Journal of Orthopaedic Surgery最新文献

{"title":"A pre-contoured hook-plate simplifies anterior coronoid fixation: A matched-pair study.","authors":"Zheng Jinwen, Ming Xiang, Yiping Li, Hang Chen, Jinsong Yang, Qing Zhang","doi":"10.1177/10225536261476723","DOIUrl":"https://doi.org/10.1177/10225536261476723","url":null,"abstract":"<p><p>BackgroundThe modified anterior neurovascular interval approach provides direct access to the anterior coronoid while preserving the flexor-pronator origin. However, the narrow working corridor makes conventional mini-plate fixation technically challenging, often requiring repeated contouring and supplementary lag screws. We developed a specialized anatomical hook-plate (SAHP) and compared it with conventional mini-plate (CMP) fixation.MethodsWe retrospectively reviewed patients with unstable ulnar coronoid fractures (Regan-Morrey type II/III) treated via the anterior approach between January 2022 and January 2025. Twenty-five consecutive patients treated with SAHP were matched 1:1 with 25 CMP controls. Matching criteria included injury mechanism, Regan-Morrey classification, dominant fracture zone, and concomitant procedures. Operative time, supplementary lag screw use, union time, Mayo Elbow Performance Score (MEPS), Disabilities of the Arm, Shoulder and Hand (DASH) score, flexion-extension arc, and complications were compared.ResultsAll 50 patients completed follow-up (median, 12.5 months; range, 12-20 months). Operative time was significantly shorter in the SAHP group than in the CMP group (93.2 ± 26.8 vs. 112.4 ± 30.5 min; mean difference -19.2 min, 95% CI -29.8 to -8.6; P = 0.001). Supplementary lag screws were required in 15 patients (60.0%) in the CMP group and in none of the SAHP group (P < 0.001). All fractures achieved union. At final follow-up, functional outcomes (MEPS, DASH, flexion-extension arc) were similar between groups (all P > 0.05). No fixation failure or reoperation occurred.ConclusionsFor coronoid fractures requiring anterior buttress fixation, the SAHP simplifies the procedure by reducing operative time and eliminating the need for supplementary lag screws compared to conventional mini-plates. This may lower the technical barrier for this challenging approach while providing comparable short-term outcomes.</p>","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"34 2","pages":"10225536261476723"},"PeriodicalIF":1.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148701428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Restoring the talar dome: A comprehensive review of treatment options for osteochondral lesions in adults.","authors":"Raymonde Dahdouh, Karim Areslan, Katherine Atallah, Luna Maria Khalil, Mohamad Badra, Ramzi Moucharafieh","doi":"10.1177/10225536261476345","DOIUrl":"https://doi.org/10.1177/10225536261476345","url":null,"abstract":"<p><p>Osteochondral lesions of the talus are injuries of the talar dome that are often overlooked until late disease progression. Throughout history, several techniques and treatment modalities have been used in the management of these lesions with an ongoing debate as to which approach is superior to the other, and what the indications and rehabilitation protocols are for each modality. Moreover, the introduction of adjunct therapies such as extracorporeal shockwave therapy and injectables widened the scope of the treatment. While most surgical and nonsurgical approaches have demonstrated satisfactory outcomes, an ideal treatment algorithm is still elusive. This literature review meticulously studies major trends in the different management techniques of osteochondral lesions of the talus, describing the mostly used protocols, comparative results, and complication rates. It also highlights the latest updates on the use of injectables and adjunct therapies, aiming to guide the clinical decision making in treating this pathology.</p>","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"34 2","pages":"10225536261476345"},"PeriodicalIF":1.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148684979","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between the hospital frailty risk score and healthcare resource utilization after total knee arthroplasty: A retrospective observational study.","authors":"Linjia Li, Zhihan Wang, Yuanwei Wu, Qinfeng Yang, Zhen Huang, Jinghua Yang","doi":"10.1177/10225536261476467","DOIUrl":"10.1177/10225536261476467","url":null,"abstract":"<p><p>BackgroundTotal Knee arthroplasty (TKA) is an effective treatment for end-stage knee osteoarthritis (KOA), but healthcare resource utilization has become an increasing concern in an aging surgical population. Hospital Frailty Risk Score (HFRS) has been associated with adverse surgical outcomes, but its impact on resource utilization after TKA remains unclear. Using a large