Journal of Orthopaedic Science最新文献

{"title":"Osteosynthesis using ultra-high molecular weight polyethylene fiber cables for periprosthetic femoral fracture.","authors":"Shohei Sogawa, Kenichi Oe, Tomohisa Nakamura, Yosuke Otsuki, Takashi Toyoda, Fumito Kobayashi, Hirokazu Iida, Takanori Saito","doi":"10.1016/j.jos.2025.06.018","DOIUrl":"https://doi.org/10.1016/j.jos.2025.06.018","url":null,"abstract":"<p><strong>Background: </strong>An ultra-high molecular weight polyethylene (UHMWPE) fiber cable, formed into a soft flexible tape, offers excellent properties for use in osteosynthesis. The purpose of this study was to evaluate the outcomes of osteosynthesis using the UHMWPE fiber cable.</p><p><strong>Methods: </strong>In this study, 23 patients who underwent osteosynthesis with the use of a UHMWPE fiber cable for periprosthetic fracture (PPF) following total or bipolar hip arthroplasty, at a total of 56 sites, were retrospectively evaluated. The procedures were performed between August 2010 and December 2022. The mean duration of clinical follow-up was 4.1 years (range, 1-10). The cable was used in two ways: direct cerclage around the femur at 38 sites and indirect cerclage around the femur through contact with a metal plate and/or strut grafts at 18 sites.</p><p><strong>Results: </strong>No clinical complications were observed after the use of UHMWPE fiber cables. Fracture union was confirmed in all cases, with a mean duration of 7.6 months (range, 2-21). Local bone atrophy was observed in 27 % (15/56 sites), with a mean occurrence of 0.9 years (range, 0.1-2.9), but this atrophy did not progress. Significantly less bone atrophy was noted at the greater trochanter than at the femoral shaft (P = 0.009). The atrophy incidence rate was 39 % (15/38 sites) for direct cerclage and 0 % for indirect cerclage (P = 0.0009).</p><p><strong>Conclusion: </strong>Osteosynthesis using a UHMWPE fiber cable for PPFs yielded successful results and was especially useful for reduction and fixation around the greater trochanter. However, for direct cerclage at the femoral shaft, particular attention to strategies that can prevent local bone atrophy is required.</p>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144675047","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":"Comment on Mehmet et al.: Relationship between systemic immune inflammation index and amputation in patients with diabetic foot ulcer.","authors":"Xiaohua Jiang, Yabin Liu, Guowu Chen","doi":"10.1016/j.jos.2024.08.006","DOIUrl":"https://doi.org/10.1016/j.jos.2024.08.006","url":null,"abstract":"","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144659439","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Application effect of vacuum sealing drainage combined with nano-silver dressings in the treatment of non-healing wounds after surgery for open limb fractures.","authors":"Taihua Huang, Haiping Huang","doi":"10.1016/j.jos.2025.05.012","DOIUrl":"https://doi.org/10.1016/j.jos.2025.05.012","url":null,"abstract":"<p><strong>Background: </strong>Non-healing wounds after open limb fracture surgery pose clinical challenges, requiring effective management; vacuum sealing drainage (VSD) promotes healing by removing exudate and stimulating granulation, while nano-silver dressings provide antimicrobial protection to reduce infection risk. We aimed to probe the application effect of VSD combined with nano-silver dressings in the treatment of non-healing wounds after surgery for Gustilo type III open limb fractures.</p><p><strong>Methods: </strong>A total of 60 patients with non-healing wounds after surgery for Gustilo type III open limb fractures were randomly divided into two groups, with 30 cases in each group. The control group received conventional therapy, and the study group received VSD combined with nano-silver dressings. Before treatment and after 7 days of treatment, inflammatory cytokines (C-reactive protein (CRP) and procalcitonin (PCT)) in serum and growth factors (transforming growth factor beta1 (TGF-β1) and vascular endothelial growth factor (VEGF)) in wound exudate were measured using enzyme-linked immunosorbent assay. The pain level of the patients was measured by the Visual Analogue Scale (VAS). Patients' skin quality was assessed by the Vancouver Scar Scale (VSS), and the efficacy of trauma treatment was observed in both groups.