Journal of Orthopaedic Trauma最新文献

{"title":"Posterior Tibial Tendon Transfer and Achilles Tendon Lengthening for Foot Drop.","authors":"Nathaniel P Mercer, Bradley A Lezak, Dylan T Lowe, Kenneth A Egol","doi":"10.1097/BOT.0000000000003193","DOIUrl":"10.1097/BOT.0000000000003193","url":null,"abstract":"<p><strong>Summary: </strong>This review describes a case of chronic post-traumatic foot drop managed with posterior tibial tendon transfer through the interosseous membrane and percutaneous Achilles tendon lengthening. Key technical considerations and postoperative rehabilitation principles are highlighted. This approach provides a durable solution for restoring ankle dorsiflexion and improving ambulation in patients with irreversible peroneal nerve injury.</p>","PeriodicalId":16644,"journal":{"name":"Journal of Orthopaedic Trauma","volume":"40 8S","pages":"S17-S18"},"PeriodicalIF":2.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148471252","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":"High Rate of Missed Geriatric U-Type Sacral Fractures Despite Advanced Imaging: A Retrospective Case Series.","authors":"Adam N Musick, Ivan J Golub, Robert K Wagner, Carla H Lehle, Healy S Vise, Jacob S Borgida, Nishant Suneja, Michael J Weaver, Derek S Stenquist, Daniel G Tobert, Mitchel B Harris, Thuan V Ly, Arun Aneja","doi":"10.1097/BOT.0000000000003177","DOIUrl":"10.1097/BOT.0000000000003177","url":null,"abstract":"<p><strong>Objectives: </strong>To determine the rate of missed diagnoses among geriatric patients with low-energy U-type sacral fractures.</p><p><strong>Methods: </strong></p><p><strong>Design: </strong>Retrospective case series.</p><p><strong>Setting: </strong>Two academic Level 1 trauma centers.</p><p><strong>Patient selection criteria: </strong>All patients ≥65 years with sacral fractures between January 2023 and January 2025 were screened using Current Procedural Terminology (CPT) and International Classification of Diseases (ICD) codes. Provider notes, radiology reports, and available pelvic/sacral advanced imaging (computed tomography and/or magnetic resonance imaging) were reviewed. Patients with low-energy U-type sacral fractures (OTA/AO 55C0 or 54C3) confirmed by study team review of advanced imaging were included.</p><p><strong>Outcome measures and comparisons: </strong>The primary outcome was the rate of missed U-type fractures, defined as fractures not diagnosed by any provider at the first clinical encounter in which advanced imaging demonstrated a U-type fracture, as identified on study team review. Missed U-type fractures were subclassified as initial misses (visible on advanced imaging at the initial encounter but not diagnosed), delayed imaging misses (no advanced imaging at the initial encounter and not diagnosed at the first subsequent encounter with advanced imaging), and evolving misses (not present or visible on initial advanced imaging but visible on subsequent imaging and not diagnosed). Complete misses were U-type fractures never diagnosed during clinical care.</p><p><strong>Results: </strong>Among 262 geriatric sacral fractures screened, 69 (26.3%) were low-energy U-type fractures (median age 79 years; 81% female) confirmed by the study team. Of these, 25 (36.2%) were missed and 44 (63.8%) were not missed. Among missed fractures, 16 (64.0%) were initial misses, 6 (24.0%) were delayed imaging misses, and 3 (12.0%) were evolving misses. Overall, 14 (56.0%) were complete misses (9 initial misses, 2 delayed imaging misses, 3 evolving misses), whereas 11 were subsequently recognized by a provider (7 initial misses, 4 delayed imaging misses).</p><p><strong>Conclusions: </strong>More than one-third of geriatric U-type sacral fractures were missed despite advanced imaging. This reinforces the need for heightened clinical vigilance and careful advanced imaging review to facilitate timely diagnosis and appropriate management of these injuries.</p><p><strong>Level of evidence: </strong>Diagnostic Level III. See Instructions for Authors for a complete description of levels of evidence.</p>","PeriodicalId":16644,"journal":{"name":"Journal of Orthopaedic Trauma","volume":" ","pages":"424-430"},"PeriodicalIF":2.