national database, this study aims to evaluate the association between HFRS-defined frailty risk categories and healthcare resource utilization after TKA, including length of stay (LOS), total charges (TOTCHG), and non-routine discharge.MethodsData on patients undergoing TKA were extracted from the National Inpatient Sample database. Patients were categorized into an analytic cohort and a validation cohort. We used the HFRS to identify frailty: low frailty risk (HFRS < 5), intermediate frailty risk (5-15), and high frailty risk (HFRS > 15). Patient demographic, hospital characteristics, and comorbidities were assessed. Logistic regression analyses, stratified analyses, ROC curve analyses, and sensitivity analyses were performed to evaluate associations, subgroup consistency, and discriminative performance.ResultsA total of 622,574 patients undergoing TKA for primary KOA were identified. Patients were categorized into low (n = 439,343), intermediate (n = 29,637), and high (n = 223) frailty risk groups according to the HFRS. In multivariable logistic regression analyses, higher HFRS-defined frailty risk categories were independently associated with increased healthcare resource utilization and complications. Compared with patients with low frailty risk, those with intermediate and high frailty risk had significantly higher odds of prolonged LOS, increased TOTCHG, non-routine discharge, any complication, and major complications (all <i>P</i> < 0.001). Sensitivity analyses using a binary classification of HFRS-defined frailty yielded consistent findings.ConclusionHFRS-defined frailty risk categories are independently associated with increased healthcare resource utilization and postoperative complications after TKA. These findings support the potential utility of HFRS for preoperative risk stratification and individualized perioperative care planning.</p>","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"34 2","pages":"10225536261476467"},"PeriodicalIF":1.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148673797","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Length-stable fixation reduces femoral neck shortening in unstable femoral neck fractures: A retrospective comparative study of length-stable dynamic hip screw versus femoral neck system fixation.","authors":"Seonghyun Kang, Wonseok Choi, Jeong Seok Choi, Eic Ju Lim, SungJin Ahn, Jong-Keon Oh, William T Kent, Whee Sung Son, Jae-Woo Cho","doi":"10.1177/10225536261415697","DOIUrl":"10.1177/10225536261415697","url":null,"abstract":"<p><p>BackgroundFemoral neck shortening following internal fixation of unstable femoral neck fractures can compromise functional recovery, particularly in young, active patients. This study aimed to evaluate the efficacy of a length-stable dynamic hip screw (LSD) construct in minimizing postoperative shortening compared to the femoral neck system (FNS).MethodsA retrospective review was conducted on 65 patients with high-grade unstable femoral neck fractures treated between February 2016 and February 2023 at a single institution. Patients underwent either FNS (<i>n</i> = 31) or LSD (<i>n</i> = 34) fixation. Femoral neck shortening was quantified using vector-based analysis derived from contralateral femoral comparison at final follow-up. Functional outcomes were assessed using the Hip Disability and Osteoarthritis Outcome Score (HOOS).ResultsThe LSD group demonstrated significantly less femoral neck shortening compared to the FNS group (5.0 ± 4.6 mm vs 10.4 ± 6.7 mm, <i>p</i> = 0.001). Final HOOS scores were significantly higher in the LSD group in the symptom (88.1 vs 75.8, <i>p</i> = 0.049) and stiffness subdomains. Union was achieved in 31 of 34 patients (91.2%) in the LSD group and 26 of 31 (83.9%) in the FNS group (<i>p</i> = 0.605). Other complications were more frequent in the FNS group but did not reach statistical significance.ConclusionLength-stable fixation using the LSD construct significantly reduced postoperative femoral neck shortening in high-grade unstable fractures, without compromising union rates or functional recovery. Our results support the role of length-stable constructs as a reliable option for maintaining anatomic integrity in unstable femoral neck fractures.</p>","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"34 1","pages":"10225536261415697"},"PeriodicalIF":1.