CI 2.47-19.31). Furthermore, polymicrobial infections (p < 0.001; OR = 2.17; 95% CI 1.50-3.15) were found to be significantly more prevalent in patients with a BMI ≥ 40.</p><p><strong>Conclusion: </strong>Obese patients (BMI ≥ 30) displayed a distinct microorganism profile in hip PJIs, mainly dominated by Firmicutes and Proteobacteria. Comorbidities such as diabetes, hypertension, and hyperlipidaemia may contribute to a leaky gut syndrome, increasing PJI risk caused by gut microorganisms. Optimizing comorbidities may help reduce the risk of hip PJI. Further research is needed to clarify the relationship between obesity, gut microbiome alterations and hip PJI development.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":"1309-1317"},"PeriodicalIF":2.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143779859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"History of surgical approaches in orthopaedics.","authors":"Jan Bartoníček, Ondřej Naňka","doi":"10.1007/s00264-025-06541-0","DOIUrl":"10.1007/s00264-025-06541-0","url":null,"abstract":"<p><p>Surgical approaches in bone surgery have undergone a long evolution over more than 130 years. While a number of publications have been devoted to the history of internal fixation, surgical approaches have remained neglected from this perspective. The development of approaches in musculoskeletal surgery is inextricably linked to four personalities. Theodor Kocher, in 1892, pointed out that descriptions of surgical approaches must be an essential part of surgical textbooks of operative techniques; James Edwin Thompson, in 1918, formulated the basic requirements for the surgical approaches to the skeleton of limbs; Arnold Kirkpatrick Henry published the first textbook of surgical approaches in 1927 and presented the concept of internervous planes in 1945; in the same year, Toufick Nicola created the first comprehensive atlas of surgical approaches to bones and joints of limbs, the pelvis and spine.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":"49 6","pages":"1537-1541"},"PeriodicalIF":2.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12075019/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143990378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of femoral shaft fractures in Sub-Saharan Africa: A systematic review.","authors":"Patrick Birkenhead, Paul Joseph Birkenhead, Clara Vella, Maritz Laubscher, Sithombo Maqungo, Simon Matthew Graham","doi":"10.1007/s00264-025-06407-5","DOIUrl":"10.1007/s00264-025-06407-5","url":null,"abstract":"<p><strong>Purpose: </strong>Femoral shaft fractures are significant injuries and if not managed appropriately can result in high complication rates and long-term disability. These complex injuries occur at a higher rate across low and middle income countries and sub-Saharan Africa is thought to have a higher incidence than other regions across the world. This study aims to summarise the most up to date evidence surrounding the treatment and associated outcomes of adult femoral shaft fractures in sub-Saharan Africa - giving a clear understanding of current practices and highlighting potential areas for further research.</p><p><strong>Methods: </strong>PubMed, Google Scholar, Africa Journals Online, Cochrane, Clinicaltrial.gov were searched using Boolean search strategies. Data collected included demographics, fracture classification, interventions, union rates, time to union, patient-reported outcomes / functional outcome scores, and secondary outcomes (orthopaedic and medical complications, malunion / non-union, length of admission).</p><p><strong>Results: </strong>Twenty-three studies reporting 2,180 patients were included-73% (1592/2180) of patients were male, with a mean age of 35 years. Overall, 59% of patients were treated with intramedullary nailing (IMN), 23% with skeletal traction, and 14% with open reduction internal fixation (ORIF). There was a heterogeneity in practice in different regions, with the highest reported rates of IMN in Tanzania (99%), and lowest in Malawi (29.4%). Union rates were highest in IMN (82.4-100%) versus traction (48 - 100%) and ORIF (83.3-87%). Intramedullary nailing demonstrated a super complication profile, with better functional outcomes, shorter hospital stays and time to mobilisation.</p><p><strong>Conclusion: </strong>Intramedullary nailing demonstrated superior clinical and functional outcomes compared to other modalities for the treatment of femur shaft fractures across sub-Saharan Africa. However, there is significant sparsity of research and variable management approaches across the region. Focused research to determine the burden of injury, current healthcare resources and cost-effective and appropriate interventions to improve outcomes are now a public health priority.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":"1499-1508"},"PeriodicalIF":2.