International Orthopaedics最新文献

{"title":"Medial closing wedge distal femur osteotomy by medial approach using paediatric locking plate for correction of Genu Valgum in adolescents.","authors":"Nishant Jagdale, Rupesh Wod, Rujuta Mehta, Alaric Aroojis","doi":"10.1007/s00264-025-06602-4","DOIUrl":"10.1007/s00264-025-06602-4","url":null,"abstract":"","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":"2171-2179"},"PeriodicalIF":2.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144575485","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 editor on \"Arthroscopic cystectomy and open surgery for the treatment of popliteal cysts: a retrospective clinical cohort study\".","authors":"Yudong Wang, Hao Wu","doi":"10.1007/s00264-025-06590-5","DOIUrl":"10.1007/s00264-025-06590-5","url":null,"abstract":"","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":"2319-2320"},"PeriodicalIF":2.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144475239","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":"Radiographic and functional outcomes of shelf acetabuloplasty versus conservative management in legg-calvé-perthes disease: an age- and gender-matched study including healthy controls for isokinetic hip muscle strength.","authors":"Mehmet Demirel, İlhan Sulejmani, Yaşar Gökçeoğlu, Türker Şahinkaya, Yavuz Sağlam, Fuat Bilgili","doi":"10.1007/s00264-025-06588-z","DOIUrl":"10.1007/s00264-025-06588-z","url":null,"abstract":"<p><strong>Introduction: </strong>Shelf acetabuloplasty, one of surgical containment methods, have been employed to preserve hip joint congruity in the management of Legg-Calvé-Perthes disease (LCPD). However, its long-term effect on radiographic and functional outcomes remains unclear due to limited evidence. Moreover, comparative studies against conservative treatment are lacking. This study aimed to (1) compare the mid- to long-term outcomes between children with advanced-stage LCPD treated with shelf acetabuloplasty and those receiving conservative management, and (2) evaluate isokinetic hip muscle strength compared to age- and gender-matched healthy controls.</p><p><strong>Materials and methods: </strong>This retrospective age- and gender-matched study included 28 children with unilateral LCPD, divided into Shelf (n = 14) and Conservative (n = 14) treatment groups. A healthy control group (n = 14) was also recruited for isokinetic comparisons. Radiographic outcomes were assessed using modified Stulberg classification and several quantitative parameters. Functional outcomes were assessed using the Harris Hip Score (HHS) and isokinetic testing of hip muscle strength.</p><p><strong>Results: </strong>The Shelf group (median follow-up: 5.5 years, IQR: 4-7) showed significantly better HHS (67.9 ± 15.9) compared to the Conservative group (median follow-up: 6 years, IQR: 5-8) (54.6 ± 13.3; p = 0.024) at the final follow-up. Shelf acetabuloplasty also resulted in significantly improved radiographic parameters, including centre-edge angle (p < 0.001) and femoral head coverage (p = 0.002). Isokinetic testing revealed that the Conservative group had significantly lower hip extension (p = 0.021), abduction (p = 0.018), and adduction (p = 0.027) torque values, as well as greater muscle fatigue (p = 0.014). In contrast, the Shelf and Control groups exhibited comparable performance in most strength and endurance parameters.</p><p><strong>Conclusions: </strong>Shelf acetabuloplasty, when applied as a salvage procedure in advanced-stage LCPD, may provide better functional outcomes and improved hip muscle performance compared to conservative treatment, despite comparable long-term femoral head morphology. Following Shelf acetabuloplasty, comparable hip flexor and extensor strength to healthy controls can be expected, although mild abductor and adductor weakness may persist.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":"2181-2194"},"PeriodicalIF":2.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12405371/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144484373","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":"Significant and lasting correction after medializing calcaneal osteotomy in collapsing flatfoot deformity: comment on the study by Farge et al.","authors":"Sitanshu Barik, Vikash RAj, Vishal Kumar","doi":"10.1007/s00264-025-06586-1","DOIUrl":"10.1007/s00264-025-06586-1","url":null,"abstract":"","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":"2321-2322"},"PeriodicalIF":2.