Journal of Orthopaedic Surgery and Research最新文献

{"title":"Assessment and quantitative analysis of hip surrounding muscles in children with developmental dysplasia of the hip via magnetic resonance imaging.","authors":"Lian Duan, Weizheng Zhou, Lianyong Li","doi":"10.1186/s13018-024-05366-8","DOIUrl":"10.1186/s13018-024-05366-8","url":null,"abstract":"<p><strong>Background: </strong>The muscles that encase the hip serve a crucial role in both joint stability and functional efficacy, and as developmental dysplasia of the hip (DDH) progresses, the surrounding musculature may undergo specific adaptations that reduce joint stability, thereby exacerbating dislocation. Yet, the exact nature of changes in muscle morphology and quality remains inadequately investigated. This study aimed to compare magnetic resonance imaging (MRI) evaluations of the iliopsoas and other hip flexor and extensor muscles in children with unilateral DDH before and after treatment.</p><p><strong>Methods: </strong>Children with unilateral DDH were included in this study and compared to a matched control group. Using T2-weighted MRI sequences, muscle cross-sectional area (CSA) and fat infiltration (FI) were measured for the iliopsoas, sartorius, rectus femoris, tensor fasciae latae, and gluteus maximus. The cross-sectional area ratio (CSAr) was calculated as the CSA of the affected side divided by the CSA of the healthy side, corresponding to the respective sides in normal controls. For long-term follow-up (≥ 5 years), data from DDH children were analyzed, categorized into groups based on treatment. Comparisons of muscle CSAr and FI at the final follow-up were made against preoperative levels.</p><p><strong>Results: </strong>Preoperative median CSAr values for the iliopsoas, rectus femoris, and gluteus maximus in DDH children were significantly lower than those of the control group (P < 0.001). FI levels were also higher in the DDH group compared to controls. In the closed reduction group, iliopsoas CSAr increased and FI decreased at the final follow-up compared to preoperative measurements. Conversely, in the open reduction group, iliopsoas CSAr and FI decreased. In the Dega osteotomy group, both iliopsoas CSAr and FI decreased, while CSAr for the sartorius, rectus femoris, and gluteus maximus increased, with also reduced FI.</p><p><strong>Conclusion: </strong>Children with DDH exhibit varying degrees of muscle atrophy and increased fat infiltration compared to their age-matched healthy counterparts. Aside from the iliopsoas, muscle morphology and fat infiltration in DDH children improved post-treatment compared to pre-treatment levels.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"19 1","pages":"871"},"PeriodicalIF":2.8,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11667936/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142885965","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":"Comparison of the efficacy of robot-assisted total knee arthroplasty in patients with knee osteoarthritis with varying severity deformity.","authors":"Pengfei Xing, Junsong Qu, Shuaijing Feng, Jiarong Guo, Tao Huang","doi":"10.1186/s13018-024-05372-w","DOIUrl":"10.1186/s13018-024-05372-w","url":null,"abstract":"<p><strong>Aim: </strong>To evaluate the clinical efficacy and imaging outcomes of a domestically produced orthopedic surgical robot for total knee arthroplasty and to explore its applicability in patients with varying degrees of deformity.</p><p><strong>Methods: </strong>This study retrospectively included 120 patients who underwent TKA at our hospital between February 2023 and June 2024. The patients were divided into a control group (conventional TKA surgery) and an observation group (robot-assisted TKA surgery), with 60 patients in each group. Based on different lower extremity alignment angles, each group was further subdivided into mild deformities (Hip knee ankle angle (HKA angle)deviation < 10°) and significant deformities (HKA angle deviation ≥ 10°). Preoperative and postoperative HKA angles, range of motion (ROM), visual analog scale (VAS) pain scores, and Knee Society (AKS) scores were recorded for both groups. Postoperative measurements included the posterior tibial slope angle (PSA), femoral coronal component angle (FFC), tibial coronal component angle (FTC), and femoral sagittal component angle (LFC), as well as the incidence of abnormal values for each angle, which were analyzed statistically.