Journal of Orthopaedic Surgery最新文献

{"title":"Short-course systemic salidroside increases week-4 tibial implant fixation strength in healthy female mice: A proof-of-concept study.","authors":"Mengchao Liu, Yiwen Liu, Xu Dong, Li Zhang, Jiaying Xue, Dehua Liu, Xue Wang, Yongdi Zhang, Gang Ji, Guobin Liu","doi":"10.1177/10225536261488195","DOIUrl":"https://doi.org/10.1177/10225536261488195","url":null,"abstract":"<p><p>BackgroundRapid early osseointegration is essential for cementless fixation, yet this postoperative window is vulnerable in metaphyseal cancellous bone exposed to surgical injury and early loading. Salidroside, a bioactive glycoside derived from Rhodiola species, has reported osteogenic and angiogenic activity, but its value as a short-course systemic perioperative adjuvant for implant fixation remains unclear.MethodsThirty-eight healthy 15-week-old female C57BL/6 mice underwent unilateral press-fit titanium implant insertion into the proximal tibia and were then randomized to intraperitoneal salidroside (20 mg/kg every other day) or volume-matched saline. The primary outcome in this report was week-4 maximum pull-out force. Ex vivo micro-computed tomography (micro-CT) assessed five parameters in peri-implant and distal metaphyseal cancellous regions. Histology and week-2 immunostaining were supportive tissue-context assessments.ResultsAt week 4, maximum pull-out force was 20.68 ± 3.06 N with salidroside and 13.01 ± 1.77 N with saline (mean difference, 7.67 N; Welch 95% confidence interval [CI], 3.86 to 11.48; p=0.0024). After Benjamini-Hochberg false-discovery-rate correction across 11 secondary or exploratory comparisons, BV/TV and connectivity density were higher and trabecular separation was lower in both cancellous regions (all q≤0.05). The peri-implant trabecular-number difference was not statistically significant (p=0.0626; q=0.0861), and trabecular thickness did not differ. Week-2 HIF-1α integrated optical density did not meet the FDR threshold in the Welch analysis (p=0.0500; q=0.0786) and was also nonsignificant in the exact Mann-Whitney sensitivity analysis (p=0.1000); it was therefore treated as supportive only.ConclusionsIn healthy 15-week-old female mice, this specific intermittent salidroside regimen increased week-4 implant fixation strength and was accompanied by concordant exploratory micro-CT findings, providing a screening-level proof-of-concept efficacy signal. The study does not establish mechanism or efficacy in male, aged, osteoporotic, or comorbidity-affected hosts.</p>","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"34 3","pages":"10225536261488195"},"PeriodicalIF":1.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148977319","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":"Convex-side medial loading during early stance in thoracic adolescent idiopathic scoliosis: A pedobarographic analysis.","authors":"Ali Eren, Cem Ismail Gungor, Furkan Aral, Ethem Burak Oklaz, Baris Akin, Ulunay Kanatli","doi":"10.1177/10225536261491553","DOIUrl":"https://doi.org/10.1177/10225536261491553","url":null,"abstract":"<p><p>BackgroundAdolescent idiopathic scoliosis (AIS) alters trunk alignment and may lead to asymmetrical lower limb loading. While gait alterations in AIS have been described, detailed convex-concave side comparisons using temporally specific pedobarographic metrics remain largely unknown. This study aimed to investigate side-specific plantar pressure asymmetries during gait in adolescents with thoracic or thoracic-dominant AIS.MethodsA cross-sectional study was conducted on adolescents with AIS recruited from a scoliosis outpatient clinic. Only thoracic or thoracic-dominant curves (Lenke Types 1-4) were included. Barefoot walking was assessed using dynamic pedobarography (Novel emed®). Convex and concave sides were defined by the direction of the major spinal curve. Plantar pressure variables included maximum force, peak pressure, force-time and pressure-time integrals, foot contact area, medial and lateral loading, center of pressure excursion index, foot progression angle, and arch index. Paired comparisons between the convex and concave sides were performed.ResultsForty-five adolescents (mean age 15.71 ± 2.22 years; 31 females) were included. The convex side demonstrated significantly greater maximum force (518.81±120.89 vs. 512.76±119.51 N, p=0.01), medial loading (151.87±57.84 vs. 146.66±57.35 N.s, p=0.04), and contact area (126.07±18.24 vs. 124.13±21.17 cm², p=0.04). Early stance revealed a reduced center of pressure excursion index (12.43±8.59 vs. 16.06 ± 9.82 %, p=0.03). No significant side-to-side differences were found in the peak pressure, total loading, foot progression angle, arch index, or pronation-supination index during the mid-to-late stance.ConclusionsAdolescents with thoracic or thoracic-dominant AIS present with a convex-side early-stance medial loading pattern compatible with pronation, though total loading remains symmetric.