International Orthopaedics最新文献_第4页

Imaging on the painful and compressed nerve: upper extremity.

IF 2 3区医学

International Orthopaedics Pub Date : 2025-04-01 Epub Date: 2025-02-10 DOI: 10.1007/s00264-025-06436-0

Marcelo Bordalo, Maria Lua Sampaio Gulde, Elisabet Hagert

{"title":"Imaging on the painful and compressed nerve: upper extremity.","authors":"Marcelo Bordalo, Maria Lua Sampaio Gulde, Elisabet Hagert","doi":"10.1007/s00264-025-06436-0","DOIUrl":"10.1007/s00264-025-06436-0","url":null,"abstract":"Compressive neuropathies of the upper extremity are a common cause of pain, weakness, and functional impairment, often resulting from chronic mechanical compression or entrapment of peripheral nerves in anatomical regions such as osteofibrous tunnels, fibrous bands, or muscular pathways. While traditional diagnostic methods, including clinical evaluation and electrophysiological studies, are essential, they are limited in localizing lesions and identifying underlying causes. Advances in ultrasonography (US) and magnetic resonance imaging (MRI), particularly MR neurography and high-resolution 3D volumetric imaging, have significantly improved the evaluation of peripheral nerves by enabling detailed visualization of nerve anatomy, adjacent structures, and muscle denervation patterns. This article reviews the role of these imaging techniques in diagnosing and managing compressive neuropathies affecting the brachial plexus, suprascapular, axillary, median, ulnar, and radial nerves, highlighting key imaging findings such as nerve thickening, signal abnormalities, and muscle changes. The integration of advanced imaging modalities into clinical practice enhances diagnostic accuracy, facilitates surgical planning, and improves treatment outcomes for patients with peripheral nerve compression.","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":"815-825"},"PeriodicalIF":2.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11971187/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143382504","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}

引用次数: 0

Outcomes of lateral femoral cutaneous nerve decompression surgery in meralgia paraesthetica: assessment of pain, sensory deficits, and quality of life.

IF 2 3区医学

International Orthopaedics Pub Date : 2025-04-01 Epub Date: 2025-03-07 DOI: 10.1007/s00264-025-06463-x

Francesco Reuter, Karl Schwaiger, Paul Panzenbeck, Michaela Gruber, Maximilian Mahrhofer, Martin Geroldinger, Andreas Gohritz, Gottfried Wechselberger, Elisabeth Russe

{"title":"Outcomes of lateral femoral cutaneous nerve decompression surgery in meralgia paraesthetica: assessment of pain, sensory deficits, and quality of life.","authors":"Francesco Reuter, Karl Schwaiger, Paul Panzenbeck, Michaela Gruber, Maximilian Mahrhofer, Martin Geroldinger, Andreas Gohritz, Gottfried Wechselberger, Elisabeth Russe","doi":"10.1007/s00264-025-06463-x","DOIUrl":"10.1007/s00264-025-06463-x","url":null,"abstract":"Purpose: Meralgia paraesthetica (MP) is a rare neuropathy of the lateral femoral cutaneous nerve (LFCN), characterized by thigh pain, paraesthesia, or sensory loss. When conservative treatments fail, surgical interventions such as neurolysis or neurectomy are considered. This study aims to evaluate the effectiveness of surgical decompression of the LFCN in alleviating pain, addressing sensory deficits, and improving quality of life.Methods: A prospective study was conducted on 26 patients who underwent LFCN decompression surgery between 2015 and 2023, with a minimum follow-up period of one year. Outcomes were assessed using pre- and postoperative questionnaires, including the Brief Pain Inventory (BPI) and the Pain Disability Index (PDI).Results: The cohort consisted of 15 males and 11 females, with 81% reporting symptom onset following prior surgeries or trauma. Postoperatively, 95.8% of patients experienced pain relief, with 76.9% achieving complete pain resolution (NRS 0). There was a significant reduction in average perceived pain (from 6.6 ± 1.9 to 0.7 ± 1.1; p < 0.001) and maximum perceived pain (8.0 ± 1.54 to 1.0 ± 1.67; p < 0.001). Full sensory function was restored in 61.2% of patients, and quality of life scores improved markedly, with an average increase of 8.4 out of 10 points (± 1.9; p < 0.001).Conclusion: These results demonstrate that neurolysis of the LFCN is highly effective in the treatment of refractory MP, offering substantial pain relief, sensory restoration, and improved quality of life. Furthermore, patients with previous injuries or surgeries benefited most from NL, suggesting that these factors serve as positive prognostic indicators.","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":"863-870"},"PeriodicalIF":2.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143572813","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}

引用次数: 0

Anatomical variations and their association with carpal tunnel syndrome: a comparison with healthy controls.