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146052545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Morphology of the scapholunate joint, lunate, and capitate in dorsal wrist ganglion: An MRI case-control study.","authors":"Zeynel Mert Asfuroğlu, Ahmet Ülker, İdris Demirtaş, Atilla Arık","doi":"10.1177/10225536261421345","DOIUrl":"10.1177/10225536261421345","url":null,"abstract":"<p><p>BackgroundDorsal wrist ganglia (DWGs) are common, yet the contribution of carpal morphology to their formation is underexplored. We investigated whether scapholunate joint, lunate, and capitate morphology differ between DWG wrists and controls.MethodsRetrospective MRI case-control study of adults aged 18-60 years, comprising 70 DWG wrists and 70 controls. Categorical variables were lunate type (medial hamatolunate facet present or absent), scapholunate joint morphology (parallel, inverted-Y, point-like parallel), and capitate head shape (flat, round, V-shaped). Quantitative measures included capitate-triquetral distance, mid-joint scapholunate gap, and medial hamatolunate facet length, recorded only when a facet was present.ResultsInterobserver agreement was generally good across both categorical and quantitative measures (categorical κ range: 0.50-0.88; quantitative ICC range: 0.72-0.95). Capitate morphology differed between groups: round heads were more frequent in DWG (71.4%) than in controls (44.3%) (<i>p</i> < 0.05). The scapholunate gap was larger in DWG (mean 1.8 mm) than in controls (1.5 mm) (<i>p</i> < 0.05). No between-group differences were observed for lunate type (Type II: 51.4% vs 38.6%; <i>p</i> = 0.107), scapholunate joint type (<i>p</i> = 0.787), capitate-triquetral distance (<i>p</i> = 0.223), or medial hamatolunate facet length (<i>p</i> = 0.395).ConclusionDWG wrists more often exhibit a round capitate head and a larger scapholunate gap than matched controls, whereas lunate type, scapholunate joint configuration, capitate-triquetral distance, and medial hamatolunate facet length are similar. Capitate head shape may be associated with DWG; however, given the lower agreement for this parameter, this finding should be considered exploratory and requires further validation before any recommendation for routine reporting can be made. The scapholunate gap can be considered supportive context alongside clinical findings. Prospective multicenter studies with multiplanar/loaded MRI or arthroscopic correlation are warranted.</p>","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"34 1","pages":"10225536261421345"},"PeriodicalIF":1.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146086115","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What you see is what you get: High degree of alignment accuracy with hand-held computer-aided technology when comparing intraoperative alignment to postoperative radiographs in direct anterior total hip arthroplasty.","authors":"Thomas Geissler, Jacob Hall, Nicolas Koerber, Michael Decker, William Lutes","doi":"10.1177/10225536261431549","DOIUrl":"10.1177/10225536261431549","url":null,"abstract":"<p><p>IntroductionTotal Hip Arthroplasty (THA) is a widely performed orthopaedic surgery, essential for treating severe pain and mobility issues arising from various conditions. The anticipated rise in Total Hip Arthroplasty (THA) procedures underscores the critical importance of their success, which is heavily dependent on the accurate positioning of prosthetic components. Various approaches like the Direct Anterior Approach with Fluoroscopy (DAA-F THA) and Robotic-assisted THA (RA THA) have their limitations. Computer-Navigated THA (CN THA) has emerged as a promising alternative, offering real-time feedback and potentially enhanced accuracy in component placement. This study evaluates the precision of CN THA in correcting leg length discrepancies and accurately positioning the acetabular component.MethodsThe study involved 122 consecutive patients undergoing direct anterior CN THA by the senior author. Exclusions were based on different surgical approaches, need for revision surgery, and infections. The study focused on the precise placement of acetabular components and leg length restoration. CN THA was used for intra-operative measurements, while post-operative radiographs were analyzed with TraumaCad® for comparison. Statistical analyses included Pearson correlation coefficients and descriptive analyses.ResultsCN THA showed high accuracy in leg length restoration with 85.25% of cases showing less than 5 mm discrepancy. Similarly, acetabular component positioning was precise, with 90.98% of inclination and 74.59% of anteversion measurements within acceptable ranges. The correlation between intra-operative and post-operative measurements was strong, indicating the reliability of CN THA measurements.ConclusionCN THA was shown to be highly accurate in correcting leg length discrepancies and achieving proper acetabular component positioning. The strong correlation between intra- and post-operative measurements underscores the reliability of CN THA. The study, however, is limited by its single-surgeon, single-approach design, and lack of a control group. Despite these limitations, CN THA shows considerable potential in improving THA precision, enhancing surgical outcomes, and customizing patient care.