International Orthopaedics最新文献

{"title":"An informational video for informed consent improves patient comprehension before total hip replacement- a randomized controlled trial.","authors":"Sebastian von Hertzberg-Boelch, Konrad Fuchs, Johanna Schubring, Dominik Rak, Kilian List, Konstantin Horas, Axel Jakuscheit, Maximilian Rudert","doi":"10.1007/s00264-025-06503-6","DOIUrl":"https://doi.org/10.1007/s00264-025-06503-6","url":null,"abstract":"<p><strong>Purpose: </strong>Effective patient comprehension is critical for informed consent, particularly in Total Hip Arthroplasty (THA), a globally prevalent procedure. This study evaluates the efficacy of an informational video to improve the patients' understanding, self-perceived knowledge, and emotional comfort in the context of THA informed consent. This randomized controlled trial investigates the impact of an additional informational video on (I) the patients' understanding, (II) self-precepted knowledge and (III) emotional comfort during the informed consent process for THA.</p><p><strong>Methods: </strong>Participants were randomized to receive either the standard informed consent procedure or the standard procedure supplemented with an informational video. The effect of the video was tested with post-consent questionnaires.</p><p><strong>Results: </strong>The informational video significantly (p = 0.014) improved the patients' understanding from 78.6% to 86.5%. Self-precepted knowledge and Emotional comfort was not effected by the video (p = 0.986; p = 0.333).</p><p><strong>Conclusions: </strong>The informational video significantly improved patient comprehension during the informed consent process before THA.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143763827","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":"Carpal tunnel syndrome diagnosis as a risk factor for falls.","authors":"Devi Lakhlani, Troy A Shahoumian, Catherine Curtin","doi":"10.1007/s00264-024-06395-y","DOIUrl":"10.1007/s00264-024-06395-y","url":null,"abstract":"<p><strong>Purpose: </strong>Subclinical peroneal neuropathy without overt foot drop has been linked to increased fall risk in adults, yet remains under reported due to subtle symptoms and lack of awareness. Patients with carpal tunnel syndrome (CTS) often experience other nerve entrapments, prompting this study to evaluate CTS (a proxy for peroneal nerve entrapment) as a significant predictor of time to first fall.</p><p><strong>Methods: </strong>Data from the Merative MarketScan Research Databases (2007-2021) were used to identify adult patients using ICD-9/10 codes. Patients were stratified by CTS diagnosis and fall occurrences, with relevant comorbidities recorded. A survival analysis employing the Cox proportional hazards model assessed relationships between CTS, comorbidities, and future fall risk, accounting for changes in health status over time. Age was the time scale with CTS as a time-varying predictor. This approach isolated CTS-associated risk, while considering the natural increase in fall risk with age.</p><p><strong>Results: </strong>Among 63,187,681 subjects (mean age = 52.82 years ± 7.61), 1,411,695 had a diagnosis of CTS. Of those with CTS, 45,479 patients had a future fall. Univariate analysis showed significant associations between CTS and higher rates of arthritis and diabetes, while heart disease was less prevalent. CTS increased fall risk by 25% (HR 1.25, p < .005). Heart disease was associated with a 10% increase in fall risk (HR 1.10, p < .005), while arthritis and diabetes increased fall risk by 2% (both HR 1.02, p < .005). Kaplan-Meier curve illustrated a steeper decline in survival probability for the CTS group, indicating they experienced falls at younger ages and at a higher rate than those without CTS (χ² = 4386.4, p < .001).</p><p><strong>Conclusion: </strong>Prior diagnosis of CTS is associated with an increased fall risk. Providers should screen CTS patients for fall risk and implement appropriate monitoring strategies. Further investigation on the role of peroneal nerve entrapment in this increased fall risk is warranted. This study identifies a treatable cause of falls, with potential to enhance patient safety and reduce fall-related morbidity.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":"805-812"},"PeriodicalIF":2.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142926994","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":"A narrative review of nerve compression syndromes in overhead throwing athletes.","authors":"Frantzeska Zampeli, Theodorakys Marín Fermín, Elisabet Hagert","doi":"10.1007/s00264-025-06453-z","DOIUrl":"10.1007/s00264-025-06453-z","url":null,"abstract":"<p><strong>Purpose of review: </strong>The purpose of this narrative review is to highlight upper extremity nerve compression syndromes and peripheral neuropathies reported in throwing and overhead athletes.