</p>","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"34 3","pages":"10225536261491553"},"PeriodicalIF":1.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149002012","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":"Functional outcomes, complications, and survival after endoprosthetic reconstruction for extremity tumours: A large regional cohort analysis from southeast asia.","authors":"Kon Yuen Yi, Vivek Ajit Singh, Rupini Devi Santharalinggam, Nor Faissal Yasin","doi":"10.1177/10225536261496572","DOIUrl":"https://doi.org/10.1177/10225536261496572","url":null,"abstract":"<p><p>BackgroundProsthetic infection is a leading cause of failure in endoprosthetic limb salvage surgery, yet comparative data between limb and pelvic reconstructions are scarce. This study characterises the microbiology, management, and outcomes of postoperative infection in this cohort.MethodsA retrospective study of 39 patients who developed deep prosthetic infection following endoprosthetic reconstruction at a tertiary oncology centre (2007-2024) was conducted. Data included microbiology, surgical management, functional scores (MSTS, TESS), and survival. Descriptive comparisons were made between limb (n=32) and pelvic (n=7) reconstructions.ResultsThere were 220 endoprosthetic replacements during the study period; the infection rate was 17.7%. With a mean follow-up of 82.5 months (range 12-228), infection control was achieved in 79.5% of patients (78.1% of limbs, 85.7% of pelvic reconstructions). Two-stage revision was the most common strategy. Infections were predominantly monomicrobial (74.4%), with <i>Staphylococcus aureus</i> (33.3%) most frequent; antimicrobial-resistant organisms were present in 46.2%. Functional outcomes were superior in limb reconstructions (mean MSTS 67.0%, TESS 71.9%) versus pelvic (mean MSTS 48.7%, TESS 50.2%). The 5- and 10-year overall survival rates were 75.4% and 71.0%, respectively. Metastatic disease was an independent predictor of mortality (HR 12.59, 95% CI 1.47-108.06; p=0.021).ConclusionInfection after endoprosthetic reconstruction necessitates complex management, with satisfactory control achievable in most patients. Functional outcomes are significantly poorer in pelvic reconstructions. Long-term survival is primarily determined by oncological status, particularly metastatic disease.</p>","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"34 3","pages":"10225536261496572"},"PeriodicalIF":1.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149137042","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":"BMI-adjusted low muscle mass under AWGS 2025 identifies functionally vulnerable patients missed by height-adjusted index in severe knee osteoarthritis.","authors":"Yoshitomo Saiki, Naoyuki Kubo, Tomohiro Ojima","doi":"10.1177/10225536261496585","DOIUrl":"https://doi.org/10.1177/10225536261496585","url":null,"abstract":"<p><p>BackgroundIn severe knee osteoarthritis (KOA) patients, muscle mass is often evaluated using appendicular skeletal muscle mass adjusted for height (ASMI). However, with higher body mass index (BMI), muscle mass may appear normal relative to height but remain insufficient for body size and mechanical demands. The Asian Working Group for Sarcopenia (AWGS) 2025 criteria newly include BMI-adjusted appendicular skeletal muscle mass (ASM/BMI). This study examined discordance between ASMI- and ASM/BMI-based low muscle mass classifications in severe KOA patients undergoing total knee arthroplasty (TKA), and evaluated whether ASM/BMI identifies functional vulnerability.MethodsThis retrospective study analyzed 205 patients with severe KOA undergoing primary TKA. Appendicular skeletal muscle was measured using multi-frequency bioelectrical impedance analysis. Low muscle mass was classified using AWGS 2025 cut-offs for ASMI and