Journal of Orthopaedic Science最新文献

{"title":"First ray mobility in hallux rigidus, hallux valgus, and normal feet based on weightbearing computed tomography and three-dimensional analysis: A case-control study","authors":"Tadashi Kimura ,&nbsp;Makoto Kubota ,&nbsp;Takumi Kihara ,&nbsp;Naoki Suzuki ,&nbsp;Asaki Hattori ,&nbsp;Mitsuru Saito","doi":"10.1016/j.jos.2024.04.002","DOIUrl":"10.1016/j.jos.2024.04.002","url":null,"abstract":"<div><h3>Background</h3><div><span>Hallux valgus and </span>hallux rigidus<span><span> are disorders affecting the first ray and are associated with hypermobility of this structure. This study aimed to investigate the three-dimensional mobility of each joint of the first ray between feet with hallux valgus or hallux rigidus and healthy feet using weightbearing and nonweightbearing </span>computed tomography (CT).</span></div></div><div><h3>Methods</h3><div><span>This case-control study analyzed 17 feet of 11 healthy volunteers (control group), 16 feet of 16 patients with hallux valgus (HV group), and 16 feet of 11 patients with hallux rigidus (HR group). First, nonweightbearing foot CT imaging was performed in the supine position on a loading device with no load applied, with the legs extended and the ankle in the neutral position. Next, a load equivalent to </span>body weight was applied for weightbearing CT imaging. Distal bone displacement relative to the proximal bone was quantified three-dimensionally under both conditions.</div></div><div><h3>Results</h3><div><span><span>In the HV group, the talonavicular joint showed significantly greater eversion (P = 00.011) compared with the control group and significantly greater dorsiflexion (P = 00.027) and eversion (P &lt; 00.01) compared with the HR group. In the medial cuneiform joint, the HV group showed significantly greater eversion (P &lt; 00.01) and abduction (P = 00.011) than the control group. For the first </span>tarsometatarsal joint, the HV group showed significantly greater dorsiflexion (P = 00.014), inversion (P = 00.028), and </span>adduction (P &lt; 00.01) than the control group, and greater inversion (P &lt; 00.01) and adduction (P &lt; 00.01) than the HR group. Dorsiflexion of the first tarsometatarsal joint was significantly greater in the HR group compared with the control group (P = 00.026).</div></div><div><h3>Conclusion</h3><div>Hypermobility of the first ray appears to be three-dimensional: in hallux valgus, it is centered at the first tarsometatarsal joint, while in hallux rigidus it is mainly in the sagittal plane at the first tarsometatarsal joint only. This difference may explain the different deformities ultimately observed in each condition.</div></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"30 2","pages":"Pages 320-324"},"PeriodicalIF":1.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140766258","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":"Comparative clinical outcomes and radiological images of clavicle hook plate versus Scorpion Plate® for unstable distal clavicle fractures","authors":"Naoki Takatori ,&nbsp;Yoshiyasu Uchiyama ,&nbsp;Eiji Shimpuku ,&nbsp;Takeshi Imai ,&nbsp;Masahiko Watanabe","doi":"10.1016/j.jos.2024.06.003","DOIUrl":"10.1016/j.jos.2024.06.003","url":null,"abstract":"<div><h3>Background</h3><div>Although various surgical methods<span><span> are available for unstable distal clavicle fractures<span>, consensus remains lacking on the optimal technique. Therefore, the present retrospective study aimed to compare the clavicle hook plate and Scorpion Plate® in terms of clinical outcomes and </span></span>radiological findings<span> for unstable distal clavicle fractures.