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147627953","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":"Supination Adduction Ankle Fracture Treated With Fibular Intramedullary Screw Fixation.","authors":"Theodor Di Pauli von Treuheim, Michele N Cerasani, Sanjit Konda, Abhishek Ganta","doi":"10.1097/BOT.0000000000003184","DOIUrl":"10.1097/BOT.0000000000003184","url":null,"abstract":"<p><strong>Summary: </strong>This abstract describes an open reduction and internal fixation technique used for a supination adduction ankle injury. This technique demonstrates medial plafond articular disimpaction with backfilling of the bony void with cancellous allograft. The medial malleolus was then fixed with a mini fragment plate in antiglide fashion with subchondral rafting screws. The lateral malleolus fracture was addressed with use of a retrograde screw rather than a fibular plate. This technique emphasizes the importance of both recognizing and addressing the anteromedial plafond impaction of supination adduction ankle fractures.</p>","PeriodicalId":16644,"journal":{"name":"Journal of Orthopaedic Trauma","volume":"40 8S","pages":"S21-S22"},"PeriodicalIF":2.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148471319","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":"Computed Tomography Scan as First-Line Imaging in Patients Suspected of a Proximal Femoral Fracture Without Obvious Clinical Findings-A Cohort Study of 927 Patients.","authors":"Frederikke R Jars, Kristoffer B Hare","doi":"10.1097/BOT.0000000000003182","DOIUrl":"10.1097/BOT.0000000000003182","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate whether first-line CT imaging, as an alternative to standard radiography, reduces the time from admission to surgery in patients suspected of a proximal femoral fracture without classic clinical signs.</p><p><strong>Methods: </strong></p><p><strong>Design: </strong>A retrospective cohort study.</p><p><strong>Setting: </strong>Single center Level 2 trauma center, Slagelse Hospital, Region Zealand, Denmark.</p><p><strong>Patient selection criteria: </strong>Patients aged 65 years and above, admitted between June 1, 2018, and May 31, 2019, undergoing radiography and/or CT of the proximal femur AO/OTA 31 or pelvis AO/OTA 61 were included.</p><p><strong>Outcome measure and comparisons: </strong>The primary outcome was comparing time from admission to surgery, mortality, and fracture distribution between the 2 groups.</p><p><strong>Results: </strong>Nine hundred twenty-seven patients were included, 452 patients before and 475 after the new imaging guideline. After the implementation of this new imaging guideline, there was a significant decrease in time from arrival at the emergency department to surgery from 1229 to 1050 minutes ( P = 0.03). Patients time to surgery was 179 minutes faster than before, a savings of approximately 3 hours and the reduced time to surgery did not lead to a significant difference on the 30-day (before = 13.23, after = 18.03 days, P = 0.29) and 1-year (before = 106.3, after = 133.45 days, P = 0.21) mortality rate.</p><p><strong>Conclusions: </strong>The new imaging guideline decreased the time from arrival at the emergency department to surgery.</p><p><strong>Level of evidence: </strong>Prognostic, Level III. See Instructions for Authors for a complete description of levels of evidence.</p>","PeriodicalId":16644,"journal":{"name":"Journal of Orthopaedic Trauma","volume":" ","pages":"e181-e185"},"PeriodicalIF":2.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147645628","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":"Do Computerized Tomography Images Influence Surgeons' Estimates of Posterior Tilt Angle or Treatment Preference for Minimally Displaced Femoral Neck Fractures?","authors":"Soroush Shabani, Nathan N O'Hara, Ryan C Ross, Julian Wier, Jordan Gasho, Sheila Sprague, Gerard P Slobogean, Joseph T Patterson","doi":"10.1097/BOT.0000000000003186","DOIUrl":"10.1097/BOT.0000000000003186","url":null,"abstract":"<p><strong>Objectives: </strong>To determine if axial computerized tomography (CT) images compared with radiographs of minimally displaced femoral neck fractures in older adults change surgeons' estimates of posterior tilt or treatment preference for internal fixation versus arthroplasty.