IF 2 3区医学

International Orthopaedics Pub Date : 2025-04-01 Epub Date: 2025-03-13 DOI: 10.1007/s00264-025-06480-w

Michaela Gruber, Agnes Wawrik, Florin Gasser, Barbara Ebner, Philipp Reitbauer, Robert Uzel, Rodolphe Poupardin, Maximilian Mahrhofer, Laurenz Weitgasser, Karl Schwaiger, Gottfried Schaffler, Gottfried Wechselberger, Elisabeth Russe

{"title":"Anatomical variations and their association with carpal tunnel syndrome: a comparison with healthy controls.","authors":"Michaela Gruber, Agnes Wawrik, Florin Gasser, Barbara Ebner, Philipp Reitbauer, Robert Uzel, Rodolphe Poupardin, Maximilian Mahrhofer, Laurenz Weitgasser, Karl Schwaiger, Gottfried Schaffler, Gottfried Wechselberger, Elisabeth Russe","doi":"10.1007/s00264-025-06480-w","DOIUrl":"10.1007/s00264-025-06480-w","url":null,"abstract":"Purpose: The prevalence of carpal tunnel syndrome (CTS) as the foremost upper extremity entrapment neuropathy is well-documented. The present study aimed to evaluate the prevalence of anatomical variations in the carpal tunnel and their potential role as risk factors for CTS.Methods: Data from 447 CTS patients who underwent median nerve decompression between 2018 and 2019 were retrospectively analyzed. As a control group, 200 hands from 103 age- and sex-matched asymptomatic volunteers were further investigated.Results: Anatomical variations identified through ultrasound in 19.7% of CTS hands and 16.0% of controls. Specifically, 10.3% of CTS hands had persistent median arteries, while 14.3% had bifid median nerves. Both variations occurred in 4.9% of CTS patients. In the control group, 13.0% had persistent median arteries and 11.0% had bifid median nerves, with both found in 8.0%.Conclusions: Anatomical variations were found in both, CTS patients and controls, but their prevalence did not differ significantly between groups, suggesting they are not independent risk factors for CTS.","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":"911-917"},"PeriodicalIF":2.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624770","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}

引用次数: 0

Imaging on the painful and compressed nerve: lower extremity.

IF 2 3区医学

International Orthopaedics Pub Date : 2025-04-01 Epub Date: 2025-01-28 DOI: 10.1007/s00264-025-06419-1

Marcelo Bordalo

引用次数: 0

Morton's neuroma: who, when and how contributed to its description and treatment? 莫顿神经瘤：谁，何时以及如何促成了它的描述和治疗？

IF 2 3区医学

International Orthopaedics Pub Date : 2025-04-01 Epub Date: 2024-12-21 DOI: 10.1007/s00264-024-06390-3

Carlo Biz, Alberto Crimì, Fabiana Mori, Felicia Deborah Zinnarello, Giovanni Sciarretta, Pietro Ruggieri

{"title":"Morton's neuroma: who, when and how contributed to its description and treatment?","authors":"Carlo Biz, Alberto Crimì, Fabiana Mori, Felicia Deborah Zinnarello, Giovanni Sciarretta, Pietro Ruggieri","doi":"10.1007/s00264-024-06390-3","DOIUrl":"10.1007/s00264-024-06390-3","url":null,"abstract":"Purpose: The interdigital nerve neuroma of the forefoot is commonly known as Morton's Neuroma. Many authors have described and treated this condition before and after Morton. This study aims to investigate the past scientific literature to better understand what comprehension and treatments have been used to master this pathology.Methods: Historical and modern scientific accounts were searched for descriptions of interdigital nerve neuroma or metatarsalgia (as some authors described it) to have a thorough overview of the subject. The scientific literature was searched to highlight the evolution of the nomenclature and to summarise historical and current treatments, especially conservative ones.Results: Influential authors described the interdigital nerve neuroma and its symptoms. Durlacher, the King's podiatrist in England in the 1800s, was the first to understand that this was a neuralgic affection; with his practical approach, he treated the Neuroma using pressure-relieving footwear. The first anatomical description should be credited to the Italian anatomist Civinini. Morton, the American Civil War surgeon, was the first to understand the aetiology of pain better and the first to propose a surgical treatment to relieve symptoms. Tubby, the British alpine climber, linguist, archaeologist and orthopaedic surgeon, observed a nodular mass on the third common digital nerve and proposed surgical treatment with resection of the metatarso-phalangeal joint.Conclusion: the use of a term widely accepted and recognised by all its users with a precise meaning and symbolisation makes it easily understandable and lasting. Also, if it is known that what is called Morton's neuroma is not a neuroma but a benign perineural fibrosis of a common plantar digital nerve, the use of the terminology Morton's neuroma is still universally accepted and recognised.","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":"975-987"},"PeriodicalIF":2.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142872033","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}

引用次数: 0

Enhanced bone exposure via laparoscopy in acetabulum and pelvic ring surgeries.

