Orthopedic Reviews最新文献

{"title":"Body Mass Index and Clinical Characteristics Among Patients Undergoing Orthopedic Implant Removal: A Retrospective Observational Study.","authors":"Fouad Qupti, Nael Dabous, Waseem Jiris, Mokbil Shalah, Fadi Khalil Hanna","doi":"10.52965/001c.167325","DOIUrl":"10.52965/001c.167325","url":null,"abstract":"<p><strong>Objective: </strong>To describe the body mass index (BMI) profile of patients who underwent orthopedic implant removal and to examine whether BMI was associated with age, sex, anatomical location, and broad symptomatic indication within the implant-removal cohort.</p><p><strong>Methods: </strong>A retrospective observational analysis was conducted using clinical records of orthopedic implant removal procedures. The analytic sample included 88 implant-removal procedures performed among 78 unique patients. BMI was calculated from recorded height and weight and categorized using standard clinical thresholds. Descriptive statistics were calculated for BMI, age, sex, and anatomical location. A one-sample t-test was used to determine whether mean BMI differed significantly from the overweight threshold of 25 kg/m². Pearson and Spearman correlations were used to examine the association between age and BMI. One-way ANOVA and Kruskal-Wallis tests were used to compare BMI across age groups and anatomical regions. Fisher's exact test was used to examine associations between high BMI, defined as BMI ≥ 25 kg/m², and weight-bearing anatomical regions. A broad symptomatic-removal variable was also examined, based on documentation of pain, irritation, prominent hardware, protruding screw, prominent metalwork, or local pressure. Statistical significance was defined as p < 0.05.</p><p><strong>Results: </strong>The study included 88 implant-removal procedures among 78 patients. Mean age was 44.9 ± 16.4 years, and mean BMI was 27.33 ± 5.06 kg/m², significantly above the overweight threshold (p < 0.001). Overall, 68.2% of cases had BMI ≥ 25. BMI was not significantly associated with sex. Age showed a positive correlation with BMI (p < 0.01). BMI differed significantly across age groups and anatomical regions. High BMI was more frequent in weight-bearing regions (90.0% vs. 61.8%, p = 0.027, OR = 5.57). Broad symptomatic removal was identified in 44.3% of cases and was more common in weight-bearing anatomical sites, especially lower-extremity locations.</p><p><strong>Conclusion: </strong>Patients undergoing orthopedic implant removal demonstrated a BMI profile predominantly within the overweight range, with higher BMI associated with older age and weight-bearing anatomical regions. These findings suggest that BMI may play a role in implant-related symptoms, particularly in lower-extremity sites exposed to mechanical loading. However, due to the absence of a non-removal comparison group, results should be interpreted as descriptive and hypothesis-generating rather than establishing causation.Keywords: body mass index; orthopedic implant removal; hardware removal; pain; irritation; obesity; anatomical location.</p>","PeriodicalId":19669,"journal":{"name":"Orthopedic Reviews","volume":"18 ","pages":"167325"},"PeriodicalIF":1.6,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13512469/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148831259","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":"Biomechanics and Injury Risk in Dance: A Bibliometric Analysis.","authors":"Annabel Lu, Vedha Dande, Omar Viswanath, Latha Ganti","doi":"10.52965/001c.167317","DOIUrl":"10.52965/001c.167317","url":null,"abstract":"<p><strong>Introduction: </strong>There are many physical demands in dance which require intense training and whole body usage. As people continue to dance, injuries remain a primary issue. Research has associated injuries from dance with overuse, extensive training, and biomechanical risks which lead to pain, long-term physical and psychological effects, and even removal from dance. This bibliometric analysis aims to analyze global research of injury risks from dance movements.</p><p><strong>Methods: </strong>A bibliometric analysis was conducted using the Web of Science database to identify publications related to dance biomechanics and injury risks. A boolean search strategy was developed incorporating three conceptual domains without restrictions: (1) dance, (2) biomechanics, and (3) injury risk. VOSviewer was used to analyze publications by country, co-authorship networks, and collaboration patterns. Analysis on number of yearly publications and top cited authors were performed using Microsoft Excel.</p><p><strong>Results: </strong>In total, 1,660 publications were identified. An overall increase in annual publications was found from 2002-2025 with the highest number, 110 publications, produced in 2018. The US produced the most publications (507), followed by England and China. The most common keywords found were \"dance\" and \"biomechanics.\" Co-authorship analysis identified three distinct networks of collaboration with author \"Cortes, Nelson\" serving as the primary connection. The top cited publication was produced by Bittencourt et al. in 2016 with 587 citations.</p><p><strong>Conclusion: </strong>Research in dance movements and injury risks has grown over the years. Future research should emphasize expanding studies into other genres of dance while also focusing on ways to help prevent injuries in dancers.</p>","PeriodicalId":19669,"journal":{"name":"Orthopedic Reviews","volume":"18 ","pages":"167317"},"PeriodicalIF":1.6,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13512468/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148831314","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":"Mapping the Competitive Swimming Sports Medicine Literature: A Bibliometric Analysis of Injuries, Biomechanics, Rehabilitation, and Performance.","authors":"Hitomi Nakamura, Pranay Gadikota, Omar Viswanath, Latha Ganti","doi":"10.52965/001c.167313","DOIUrl":"10.52965/001c.167313","url":null,"abstract":"<p><strong>Introduction: </strong>Competitive swimming sports medicine is an interdisciplinary field encompassing musculoskeletal injury prevention, exercise physiology, biomechanics, rehabilitation, and performance optimization. This study aimed to characterize the growth, contributors, collaboration networks, and thematic evolution of research involving competitive swimmers.