</span></span></div></div><div><h3>Methods</h3><div><span>Fifty-seven patients with unstable distal clavicle fractures who underwent treatment using a clavicle hook plate (Group H; 28 patients) or Scorpion Plate® (Group S; 29 patients) were included in the present study. No patients received additional augmentation and all were followed-up for &gt;1 year (mean follow-up, 28 months). Clinical outcomes were operation time, bleeding volume, complications, range of motion (ROM) at 6 months after surgery and final follow-up, and clinical scores (Constant–Murley score and University of California, Los Angeles (UCLA) shoulder score). Radiological outcomes assessed were coracoclavicular distance (CCD), difference in CCD between affected and non-affected sides (ΔCCD), and acromioclavicular subluxation ratio (%ACS) from plain X-rays. The χ</span>² test and Mann–Whitney <em>U</em> test were used to compare each outcome.</div></div><div><h3>Results</h3><div>Complications were seen in 3 shoulders (10.7%) in Group H. ROM was significantly worse in Group H at 6 months postoperatively, but no significant differences between groups were evident at final follow-up. Moreover, no significant differences in clinical outcomes were seen between groups. In terms of radiological results, Group H showed greater improvement in CCD and ΔCCD than Group S. Further, %ACS was significantly worse in Group S.</div></div><div><h3>Conclusions</h3><div>The clavicle hook plate allows reconstruction of a more anatomical position than the Scorpion Plate®, but carries a greater risk of complications. Conversely, the Scorpion Plate® has a low risk of complications, but acromioclavicular subluxation remains. However, no significant differences in ROM or clinical outcomes were apparent at final follow-up.</div></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"30 2","pages":"Pages 307-312"},"PeriodicalIF":1.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141427102","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":"Subchondral insufficiency fractures of the medial tibial condyle are associated with medial meniscus extrusion: A retrospective observational study","authors":"Satoshi Kishiro ,&nbsp;Kenji Uehara ,&nbsp;Naoki Minakawa ,&nbsp;Mahiro Ono ,&nbsp;Takaaki Kudo ,&nbsp;Takashi Kotani ,&nbsp;Takanori Kumai ,&nbsp;Hiroyuki Onuma ,&nbsp;Tsutomu Akazawa ,&nbsp;Hisateru Niki","doi":"10.1016/j.jos.2024.04.010","DOIUrl":"10.1016/j.jos.2024.04.010","url":null,"abstract":"<div><h3>Background</h3><div>To the best of our knowledge, no prior studies have identified any risk factors for subchondral insufficiency fractures of the medial tibial condyle. This study aimed to explain relationships between subchondral insufficiency fractures of the medial tibial condyle and the meniscus status, lower extremity alignment, or osteoporosis.</div></div><div><h3>Methods</h3><div>This retrospective study included 325 consecutive patients whose chief complaint is knee joint pain and who had visited one institution between April 2016 and March 2021, of which 70 patients (8 men and 62 women) who had suspected subchondral insufficiency fractures of the medial tibial condyle had undergone magnetic resonance imaging and radiographic examination. These patients were divided into two groups based on the results of their magnetic resonance imaging: the insufficiency fracture group included 46 patients who had subchondral insufficiency fractures of the medial tibial condyle and the nonfracture group included 24 patients without fractures. The meniscus injury and medial meniscus extrusion (MME) were evaluated by using magnetic resonance imaging. The Kellgren–Lawrence grade, the femorotibial angle, and the percent mechanical axis (%MA) were evaluated with the use of knee radiographs. T-scores were also measured by using dual-energy X-ray absorptiometry with a bone densitometer.</div></div><div><h3>Results</h3><div>MME were significantly larger and the %MA was significantly smaller in the insufficiency fracture group than that in the nonfracture group. The prevalence of medial meniscus injuries and pathological MME were higher in the insufficiency fracture group than those in the nonfracture group. The prevalence of varus knee and osteoporosis did not vary remarkably different between the two groups.</div></div><div><h3>Conclusion</h3><div>The patients who had insufficiency fractures of the medial tibial condyle tended to have medial meniscus extrusion.