</p><p><strong>Methods: </strong></p><p><strong>Design: </strong>A survey was developed from the clinical vignettes, injury radiographs of anteroposterior (AP) pelvis and lateral hip, and CT pelvis axial images of 10 patients randomly selected from 50 patients with minimally displaced femoral neck fractures enrolled in a clinical trial. Survey respondents estimated femoral neck fracture posterior tilt angle (0-90 degrees) and stated their treatment preference on a scale of 100% for internal fixation to 100% for arthroplasty based on the radiographs, then again after viewing the CT images of the same patient.</p><p><strong>Setting: </strong>The survey was administered electronically using REDCap and distributed by email between 15 June and 15 July 2025.</p><p><strong>Patient selection criteria: </strong>The survey was distributed to a convenience sample of attending orthopaedic surgeons with hip fracture call experience nonrandomly selected from email contacts of colleagues, acquaintances, and extramural research collaborators located in North America, South America, and Europe. Neither fellowship training nor practice setting were requirements for participation.</p><p><strong>Outcome measures and comparisons: </strong>The mean differences in posterior tilt estimates and treatment preferences between radiographs and CT were estimated using linear mixed-effects models.</p><p><strong>Results: </strong>Complete survey responses were received from 69 of 98 participants (70.4% response rate). Posterior tilt estimates were 6 degrees greater based on CT versus radiographs (95% confidence interval [CI], 4-7 degrees; P < 0.0001). CT images significantly changed treatment preferences by 20% more in favor of arthroplasty (95% CI, 14%-26%; P < 0.0001).</p><p><strong>Conclusions: </strong>Axial CT images significantly changed orthopaedic surgeons' estimates of posterior tilt and treatment preferences in favor of arthroplasty for minimally displaced femoral neck fractures compared with radiographs.</p><p><strong>Level of evidence: </strong>Prognostic Level V. See Instructions for Authors for a complete description of levels of evidence.</p>","PeriodicalId":16644,"journal":{"name":"Journal of Orthopaedic Trauma","volume":" ","pages":"e186-e191"},"PeriodicalIF":2.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147839313","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":"Early Open Repair of a Multiligamentous Knee Injury.","authors":"Camas C Curran, Max E Davis","doi":"10.1097/BOT.0000000000003195","DOIUrl":"10.1097/BOT.0000000000003195","url":null,"abstract":"<p><strong>Summary: </strong>This review discusses the utility of early open repair of multiligamentous knee injuries in patients with high-energy mechanisms. The surgical technique for anterior cruciate ligament, posterior cruciate ligament, and medial collateral ligament repair was demonstrated on a polytraumatized patient using the medial parapatellar approach. The posterior cruciate ligament was repaired first with suture through a drill tunnel in the femoral insertion followed by the anterior cruciate ligament in a similar fashion. The medial collateral ligament was repaired last with a staple. With some exceptions, weight bearing and knee range of motion are permitted immediately postoperatively. In the right patient population, this procedure may expedite patients' recovery and return to daily life.</p>","PeriodicalId":16644,"journal":{"name":"Journal of Orthopaedic Trauma","volume":"40 8S","pages":"S13-S14"},"PeriodicalIF":2.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148471298","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":"Ankle Syndesmotic Injury With Posterior Tibial Tendon Rupture.","authors":"Bradley A Lezak, Nathaniel P Mercer, Dylan T Lowe, Kenneth A Egol","doi":"10.1097/BOT.0000000000003197","DOIUrl":"10.1097/BOT.0000000000003197","url":null,"abstract":"<p><strong>Summary: </strong>Isolated ankle syndesmotic injuries are uncommon and are typically discussed in the context of athletic high ankle sprains; however, concomitant rupture of the posterior tibial tendon represents an exceedingly rare injury pattern. This case highlights the importance of maintaining a high index of suspicion for associated soft-tissue pathology in patients presenting with syndesmotic instability in the absence of fracture. This case underscores the need for comprehensive clinical and imaging evaluation of isolated syndesmotic injuries and supports primary tendon repair when rupture is identified.