</p><p><strong>Recent findings: </strong>The overhead-throwing athlete may experience unique patterns of injuries and pathology related to the biomechanics and demands of the throwing motion, a demanding manoeuvre that places a significant amount of stress across the upper limb. Nerve injuries that may appear in high-level throwers include suprascapular and long thoracic neuropathy, quadrilateral space syndrome, and thoracic outlet syndrome. Nerve compression syndromes around the shoulder may appear with pain, paresthesia, and upper limb weakness. Overlapping features may be common among these compression neuropathies or mimic other common shoulder pathologies. Prompt differential diagnosis and successful treatment should be based on knowledge of key anatomical features, pathophysiology, clinical examination, and appropriate paraclinical studies.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":"827-834"},"PeriodicalIF":2.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143440936","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":"The clinical triad: a structured approach to diagnosing peripheral nerve compressions.","authors":"Elisabet Hagert","doi":"10.1007/s00264-025-06452-0","DOIUrl":"10.1007/s00264-025-06452-0","url":null,"abstract":"<p><strong>Purpose: </strong>Peripheral nerve compression syndromes are a common cause of pain, weakness, and functional limitations, yet they often remain underdiagnosed due to the limitations of traditional diagnostic methods such as electromyography and imaging. This article describes the clinical triad-manual muscle testing (MMT), sensory-collapse testing (SCT), and pain evaluation-as a structured, integrative approach to improving the diagnosis of nerve compressions.</p><p><strong>Methods: </strong>This narrative review examines the anatomical basis and diagnostic application of the clinical triad across common peripheral nerve compression syndromes. The review focuses on the median, ulnar, and radial nerves in the upper extremity, as well as the peroneal nerve in the lower extremity. Each component of the triad is analyzed for its role in detecting nerve compressions, including the reliability of MMT for identifying muscle weakness patterns, the specificity of SCT as a confirmatory tool, and the role of pain assessment in localizing entrapment sites.</p><p><strong>Results: </strong>The clinical triad provides a structured and accessible diagnostic framework that enhances the detection of nerve compressions, even in early-stage presentations that may evade standard diagnostic tools. It demonstrates adaptability to complex cases, including double- and multiple-crush syndromes, and offers a non-invasive, cost-effective alternative to traditional diagnostic approaches.</p><p><strong>Conclusion: </strong>The clinical triad enhances diagnostic precision in peripheral nerve compression syndromes by integrating motor, sensory, and pain assessments. Its structured methodology facilitates early detection and targeted interventions, potentially improving patient outcomes while reducing reliance on invasive or resource-intensive diagnostic methods.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":"899-909"},"PeriodicalIF":2.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11971183/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143572832","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":"Applications of artificial intelligence in ultrasound imaging for carpal-tunnel syndrome diagnosis: a scoping review.","authors":"Yosra Magdi Mekki, Hye Chang Rhim, Daniel Daneshvar, Antonios N Pouliopoulos, Catherine Curtin, Elisabet Hagert","doi":"10.1007/s00264-025-06497-1","DOIUrl":"10.1007/s00264-025-06497-1","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this scoping review is to analyze the application of artificial intelligence (AI) in ultrasound (US) imaging for diagnosing carpal tunnel syndrome (CTS), with an aim to explore the potential of AI in enhancing diagnostic accuracy, efficiency, and patient outcomes by automating tasks, providing objective measurements, and facilitating earlier detection of CTS.</p><p><strong>Methods: </strong>We systematically searched multiple electronic databases, including Embase, PubMed, IEEE Xplore, and Scopus, to identify relevant studies published up to January 1, 2025. Studies were included if they focused on the application of AI in US imaging for CTS diagnosis. Editorials, expert opinions, conference papers, dataset publications, and studies that did not have a clear clinical application of the AI algorithm were excluded.