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143572809","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the editor: The efficacy of intra-articular corticosteroid injections for elbow arthritis: a retrospective cohort study.","authors":"Dazhi Li, Li Liu, Cheng Li","doi":"10.1007/s00264-025-06508-1","DOIUrl":"https://doi.org/10.1007/s00264-025-06508-1","url":null,"abstract":"","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":"49 6","pages":"1551-1552"},"PeriodicalIF":2.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143990091","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhanced accuracy and reduced complications: robot-assisted navigation for retrograde intramedullary nailing in distal femoral fractures.","authors":"Quanjie He, Zhitao Xie, Jingyu Zhang, Yongqiang Jiao, Yongtao Zhang, Yongcheng Hu","doi":"10.1007/s00264-025-06544-x","DOIUrl":"https://doi.org/10.1007/s00264-025-06544-x","url":null,"abstract":"<p><strong>Purpose: </strong>This research investigates the benefits of robot-assisted navigation systems in retrograde intramedullary nailing for distal femoral fractures and contrasts their outcomes with conventional surgical methods. This is a retrospective clinical study designed to compare the outcomes of these two approaches.</p><p><strong>Methods: </strong>This study included 56 distal femoral fracture patients treated between February 2020 and May 2023. Among them, 28 patients underwent robot-assisted retrograde intramedullary nailing (robot group), while 28 received conventional retrograde intramedullary nailing (traditional group). Surgical duration, intraoperative fluoroscopy frequency, number of guidewire insertions into the femoral medullary cavity, and intraoperative blood loss were recorded. Healing progress and fixation stability status were observed, and postoperative articular function was assessed using Neer's scoring system at a one year follow-up.</p><p><strong>Results: </strong>Baseline characteristics were comparable between the two groups, showing no statistically significant differences.The robot group demonstrated shorter operative time, fewer guidewire placements, reduced intraoperative hemorrhage and incision size compared to the traditional group (P < 0.05). While the Neer's score for postoperative joint function showed a higher excellent-to-good rate in the robot group, no significant difference was observed between the group (P > 0.05).</p><p><strong>Conclusion: </strong>Compared with traditional surgical methods, robot-assisted retrograde intramedullary fixation for fractures of the distal femur offers advantages of being minimally invasive, more precise, requiring shorter operative times, and resulting in reduced blood loss, fluoroscopy exposure, and guidewire insertion attempts. These benefits may contribute to a reduction in postoperative complications.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":"49 6","pages":"1519-1527"},"PeriodicalIF":2.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143971355","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors and clinical characteristics of spondylodiscitis: a comparative study.","authors":"Emine Bal, Ertuğrul Topcu, Zerrin Yuluğkural","doi":"10.1007/s00264-025-06540-1","DOIUrl":"https://doi.org/10.1007/s00264-025-06540-1","url":null,"abstract":"<p><strong>Purpose: </strong>Spondylodiscitis is a serious infection of the intervertebral discs and vertebrae, with rising incidence. This study provides an updated evaluation by analyzing causative microorganisms in tuberculous (TS), brucellar (BS), and pyogenic spondylodiscitis (PS). Our findings offer contemporary data to enhance understanding and management of spondylodiscitis.</p><p><strong>Methods: </strong>This retrospective study included 109 adult patients diagnosed with spondylodiscitis between 2011 and 2021 at a tertiary research center. Patients were categorized into three groups based on the causative pathogen. Demographic data, clinical presentations, laboratory findings, radiological imaging, and microbiological results were analyzed.</p><p><strong>Results: </strong>Among 109 patients, 59 (54.1%) had PS, 33 (32%) BS, and 17 (15.5%) TS. The cohort included 65 males (59.6%) and 44 females (40.4%), with a mean age of 57.6 ± 13.8 years. Back pain was the most common symptom (85.3%). Night sweats were more prevalent in BS (p < 0.001), while weight loss was less frequent in PS (p < 0.05). Diabetes was more common in PS (p < 0.001). PS cases had higher inflammatory markers (p < 0.001). Blood culture positivity was 53.6% in BS and 53.8% in PS. Surgery with tissue sampling was performed in 62 cases (56.9%). S. aureus was the most frequent pathogen, followed by Brucella spp.</p><p><strong>Conclusion: </strong>Spondylodiscitis requires a multidisciplinary diagnostic approach due to its variable clinical presentations. PS is characterized by elevated inflammatory markers and concurrent infectious foci, BS by endemic risk factors and systemic symptoms, and TS by prolonged symptoms and thoracic involvement.