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144475240","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 origins of limb lengthening and reconstruction surgery date back to 1521 when the first intervention ever reported in history was performed on St. Ignatius of Loyola.","authors":"Filippo Vandenbulcke, Beth Lineham, Emiliano Malagoli, Alexander Kirienko","doi":"10.1007/s00264-025-06591-4","DOIUrl":"10.1007/s00264-025-06591-4","url":null,"abstract":"<p><strong>Purpose: </strong>To explore the historical case of Saint Ignatius of Loyola's leg injury and subsequent surgical interventions as a potential early instance of limb lengthening and reconstruction surgery.</p><p><strong>Methods: </strong>A detailed analysis of \"A Pilgrim's Journey\" (Ignatius of Loyola's autobiography) was conducted, focusing on orthopaedic descriptions of his injury and treatments.</p><p><strong>Results: </strong>In 1521, Íñigo López de Loyola sustained a severe, comminuted open fracture of the tibia due to a cannonball wound during the siege of Pamplona. Initial attempts at reduction were unsuccessful, leading to a non-union with significant deformity and shortening. He underwent a revision surgery, a procedure described as \"carnage\" and endured without a single lament. Although the fracture eventually united, residual shortening and a prominent bone deformity persisted. Unwilling to accept this disfigurement for social reasons, Ignatius requested a second, highly painful osteotomy to remove the protruding bone followed by continuous traction for \"days and days of martyrdom\" for progressive lengthening. Crucially, after these arduous treatments, Ignatius was able to walk and even ride a horse again. The only significant residual symptom was swelling in his leg by evening.</p><p><strong>Conclusion: </strong>St. Ignatius of Loyola's case provides a compelling historical account of complex orthopaedic challenges in the early 16th century. The documented surgeries represent remarkably early attempts at managing non-union, deformity, and potentially achieving limb lengthening, predating modern reconstructive techniques by centuries. This historical narrative offers valuable insights into the nascent stages of orthopaedic surgery and highlights how a physical ordeal can profoundly shape one's life path.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":"2289-2296"},"PeriodicalIF":2.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12405292/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144484374","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":"Superior Capsular Reconstruction Using the Long Head of the Biceps Tendon for Large to Massive Rotator Cuff Tears with Pseudoparalysis: A Prospective Clinical Study.","authors":"Nam Sy Ho, Nhan Nghi Thanh Le, Phi Duong Nguyen, Anh Ha Nam Tang, Dung Huu Tran","doi":"10.1007/s00264-025-06612-2","DOIUrl":"10.1007/s00264-025-06612-2","url":null,"abstract":"<p><strong>Background: </strong>Managing large to massive rotator cuff tears accompanied by pseudoparalysis poses a considerable challenge in shoulder surgery. Superior capsular reconstruction (SCR) is increasingly considered a viable surgical option, yet optimal graft choices and outcomes in pseudoparalysis patients remain under investigation. This study assesses the clinical effectiveness of arthroscopic SCR using the long head of the biceps tendon (LHBT) in patients with large-to-massive RCT, comparing outcomes between those with and without pseudoparalysis.</p><p><strong>Methods: </strong>A prospective analysis was carried out involving 28 patients (14 with pseudoparalysis and 14 without) who underwent SCR using LHBT between January 2022 and December 2023. Clinical outcomes were assessed before surgery and subsequently at three, six and 12 months following the procedure, utilizing the Visual Analog Scale (VAS), University of California Los Angeles (UCLA) shoulder score, American Shoulder and Elbow Surgeons (ASES) score, and shoulder range of motion metrics.</p><p><strong>Results: </strong>Each group demonstrated substantial gains in reducing pain, enhancing functional outcomes, and increasing shoulder mobility. VAS scores decreased markedly, and ASES and UCLA scores improved substantially in both groups. Forward elevation and external rotation improved significantly, with a slightly greater range observed in the non-pseudoparalysis group. Pseudoparalysis was successfully reversed in 92.85% of affected patients. No major complications were reported.</p><p><strong>Conclusion: </strong>Arthroscopic SCR using LHBT provides significant functional restoration and pain reduction in patients with massive RCT, effectively reversing pseudoparalysis in most cases. This technique offers a reliable and anatomically favorable graft option, supporting its use in both pseudoparalytic and non-pseudoparalytic patients.