ASM/BMI. Agreement and discordance were assessed overall, and discordance rates were compared between patients with BMI <25 and ≥25 kg/m². To determine whether ASM/BMI detects vulnerability missed by ASMI, patients with normal ASMI but low ASM/BMI were compared with those normal by both indices, and preoperative function and 12-month postoperative trajectories were analyzed using age- and sex-adjusted linear mixed-effects models.ResultsLow muscle mass was identified more frequently by ASM/BMI than by ASMI (32.7% vs 8.8%). Overall discordance was 26.9%, and was higher in patients with BMI ≥25 kg/m² than with BMI <25 kg/m² (41.0% vs 12.0%). Compared with the concordant normal group, the ASM/BMI-only group had weaker grip and hamstring strength and slower 40-m fast-paced walk and stair-climb performance preoperatively. Although recovery trajectories did not differ significantly, the ASM/BMI-only group showed poorer walking, stair-climbing, and quadriceps strength at 12 months.ConclusionsIn severe KOA, ASM/BMI identified patients whose muscle mass was insufficient relative to body size despite normal ASMI. ASM/BMI may help detect functional vulnerability, particularly in patients with BMI ≥25 kg/m².</p>","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"34 3","pages":"10225536261496585"},"PeriodicalIF":1.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149166298","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":"Reverse total shoulder arthroplasty vs non-operative management for proximal humerus fracture: Systemic review and meta-analysis of comparative studies.","authors":"Fatiha Chowdhury, Mohammad Cheik-Hussein, Sara Sadat Farshidfar, Michael James Jenkins, Mohammed Baba","doi":"10.1177/10225536261488187","DOIUrl":"10.1177/10225536261488187","url":null,"abstract":"<p><p>BackgroundProximal humerus fractures (PHF) are the third most common osteoporotic fracture. Non-operative management and reverse total shoulder arthroplasty (rTSA) have become the mainstay of management for elderly patients, however there is yet to be a consensus on the best treatment modality. This systematic review aims to compare the clinical outcomes of non-operative management and rTSA in the management of PHF.MethodsA systematic review was performed in accordance with PRISMA guidelines. A search was conducted using MEDLINE, CINAHL, EMBASE and CENTRAL databases.ResultsThis study analysed the results of 536 study participants published in the 9 studies. There was statistically significant improvement in forward elevation in the rTSA cohort (105 vs 83.3, p<0.01). Patients who underwent a rTSA also had a statistically significant reduction in VAS scores (1.4 vs 2.3, p = 0.02).DiscussionThe greatest differences in range of motion and VAS scores were observable within the first 3 months of follow-up. However, the translation of these results to functional outcomes is still yet to be determined.ConclusionrTSA may provide earlier pain relief and range of motion. This may be key treatment consideration in functionally active patients who would like to prioritise early return to activity.</p>","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"34 3","pages":"10225536261488187"},"PeriodicalIF":1.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148930187","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":"Percutaneous endoscopic lumbar discectomy combined with annular suture versus PELD alone for single-level lumbar disc herniation: A prospective propensity score-matched cohort study.","authors":"Chen Li, Xi Xie, Jiaxin Ma, Yang Yang, Shujun Ren, Xi Gao","doi":"10.1177/10225536261488132","DOIUrl":"10.1177/10225536261488132","url":null,"abstract":"<p><p>BackgroundSymptomatic same-level recurrence remains a concern after percutaneous endoscopic lumbar discectomy (PELD). We compared PELD plus endoscopic annular suture with PELD alone.MethodsThis single-center prospective observational cohort enrolled patients from January 2023 through October 2024. Treatment was selected through shared clinician-patient decision-making. Propensity scores based on eight baseline variables were matched 1:1, yielding 51 patients per group. Clinical scores were assessed through 12 months; symptomatic recurrence was followed for up to 23.9 months. Kaplan-Meier and exploratory Cox analyses were used.ResultsBoth groups improved. At 6 and 12 months, the suture group had better Japanese