</p><p><strong>Results: </strong>After 7-day treatment, the study group performed lower levels of CRP and PCT, higher levels of TGF-β1 and VEGF, lower VAS scores and VSS scores, and better overall treatment rate compared to the control group (all P < 0.05).</p><p><strong>Conclusion: </strong>VSD combined with nano-silver dressings has good therapeutic efficacy in non-healing wounds after surgery for open limb fractures and can inhibit inflammatory response and improve skin quality.</p>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144659438","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":"Intercalary autograft not mandatory for shortening in total hip arthroplasty: A retrospective study.","authors":"Mehmet Fevzi Cakmak, Serkan Bayram, Levent Horoz, Hicabi Sezgin, Burak Akan","doi":"10.1016/j.jos.2025.06.011","DOIUrl":"https://doi.org/10.1016/j.jos.2025.06.011","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to compare the clinical and radiological outcomes of patients who underwent autograft application following standard transverse osteotomy supported by two cobalt-chrome cables with those who did not use autografts to support the osteotomy line in Crowe type IV Developmental Dysplasia of the Hip (DDH).</p><p><strong>Methods: </strong>Sixty-nine patients (78 hips) with Crowe type IV DDH underwent a transverse subtrochanteric shortening osteotomy. In Group 1, 42 hips had their osteotomy site supported with an autograft harvested from the shortening osteotomy. Conversely, Group 2 consisted of 36 hips in which graft application was not performed, and fixation of the osteotomy site was solely achieved by employing the femoral stem. Clinical outcome measures included limb length discrepancy, pain (visual analog score), and functional Harris Hip Score (HHS). For radiological evaluation, bone healing of the femoral osteotomy site was assessed using the radiographic union score for tibial (mRUST) classification, and stabilization of components was evaluated according to the Engh classification.</p><p><strong>Results: </strong>There were no significant differences in age, body mass index, follow-up duration, preoperative and postoperative LLD, VAS score, and HHS values. No statistically significant difference was identified between the Engh classification. Significant differences between the groups were detected in the mRUST classification (p = 0.020). The mean value of the group not utilizing autograft (11,89 ± 1,83) was higher than that of the group using autografts (10,95 ± 1,59). There was no statistically significant relationship between complications between the groups (p = 0.981).</p><p><strong>Conclusion: </strong>Performing of THA in Crowe type IV DDH, the press-fit application of the femoral component, without additional implantation or grafting, have shown comparable and satisfactory outcomes.</p>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144649805","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":"A clinical study of ten-year prognosis in patients with lumbar disc herniation treated with condoliase in a phase III trial.","authors":"Yukihiro Matsuyama, Tomohiro Banno, Hideaki Imabayashi, Tetsuro Takatsu, Fumihiro Oha, Takashi Tsuji, Tetsuya Watanabe, Masaki Tatsumura, Kyohei Sakaki, Yoji Ogura, Yoshihisa Suzuki, Tetsuya Ohara, Tadashi Komatsubara, Takahiko Hyakumachi, Masahiro Hoshino, Yoshio Sakuma, Kozo Chino, Kei Ando, Kiyotaka Yamada, Ippei Watanabe, Miwako Sato, Taiichi Shirogane, Kazuhiro Chiba","doi":"10.1016/j.jos.2025.05.006","DOIUrl":"https://doi.org/10.1016/j.jos.2025.05.006","url":null,"abstract":"<p><strong>Background: </strong>Condoliase is a chemonucleolytic agent approved in Japan for the treatment of lumbar disc herniation (LDH). There had been no follow-up evaluation of its long-term effects on discs covering a period exceeding 10 years.</p><p><strong>Methods: </strong>The present study evaluated the 10-year post-dose outcomes of patients treated with condoliase during the phase III trial in terms of neurological results, Oswestry Disability Index (ODI), X-ray findings (disc height, posterior intervertebral angle, vertebral body translation), and magnetic resonance image findings (Modic classification, Pfirrmann grade).