</div></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"30 2","pages":"Pages 333-338"},"PeriodicalIF":1.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141080752","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Conditional deletion of IκBζ in hematopoietic cells promotes functional recovery after spinal cord injury in mice","authors":"Naoya Taki ,&nbsp;Atsushi Kimura ,&nbsp;Yasuyuki Shiraishi ,&nbsp;Takashi Maruyama ,&nbsp;Tsukasa Ohmori ,&nbsp;Katsushi Takeshita","doi":"10.1016/j.jos.2024.04.008","DOIUrl":"10.1016/j.jos.2024.04.008","url":null,"abstract":"<div><h3>Background</h3><div>Transcription factor protein IκBζ (encoded by the <em>Nfkbiz</em><span><span> gene) regulates nuclear factor-κB (NF-κB) and is involved in the pathophysiology<span> of various inflammatory diseases. However, the role of IκBζ in secondary damage following </span></span>spinal cord injury<span> (SCI) remains to be determined. Here, we investigated the effect of IκBζ expressed in hematopoietic cells on the progression of secondary damage and functional recovery after SCI.</span></span></div></div><div><h3>Methods</h3><div>We used conditional IκBζ-knockout mice (<em>Mx1-Cre</em>;<em>Nfkbiz</em>^{<em>fl/f</em>}<span><span>) to examine the role of IκBζ in hematopoietic cells after SCI. Contusion SCI was induced using a force of 60 kdyn. The recovery of locomotor performance was evaluated using the nine-point Basso Mouse Scale (BMS) until 42 days post-injury. Expression patterns of inflammatory cytokines and </span>chemokines<span> were examined by quantitative real-time PCR or proteome array analysis. Bone marrow transplantation (BMT) was performed to eliminate the effect of IκBζ deletion in non-hematopoietic cells.</span></span></div></div><div><h3>Results</h3><div><em>Mx1-Cre</em>;<em>Nfkbiz</em>^{<em>fl/fl</em>} mice had significantly improved locomotor function compared with wild-type (WT) mice. The mRNA expression of <em>Nfkbiz</em> in WT mice peaked at 12 h after SCI and then decreased slowly in both the spinal cord and white blood cells. <em>In situ</em> hybridization showed that <em>Nfkbiz</em><span> mRNA was localized in cell nuclei, including macrophage-like cells, in the injured spinal cord of WT mice at 1 day after SCI. Compared with WT mice, </span><em>Mx1-Cre</em>;<em>Nfkbiz</em>^{<em>fl/fl</em>} mice had significantly increased mRNA expressions of interleukin (<em>Il</em>)<em>-4</em> and <em>Il-10</em> in the injured spinal cord. In addition, <em>Mx1-Cre;Nfkbiz</em>^{<em>fl/fl</em>} mice had significantly higher protein levels of granulocyte-macrophage colony-stimulating factor and C–C motif chemokine 11 compared with WT mice. BMT from <em>Mx1-Cre</em>;<em>Nfkbiz</em>^{<em>fl/fl</em>} mice into WT mice improved functional recovery after SCI compared with control mice (WT cells into WT mice).</div></div><div><h3>Conclusions</h3><div>IκBζ deletion in hematopoietic cells improved functional recovery after SCI, possibly by shifting the inflammatory balance towards anti-inflammatory and pro-regenerative directions.</div></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"30 2","pages":"Pages 287-294"},"PeriodicalIF":1.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140958052","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":"Comparison of conjoined tendon-preserving posterior approach and conventional posterolateral approach in hemiarthroplasty for femoral neck fracture in the elderly: A multicenter (TRON group) retrospective study","authors":"Keisuke Ogura ,&nbsp;Yasuhiko Takegami ,&nbsp;Yutaro Kuwahara ,&nbsp;Katsuhiro Tokutake ,&nbsp;Ryo Nakashima ,&nbsp;Shigeto Yamamoto ,&nbsp;Kenta Naito ,&nbsp;Takehiro Kasai ,&nbsp;Kazuya Makida ,&nbsp;Shiro Imagama","doi":"10.1016/j.jos.2024.05.003","DOIUrl":"10.1016/j.jos.2024.05.003","url":null,"abstract":"<div><h3>Background</h3><div>Femoral neck fractures<span> (FNF) are one of the most common traumatic injuries in the elderly. The conjoined tendon-preserving posterior (CPP) approach was developed as a modification of the conventional posterolateral (PL) approach in hemiarthroplasty (HA) for displaced femoral neck fractures (FNF) to reduce postoperative dislocation. We hypothesized that the CPP approach would result in fewer dislocations and similar functional and radiographic outcomes compared to the PL approach.