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":"2123-2130"},"PeriodicalIF":2.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144642553","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":"Total shoulder arthroplasty preoperative planning: the effect of patient's humeral position on the lateralization and distalization measurements.","authors":"Alexandre Caubère, François Boux de Casson, Amaury Jung, Jean-David Werthel, Alexander J Vervaecke, Marc-Olivier Gauci","doi":"10.1007/s00264-025-06619-9","DOIUrl":"10.1007/s00264-025-06619-9","url":null,"abstract":"<p><strong>Background: </strong>The aim of this study was to define the variability of the scapulohumeral position during preoperative Computed Tomography (CT) acquisition and to evaluate its influence on angular lateralization and distalization measurements. We hypothesized that the preoperative resting arm position, in terms of humeral abduction, flexion and internal rotation, would vary significantly between patients and that this variability would influence the lateralization (LSA) and distalization shoulder angle (DSA).</p><p><strong>Methods: </strong>We analyzed a prospectively collected database of preoperative de-identified CT scans from a single Total Shoulder Arthroplasty (TSA) planning system (Equinoxe, Exactech GPS, Blue-Ortho), including all cases with scapular and humeral segmentation. Validated three-dimensional (3D) bone models were used to compute and automatically position scapular and humeral landmarks. These included: the superior glenoid tubercle; the most lateral border of the acromion and the most lateral border of the greater tuberosity. The position of the humerus relative to the scapula was automatically calculated, allowing the angles of abduction, flexion and internal rotation of the scapulohumeral joint to be assessed. Additionally, the potential relationship between the body mass index (BMI) and the resting arm position was assessed. Finally, LSA and DSA were calculated. A multiple linear regression analysis was performed to assess the relationship between the humeral position and the LSA and DSA.</p><p><strong>Results: </strong>A total of 21,863 patients were included. Preoperative humeral positioning relative to the scapula showed a mean abduction of 10.3°±12.4 (-14.0°; 36.6°), mean flexion of 3.9°±8.9 (-16.0°; 26.1°) and mean internal rotation of 6.5°±18.9 (-41.4°; 48.9°). The preoperative median of LSA and DSA were 87.4°±14.3° and 43°±12.4, respectively. Among the independent variables, abduction showed the strongest negative correlation with LSA (β = -0.2998, p < 0.0001), followed by flexion (β = -0.04342, p < 0.0001). Internal rotation was positively correlated with LSA (β = 0.1229, p < 0.0001). For DSA, abduction had a weak positive influence (β = 0.04321, p < 0.0001), while flexion (β = -0.04302, p < 0.0001) and internal rotation (β = -0.04654, p < 0.0001) were negatively associated. Notably, a 10° variation in abduction, flexion or internal rotation led to a -3°, -0.4° and + 1.2° change in LSA, respectively, whereas DSA was minimally affected, with variations limited to + 0.4°, -0.4° and - 0.5°, respectively.</p><p><strong>Conclusion: </strong>The resting arm position during preoperative CT scans varies significantly, potentially affecting the preoperative planning of TSA. The main findings of this study suggest that there exists a weak correlation between the initial scapulohumeral position and the LSA/DSA measurements.</p><p><strong>Level of evidence: </strong>Level IV. Case series with no comparison group","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":"2111-2122"},"PeriodicalIF":2.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144674761","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":"One-stage surgical correction of Shepherd's crook deformity in fibrous dysplasia using fibular strut allograft augmentation: a retrospective case-series.","authors":"Khodamorad Jamshidi, Abolfazl Bagherifard, Amin Hamidzadah Khiavi, Alireza Mirzaei","doi":"10.1007/s00264-025-06627-9","DOIUrl":"10.1007/s00264-025-06627-9","url":null,"abstract":"<p><strong>Purpose: </strong>Shepherd's crook deformity is a characteristic complication of fibrous dysplasia (FD) of the femur, leading to coxa vara and mechanical instability. Two-stage surgical approaches involve initial valgus osteotomy followed by delayed intramedullary femoral stabilization, prolonged treatment, and increasing morbidity. This study evaluates a one-stage surgical correction that employs fibular strut allograft augmentation for both the femoral neck and shaft.