</p><p><strong>Results: </strong>The operation time in the observation group was longer than that in the control group, but intraoperative blood loss was significantly lower in the observation group (P < 0.05). Postoperatively, the differences in the HKA and PSA angles and the incidence of abnormal values were significantly better in the robot-assisted group than in the control group (P < 0.05). The other indicators did not significantly differ between the two groups. (P > 0.05). For patients with mild preoperative deformities, those in the robot-assisted group had significantly better postoperative HKA angle deviations and rates of postoperative HKA angle outliers than those in the conventional group. For patients with significant deformities, the robot-assisted group presented greater postoperative HKA and PSA angle deviations than the control group; the postoperative HKA and PSA angle outlier rates were significantly lower in the robot-assisted group (P < 0.05).</p><p><strong>Conclusion: </strong>The TINAVI robotic system demonstrated superior safety and efficacy in TKA surgery. Compared with conventional TKA, the robot-assisted system achieved significantly better outcomes regarding prosthesis implantation accuracy and lower extremity alignment, with a particular advantage in patients with severe limb alignment deformities.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"19 1","pages":"872"},"PeriodicalIF":2.8,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11668079/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142886004","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":"Rotational osteotomy of forearm bones for treatment of congenital radioulnar synostosis in children.","authors":"Xiaolin Luo, Zhenbiao Li, Shengping Tang, Xinda Zheng, Xiujiang Yang, Yangjie Cai, Shijie Liao, Xiaofei Ding","doi":"10.1186/s13018-024-05393-5","DOIUrl":"10.1186/s13018-024-05393-5","url":null,"abstract":"<p><strong>Background: </strong>Congenital radioulnar synostosis (CRUS) is a rare upper limb deformity characterized by impaired rotational movement of the forearm. Rotational osteotomy is a commonly employed surgical procedure for treatment. This study aimed to analyze its surgical efficacy in treating CRUS in children.</p><p><strong>Methods: </strong>22 children (24 limbs) with CRUS from January 2010 to December 2023 were retrospectively collected. Rotational osteotomy of proximal ulna and distal radius was performed. Forearm function was evaluated using Failla scores and hygiene and self-care scores in Activities of daily Living score (ADL score). In addition, patients were further grouped and compared according to type of ulnar internal fixation and age at surgery.</p><p><strong>Results: </strong>22 patients (14 males, 8 females), with an average age of 6.0 years and an average follow-up time of 56 months. The mean pronation angle before surgery was 75.0 ± 11.3°, the mean postoperative pronation angle was 3.8 ± 7.1°, and the mean correction degree was 78.8 ± 12.9°. The average Failla scores were 5.6 ± 2.1 points before operation and 14.0 ± 1.0 points after operation. The average scores of hygiene and self-care scores were 19.0 ± 5.1 points before surgery and 36.0 ± 3.9 points after surgery. No child developed complications such as osteofascial compartment syndrome or infection. The correction angle in the plate fixation group was 86.8 ± 10.6°, while in the K-wires group was 72.0 ± 10.7°. The postoperative Failla scores in the older age group were 13.0 ± 1.1 points, and in the younger age group were 14.3 ± 0.8 points.</p><p><strong>Conclusion: </strong>Rotational osteotomy of forearm bones is safe and effective in the treatment of CRUS in children. Ulnar plate fixation has better correction than K-wires. Furthermore, younger children have better surgical outcomes than older ones.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"19 1","pages":"873"},"PeriodicalIF":2.8,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11669240/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142885000","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":"Association between polymorphisms of glucagon-like peptide-1 receptor gene and susceptibility to osteoporosis in Chinese postmenopausal women.","authors":"Xiaoxue Bao, Chang Liu, Huiming Liu, Yan Wang, Peng Xue, Yukun Li","doi":"10.1186/s13018-024-05361-z","DOIUrl":"10.1186/s13018-024-05361-z","url":null,"abstract":"<p><strong>Background: </strong>The influence of the glucagon-like peptide-1 receptor (GLP-1R) on bone metabolism is well-established. However, it has been observed that single nucleotide polymorphisms (SNPs) in the GLP-1R gene can partially affect its function. Therefore, this study aims to investigate the association between SNPs in the GLP-1R gene and postmenopausal osteoporosis (PMOP) within the Chinese Han population.