Orthopedic Research and Reviews最新文献

{"title":"Artificial Single-Layer, Multi-Layer, and Gradient Scaffolds for Enhancing the Healing of Tendon-to-Bone Interfaces: A Mini-Review.","authors":"Tianyi Song, Lin Guo, Changcheng Wang, Mingcheng Li","doi":"10.2147/ORR.S501260","DOIUrl":"10.2147/ORR.S501260","url":null,"abstract":"<p><p>Tendon healing after ligament or tendon reconstruction remains a significant challenge. Regenerative tissue engineering, an interdisciplinary field that combines biology, materials science, and engineering, offers promising solutions. Recent developments have introduced scaffold materials designed to enhance the proliferation and differentiation of tendon-to-bone tissue cells. These scaffolds possessing three-dimensional composites of tissue cells and biomaterials, have proven effective in facilitating tendon-to-bone curing post-surgery. The successful development of the tendon-to-bone interface is a critical factor for early rehabilitation and functional recovery. In this mini-review, we present a comprehensive update on contemporary strategies for synthetic scaffold-based materials and their influence on tendon-to-bone healing. We described the synthetic materials compositions, structures and features of single-layer, multi-layer, and gradient scaffolds with their special mechanical properties. We examined the construction of engineering scaffolds from the perspectives of biomaterials and design strategies, providing a comprehensive evaluation of the advantages and disadvantages associated with each approach. Ultimately, this review articulates clear research directions aimed at achieving breakthroughs in future studies.</p>","PeriodicalId":19608,"journal":{"name":"Orthopedic Research and Reviews","volume":"17 ","pages":"105-113"},"PeriodicalIF":1.7,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11892362/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143597037","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Red Yeast Rice Increases Bone Morphogenetic Protein-2 Expression and Enhances Fracture Healing Process in Delayed Union Models of Sprague-Dawley Rats: A Preclinical Study.","authors":"Aryadi Kurniawan, Felais Hediyanto Pradana, Evelina Kodrat, Anissa Feby Canintika, Aufa Kunti Riona Aryandhani","doi":"10.2147/ORR.S490880","DOIUrl":"10.2147/ORR.S490880","url":null,"abstract":"<p><strong>Introduction: </strong>Delayed union management is both challenging and expensive. Statins, which are HMG-CoA reductase inhibitors, induce bone morphogenetic protein-2 (BMP-2) gene expression, which in turn increases bone formation. Red yeast rice contains monacolin, which has a similar activity to lovastatin as an HMG-CoA reductase inhibitor. Red-yeast rice is readily available and inexpensive. This study aimed to demonstrate the effectiveness of red yeast rice in enhancing fracture healing in a delayed union model through increased expression of BMP-2.</p><p><strong>Materials and methods: </strong>This experimental animal study was conducted using 24 delayed union Sprague-Dawley (SD) rats divided into four groups (n=6 each), consisting of; the 4-weeks-given-red yeast rice extract group (4RYR), 2-weeks-given-red yeast rice extract group (2RYR), 4-weeks-control group (4C), and 2-weeks-control group (2C). The animals were euthanized in the second and fourth week. Immunohistochemical staining was used to assess BMP-2 expression using an Immunoreactive Score (IRS). The fracture healing process was evaluated using histomorphometry by measuring the fibrous area, cartilage area, and woven bone area percentage.</p><p><strong>Results: </strong>In the 2RYR group, there was significantly higher BMP-2 expression (p=0.03), less fibrous area (p=0.05), and larger cartilage area (p= 0.04) than in the 2C group. In the 4RYR group, there was significantly higher expression of BMP-2 (p=0.011), larger woven bone area (p=0.01), and less fibrous area (p = 0.03) than in the 4C group. There was also a significantly smaller fibrous area (p=0.02), a larger cartilage area (p=0.05), and a larger woven bone area (p=0.04) in the 4RYR group than in the 2RYR group. The BMP-2 expression in the 2RYR group was as high as that in the 4RYR group.</p><p><strong>Conclusion: </strong>Red yeast rice effectively improved fracture healing by increasing BMP-2 expression in a delayed-union model in SD rats.