</span></div></div><div><h3>Patients and methods</h3><div>This was a retrospective multicenter (TRON group) study. We evaluated the rate of complications, and functional and radiographic outcomes for patients aged &gt;65 years who underwent HA via the PL approach or the CPP approach from 2017 to 2019 and followed up for at least 24 months. To adjust for baseline differences between the groups, a propensity score-matching algorithm was used in a 1:1 ratio.</div></div><div><h3>Results</h3><div>We identified 135 patients who underwent HA via the PL approach and 135 patients via the CPP approach. The mean follow-up period was 32.4 ± 14.0 months. The incidence of dislocation was 6 in 135 patients (4.4%) in the PL group and 0 in 135 patients (0%) in the CPP group, and there was significant difference (p = 0.04). Operation time was equivalent between the two groups (73.1 ± 30.4 vs. 71.8 ± 30.0 min; p = 0.72). The rate of varus insertion of stems in the PL group lower than that in the CPP group (19.3% vs. 33.3%; p = 0.01). Postoperative Parker's mobility score was similar between the two groups at 12 months follow-up (6.17 vs. 6.27; p = 0.81).</div></div><div><h3>Conclusion</h3><div>The CPP approach showed a significantly lower dislocation rate, similar functional outcome and more varus stem insertions compared with the PL approach in this retrospective study.</div></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"30 2","pages":"Pages 352-357"},"PeriodicalIF":1.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141175997","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":"Intertrochanteric femoral fracture with lateral wall fracture at the lag screw insertion site may cause postoperative anterior wall fracture and lead to deterioration in activities of daily living","authors":"Takuji Matsumoto ,&nbsp;Shuzo Nakatani ,&nbsp;Katsuhide Inoue ,&nbsp;Yuko Michiue ,&nbsp;Ikuko Matsumoto ,&nbsp;Nobuhiko Funaoka","doi":"10.1016/j.jos.2024.06.004","DOIUrl":"10.1016/j.jos.2024.06.004","url":null,"abstract":"<div><h3>Background</h3><div>Incomplete reduction and fixation of intertrochanteric femoral fractures significantly affect patients' daily activities. The lateral wall's integrity is pivotal in such fractures. This study examines instability, particularly lateral wall fractures at the lag screw insertion site and postoperative anterior wall fractures.</div></div><div><h3>Methods</h3><div>Overall, 161 patients with femoral intertrochanteric fractures<span> were included. Three-dimensional computed tomography<span> was conducted preoperatively and 3 weeks postoperatively to determine the postoperative anterior wall fractures incidence. Patient background, operative time, intraoperative blood loss, postoperative telescoping, and daily living activities were compared.</span></span></div></div><div><h3>Results</h3><div>The study recorded 51 cases of lateral wall fractures at the lag screw insertion site and 17 of postoperative fractures of the anterior wall. Postoperative fractures of the anterior wall were found in 3 of 110 and 14 of 51 patients in the group without and with the lag screw insertion site, respectively. The group of postoperative fractures of the anterior wall had significantly lower bone mineral density, longer operative time, and increased intraoperative blood loss. At 4 weeks postoperatively, the group of postoperative fractures of the anterior wall showed increased telescoping and decreased motor component of the functional independence measure (with postoperative fractures of the anterior wall: 28, without postoperative fractures of the anterior wall: 30), and significant reductions were observed in the transfer and locomotion items, indicating lower limb function (with postoperative fractures of the anterior wall group: 11, without postoperative fractures of the anterior wall group: 12).