</p><p><strong>Methods: </strong>This study employed a cross-sectional case-control design, recruiting a total of 152 participants, including 76 patients with osteoporosis (OP) (case group) and 76 healthy individuals (control group). Seven tag SNPs of GLP-1R were selected from the National Center of Biotechnology Information and Genome Variation Server. The association between GLP-1R polymorphisms and PMOP risk was assessed using different genetic models and haplotypes, while also exploring SNP-SNP and SNP-environment interactions.</p><p><strong>Results: </strong>Our results showed that minor alleles A at rs3765468, A at rs3765467 and G at rs4714210 showed significant associations with an increased risk of OP. Individuals with rs3765468 AG-AA genotype and rs3765467 AG-AA genotype exhibited a significantly higher risk of PMOP. Moreover, haplotype analysis revealed a significant association of the GACACA haplotype on PMOP risk (P = 0.033). Additionally, a multiplicative interaction was observed between rs3765468 and rs3765467 that was associated with an increased risk of PMOP (P_interaction = 0.012).</p><p><strong>Conclusions: </strong>Specific SNPs in the GLP-1R gene were linked to an increased risk of PMOP. This study improves our understanding of the genetic basis of PMOP in this population and suggests that genetic screening can identify individuals at risk for developing PMOP, enabling early prevention.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"19 1","pages":"869"},"PeriodicalIF":2.8,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11667832/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142882252","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":"Comparison of crossed and parallel rod configurations used in posterior occipitocervical and atlantoaxial fixations: a retrospective cohort study.","authors":"Mandi Cai, Haozhi Yang, Shuang Zhang, Chenfu Deng, Junlin Chen, Rencai Ma, Xiaobao Zou, Xiangyang Ma","doi":"10.1186/s13018-024-05330-6","DOIUrl":"10.1186/s13018-024-05330-6","url":null,"abstract":"<p><strong>Background: </strong>This study is aimed to compare the differences in clinical outcomes between the crossed rod configuration and the parallel rod configuration applied in posterior occipitocervical and atlantoaxial fixations, and to assess the clinical applicability of crossed rods.</p><p><strong>Methods: </strong>From January 2015 to December 2021, 21 patients with craniocervical junction disorders were treated surgically with the crossed rod technique (CR group). Meanwhile, 27 corresponding patients treated with the conventional parallel rod technique were included as control (PR group). Clinical data, internal fixation type, neurological status, clinical symptoms relief, image parameter, complications and bone fusion conditions were retrospectively analyzed and evaluated.</p><p><strong>Results: </strong>No statistically significant differences were found in baseline characteristics, fixation type and postoperative complications between the two groups. Although the postoperative ADI was significantly reduced in both groups, the ADI was significantly greater in the CR group than that in the PR group after surgery and at the final follow-up (P < 0.05). All patients achieved bone fusion at 1-year postoperative follow-up except for one case in the PR group. However, patients in the CR group had a significantly higher fusion rate than those in the PR group at 3 months postoperatively (P < 0.05).</p><p><strong>Conclusions: </strong>The application of a crossed rod configuration in posterior occipitocervical and atlantoaxial fixations provides good clinical applicability. Although this technique has a relatively weaker reduction force, it has greater fixation stability and a higher rate of early bone fusion. This technique could be an easy and viable alternative to the current parallel rod configuration for upper cervical surgery.