</p>","PeriodicalId":19608,"journal":{"name":"Orthopedic Research and Reviews","volume":"17 ","pages":"95-103"},"PeriodicalIF":1.7,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11834685/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143449621","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anterior Knee Pain Evaluation Following Anterior Cruciate Ligament (ACL) Reconstruction Using Anterior Half of The Peroneus Longus (AHPL) Autograft.","authors":"Ludwig Andibert Powantia Pontoh, Ismail Hadisoebroto Dilogo, Achmad Fauzi Kamal, Sholahuddin Rhatomy, Anggaditya Putra, Jessica Fiolin, Joshua Alward Herdiman, Ega Wirayoda Pontoh","doi":"10.2147/ORR.S495410","DOIUrl":"10.2147/ORR.S495410","url":null,"abstract":"<p><strong>Introduction: </strong>The anterior cruciate ligament (ACL) is crucial for knee stability and joint movement coordination. ACL injuries are common, often leading to knee instability and subsequent complications. ACL reconstruction is a standard treatment option, with various autograft sources available. The anterior half of the peroneus longus (AHPL) tendon has emerged as a potential alternative autograft. This study aimes to examine the anterior knee pain in ACL reconstruction using AHPL.</p><p><strong>Materials and methods: </strong>This study included 51 patients with ACL injuries undergoing ACL reconstruction using the AHPL tendon autograft. Patient demographics, surgical details, and Kujala scores were collected.</p><p><strong>Results: </strong>The average age of our participants was 25.88 ± 5.39 years, with mean BMI classified as obese. Significant improvements in Kujala and KOOS pain scores were observed between each data collection. There was a negative correlation between baseline and three and six months post-operatively Kujala and KOOS pain scores with BMI.</p><p><strong>Discussion: </strong>The study findings suggest that ACL reconstruction using the AHPL tendon autograft significantly reduced anterior knee pain, as indicated by a better Kujala and KOOS pain score. Previous studies have highlighted concerns regarding anterior knee pain with other autograft sources, such as the patellar and hamstring tendons. The AHPL tendon autograft offers a promising alternative with favorable anterior knee pain and minimal donor site morbidity.</p><p><strong>Conclusion: </strong>In ACL reconstruction, the AHPL tendon autograft demonstrates excellent outcomes regarding anterior knee pain, as measured by the Kujala score.</p>","PeriodicalId":19608,"journal":{"name":"Orthopedic Research and Reviews","volume":"17 ","pages":"83-93"},"PeriodicalIF":1.7,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11831479/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143441237","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Network Pharmacology and Experimental Validation of the Therapeutic Effect of Baji Capsule on LPS-Induced Osteoporosis.","authors":"Qian Li, Dinglin Li, Ciqiu Tian, Xiangjie Liu, Hui Wang, Hao Liu","doi":"10.2147/ORR.S488478","DOIUrl":"10.2147/ORR.S488478","url":null,"abstract":"<p><strong>Purpose: </strong>Osteoporosis is a common skeletal disease characterized by impaired bone microarchitecture, decreased bone mineral density and increased bone fragility, leading to a heavy physical and economic burden due to its greatly increased risk of fracture. Baji capsule is a proprietary medicine that can treat menstrual disorders and postmenopausal osteoporosis. However, the efficacy of Baji capsule has not been reported for osteoporosis caused by oxidative stress and inflammation. Therefore, the aim of this study was to evaluate whether Baji capsule has a therapeutic effect on lipopolysaccharide (LPS)-induced inflammatory osteoporosis and to explore the underlying mechanisms through network pharmacology.</p><p><strong>Patients and methods: </strong>Osteoporosis model in ICR mice induced with LPS. Mice were treated with vitamin E (100mg/kg), PBS, high-dose Baji capsule (810mg/kg) and low-dose Baji capsule (90mg/kg), respectively. The therapeutic effect of Baji capsule was evaluated by high-resolution micro-computed tomography (Micro-CT) and tissue section staining, serum inflammatory factor levels were assessed by ELISA, serum oxidative stress-related marker levels were determined by kits, and finally the mechanism was explored by network pharmacology and then verified by immunohistochemistry.</p><p><strong>Results: </strong>Micro-CT results showed that Baji capsule attenuated LPS-induced inflammatory bone loss.Baji capsule also reduced serum inflammatory factor levels and oxygen free radical production. Target screening by network pharmacology yielded a total of 236 active ingredients of Baji capsule, as well as 278 common targets after taking the intersection of Baji capsule active ingredient targets and osteoporosis disease-related targets.</p><p><strong>Conclusion: </strong>Baji capsule can treat osteoporosis by reducing inflammation and oxidative stress. The therapeutic effects of Baji capsule were shown to be multi-targeted and multi-pathway through network pharmacology. In the future, its anti-inflammatory and antioxidant properties can be utilized to further explore its therapeutic effects on inflammatory diseases, as well as a prospective study for the clinical treatment of osteoporosis.