</p><p><strong>Results: </strong>345 articles were identified, following abstract and full-text review by two independent reviewers, 18 manuscripts were included. Of these, thirteen studies were experimental studies, three were comparative studies, and one was a feasibility study. All eighteen studies shared the common objective of improving CTS diagnosis and/or initial assessment using AI, with shared aims ranging from median nerve segmentation (n = 12) to automated diagnosis (n = 9) and severity classification (n = 2). The majority of studies utilized deep learning approaches, particularly CNNs (n = 15), and some focused on radiomics features (n = 5) and traditional machine learning techniques.</p><p><strong>Conclusion: </strong>The integration of AI in US imaging for CTS diagnosis holds significant promise for transforming clinical practice. AI has the potential to improve diagnostic accuracy, streamline the diagnostic process, reduce variability, and ultimately lead to better patient outcomes. Further research is needed to address challenges related to dataset limitations, variability in US imaging, and ethical considerations.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":"965-973"},"PeriodicalIF":2.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11971218/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143657145","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":"Immersive virtual reality in the rehabilitation of athlete nerve entrapments.","authors":"Tom Lattré, Mariusz P Furmanek, Alejandro Suero-Pineda","doi":"10.1007/s00264-025-06433-3","DOIUrl":"10.1007/s00264-025-06433-3","url":null,"abstract":"<p><strong>Introduction: </strong>The implementation of Virtual Reality technology is approaching a breakthrough within the medical, and rehabilitation fields. The level of immersion in the virtual environment is profound and the potential applications are vast.</p><p><strong>Methods: </strong>This article reviews the capabilities of Virtual Reality in conjunction with the rehabilitation of nerve entrapments in sport athletes and examines the interactions between our body and brain within the virtual realm. In clinical practice it could be used as a complement to face-to-face therapy to asynchronous use by the patient in any location as a telerehabilitation system.</p><p><strong>Conclusion: </strong>The use of Virtual Reality is a novel, potential, and promising tool in the treatment of nerve entrapments, even possible in the form of telerehabilitation. The response of body and brain in a virtual setting is good, the evolutions in technology can only improve this and this need to be substantiated by further scientific research.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":"943-949"},"PeriodicalIF":2.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143382454","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: Carpal tunnel syndrome diagnosis as a risk factor for falls.","authors":"Nienke A Krijnen, Teun Teunis","doi":"10.1007/s00264-025-06490-8","DOIUrl":"10.1007/s00264-025-06490-8","url":null,"abstract":"","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":"813"},"PeriodicalIF":2.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624803","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":"The emerging field of ultrasound-guided nerve decompression surgery: a narrative review.","authors":"Thomas Apard","doi":"10.1007/s00264-025-06418-2","DOIUrl":"10.1007/s00264-025-06418-2","url":null,"abstract":"<p><strong>Introduction: </strong>The development of high-frequency ultrasound technology has transformed musculoskeletal diagnostic practices, offering detailed, multi-plane visualization of superficial structures with remarkable precision and comfort. This non-invasive, pain-free modality is particularly suited for patients of all ages, including children.</p><p><strong>Purpose: </strong>Ultrasound serves as a valuable adjunct to clinical evaluations by facilitating the identification of conditions such as tumours, tenosynovitis, fractures, and nerve entrapments. Portable ultrasound devices have further expanded its utility to clinical, surgical, and emergency settings. Dynamic assessments, such as nerve gliding and entrapment detection, benefit from its precision, enabling targeted therapeutic interventions with minimal risks.</p><p><strong>Method: </strong>The integration of ultrasound into surgical techniques, termed ultrasonosurgery, allows for minimally invasive management of conditions like carpal tunnel syndrome and other nerve compressions. By leveraging high-resolution imaging, these procedures can be performed under local anaesthesia, minimizing traditional surgical complications.</p><p><strong>Result: </strong>This innovative approach aligns with contemporary healthcare trends emphasizing wide-awake surgeries, office-based care, mini-invasive procedures, and technological advancements. Such practices not only streamline patient care but also reduce costs and improve outcomes.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":"935-941"},"PeriodicalIF":2.