</p><p><strong>Results: </strong>Among the 82 patients treated with condoliase during the phase III trial, 37 (45.1 %) were available for the 10-year post-dose follow-up in the present study. At 10 years post-dose, low back pain and leg pain were observed in 15 (40.5 %) and 6 (16.2 %) of 37 patients, and the number of patients with positive straight leg raise test, hypesthesia, muscle weakness, and deep tendon hyporeflexia were 1 (2.7 %), 2 (5.4 %), 0 (0 %), and 8 (21.6 %), respectively; mean ODI was 8.6, with 32/37 (86.5 %) patients having ODI of 0 %-20 %; 8 (21.6 %) patients had disc height decreased by ≥ 30 %; 1 patient had posterior intervertebral angle of ≥5° and 1 had vertebral body translation of ≥3 mm. Although 5 patients (13.5 %) underwent lumbar surgery after receiving condoliase, no patient underwent surgery for spinal instability. In the Modic classification, the number of patients with \"Type 0,\" \"Type 1,\" and \"Type 3\" decreased, while those with \"Type 2\" increased compared to evaluations conducted at 1-year post-dose. For Pfirrmann grade, the number of patients with \"Grade IV\" decreased and those with \"Grade V″ increased from 1 to 10 years post-dose.</p><p><strong>Conclusions: </strong>No significant imaging findings necessitating surgery were observed, suggesting that chemonucleolysis with condoliase remains a safe and effective treatment option for LDH over the long term.</p>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144642791","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does the upper line of the sacral ala approximate a horizontal line on pelvic radiographs of idiopathic scoliosis?","authors":"Masaki Ikejiri, Hideki Shigematsu, Sachiko Kawasaki, Yuma Suga, Takahiro Mui, Yasuhito Tanaka","doi":"10.1016/j.jos.2025.06.009","DOIUrl":"https://doi.org/10.1016/j.jos.2025.06.009","url":null,"abstract":"<p><strong>Background: </strong>Lower instrumented vertebra (LIV) in adolescent idiopathic scoliosis (AIS) corrective surgery is selected using the center sacral vertical line on supine side-bending radiographs. However, a horizontal line reference is not possible on supine radiographs. Therefore, we aimed to determine the pelvic reference line that best reflects the horizontal line, which can be used in determining the LIV on supine side-bending radiograph in patients with AIS.</p><p><strong>Methods: </strong>Patients with AIS (n = 258) were evaluated. On whole-spine standing anteroposterior radiographs, three lines were selected (the upper sacral line [USL], sacroiliac joint line [SIL], and upper iliac line [UIL]) and compared with the horizontal line to investigate tilt angles. Patients were allocated into thoracic (T; n = 90), lumbar (L; n = 61), and double (D; n = 107) curve groups based on thoracic and lumbar Cobb angles.</p><p><strong>Results: </strong>The mean USL; SIL; and UIL tilts were 2.3°, 4.7°, and 3.8°; 1.6°, 2.0°, and 2.0°; and 1.4°, 2.2°, and 1.8° in the T, L, and D groups, respectively. The USL was significantly tilted in all groups, without significant difference between the SIL and UIL tilts. The USL tilted significantly more from the horizontal line in the L and D groups than in the T group; the UIL tilted more in the L group compared with the T group. The SIL tilt was comparable between the groups. The Cobb angle on the thoracolumbar or lumbar curve significantly, albeit weakly, correlated with the USL and UIL tilt.</p><p><strong>Conclusions: </strong>On whole-spine standing anteroposterior radiographs, the USL had the greatest tilt (mean: 3.5°), whereas the SIL had the smallest tilt (mean: 1.8°) without significant variation across scoliosis types. Independent of Cobb angle and scoliosis type, the SIL was the most stable and reliable reference line for horizontal alignment, making it the preferred reference to LIV selection in patients undergoing AIS corrective surgery.