</p>","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"34 1","pages":"10225536261431549"},"PeriodicalIF":1.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147355325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does tibial slope modification influence early recovery in mechanically aligned robotic-assisted total knee arthroplasty? A retrospective cohort study.","authors":"Jeremy Tze En Lim, Cheryl Gatot, Mann Hong Tan","doi":"10.1177/10225536261444454","DOIUrl":"10.1177/10225536261444454","url":null,"abstract":"<p><p>PurposeTibial slope influences posterior cruciate ligament tension, flexion-gap mechanics, and mid-flexion stability in cruciate-retaining total knee arthroplasty (TKA). Robotic assistance enables precise slope adjustment, yet the clinical relevance of intentional slope modification for early postoperative recovery remains unclear. This study evaluated whether tibial slope modification during mechanically aligned robotic-assisted CR-TKA affects early functional outcomes.MethodsA retrospective cohort of 55 consecutive mechanically aligned robotic-assisted CR-TKAs performed using the VELYS™ system with ATTUNE® implants (January-July 2024) was analyzed. Patients were stratified by tibial slope change relative to baseline: Decreased (n = 42), Neutral (±0.5°; n = 5), and Increased (n = 8). Early recovery endpoints included postoperative day-1 (POD1) ambulation, POD1 pain score, length of stay, and postoperative knee range of motion. Inter-group differences were assessed using one-way ANOVA with non-parametric sensitivity testing, and linear regression evaluated slope change (Δ°) as a continuous variable.ResultsNo significant differences were observed between groups in POD1 ambulation (p = 0.78), POD1 pain (p = 0.87), length of stay (p = 0.58), postoperative flexion (p = 0.69), or extension (p = 0.27). Findings were consistent on non-parametric analysis. Regression demonstrated no meaningful association between slope change and early outcomes (all p > 0.05; R² < 0.03), with a near-flat slope-ambulation relationship (β = 0.49, p = 0.28).ConclusionWithin a mechanically aligned robotic CR-TKA workflow, tibial slope modification was not associated with early postoperative recovery. Individualized slope adjustment may have limited impact on short-term functional outcomes. Larger prospective studies incorporating PROMs and long-term follow-up are warranted.</p>","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"34 1","pages":"10225536261444454"},"PeriodicalIF":1.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147717112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Application of artificial intelligence in orthopaedic research: From preclinical to translational.","authors":"Ludwig Andribert Powantia Pontoh, Ismail Hadisoebroto Dilogo, Jessica Fiolin, Stephanie Gosal, Joshua Alward Herdiman, Abi Aufar Hawali, Erica Kholinne","doi":"10.1177/10225536261424029","DOIUrl":"10.1177/10225536261424029","url":null,"abstract":"<p><p>Artificial intelligence (AI) has become pervasive in biomedicine and is transforming orthopaedic research from bench to bedside. Beyond its established roles in robotic surgery and diagnostics, AI now supports advances in biomechanics, imaging, tissue engineering, drug discovery, genomics, and prosthetic control. In biomechanics, AI enables faster finite-element simulations, markerless gait analysis, and data augmentation using synthetic signals. Imaging applications include automated segmentation of the spine and hip, opportunistic screening for osteoporosis, bone metastasis detection, and three-dimensional analysis of knee osteoarthritis. In regenerative medicine, AI assists in scaffold optimization, bioprinting, and personalized cell therapies, while integration with genomic and proteomic data enhances precision orthopaedics. Machine learning-based control systems also improve the usability of prosthetics and exoskeletons, reducing cognitive burden for patients. Despite challenges such as data scarcity, validation, and ethical considerations, AI is emerging as a powerful complement to traditional research methods. By accelerating workflows, improving accuracy, and enabling individualized care, AI holds strong potential to bridge laboratory discoveries with clinical applications in orthopaedics. This review highlights the application of AI in orthopaedic research and assesses how it could integrate into clinical practice in the future.</p>","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"34 1","pages":"10225536261424029"},"PeriodicalIF":1.