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143122995","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":"Special issue: nerve compression syndromes \"Brachioradialis, or \"High Wartenberg\", syndrome - compression of the sensory branch of the radial nerve in the proximal forearm.","authors":"Elisabet Hagert, Camila Azocar, Ulrika Jedeskog, Ashraf Hantouly","doi":"10.1007/s00264-024-06350-x","DOIUrl":"10.1007/s00264-024-06350-x","url":null,"abstract":"<p><strong>Purpose: </strong>Compression of the sensory branch of the radial nerve (SBRN) in the proximal forearm is an uncommon condition, leading to both motor and sensory deficits. The aim of this study is to assess the surgical outcomes of SBRN release at the level of the brachioradialis arcade.</p><p><strong>Methods: </strong>A retrospective study of prospectively collected data was conducted on patients undergoing brachioradialis release (BRR) from March 2014 to March 2021. The measured outcomes included quick-DASH (Disability of the Arm Shoulder Hand questionnaire), work-DASH, visual analog scale (VAS) scores for pain, and patient satisfaction with surgery, at a minimum six month follow-up.</p><p><strong>Results: </strong>A total of twenty patients (mean age of 44.1 (range 25-62) were included in this study, of which nine (45%) were males. Eleven patients (55%) underwent isolated BRR, while the other nine patients (45%) underwent concomitant BRR and lacertus release. The three most common presenting symptoms in patients with isolated BRS were radiovolar forearm pain (100%), disturbed sensation in the SBRN territory (85%), and hand/thumb fatigue (75%). Forearm pain and fatigue were found in all patients with combined BRS and lacertus syndrome. The response rate for the functional outcome scores was 65% (13/20). Quick-DASH significantly improved (preoperative 29.6 (range 13.6-57.5) to postoperative 6.9 (range 0-27.27), p < 0.0001) as did the work DASH (p < 0.0001). Follow-up VAS Pain was 1 and satisfaction with surgery 9.6.</p><p><strong>Conclusion: </strong>BRS is an uncommon radial nerve compression syndrome in the proximal forearm that differs from the more commonly recognized radial tunnel syndrome. It presents with radio-volar forearm pain, disturbed sensation in the SBRN distribution, and loss of hand/thumb endurance. Minimally invasive BRR immediately restores wrist extension strength, significantly improves DASH scores, and yields positive outcomes at a minimum six-month follow-up.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":"799-804"},"PeriodicalIF":2.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11971141/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142465601","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":"The role of nerve transfers in chronic nerve compression syndromes.","authors":"Patrick J Kennedy, Shayoni Nag, Reade Otto-Moudry, Amy M Moore","doi":"10.1007/s00264-025-06434-2","DOIUrl":"10.1007/s00264-025-06434-2","url":null,"abstract":"<p><strong>Purpose: </strong>Compression neuropathy is a common problem that results in impaired axonal conduction, and with time, numbness, tingling and weakness from muscle atrophy. Supercharge reverse end-to-side (SETS) nerve transfers have emerged as a novel approach to augment function in chronic nerve compression syndromes with minimal donor site morbidity. This review answers the question, \"What are the indications, surgical techniques, and nuances of SETS nerve transfers for ulnar, axillary, radial, and femoral compression neuropathies?\".</p><p><strong>Methods: </strong>This article reviews current literature and technical components of the use of SETS in chronic nerve compression syndromes.</p><p><strong>Results: </strong>SETS nerve transfers improve functional outcomes and reduce disability in chronic nerve compression syndromes with limited donor site morbidity. SETS nerve transfers for ulnar, axillary, and femoral compressive neuropathy improve muscle strength, as demonstrated by increased MRC scores. It has also been shown that SETS transfers decrease clawing in ulnar nerve compression and pain in axillary nerve compression. More research is needed for SETS transfers for radial nerve compression neuropathies.</p><p><strong>Conclusion: </strong>SETs nerve transfers have emerged as a novel approach to restore function and reduce pain and dysfunction in chronic nerve compression syndromes. SETS nerve transfers have minimal donor site morbidity and improve the strength and function of muscles innervated by the effected \"recipient\" nerve. This review explores the indications and surgical techniques of SETS nerve transfers for ulnar, axillary, radial, and femoral compression neuropathies as well as their reported outcomes.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":"881-889"},"PeriodicalIF":2.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11971203/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143458096","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}