</p>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144618645","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":"Effects of decompression surgery and erythropoietin combination on a rat model of compressive myelopathy.","authors":"Yuki Shiratani, Takeo Furuya, Yuki Nagashima, Yasunori Toki, Masataka Miura, Sho Okimatsu, Juntaro Maruyama, Kyota Kitagawa, Takaki Inoue, Atsushi Yunde, Satoshi Maki, Seiji Ohtori","doi":"10.1016/j.jos.2025.06.013","DOIUrl":"https://doi.org/10.1016/j.jos.2025.06.013","url":null,"abstract":"<p><strong>Introduction: </strong>Cervical spondylotic myelopathy (CSM) is a degenerative condition caused by spinal cord compression, leading to significant neurological impairments. While decompression surgery is the gold standard for treating CSM, recovery is often incomplete, prompting the need for adjunct therapies. Erythropoietin (EPO), widely used for anemia treatment, has shown beneficial effects on the nervous system. This study evaluates the combined effects of decompression surgery and EPO administration in a rat model of compressive myelopathy.</p><p><strong>Methods: </strong>We developed a rat model of compressive myelopathy using a gradually expanding polymer sheet at C4-C5 levels. Rats were divided into three groups: Control (sham surgery, weekly saline injections), Decompression (decompression surgery, weekly saline injections), and Decompression + EPO (decompression surgery, weekly EPO injections). Motor function, myelination, and axonal integrity were evaluated over eight weeks using Basso, Beattie, and Bresnahan (BBB) scores, grid runway tests, and histological analyses.</p><p><strong>Results: </strong>The decompression + EPO group exhibited significantly better motor function, with higher BBB scores and fewer hindlimb drops in grid runway tests compared to the Control group. Histological analyses revealed enhanced myelination in the corticospinal tract, as shown by Luxol Fast Blue (LFB) staining and myelin basic protein (MBP) staining, along with increased axonal growth marked by growth-associated protein 43 (GAP-43) expression.</p><p><strong>Conclusion: </strong>Combining decompression surgery with EPO administration significantly improved motor recovery and promoted spinal cord myelination in a rat model of compressive myelopathy. These findings suggest EPO as a promising adjunct to surgical treatment in CSM, warranting further clinical investigation.</p>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144600844","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":"Locomotive syndrome clinical practice guide 2021.","authors":"Katsushi Takeshita, Kozo Nakamura, Hiromoto Ito, Yasumoto Matsui, Noriko Yoshimura, Yuichi Hoshino, Takashi Ohe, Atsushi Seichi, Shingo Muranaga, Takeshi Fuji, Keiko Yamada, Shigeyuki Muraki, Etsuo Chosa, Hideaki Ishibashi","doi":"10.1016/j.jos.2025.05.004","DOIUrl":"https://doi.org/10.1016/j.jos.2025.05.004","url":null,"abstract":"<p><strong>Background: </strong>\"Locomotive syndrome\" (LS), proposed by the Japanese Orthopaedic Association in 2007, refers to a condition where a person experiences a decline in mobility due to disorders of the locomotor system. Addressing LS is mandatory to extend healthy life expectancy, especially in any super aging society. In Japan, \"Locomotive Syndrome Clinical Guide 2010\" was published in 2010, followed by the standardization of English terms related to locomotive syndrome. To raise international awareness, the translation of this guide into English was planned.</p><p><strong>Methods: </strong>We followed the standardization of English terms related to locomotive syndrome. We used the figures and tables from the Japanese version in the English translation, and specifically selected key clinical questions for translation.</p><p><strong>Results: </strong>We selected 14 clinical questions, with nine tables and 25 figures.</p><p><strong>Conclusion: </strong>The abbreviated English version of \"Locomotive Syndrome Clinical Guide 2010\" is complete, and we hope this Clinical Guide are utilized for any people who care \"Locomotive syndrome\".