</p><p><strong>Methods: </strong>A retrospective review was performed on 17 patients with Shepherd's crook deformity who underwent one-stage hip lag screw and side plate fixation with fibular strut allograft augmentation of the femoral neck and shaft between 2002 and 2022. Radiographic and clinical outcomes were assessed, including neck-shaft angle (NSA) restoration, fixation stability, graft incorporation, and functional improvement. The median follow-up of the patients was 96 months.</p><p><strong>Results: </strong>The mean preoperative NSA was 93° (SD: 13.5°), improving significantly to 130° (SD: 5°) at the latest follow-up (p < 0.001). Stable fixation was achieved in 16 of 17 patients, with one case of fixation failure. Fibular graft resorption was noted in six patients but did not compromise fixation. Clinically, postoperative pain, limping, and activity limitations improved substantially, though seven patients experienced persistent restrictions in outdoor activities. The average limb shortening was 3.5 cm before the operation and 0.9 cm at the end of the follow-up.</p><p><strong>Conclusion: </strong>One-stage correction of Shepherd's crook deformity using lag hip screw fixation and fibular strut allograft augmentation could be a viable alternative to staged procedures, though further studies are needed to confirm its efficacy and generalizability.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":"2069-2075"},"PeriodicalIF":2.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144730919","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":"Response to letter regarding \"Long-term implant survival after debridement, antibiotics and implant retention (DAIR) for acute prosthetic joint infections: is it a viable option beyond four weeks after index arthroplasty?\"","authors":"Ernesto Muñoz-Mahamud, Andrés Combalia","doi":"10.1007/s00264-025-06584-3","DOIUrl":"10.1007/s00264-025-06584-3","url":null,"abstract":"","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":"2327-2328"},"PeriodicalIF":2.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12405350/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144600372","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":"Surgical correction of severe limb deformities with Yester biological procedures -Fifty cases with thirty five years follow-up.","authors":"Surender Singh Yadav","doi":"10.1007/s00264-025-06599-w","DOIUrl":"10.1007/s00264-025-06599-w","url":null,"abstract":"<p><strong>Aim: </strong>Although a severe limb deformity is rare, its management continues to be quite challenging. Various options have been described for correction. However, most of them are expensive, extensive and result in complications. Correction of severe deformities of the extremities has been suggested using the yester biological procedures with successful long term outcome.</p><p><strong>Materials and methods: </strong>During the last five decades, 50 patients of challenging limb deformities were surgically managed by yester procedures which included corrective osteotomy, arthrodesis and Girdlestone arthroplasty. Eleven patients had upper limb deformity and 39 had lower limb deformity. Sixteen patients had congenital anomaly and 34 acquired. Twelve patients were non-walkers with multiple joint involvement. No metallic implant had been used in any case. No patient had repeat surgery. The age of the patients ranged from five-27 years.</p><p><strong>Results: </strong>Depending on the procedure adopted in a particular patient, all patients were examined periodically and regularly. The treatment time in a patient with multiple deformities ranged from six-12 months. Out of the twelve non-walkers, eleven could ambulate after the management. Superficial infection was recorded in 27 patients. No deep infection was observed. A long follow-up of 35 years has been available.</p><p><strong>Conclusion: </strong>A rare series of 50 patients with challenging deformities of the extremities has been reported. The patients had been managed with procedures like corrective osteotomy, arthrodesis and Girdlestone arthroplasty with acceptable outcome. After the management 11 out of 12 non-walkers could ambulate themselves. The described procedures are simple, biological, dependable, patient friendly and available at no cost.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":"2021-2028"},"PeriodicalIF":2.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144637022","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}