</p>","PeriodicalId":16644,"journal":{"name":"Journal of Orthopaedic Trauma","volume":"40 8S","pages":"S19-S20"},"PeriodicalIF":2.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148471236","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":"Carpal Tunnel Release: Technical Considerations for the Orthopaedic Trauma Surgeon.","authors":"Atticus Coscia, Jonathan Weinerman, Mark Hake, Jeffrey Lawton","doi":"10.1097/BOT.0000000000003183","DOIUrl":"10.1097/BOT.0000000000003183","url":null,"abstract":"<p><strong>Summary: </strong>Emergent carpal tunnel release is indicated for acute carpal tunnel syndrome, most commonly secondary to distal radius fracture and may be performed in the setting of forearm/hand compartment syndrome along with forearm and/or hand fasciotomies if median nerve compression is suspected. Carpal tunnel release can safely and efficiently be performed concurrent to fracture fixation and/or compartment release, generally with excellent results. This abstract is intended to serve as a succinct review for orthopaedic traumatologists who do not routinely perform carpal tunnel release on an elective basis, describing the relevant anatomy, structures at risk, and an incision design required to successfully perform open carpal tunnel release.</p>","PeriodicalId":16644,"journal":{"name":"Journal of Orthopaedic Trauma","volume":"40 8S","pages":"S7-S8"},"PeriodicalIF":2.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148471205","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":"Do Amputation Characteristics Predict Outcomes Measures and Infections After Osseointegration Surgery?","authors":"Julio A Rivera, Ashley B Bozzay, Jason M Souza, Benjamin K Potter, Jonathan A Forsberg","doi":"10.1097/BOT.0000000000003178","DOIUrl":"10.1097/BOT.0000000000003178","url":null,"abstract":"<p><strong>Objective: </strong>To determine which patient characteristics are associated with patient-reported outcomes (PROs) and infection outcomes after transfemoral Osseointegration (OI) surgery.</p><p><strong>Methods: </strong></p><p><strong>Design: </strong>Single-center retrospective study.</p><p><strong>Setting: </strong>Walter Reed National Military Medical Center, Bethesda, MD.</p><p><strong>Patient selection criteria: </strong>Patients who underwent unilateral or bilateral transfemoral OI surgery and completed 2-year follow-up.</p><p><strong>Outcome measures and comparisons: </strong>Baseline patient characteristics (age at primary amputation, time living with limb loss, residual femur length, age at OI surgery, and limb-loss-adjusted body mass index [BMI]) were evaluated as predictors of change in PROs from baseline to 2-year follow-up (Questionnaire for Persons with a Transfemoral Amputation (Q-TFA) domains, patient-reported outcomes measurement information system (PROMIS) domains, and patient-reported prosthesis use) and of infection outcomes (any infection and number of infections), using generalized linear models with Akaike information criteria-guided backward elimination and adjustment for amputation laterality (unilateral vs. bilateral).</p><p><strong>Results: </strong>There were 54 patients included (37 unilateral and 17 bilateral) who completed 2-year follow-up. The unilateral cohort had a mean age of 41.1 years (range, 24-72 years) and was predominantly male (33 men and 4 women), whereas the bilateral cohort had a mean age of 33.6 years (range, 26-41 years) and consisted entirely of male patients. Adjusted BMI best predicted changes in Q-TFA Global (R 2 = 0.06, F(1,48) = 3.8, P = 0.05) and problem scores (R 2 = 0.07, F(1,48) = 4.7, P = 0.03), as well as PROMIS Pain Interference (R 2 = 0.25, F(1,50) = 17.8, P < 0.001) and Pain Behavior scores (R 2 = 0.26, F(1,50) = 18.7, P < 0.001) between baseline and 2-year follow-up. Adjusted BMI also best predicted changes in Q-TFA Prosthetic Use, PROMIS Physical Function, and prosthesis use time. Adjusted BMI was the strongest predictor of the number of infections.