</p>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144600845","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":"Prognostic factors in patients with bone metastasis of renal cell carcinoma in the era of immune checkpoint inhibitors.","authors":"Yuki Ishibashi, Hiroshi Kobayashi, Koichi Okajima, Takahiro Oki, Yusuke Tsuda, Yusuke Shinoda, Ryoko Sawada, Sakae Tanaka","doi":"10.1016/j.jos.2025.06.008","DOIUrl":"https://doi.org/10.1016/j.jos.2025.06.008","url":null,"abstract":"<p><strong>Background: </strong>Patients with clear cell renal cell carcinoma (ccRCC) have a higher incidence of bone metastasis; however, the availability of immune checkpoint inhibitors (ICIs) is expected to improve their overall survival (OS). Hence, accurate data on the prognosis and survival of patients with bone metastases are necessary to recommend appropriate treatments. Therefore, we investigated the prognosis and prognostic factors of patients with ccRCC bone metastasis in the era of ICIs.</p><p><strong>Methods: </strong>This retrospective cohort study included 33 patients with ccRCC who were treated for bone metastases between 2016 and 2022. We evaluated the association between OS and clinical parameters, including serum biochemical concentrations, and blood cell count, using Kaplan-Meier curves and Cox proportional hazards models.</p><p><strong>Results: </strong>The median OS was 28 months (95 % confidence interval (CI): 8 months - not censored), and the 1-year survival rate was 64 %. Twenty-one patients were treated with ICIs after bone metastasis diagnosis. The multivariate analysis revealed that the use of ICIs after bone metastasis diagnosis was a good prognostic factor (hazard ratio, 0.32; 95 % CI: 0.11-0.89, p = 0.029). Patients in the Katagiri score 5-7 points group using ICIs had a significantly longer survival (p = 0.012) but similar OS compared to the 2-4 points group (p = 0.34).</p><p><strong>Conclusions: </strong>ICI use after the diagnosis of bone metastasis may be a favorable prognostic factor in patients with bone metastases due to ccRCC. The predictive power of the current scoring system could underestimate the prognoses in patients with ccRCC and bone metastasis not treated with ICIs, highlighting the need for a better predictive scoring system in the era of ICIs.</p>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144560428","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":"Early surgery within 48 h for post-injury hip fractures improved clinical outcomes.","authors":"Tsunemasa Kita, Taro Funamoto, Haruki Mori, Hiroshi Ikejiri, Takuya Tajima, Etsuo Chosa, Naosuke Kamei","doi":"10.1016/j.jos.2025.05.008","DOIUrl":"https://doi.org/10.1016/j.jos.2025.05.008","url":null,"abstract":"<p><strong>Background: </strong>A medical fee incentive based on a 48-h target time for hip fracture surgery has been implemented in Japan since 2022. This study aimed to evaluate the clinical outcomes of early surgery within 48 h after hip fracture.</p><p><strong>Methods: </strong>This study was a retrospective, single-center study. Patients >60 years of age who underwent hip fracture surgery between 2021 and 2022 were eligible. They were divided into 2 groups: 2021 (before implementation of the system) and 2022 (after implementation of the system). The primary outcome was the surgical waiting time after injury. The secondary outcomes were clinical outcomes such as postoperative complication rate, mortality rate at 1 and 6 months after surgery, and length of stay in our institution. To assess the influence of early surgery on these outcomes, an additional analysis was performed in 2 groups: the early group (surgery within 48 h) and the delayed group (surgery beyond 48 h).</p><p><strong>Results: </strong>In total, 365 patients were included in this study. The surgical waiting time was significantly shortened after the implementation of the system (64.5 h in 2021 vs. 42.8 h in 2022, p < 0.001). There were significant differences between the 2021 and 2022 groups in the complication rate (17 % vs. 9 %, p = 0.03) and length of hospital stay (15 days vs. 13 days, p < 0.001). A multivariate analysis between the early and delayed group showed that early surgery was associated with a lower complication rate and shorter length of stay (p < 0.05).</p><p><strong>Conclusion: </strong>Efforts to perform early surgery within 48 h of injury following the new reimbursement scheme have contributed to improved clinical outcomes, including lower complication rates and shorter hospital stay in our institution.</p>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144564923","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}