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"19 1","pages":"863"},"PeriodicalIF":2.8,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11665243/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142877027","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":"Lower socioeconomic status is correlated with worse outcomes after arthroscopic rotator cuff repair.","authors":"Taylor Timoteo, Julio Nerys-Figueroa, Cassandra Keinath, Aghdas Movassaghi, Nicholas Daher, Alexander Jurayj, Jared M Mahylis, Stephanie J Muh","doi":"10.1186/s13018-024-05360-0","DOIUrl":"10.1186/s13018-024-05360-0","url":null,"abstract":"<p><strong>Background: </strong>Socioeconomic status has been recognized as a crucial social determinant of health influencing patient outcomes. Area Deprivation Index (ADI) is a validated measure of an area's socioeconomic status. Limited data exists on the impact of ADI and clinical outcomes and complications following rotator cuff repair (RCR). The purpose of this study was to investigate the impact socioeconomic factors have on outcomes following primary arthroscopic RCR.</p><p><strong>Methods: </strong>This is a retrospective cohort study with 1-year follow-up. Patients who underwent primary rotator cuff repair at a single institution from March 2014 to September 2022 were identified. Patient demographics, pre-and post-operative visual analog scale (VAS) scores, Patient-Reported Outcomes Measurement Information System (PROMIS) scores, range of motion, complications, and subsequent ipsilateral shoulder surgeries were collected. ADI was collected from an online mapping database using each patient's home address. Patients were split into ADI terciles, with ADI1 representing the least disadvantaged group and ADI3 representing the most disadvantaged group. Analysis of variance and T-test were used for continuous variables, and chi-square analyses were conducted for categorical variables.</p><p><strong>Results: </strong>In total, 467 patients underwent RCR and had complete demographic data and postoperative follow-ups over a year. There was a significant difference in race, with 78.2% of patients identifying as black in ADI3 and 18.1% in ADI1 (P < .001). Pre-operative PROMIS-Pain Interference, VAS, forward flexion, and abduction were significantly worse in ADI3 compared to ADI1 (P = .001, P < .001, P = .012, and P = .023). At one-year postoperative, patients in ADI3 scored significantly worse than patients in ADI1 in PROMIS- Upper Extremity score (P = .016), PROMIS- Pain Interference (P < .001), VAS (P < .001), forward flexion (P < .001) and abduction (P = .034). Higher ADI scores were associated with a positive correlation for pain (r = .258, P = < 0.001) a negative correlation with upper extremity function (r = - .233, P = .026), a positive correlation with pain interference (r = .355, P < .001), and negative correlation with forward flexion (r = - .227, P < .001). There were no significant differences in postoperative complications (P = .54), retears (P = .47), or reoperations rates (P = .22).</p><p><strong>Conclusion: </strong>Lower socioeconomic status measured by ADI is associated with worse preoperative and 1-year postoperative pain, shoulder function, and range of motion following RCR. However, no differences were appreciated between cohorts regarding reoperation or complications.</p><p><strong>Level of evidence iii: </strong>Retrospective Cohort Study.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"19 1","pages":"865"},"PeriodicalIF":2.8,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11665242/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142877156","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":"Prevalence of flatfoot and analysis of plantar pressure distribution in adolescents based on body mass index: a regional study.","authors":"Jiangtao Shen, Ji Liu, Feng Liang, Xiaohui Liu, Mingzhu Zhang","doi":"10.1186/s13018-024-05365-9","DOIUrl":"10.1186/s13018-024-05365-9","url":null,"abstract":"<p><strong>Background: </strong>The foot is an essential organ for human locomotion. Assessment of plantar pressure distribution could provide key clinical information on foot functions. However, the mechanism that links body mass index to injury is not clear. The aims of this study were (1) to analyze the feature of plantar pressure distribution in Chinese adolescents and (2) to estimate the prevalence of flatfoot.</p><p><strong>Methods: </strong>1,217 participants aged 17-23 years (756 males and 461 females) were enrolled in this study. Static and dynamic foot-related variables, including contact area and plantar pressure, were measured. Based on BMI, participants were stratified into three groups: the underweight group (BMI < 18.5 kg/m²), the norm weight group (18.5 ≤ BMI < 25 kg/m²), and the overweight group (BMI ≥ 25 kg/m²). Mann-Whitney U test was used to compare the three different BMI groups.