IF 2 3区医学

International Orthopaedics Pub Date : 2025-03-31 DOI: 10.1007/s00264-025-06515-2

Guillaume David, Marine Giorgi, Florian Bernard, Remi Di Francia, Cyril Mauffrey, Louis Rony

{"title":"Enhanced bone exposure via laparoscopy in acetabulum and pelvic ring surgeries.","authors":"Guillaume David, Marine Giorgi, Florian Bernard, Remi Di Francia, Cyril Mauffrey, Louis Rony","doi":"10.1007/s00264-025-06515-2","DOIUrl":"https://doi.org/10.1007/s00264-025-06515-2","url":null,"abstract":"Purpose: In orthopaedic surgery, achieving optimal exposure for acetabular and pelvic ring fractures with minimal invasiveness remains a challenge. This study compares bone exposure in key pelvic zones using an endoscopic approach versus the AIP (Modified Stoppa) in cadaveric specimens.Materials and methods: We dissected ten adult cadaveric bodies, obtained from our institution's body donation program, using an extraperitoneal endoscopic dissection on one side and an AIP approach on the other. Bone areas were marked at each step of dissection by drill holes to measure the bone exposure surface for each zone (true and false pelvis) between the laparoscopic and open approaches. A Student's t test was used to compare the exposure areas obtained.Results: The average age of the cadavers was 83 years, with a balanced representation of genders (60% male, 40% female). Comparison of zones between endoscopy and AIP found for Zone 1: 1.4 cm2 (range - 3.813 to 1.013) for AIP with no statistical significance. For Zone 2: 0.5 cm2 (range - 1.9141 to 2.9141) for AIP with no statistical significance. For Zone 3: 0,6 cm2 (range - 1.0243 to 2.2243) for AIP with no statistical significance. And for Zone 4: 3.5 cm2 (1.874; 5.126) for endoscopy with statistical significance (p = 0.001).Conclusion: Our study demonstrates that the endoscopic method provides comparable visualization of the different pelvic zones compared to the open method (AIP), with enhanced access to Zone 4, a crucial area in managing acetabulum and pelvic ring fractures.Level of evidence: Level V, cadaveric study.","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752713","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}

引用次数: 0

Concomitant sacroiliac joint abnormalities in patients with femoroacetabular impingement.

IF 2 3区医学

International Orthopaedics Pub Date : 2025-03-29 DOI: 10.1007/s00264-025-06484-6

Sonia E Ubong, Teresa Clode Araújo, Zaki Arshad, Vikas Khanduja

{"title":"Concomitant sacroiliac joint abnormalities in patients with femoroacetabular impingement.","authors":"Sonia E Ubong, Teresa Clode Araújo, Zaki Arshad, Vikas Khanduja","doi":"10.1007/s00264-025-06484-6","DOIUrl":"https://doi.org/10.1007/s00264-025-06484-6","url":null,"abstract":"Purpose: Despite the increasing understanding of femoroacetabular impingement (FAI), the impact of specific patient characteristics, including inflammatory pathologies like axial spondyloarthritis (axSpA), on its pathophysiology and clinical outcomes following treatment remains inadequately defined. Therefore, the purpose of this scoping review was to evaluate the relationship between FAI and sacroiliac (SI) joint abnormalities and FAI and axSpA.Methods: The study was conducted following the framework established by Arksey and O'Malley and Levac et al., adhering to the PRISMA scoping review extension checklist. A systematic search was performed across MEDLINE, EMBASE, and Cochrane Library databases for articles published until August 2024. A total of 120 articles were screened and eight finally met the inclusion criteria.Results: The review analysed data from the eight retrospective studies with a total of 1,723 patients. We found that the prevalence of SI joint abnormalities in patients with FAI can be as high as 25-28%. Furthermore, the prevalence of FAI morphology in patients with axial spondyloarthritis can be as high as 20-37%. Finally, patients undergoing hip arthroscopy for FAI with axSpA and/or SI joint abnormalities have lower postoperative outcome scores reported in comparison with those patients who do not have these comorbidities.Conclusion: Over a quarter of patients with FAI can have concomitant radiographic SI joint abnormalities. We cannot overemphasise the importance of assessing the spine, specifically the SI joint, and ruling out symptoms emanating from the SI joint in all patients with FAI. There is clearly a knowledge gap in understanding the underlying pathophysiology linking FAI and axSpA. We require further research to elucidate the underlying mechanisms of this relationship, standardise evaluation methods, and explore long-term outcomes in this cohort of patients.","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143742891","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}

引用次数: 0

Letter to the editor on "Comprehensive Comparison Between Conservative Therapy and Surgical Management for Completely Displaced and Comminuted Mid-Shaft Clavicle Fractures".