</p><p><strong>Conclusion: </strong>Among unilateral and bilateral transfemoral amputees undergoing OI surgery with 2-year follow-up, lower adjusted BMI was associated with improved PROs and fewer infection events. Differences between unilateral and bilateral amputees suggest that amputation laterality may modify postoperative outcomes.</p><p><strong>Level of evidence: </strong>Prognostic, Level III. See Instructions for Authors for a complete description of levels of evidence.</p>","PeriodicalId":16644,"journal":{"name":"Journal of Orthopaedic Trauma","volume":" ","pages":"440-445"},"PeriodicalIF":2.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147638916","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":"Screw Density Is Not Associated With Outcomes of Lateral Bridge Plating of Distal Femur Fractures.","authors":"Adam M Schlauch, Robert E Bilodeau, Alona Katzir, Craig E Klinger, William M Ricci","doi":"10.1097/BOT.0000000000003176","DOIUrl":"10.1097/BOT.0000000000003176","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To examine whether screw density was associated with reoperation to promote union in distal femur fractures fixed with lateral bridge plating.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design: &lt;/strong&gt;Systematic review, meta-analysis and retrospective clinical cohort.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Setting: &lt;/strong&gt;Tertiary referral center.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Patient selection criteria: &lt;/strong&gt;Systematic review and meta-analysis : PubMed, Embase, and Cochrane databases were systematically searched from the earliest available records of each database through May 2025. Included were observational studies and randomized controlled trials that reported the union rate after index distal femur fracture fixation with a single lateral distal femur plate and screw density of the lateral distal femur plate for groups that did and did not require a reoperation to promote union. Retrospective clinical cohort : Adult patients who underwent lateral single-plate bridge fixation for acute distal femur fracture (OTA/AO 33A and 33C) at a single institution from January 2017 to January 2024 were reviewed. Excluded were patients with pathologic fractures, interprosthetic fractures, missing records, and &lt;6 months of follow-up without radiographic union.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Outcome measures and comparisons: &lt;/strong&gt;Systematic review and meta-analysis : The meta-analysis used total screw density (TSD) of the lateral distal femur plate as the effect variable on reoperation rates in the groups that either did or did not achieve union after distal femur fracture fixation. Proximal screw density (PSD) was not used as a main effect variable to avoid the inconsistent definitions and reporting of PSD used in the literature. Retrospective clinical cohort : The primary outcome was reoperation to promote union. PSD (screw holes filled proximal to the fracture/screw holes proximal to the fracture) and TSD (TSD; screw holes filled/screw holes) were calculated and compared between groups that either did or did not require a reoperation to promote union. Screws in the distal metaphyseal block of the plate were excluded from all analyses.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Meta-analysis and systematic review : The search generated 429 articles, of which 6 studies met inclusion criteria producing a patient sample of 1272 with mean age 65.1 years (range 16-102 years) and 33% male (range 20%-53%) with a mean nonunion rate of 16.5% (range 10.5%-28.8%). There was no significant association between TSD and nonunion rates (effect size = 0.05, 95% CI -0.21, 0.32). The mean TSD for patients achieving union versus those who did not was 0.60 versus 0.61, respectively ( P = 0.98). No study showed a significant effect of TSD on reoperation to promote union. Retrospective cohort : Fifty-six patients were included with a mean age of 72.2 (range 25-97) years, of which 80.4% were female. Six (10.7%) underwent reoperation to promote union. For patients requiring reoperation to promote union ","PeriodicalId":16644,"journal":{"name":"Journal of Orthopaedic Trauma","volume":" ","pages":"431-439"},"PeriodicalIF":2.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147627932","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}