</p>","PeriodicalId":19608,"journal":{"name":"Orthopedic Research and Reviews","volume":"17 ","pages":"61-81"},"PeriodicalIF":1.7,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11829595/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433552","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Isolated Idiopathic Cervical Dystonia with a Rare Type of Atlantoaxial Dislocation. A Case Report and a Short Literature Review.","authors":"Dakheel A Aldakheel","doi":"10.2147/ORR.S501294","DOIUrl":"10.2147/ORR.S501294","url":null,"abstract":"<p><strong>Introduction: </strong>Dystonia is a prevalent movement disorder characterized by involuntary muscle contractions, and cervical dystonia is among the most common forms. This report presents a rare case of severe isolated cervical dystonia in a young male patient that progressed to type IV atlantoaxial rotatory subluxation, highlighting the clinical presentation and diagnostic challenges associated with this condition.</p><p><strong>Case description: </strong>A 27-year-old male patient presented with abnormal head posture and severe cervical pain. Clinical examinations revealed severe cervical muscle spasms and a unique head posture, as if he was looking at the tip of his right shoulder. Radiological evaluation revealed a type IV atlantoaxial rotatory subluxation. Despite initial attempt of close reduction under anesthesia, recurrence of the subluxation occurred, and surgical intervention was necessary.</p><p><strong>Conclusion: </strong>This case underscores the importance of thorough clinical evaluation and imaging in the diagnosis of isolated cervical dystonia, particularly given its potential to present with atypical features. These findings suggest that early recognition and intervention may be critical for preventing complications and improving patient outcomes.</p>","PeriodicalId":19608,"journal":{"name":"Orthopedic Research and Reviews","volume":"17 ","pages":"55-60"},"PeriodicalIF":1.7,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11809398/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143391427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Admission Blood Glucose Level with a Cutoff Value of 15 mmol/L Is a Reliable Predictor of Mortality in Polytraumatized Patients-a Prospective, Observational, Longitudinal Study From a North African Level One Trauma Center.","authors":"Tamer R Armanious, Ahmed A Khalifa, Hossam Abubeih, Mahmoud Badran, Faisal Fahmy Adam, Osama Farouk","doi":"10.2147/ORR.S503377","DOIUrl":"10.2147/ORR.S503377","url":null,"abstract":"<p><strong>Background: </strong>Abnormal admission blood glucose levels were proved to have a mortality predictive value in polytraumatized patients, as reported by studies in developed countries. Reports from developing countries are scarce.</p><p><strong>Objective: </strong>To evaluate the reliability of on-admission blood glucose levels in predicting mortality in polytraumatized patients presented to a North African (developing country) trauma center. The secondary objectives were to investigate other possible mortality predictors and if a cutoff value for each could be obtained.</p><p><strong>Methods: </strong>In this prospective longitudinal study, over one year, we included adult (≥18 years) patients who were polytraumatized (ISS ≥17) and presented to our trauma center within six hours of the trauma incident. Various clinical, laboratory, and trauma scores were collected. Blood glucose levels were assessed from blood samples obtained directly after admission. Patients were divided into five groups based on the admission blood glucose levels.</p><p><strong>Results: </strong>We included 202 patients, having a mean age of 44±13.9 (20 to 70) years, and 52% were females. The mortality rate was 10.9% (including all patients presented with blood glucose levels≥15 mmol/L). The following were significant mortality predictors, admission blood glucose (OR=3.31, 95% CI=1.902-5.763, p<0.001), serum lactate levels (OR=4.017, 95% CI=1.627-9.917, p=0.003), length of hospital stay (OR=1.18, 95% CI= 1.058-1.305, p=0.003), RTS score (OR=1.43, 95% CI=1.023-2.005, p=0.037), and TRISS score (OR=1.099, 95% CI=1.052-1.148, p<0.001). Admission blood glucose levels cutoff value of 15 mmol/L can significantly differentiate between survivors and non-survivors with sensitivity, specificity, PPV, and NPV of 86.4%, 100%, 100%, and 88%, respectively.