Orthopaedic Association and Oswestry Disability Index scores, whereas 12-month pain scores were similar. Symptomatic recurrence occurred in 13/51 controls (25.49%) and 4/51 suture patients (7.84%; P = 0.017). Eighteen-month recurrence-free estimates were 75.2% (95% CI 59.2%-85.6%) and 94.9% (95% CI 80.3%-98.7%), respectively (log-rank P = 0.028). Reoperation (10/51 vs 4/51; P = 0.084) and complications (4/51 vs 3/51) did not differ significantly. Subgroup estimates were limited by only 17 events.ConclusionsAnnular suture was associated with better short-to midterm function and fewer symptomatic recurrences, but causality and long-term effectiveness remain uncertain. Larger multicenter studies with longer, imaging-based follow-up are required.</p>","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"34 3","pages":"10225536261488132"},"PeriodicalIF":1.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148900645","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":"Reply to the letter to the editor regarding \"Similar functional outcomes but different remodeling patterns: A minimum 5-years radiographic comparison of short fit-and-fill stem and quadrangular taper stem\".","authors":"Yasutaka Masada, Tomonori Tetsunaga, Kazuo Fujiwara, Kazuki Yamada, Tomohiro Inoue, Ryuichiro Okuda, Toshifumi Ozaki","doi":"10.1177/10225536261496576","DOIUrl":"https://doi.org/10.1177/10225536261496576","url":null,"abstract":"","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"34 3","pages":"10225536261496576"},"PeriodicalIF":1.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149148604","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":"Osteoporosis risk in patients with primary open-angle glaucoma using muscarinic and prostaglandin agonists: A retrospective cohort study.","authors":"Joseph Bisiani, Jonathan Zhu, Brian Lynch","doi":"10.1177/10225536261466347","DOIUrl":"https://doi.org/10.1177/10225536261466347","url":null,"abstract":"<p><p>BackgroundGlaucoma is the leading cause of irreversible blindness worldwide, with primary open-angle glaucoma (POAG) arising as the most common subtype. Recent studies have shown that muscarinic and prostaglandin pathways can modulate bone remodeling under systemic, context-dependent conditions. M3 muscarinic receptor activation has been linked to increased bone formation and decreased resorption, whereas continuous prostaglandin E2 (PGE2) administration inhibits bone resorption, with intermittent use inducing bone formation. Given the minimal systemic findings of topical ophthalmic medications, the clinical relevance of bone remodeling effects for patients treated with glaucoma eye drops, particularly in regard to osteoporosis, remains uncertain and warrants evaluation.Patients and MethodsA retrospective cohort study was conducted using the TriNetX network with approximately 100 million de-identified electronic medical records. Cohorts included POAG patients prescribed either prostaglandin analogs (e.g. latanoprost, bimatoprost, travoprost, tafluprost) without muscarinic agonist use, or muscarinic M3 agonists (e.g. pilocarpine, carbachol) without prostaglandin analog use. Propensity score matching was performed for age, sex, comorbidities, and concurrent glaucoma medications to limit possible cofounders. The outcome was defined as a diagnosis of osteoporosis without current pathological fracture (ICD code M81). Risk ratios (RR), odd ratios (OR), and 95% confidence intervals (CI) were calculated.ResultsAfter matching, each cohort included 6,743 patients. The incidence of osteoporosis is 13.3% in the prostaglandin cohort and 8.9% in the muscarinic cohort. Prostaglandin agonist use was associated with a statistically significant increase in osteoporosis risk (RR = 0.67, 95% CI 0.60-0.73; OR = 0.63, 95% CI 0.57-0.71; p < 0.0001).ConclusionProstaglandin agonist use was associated with an increased risk of osteoporosis compared with muscarinic agonist therapy in POAG patients. These findings suggest potential systemic effects (e.g. changes to bone health) of prostaglandin agonist use beyond previously known local, ocular effects and highlight the importance of considering osteoporosis risk in glaucoma management.</p>","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"34 3","pages":"10225536261466347"},"PeriodicalIF":1.