</div></div><div><h3>Conclusions</h3><div>Postoperative anterior wall fractures occurred in 27.5% cases with lateral wall fractures at the lag screw insertion site. Three-dimensional computed tomography is useful for preoperative evaluation of lateral wall fractures at the lag screw insertion site to assess instability. Postoperative fractures of the anterior wall related reduction in daily living activities needs attention.</div></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"30 2","pages":"Pages 358-363"},"PeriodicalIF":1.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141468960","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":"Clinical outcome of ulnar superficialis slip tendon resection for stenosing tenosynovitis of the finger with proximal interphalangeal joint fixed flexion deformity","authors":"Takanori Hatanaka,&nbsp;Jun Nishida,&nbsp;Yuichi Ichikawa,&nbsp;Taro Nagai,&nbsp;Hanako Tsuji,&nbsp;Takaaki Shishido,&nbsp;Kengo Yamamoto","doi":"10.1016/j.jos.2024.04.004","DOIUrl":"10.1016/j.jos.2024.04.004","url":null,"abstract":"","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"30 2","pages":"Pages 295-301"},"PeriodicalIF":1.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140856537","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":"Webplasty using an external fixator for complex syndactyly caused by Apert syndrome","authors":"Akira Kinoda ,&nbsp;Kazuki Sato ,&nbsp;Takuji Iwamoto ,&nbsp;Noboru Matsumura ,&nbsp;Taku Suzuki ,&nbsp;Yasuhiro Kiyota ,&nbsp;Takeshi Kimura ,&nbsp;Toshiyasu Nakamura","doi":"10.1016/j.jos.2024.04.007","DOIUrl":"10.1016/j.jos.2024.04.007","url":null,"abstract":"<div><h3>Background</h3><div>Webplasty can be conducted for complex syndactyly<span> caused by Apert syndrome<span> (also referred to as Apert hand) by extending the soft tissue in the lateral direction using an external fixator. This study aimed to verify the usefulness of webplasty without skin grafting.</span></span></div></div><div><h3>Methods</h3><div>Webplasty with lateral extension was conducted at a single institution from 2015 to 2023. The patients were four children with Apert hand aged 1–3 years. A custom-made small external fixator was used for all of the soft tissue extension.</div></div><div><h3>Results</h3><div>Webplasty without skin grafting was completed by the time all five patients were 5–6 years of age.</div></div><div><h3>Conclusion</h3><div>Webplasty without skin grafting was possible with lateral extension of the soft tissue using a simple external fixator.</div></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"30 2","pages":"Pages 302-306"},"PeriodicalIF":1.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141074525","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":"Directly measured strain patterns of the anterior talofibular and calcaneofibular ligaments after isolated ATFL repair in a combined ATFL and CFL injury: A cadaver study","authors":"Masato Takao ,&nbsp;Satoru Ozeki ,&nbsp;Maya Kubo ,&nbsp;Xavier M. Oliva ,&nbsp;Takayuki Yamazaki ,&nbsp;Dani Lowe ,&nbsp;Kentaro Matsui ,&nbsp;Mai Katakura ,&nbsp;Yoshitaka Takeuchi ,&nbsp;Mark Glazebrook","doi":"10.1016/j.jos.2024.06.002","DOIUrl":"10.1016/j.jos.2024.06.002","url":null,"abstract":"<div><h3>Background</h3><div>Even though 20% of chronic lateral ankle instability results from a combined anterior talofibular ligament (ATFL) and calcaneofibular ligament (CFL) injury, only the ATFL is sutured using arthroscopic ligament repair<span> techniques. Although some biomechanical and clinical studies have proved that isolated ATFL repair yields excellent results, previous biomechanical studies were performed using systems that only allow indirect estimations. The purpose of this study was to clarify strain patterns by directly measuring repaired ATFL and CFL strain patterns on cadaveric models that underwent isolated ATFL repair of a combined ATFL and CFL injury.