</p><p><strong>Results: </strong>Overall, BMI had an impact on the contact area and plantar pressure at the 2nd to 4th metatarsal, 5th metatarsal, midfoot, and lateral heel, with greater pressure in these areas in the dynamic state. In particular, when shifting from the static phase to the dynamic phase, the plantar pressure of the forefoot shifted laterally. Moreover, the contact area, and plantar pressure at 2nd to 4th metatarsal, 5th metatarsal, middle foot, and lateral heel pressures were positively correlated with BMI. Among the 1217 participants, 67 adolescents were diagnosed with flatfoot.</p><p><strong>Conclusions: </strong>This study confirms that BMI does influence plantar pressures and that each BMI classification displays unique plantar pressure characteristics in Chinese adolescents.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"19 1","pages":"864"},"PeriodicalIF":2.8,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11664854/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142877161","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":"Development and validation of a three-dimensional nomogram prediction model for knee osteoarthritis in middle-aged population.","authors":"Ying Li, Yabin Guo, Peipei Zhao, Biyun Zeng, Yang Zhou","doi":"10.1186/s13018-024-05349-9","DOIUrl":"10.1186/s13018-024-05349-9","url":null,"abstract":"<p><strong>Objectives: </strong>This study aims to identify predictors of knee osteoarthritis (KOA) risk in middle-aged population, construct and validate a nomogram for KOA in this demographic.</p><p><strong>Methods: </strong>From June to December 2020, we conducted a cross-sectional survey on 5,527 middle-aged individuals from Changsha and Zhangjiajie cities in Hunan Province, selected using a stratified multi-stage random sampling method. Data collection involved a structured questionnaire encompassing general demographic, physical condition, and lifestyle behaviors dimensions. The dataset was randomly split into a training set (n = 3868) and a validation set (n = 1659) at a 7:3 ratio via computerized randomization. We analyzed the prevalence of self-reported KOA and identified its influencing factors using logistic regression. A nomogram was constructed based on these \"three-dimensional\" factors. Subsequent validation was conducted, and the nomogram's performance was further evaluated through ROC curves, C-index, Hosmer-Lemeshow test, and calibration curves.</p><p><strong>Results: </strong>The self-reported prevalence of KOA in the middle-aged population was 11.4% (632/5527). The risk factor with the greatest impact is: diagnosed with osteoporosis(95% CI 2.269-3.568, OR = 2.845), followed by age between 51 to 60 years (95% CI 2.176-3.151, OR = 2.619), diagnosed with hypertension(95% CI 1.633-2.499, OR = 2.02), diagnosed with diabetes (OR = 1.689), ethnic Han Chinese (OR = 1.673), exercise according to physical condition (OR = 1.643), pay attention to keeping the knee joint warm (OR = 1.535), eating habits are mainly light vegetables (OR = 1.374), male gender (OR = 1.343), drink occasionally in small amounts (OR = 1.286); a higher level of education (OR = 0.477) and frequently or always apply an external or plaster to relieve symptoms after knee discomfort (OR = 0.377; OR = 0.385) are protective factors. The C-index of the training set model was 0.8107 (95% CI: 0.8102-0.8111), with a statistically significant area under the ROC curve (AUC = 0.818), and the calibration curve showed a good fit. The C-index for the validation set was 0.8124 (95% CI: 0.8109-0.8140), with an AUC of 0.812. The Hosmer-Lemeshow test resulted in a P-value of 0.46 (P ≥ 0.05)indicating good calibration of the model.</p><p><strong>Conclusion: </strong>The three dimensions nomogram generated in this study was a valid and easy-to-use tool for assessing the risk of KOA in middle-aged population, and helped healthcare professionals to screen the high-risk population.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"19 1","pages":"866"},"PeriodicalIF":2.8,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11664829/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142877108","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":"Risk of infection and conversion time from external to definitive fixation in open tibial fracture.","authors":"Wazzan S Aljuhani, Yasir A Alshabi, Abdullah M Alanazi, Meshal A Alothri, Saleh A Almutairi, Ziad A Aljaafri, Abdullah M Alzahrani","doi":"10.1186/s13018-024-05350-2","DOIUrl":"10.1186/s13018-024-05350-2","url":null,"abstract":"<p><strong>Background: </strong>An open fracture of the tibia is one of the most common and dangerous type of open fractures. In the management of these injuries, the primary focus is on reducing the infection rate, as this is crucial for achieving the best clinical outcomes. This study aims to explore how provisional external fixation duration influences the rates of infection and union in open tibial shaft fractures.