IF 2 3区医学

International Orthopaedics Pub Date : 2025-03-29 DOI: 10.1007/s00264-025-06514-3

Yiwei Zhang, Xin Tang, Yanming Gao, Rongsheng Huang

{"title":"Letter to the editor on \"Comprehensive Comparison Between Conservative Therapy and Surgical Management for Completely Displaced and Comminuted Mid-Shaft Clavicle Fractures\".","authors":"Yiwei Zhang, Xin Tang, Yanming Gao, Rongsheng Huang","doi":"10.1007/s00264-025-06514-3","DOIUrl":"https://doi.org/10.1007/s00264-025-06514-3","url":null,"abstract":"We discuss the study by Xiao Han et al., titled \" Comprehensive Comparison Between Conservative Therapy and Surgical Management for Completely Displaced and Comminuted Mid-Shaft Clavicle Fractures \" The authors compared outcomes between conservative and surgical treatments in 105 patients, finding higher union rates, faster healing, and no malunion in the surgical group, albeit with a notable incidence of postoperative numbness. While long-term functional outcomes were comparable, surgery offered quicker recovery of strength and return to work. However, as a retrospective study, potential selection bias exists-more active, younger patients tended to undergo surgery, while older patients with comorbidities opted for conservative care. The absence of propensity score matching (PSM) further limits comparability. Moreover, the relatively short follow-up (mean: 21.24 months) restricts insights into long-term complications. Previous long-term studies suggest surgical benefits may wane over time. Future randomized, long-term, and cost-focused studies would be valuable to guide treatment decisions more robustly.","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143742892","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}

引用次数: 0

Critical review of "Normative values of grip and pinch strength and their predictor factors: PERSIAN cohort study of healthcare staff".

IF 2 3区医学

International Orthopaedics Pub Date : 2025-03-28 DOI: 10.1007/s00264-025-06505-4

Raju Vaishya, Abhishek Vaish, Anoop Misra

引用次数: 0

Paediatric ballistic fracture patients: who has poor follow-up and why?

IF 2 3区医学

International Orthopaedics Pub Date : 2025-03-28 DOI: 10.1007/s00264-025-06506-3

Zachary Jodoin, Daanish Sheikh, Cameron Atkinson, Loc Uyen Vo, Alvaro Moreira, Christina Brady, Boris Zelle

{"title":"Paediatric ballistic fracture patients: who has poor follow-up and why?","authors":"Zachary Jodoin, Daanish Sheikh, Cameron Atkinson, Loc Uyen Vo, Alvaro Moreira, Christina Brady, Boris Zelle","doi":"10.1007/s00264-025-06506-3","DOIUrl":"https://doi.org/10.1007/s00264-025-06506-3","url":null,"abstract":"Purpose: Firearm-related injuries in children and adolescents have increased over the past decade. The standard of care for ballistic fractures in children is complex, resulting in a burden of healthcare follow-up that many families find challenging. Consistent follow-up is crucial, especially in orthopaedic trauma and firearm cases, to prevent complications. This study aims to identify demographic and clinical variables associated with loss to follow-up (LTFU) in paediatric patients with ballistic fractures.Methods: This is a retrospective registry study at a Level I trauma centre for patients aged zero to 21 who presented with a ballistic-induced fracture. Patients with isolated skull, facial, or rib fractures were excluded. Follow-up was dichotomized at the median number of follow-up days for analysis. Logistic regression analysis was used to identify predictors of LTFU.Results: The study included 144 patients with a median age of 18 years. The majority were male (89%) and White (72%). Most patients had government insurance (44%) or were uninsured (33%). The mechanism of injury was primarily assault (71%). Operative intervention occurred in 55% of cases. Key factors increasing follow-up adherence included male sex (p = 0.011), higher injury severity scores (p = 0.009), requiring operative intervention (p < 0.001), air transportation (p < 0.001), or injury at a private residence (p = 0.040). Uninsured status (p = 0.007), opioid use (p = 0.047), and greater distance from the hospital (p = 0.002) were associated with low follow-up.Conclusions: This study identifies key factors influencing follow-up adherence in pediatric patients with ballistic fractures. Identifying these factors allows for tailoring future interventions to improve follow-up adherence for this vulnerable population.","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143735838","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}

引用次数: 0