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":"49 6","pages":"1461-1470"},"PeriodicalIF":2.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143980695","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the Editor regarding the article: \"Proximal versus distal tenotomy of the Iliopsoas tendon in the surgical treatment of developmental dysplasia of the hip: a randomized clinical trial\".","authors":"Yunjie Song, Limin Wei","doi":"10.1007/s00264-025-06516-1","DOIUrl":"10.1007/s00264-025-06516-1","url":null,"abstract":"","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":"1549-1550"},"PeriodicalIF":2.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143811460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term follow-up of the medial arch correction with calcaneal medialization osteotomy in progressive collapsing foot deformity.","authors":"Julien Farge, Aurélien Moulin-Traffort, Romain Derousseaux, Valentin Rodrigues, Carlos Maynou, Thomas Amouyel","doi":"10.1007/s00264-025-06464-w","DOIUrl":"10.1007/s00264-025-06464-w","url":null,"abstract":"<p><strong>Purpose: </strong>Medializing displacement calcaneal osteotomies are part of conservative surgical treatments and represent a reliable option in valgus flatfoot deformities. Favorable short-term results of this procedure is well-known. However, there are few series with follow-up beyond five years. This study reports the clinical outcomes of calcaneal medialization osteotomy with a minimum follow-up of five years. The primary objective was to compare functional scores and radiographic measurements at the preoperative stage, immediately post operative, and at the final follow-up.</p><p><strong>Materials and methods: </strong>This was a retrospective, single-centre, multi-operator study of 32 patients, who underwent a medialization calcaneal osteotomy for type II flatfoot. Clinical evaluation of the patients was conducted using the American Orthopaedic Foot and Ankle Surgery (AOFAS) score and the European Foot and Ankle Society (EFAS) score. Radiographic evaluation used the plantar arch angle angle, the talus-first metatarsal axis (T-M1) on lateral weight-bearing radiographs, and calcaneal valgus on Meary's angle in a hindfoot alignment view.</p><p><strong>Results: </strong>Mean follow-up was seven years. AOFAS score improved from 46 to 87 and EFAS score from 11 to 20 (p < 0.05). Each radiographic parameter was significantly modified between the preoperative and immediate postoperative periods.</p><p><strong>Conclusion: </strong>We observed a significant and lasting improvement in functional scores at a mean follow-up of seven years. The correction of the evaluated radiographic parameters was significant and remained stable over time.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":"1351-1358"},"PeriodicalIF":2.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12075402/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143542014","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Single incision surgical approach for the release of lacertus syndrome and cubital tunnel syndrome.","authors":"Mohammed Muneer, Salwa Al-Maraghi","doi":"10.1007/s00264-025-06494-4","DOIUrl":"10.1007/s00264-025-06494-4","url":null,"abstract":"<p><strong>Background: </strong>understanding the concept of multiple compression neuropathy syndrome has recently evolved, leading to better clinical assessment and evaluation. However, decompression of the involved nerves might require multiple incisions. Concomitant compression neuropathy, such as Lacertus Syndrome (LS) and cubital tunnel syndrome, is not uncommon. The traditional approach for releasing both nerves encompasses two separate surgical incisions. Minimazing surgical incisions is essential for postoperative scar management and nerve gliding. In this paper we describe a single surgical incision for releasing both compressions.</p><p><strong>Surgical technique: </strong>To release the Lacertus Fibrosis using the classical surgical incision for cubital tunnel syndrome, an incision is made between the medial epicondyle and olecranon. After reaching the brachial fascia, the skin and subcutaneous tissue are raised as a one flap off the fascia. The lacertus fibrosis, identified as a thick rectangular or trapezoid stracture attached to the brachial fascia, is then incised to expose the median nerve beneath it.</p><p><strong>Conclusion: </strong>As we advance towards the concept of multiple compression neuropathy, it is crucial to minimize surgical incisions to reduce pain, wound breakdown, scar formation, traction neuropathy, neuroma formation, and unsatisfactory aesthetic outcomes.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":"1421-1425"},"PeriodicalIF":2.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12075323/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143648527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}