</p><p><strong>Conclusion: </strong>Abnormal admission blood glucose with a cutoff value of 15mmol/L is a significant mortality predictor in polytraumatized patients from developing country trauma center, among other clinical, laboratory, and trauma scores parameters.</p>","PeriodicalId":19608,"journal":{"name":"Orthopedic Research and Reviews","volume":"17 ","pages":"43-54"},"PeriodicalIF":1.7,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11787776/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143079905","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"β-Caryophyllene and Statins in Bone Fracture Healing - A Narrative Review.","authors":"Hilik Marom, Mansoor A Khan, Nissim Darvish, Paul Tornetta Iii, Amal Khoury, Yoram A Weil, Nathan W M Skelley, Daniel C Allison, Sahar Meiron, Tami Ehrmann Barr","doi":"10.2147/ORR.S506427","DOIUrl":"10.2147/ORR.S506427","url":null,"abstract":"<p><p>Bone fractures are a leading cause of morbidity and healthcare expenditure globally. The complex healing process involves inflammation, cartilage formation, mineralization, and bone remodeling. Current treatments like immobilization, surgery, and bone grafting, though effective, pose significant challenges, such as prolonged recovery and high costs. Emerging therapies such as biological agents, pharmacological treatments, and physical stimulation techniques are also associated with high costs, side effects, and practical applicability limitations. There is a critical need for alternative therapies that are cost-effective, safe, and easy to use. Recent studies suggest the potential of β-caryophyllene (BCP) and statins in promoting bone healing. BCP, a naturally occurring anti-inflammatory and antioxidant compound found in essential oils, enhances osteoblast activity and inhibits osteoclastogenesis. Statins, known for their cholesterol-lowering effects, also promote bone formation and reduce bone resorption through multiple biochemical pathways. Both BCP and statins have shown promising results in preclinical studies, enhancing bone density and promoting fracture healing. This review explores the individual and potential synergistic effects of BCP and statins on bone fracture healing. It highlights the complementary mechanisms of these agents: BCP's anti-inflammatory and osteogenic properties and statins' ability to inhibit osteoclast activity and promote angiogenesis. Combining BCP and statins could offer a multifaceted approach to enhance fracture healing, reduce complications, and improve patient outcomes. While individual effects are supported preclinically, further studies investigating synergies, formulations, and clinical translation are needed to develop this promising novel therapeutic approach for improving fracture repair outcomes.</p>","PeriodicalId":19608,"journal":{"name":"Orthopedic Research and Reviews","volume":"17 ","pages":"31-42"},"PeriodicalIF":1.7,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11771162/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143053087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Outcome of Achilles Tendon Rupture Repaired by a Modified Minimally Invasive Percutaneous Suturing.","authors":"Xiaoyang Qi, Danxia Zheng, Zhijie Lei, Jianglin Yu, Xusheng Qiu, Yixin Chen","doi":"10.2147/ORR.S486218","DOIUrl":"10.2147/ORR.S486218","url":null,"abstract":"<p><strong>Purpose: </strong>Minimally invasive percutaneous techniques offer a promising alternative to open surgical repair of the Achilles tendon. However, the possibilities of recurrent rupture and nerve complications remain. Hence, the present study was conducted to describe a modified repair technique for the Achilles tendon able to overcome these limitations.</p><p><strong>Patients and methods: </strong>This retrospective study included 36 patients with acute closed Achilles tendon rupture treated at our institution between January 2020 and January 2022. All patients underwent surgery at our institution and were followed up for 12-25 months. Functional evaluation was based on the American Orthopedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Scale and the Achilles tendon total rupture score (ATRS), along with local complications.</p><p><strong>Results: </strong>None of the patients had sural nerve injury, infection or re-rupture at a minimum follow up of 12 months. At the final follow-up, the average AOFAS ankle-hindfoot score and ATRS were 95.5 and 90.0, respectively. The final magnetic resonance imaging showed continuity and thicker regeneration of the tendon.</p><p><strong>Conclusion: </strong>The modified percutaneous repair of the Achilles tendon is an effective procedure which yields good functional outcome with few complications, and it could be widely promoted in clinical practice.