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149169602","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":"Baseline peroneus longus reaction time predicts the response to proprioceptive training in chronic ankle instability: A single-centre retrospective cohort study.","authors":"Fawu A, Shengzhong Wu, Jie Yang, Kailiang Zhou","doi":"10.1177/10225536261480760","DOIUrl":"https://doi.org/10.1177/10225536261480760","url":null,"abstract":"<p><p>BackgroundChronic ankle instability (CAI) is a common sequel of lateral ankle sprain, and proprioceptive training is its first-line treatment, yet the gain differs widely between patients. A prolonged peroneus longus reaction time (PRT) is a hallmark neuromuscular deficit of CAI, but whether it forecasts the training response is unknown.MethodsWe retrospectively analysed 183 adults with CAI who completed a supervised 12-week proprioceptive programme. Baseline PRT to sudden inversion was measured by surface electromyography. The primary outcome was the change in the Cumberland Ankle Instability Tool (CAIT); the Star Excursion Balance Test (SEBT) was secondary. Associations were tested with Pearson and partial correlation, analysis of covariance, multivariable linear regression and receiver-operating-characteristic analysis.ResultsCAIT improved from 18.4 to 22.2 points (mean change +3.8, p < 0.001). Baseline PRT was inversely related to the CAIT gain (Pearson r = -0.51, 95% CI -0.61 to -0.39; partial r adjusted for baseline CAIT = -0.57). In the adjusted model PRT remained the strongest predictor (partially standardized β = -2.09 CAIT points per SD, p < 0.001). PRT discriminated non-responders with an area under the curve of 0.78 (95% CI 0.71-0.84).ConclusionsA shorter baseline peroneal reaction time was associated with a larger improvement after proprioceptive training. PRT is an inexpensive candidate marker that may help stratify CAI patients, although the retrospective single-centre design warrants prospective confirmation.</p>","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"34 3","pages":"10225536261480760"},"PeriodicalIF":1.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148919742","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":"Retrospective study on fracture patterns associated with motorcycle accidents and other vehicle accidents.","authors":"Hüseyin Kürüm, Faruk Aydemir, Funda İpekten, Kübra Orhan Kürüm, Fatih Çetinkaya","doi":"10.1177/10225536261488193","DOIUrl":"https://doi.org/10.1177/10225536261488193","url":null,"abstract":"<p><p>PurposeThere are a limited of studies on determining injury patterns according to motorcycle types and comparing them with other vehicles. We evaluated data on the fractures and dislocations resulting from motorcycle and passenger car collisions.MethodsThis was a retrospective review of 1149 patients. Patients were divided into four groups based on whether they were e-scooter, moped, motorcycle, or passenger car. Furthermore, using a two-group design, two groups were created: one for all types of motorcycles and another for passenger cars. We evaluated data on the types of fractures and dislocations resulting from motorcycle and passenger car collisions, whether they required surgical intervention, hospitalization, intensive care unit (ICU) rates, injury severity scores (ISS), concomitant injuries, and the mechanism of injury.Results174 (15.1%) e-scooter, 135 (11.7%) motorcycle, 156 (13.6%) moped, and 684 (59.5%) passenger car riders were represented in the study. Lower extremity fractures occurred at a rate of 427 (37.2%). Of the fractures, 126 (11.0%) were open fractures, while 416 (36.2%) extended into the joint. For the ISS, the median values were 9.0 (7.0-14.0)^a for e-scooters, 14.0 (10.0-18.0)^b for motorcycle riders, 10.0 (8.0-16.0)^b for moped riders, and 12.0 (8.0-17.0)^b for car passenger riders, and these differences were statistically significant (p<0.001).ConclusionThe fractures observed in motorcycle riders tended to be more open fractures and more likely to extend into the joint. The low speed of e-scooter collisions may reduce the severity of trauma; nevertheless, falls occurring at low to moderate speeds among motorcycle and moped riders can lead to more serious injuries.</p>","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"34 3","pages":"10225536261488193"},"PeriodicalIF":1.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148912517","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}