</p><p><strong>Methods: </strong>A retrospective study with a total of 55 patients who received temporary external fixation. Groups A (less than 12 days), B (12-24), C (25-36), and D (more than 36) were the four groups into which they were split according to the conversion time.</p><p><strong>Results: </strong>12.8%, 18.2%, 50%, and 100% of the infections were found in Groups A, B, C, and D, respectively. Significant (P < 0.05) differences were found throughout the four groups. The conversion time from external to definitive fixation was found to have a relationship with the occurrence of an infection (P = 0.004). A higher prevalence of infection was observed over time. However, no association was observed between infection and antibiotic duration or initial debridement time (P = 0.689 and P = 0.963, respectively).</p><p><strong>Conclusions: </strong>Results of this study demonstrate that the likelihood of infection increases when the change from external fixation to definitive internal fixation is delayed. Therefore, it is important to convert to definitive internal fixation immediately when the local and general conditions are favorable for doing so.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"19 1","pages":"867"},"PeriodicalIF":2.8,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11665134/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142877118","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":"Treatment of lumbar spondylolysis in young adults using modified intravertebral screw-rod fixation system for single vertebral body combined with autologous cancellous bone graft: a technical note and preliminary report.","authors":"Xiu Yang, Shun Lin, Han-Lin Chen, Jie Liang, Qing-Quan Chen, Jie Xiao, Jin-Shui Chen","doi":"10.1186/s13018-024-05382-8","DOIUrl":"10.1186/s13018-024-05382-8","url":null,"abstract":"<p><strong>Background: </strong>There is currently no consensus on the surgical treatment of lumbar spondylolysis in young adults, and the nonunion rate remains relatively high even after surgery. Therefore, in this study, we proposed a modified intravertebral screw-rod fixation technique within a single vertebral segment and investigated the clinical efficacy of this modified fixation system combined with autologous cancellous bone grafting in the treatment of lumbar spondylolysis in young adults.</p><p><strong>Methods: </strong>This study included 28 young adults with lumbar spondylolysis who were treated at our center between 2021 and 2023. All patients underwent modified intravertebral screw-rod fixation within a single vertebral segment combined with autologous cancellous bone grafting. We performed postoperative follow-ups regularly to assess the patient's pain status using the visual analog scale (VAS), Oswestry Disability Index (ODI), and radiological findings.</p><p><strong>Results: </strong>All 28 patients successfully underwent the surgery with an average operation time and blood loss volume of 96.01 ± 21.3 min and 186.78 ± 63.43 mL, respectively. Postoperatively, patients experienced significant symptom relief, with notable decreases in VAS scores and ODI indices at 1, 3, 6, and 12 months compared with preoperative conditions. These differences were statistically significant (P < 0.05). Radiological findings revealed a healing rate of 92.86% for the 56 fractured pars interarticularis among the 28 patients. No implant-related complications, such as fracture, loosening, or pseudarthrosis, were observed.</p><p><strong>Conclusions: </strong>The modified intravertebral screw-rod fixation system within a single vertebral segment combined with autologous cancellous bone grafting is a safe and effective treatment for lumbar spondylolysis in young adults. It significantly improves pain and functional disability as it promotes bone healing.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"19 1","pages":"868"},"PeriodicalIF":2.8,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11664932/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142877125","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}