</p>","PeriodicalId":19608,"journal":{"name":"Orthopedic Research and Reviews","volume":"17 ","pages":"21-29"},"PeriodicalIF":1.7,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11742089/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143009185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Giant Granular Cell Tumor of the Left Thigh, a Rare Case Report and Literature Review.","authors":"Qian Liu, Xiangyu Kong, Jun Yang, Dongdong Zhang","doi":"10.2147/ORR.S499488","DOIUrl":"10.2147/ORR.S499488","url":null,"abstract":"<p><strong>Background: </strong>Granular cell tumor (GCT) is a rare soft tissue tumor characterized by Schwann cell differentiation. While GCT can occur in any part of the body, it is less common in the lower limbs. We report a case of a giant atypical GCT located in the left thigh, the tumor was initially small and painless at the time of discovery but gradually grew to 17 cm over a two-year period.</p><p><strong>Case presentation: </strong>A 60-year-old male patient presented to our hospital two years ago with a painless mass measuring 39×22 mm on the left thigh. He refused treatment due to the absence of discomfort. Over the following two years, the painless mass gradually enlarged. Magnetic resonance imaging (MRI) upon admission revealed a mixed signal, spindle-shaped shadow measuring approximately 170 mm × 50 mm × 55 mm in the left femur's subcutaneous soft tissue, accompanied by mild surrounding swelling. Surgical resection was performed. Microscopic examination revealed round or polygonal tumor cells distributed in sheets or nests, with no evident atypical cells or signs of nuclear division. Immunohistochemistry demonstrated positive staining for S100, SOX-10, Vimentin, NSE, CD56, and H3K27Me3 in the tumor cells, with a Ki-67 labeling index of approximately 15%. The postoperative pathological diagnosis confirmed giant GCT.</p><p><strong>Conclusion: </strong>We report a case of a benign giant GCT in the left thigh. Early diagnosis and treatment of painless lower-limb masses are essential to prevent their enlargement or malignant transformation. Surgery remains the primary treatment for this condition. Pathological assessment is crucial for definitive diagnosis and for distinguishing between benign and malignant forms.</p>","PeriodicalId":19608,"journal":{"name":"Orthopedic Research and Reviews","volume":"17 ","pages":"1-7"},"PeriodicalIF":1.7,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11724620/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142971677","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reconstruction of the Tibial Stump After Fibulectomy.","authors":"Yurii Oleksiiovych Bezsmertnyi, Oleg Andriyovych Veremii, Viktor Ivanovych Shevchuk, Olexander Yuriyovych Bezsmertnyi","doi":"10.2147/ORR.S504597","DOIUrl":"10.2147/ORR.S504597","url":null,"abstract":"<p><p>The formation of a functional tibial stump after combat injuries with extensive tissue damage is sometimes difficult. We describe a case of reconstruction of the tibial stump after a mine-blast injury. In this case, the fibula was completely removed as a result of fracture, and the tibia was amputated at the border of the upper and middle thirds. To create a stable platform with a larger bearing surface area and reduce the load on the distal fossa, the Ilizarov method was used. For the first time, the area of the bearing surface of the tibia stump was increased by more than 2 times in the case of the removed fibula. Thanks to the original surgery technique, the mushroom shape of the stump end was also obtained for the first time. In the process of prosthetics, this geometry actually increases the bearing surface area and has advantages over the Ertl technique, where the cylindrical end of the stump due to muscle atrophy and thinning of the fibro-skin lining can lead to bursitis and even ulcers. The spherical shape of the stump end causes less soft tissue trauma, increases the load-bearing capacity and durability of the results. According to the data of the GaitRite system, the walking performance in the long-term period practically corresponded to that of a healthy person. The technique of the operation is described in detail, including petal decortication, two oblique corticotomies of the tibia, formation of bone and periosteum fragments, distraction. The result is a highly functional stump with the possibility of using end support and full prosthetics. The proposed technique can be used in reconstructive operations on the tibia and femur stumps.</p>","PeriodicalId":19608,"journal":{"name":"Orthopedic Research and Reviews","volume":"17 ","pages":"9-20"},"PeriodicalIF":1.7,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11724671/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142971764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}