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146180702","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postoperative duloxetine administration did not significantly modify overall pain trajectories following high tibial osteotomy: An open-label randomized controlled trial.","authors":"Masaya Sengoku, Hiroyasu Ogawa, Yutaka Nakamura, Tetsuya Shimokawa, Kazuichiro Ohnishi, Haruhiko Akiyama","doi":"10.1177/10225536261437327","DOIUrl":"10.1177/10225536261437327","url":null,"abstract":"<p><p>BackgroundDuloxetine is a potent analgesic that reduces pain associated with knee osteoarthritis. This study aimed to evaluate the analgesic effects of regular postoperative duloxetine after high tibial osteotomy (HTO) and its influence on knee function, pain severity, and daily life.MethodsThis open-label randomised controlled trial was designed as a single-centre, parallel-group study. Patients undergoing HTO were randomly allocated to the control and duloxetine groups. Patients allocated to the duloxetine group were administered oral duloxetine for the first 12 weeks postoperatively and were followed up for 6 months following surgery. The primary outcome was pain assessed by the visual analogue scale (VAS), and secondary outcomes included evaluations using the Brief Pain Inventory, the Knee Society Score, and the 2011 Knee Society Score.ResultsA total of 38 patients in the duloxetine group and 37 patients in the control group were analyzed. The duloxetine group demonstrated significantly lower pain VAS scores at rest 6 months postoperatively compared with the control group (0.5 ± 1.0 vs 1.3 ± 2.0, respectively; <i>p</i> = 0.029). There were no significant differences between the groups in the other scores. However, patients in the duloxetine group showed significantly lower consumption of acetaminophen in the third postoperative week (0.0 ± 0.0 vs 0.3 ± 0.8 tablets/day, respectively).ConclusionsDuloxetine demonstrated a modest analgesic benefit following HTO, with reduced pain at rest at 6 months and decreased rescue medication use during the third postoperative week. Routine use after HTO may therefore not be warranted in unselected patients. Due to the open-label design, performance and detection bias cannot be excluded.Trial registrationThe study protocol was registered in the UMIN clinical trial registration before starting recruitments: UMIN000040026 (registration date: June 1, 2020) https://center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000045630.</p>","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"34 1","pages":"10225536261437327"},"PeriodicalIF":1.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147512780","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patterns of orthopedic injuries presenting to emergency departments in Gaza amid the 2023-2025 conflict: A cross-sectional analysis.","authors":"Younis Elijla, Fahmy Almedana, Abdalrahman Ajjur, Ayham Abu ElQomboz, Mohammed Al-Ghazi, Eman Rabah, Raghd Alfarra, Heba Abu Shiha, Yara Asi, Mohammed Al-Hasan, Shayan Ali, Barock Tesfaye, Bilal Irfan","doi":"10.1177/10225536261426604","DOIUrl":"10.1177/10225536261426604","url":null,"abstract":"<p><p>The Israeli military invasion of 2023-2025 has decimated Gaza's health system, constraining trauma capacity and disrupting prehospital and hospital care. We aimed to characterize emergency department (ED) orthopedic injury patterns. We conducted a multicenter, descriptive cross-sectional study across four referral hospitals in different governorates (September 1-16, 2024). A standardized interviewer-administered instrument and chart review captured demographics, mechanism, injury type/site, soft-tissue and neurovascular findings, acute interventions, disposition, perceived care quality, and time metrics (to first care, ED evaluation, surgery). Primary outcomes were admission and emergency surgery. Analyses included descriptive statistics and bivariable/multivariable logistic regression with hospital-clustered standard errors. Among 449 patients, the cohort was predominantly young, male, and displaced. Most presentations followed explosive violence. Fractures predominated, with a large share open; comminuted and segmental patterns were frequent, and neurovascular compromise was common. Many patients reached some form of care rapidly, yet few received first aid before ED arrival, indicating prehospital collapse amid unsafe transit. Median wait-time was short but highly variable between hospitals. Operative demand exceeded theatre capacity, with notable interhospital variation in time to surgery. Orthopedic trauma care in Gaza continues to be affected by widespread damage, though unevenly across the enclave. Immediate priorities include the entry of essential medical supplies and safe protection for hospitals and healthcare workers to operate.</p>","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"34 1","pages":"10225536261426604"},"PeriodicalIF":1.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146194509","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}