</span></div></div><div><h3>Methods</h3><div><span>The miniaturization ligament performance probe (MLPP) system was used for directly measuring the strain patterns to insert the strain gauges into the mid-substance of normal and repaired ATFL and CFL fibers in five </span>cadaveric specimens to allow measurement of strain patterns in the axial and three-dimensional motion of the ankle.</div></div><div><h3>Results</h3><div>The normal and repaired ATFL showed similar strain patterns in axial and three-dimensional motions. During the axial range of motion of the ankle, the repaired CFL showed a strain pattern almost similar to that of normal CFL, but the strain increased as the plantar flexion or dorsiflexion<span> angle increased to the maximum value of 100 at 30° plantarflexion or strain values of 17–55/100 at 15°dorsiflexion. During three-dimensional motion, the repaired CFL was under the maximum value of 100 during dorsiflexion-inversion and exhibited less strain (7–38/100) during plantar flexion-eversion.</span></div></div><div><h3>Conclusion</h3><div>The repaired CFL did not show a strain pattern that was completely consistent with a normal strain pattern; however, it did have some degree of tension similar to a normal strain pattern, even though it was not directly repaired.</div></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"30 2","pages":"Pages 364-371"},"PeriodicalIF":1.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141419555","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":"Far cortical locking constructs for fixation of distal femur fractures in an Asian population: A prospective observational study","authors":"Eic Ju Lim ,&nbsp;Jae-Woo Cho ,&nbsp;Oog-Jin Shon ,&nbsp;Jong-Keon Oh ,&nbsp;Kyu Tae Hwang ,&nbsp;Gwang Chul Lee","doi":"10.1016/j.jos.2024.03.007","DOIUrl":"10.1016/j.jos.2024.03.007","url":null,"abstract":"<div><h3>Background</h3><div>The stiffness of locked plates suppresses healing process, prompting the introduction of far cortical locking to address this issue. This study aimed to demonstrate the clinical efficacy of far cortical locking constructs in treating distal femoral fractures in an Asian population.</div></div><div><h3>Methods</h3><div>This multicenter prospective observational study was conducted at four university hospitals between February 2018 and February 2021. Demographic data, the presence of metaphyseal comminution, and surgical fixation details were recorded. Clinical outcomes, including single-leg standing, EQ-5D, and EQ-VAS scores, and radiologic outcomes, including the RUST score of each cortex, were evaluated and compared according to the presence of metaphyseal comminution.</div></div><div><h3>Results</h3><div>There were 37 patients (14 men and 23 women) with a mean age of 67.3 ± 11.8 years. Twenty-two patients had metaphyseal comminution (59%), and 15 presented simple fractures in metaphyseal areas. Four patients (13%) could stand on one leg &gt;10s at 6 weeks, and 24 patients (92%) at 1 year. EQ-5D increased from 0.022 ± 0.388 to 0.692 ± 0.347, and the mean EQ-VAS 51.1 ± 13.1 to 74.1 ± 24.1 between discharge (n = 37) and post-operative 1 year (n = 33), respectively. RUST score presented increment for time, from 6.2 ± 1.8 at 6 week to 11.6 ± 1.1 at 1 year. Radiological healing demonstrated rapid increase from week 6 (16/28, 43%) to month 3 (27/31, 87%), with no obvious increase was observed in 6 months (23/26, 89%) or 12 months (25/28, 89%). Simple metaphyseal fractures presented significantly higher RUST scores at 6 weeks and 3 months, but there was no difference in RUST scores at 6 months or 1 year according to metaphyseal comminution.</div></div><div><h3>Conclusions</h3><div>Plate constructs with far cortical locking screws provided safe and effective fixation for distal femoral fractures, with consistent radiological and clinical results, regardless of metaphyseal comminution.</div></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"30 2","pages":"Pages 372-378"},"PeriodicalIF":1.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140782285","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}