</p><p><strong>Methods: </strong>A two-layer search strategy was applied to the Web of Science Core Collection using sport-specific topic terms and selected Web of Science categories, including Sport Sciences, Orthopedics, Rehabilitation, Pediatrics, Nutrition & Dietetics, and Psychology Applied. Publications were analyzed using VOSviewer and Bibliometrix to evaluate annual output, productive authors, institutions, countries, journals, citation patterns, co-authorship networks, and keyword co-occurrence.</p><p><strong>Results: </strong>The search identified 1,825 publications published between 1969 and June 2026. Annual output increased from fewer than five publications per year before 1985 to a peak of 95 publications in 2021. Sport Sciences was the dominant Web of Science category, accounting for 92.7% of records. The United States, Australia, and Portugal were the leading contributing countries. Medicine & Science in Sports & Exercise was the most productive journal, with 142 publications. Major research clusters involved swimming biomechanics, training physiology, athlete monitoring, and clinical sports medicine, including swimmer's shoulder, rotator cuff pathology, scapular dysfunction, and overuse injury.</p><p><strong>Discussion: </strong>The field has evolved from an early emphasis on hydrodynamics and stroke mechanics toward exercise physiology, training monitoring, injury prevention, rehabilitation, immunology, nutrition, and athlete health. Research remains concentrated in a limited number of countries and institutions, while injury surveillance, para swimming, masters swimming, and standardized return-to-sport criteria remain underdeveloped.</p><p><strong>Conclusion: </strong>Competitive swimming sports medicine has developed into a multidisciplinary research field integrating biomechanics, physiology, musculoskeletal injury management, and performance science. This bibliometric map identifies influential contributors and emerging research priorities while highlighting the need for standardized injury definitions, improved surveillance, and clinically applicable return-to-sport guidance.</p>","PeriodicalId":19669,"journal":{"name":"Orthopedic Reviews","volume":"18 ","pages":"167313"},"PeriodicalIF":1.6,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13512470/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148831316","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":"Polymer-Based Resorbable vs Non-resorbable Implants for Pediatric Upper Extremity Fractures: A Systematic Review.","authors":"Kareem Elhigzi, Konstantinos Oikonomou, Benjamin Vanderkwaak, Benjamin Cassidy, Matthew Smith, Omar Protzuk, John Cyrus, Victoria Kuester","doi":"10.52965/001c.166443","DOIUrl":"10.52965/001c.166443","url":null,"abstract":"<p><strong>Background: </strong>Pediatric upper extremity fractures are common and frequently require surgical intervention. Traditional fixation methods using metallic implants, such as Kirschner wires and elastic stable intramedullary nails, offer reliable mechanical stability but necessitate secondary procedures for hardware removal. Polymer-based resorbable implants offer an advantage by eliminating the need for secondary procedures for hardware removal while maintaining efficacy. This systematic review evaluates the safety, efficacy, and clinical outcomes of resorbable compared to non-resorbable implants in pediatric patients.</p><p><strong>Methods: </strong>A systematic search of PubMed, Embase, and Web of Science was conducted according to PRISMA guidelines. Inclusion criteria targeted studies comparing outcomes of resorbable versus non-resorbable implants in pediatric upper extremity fractures. Risk of bias was assessed using the JBI critical appraisal tools. Nine studies met inclusion criteria, comprising one randomized controlled trial and eight retrospective cohort studies.</p><p><strong>Results: </strong>Nine studies including 391 pediatric patients were analyzed. The most common fractures involved the forearm (four studies), followed by lateral condyle (three studies) and medial epicondyle injuries (two studies). Mean patient age ranged from 5.6 to 11.6 years. Surgical site infections, skin irritation, postoperative pain, and nonunion were less common with resorbable implants with only one case requiring implant removal. Re-displacement was more frequent with resorbable implants but rarely required revision. Functional outcomes were comparable across groups.</p><p><strong>Conclusions: </strong>Resorbable implants are a safe and efficacious alternative to traditional metallic devices for pediatric upper extremity fractures. Their favorable complication profile and elimination of hardware removal procedures support wider clinical adoption. Further randomized trials are warranted.</p>","PeriodicalId":19669,"journal":{"name":"Orthopedic Reviews","volume":"18 ","pages":"166443"},"PeriodicalIF":1.6,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13496981/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148796278","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 and demographic factors associated with coexisting carpal tunnel syndrome and trigger finger in Kazakhstan.","authors":"Assel Kaliyeva, Arman Batpen, Meiram Baubekov, Maksut Ibrayev, Samat Boirabayev, Yerzhan Karatayev, Arsen Kaliyev","doi":"10.52965/001c.166445","DOIUrl":"10.52965/001c.166445","url":null,"abstract":"<p><strong>Background: </strong>Carpal tunnel syndrome (CTS) and trigger finger (TF) are common hand disorders that frequently coexist. Most available data originate from North American, European, and East Asian populations, whereas data from Central Asian countries remain limited. This study aimed to estimate the prevalence of concurrent CTS and TF and identify associated demographic and clinical factors in a clinical cohort from Kazakhstan.</p><p><strong>Methods: </strong>This cross-sectional study included patients diagnosed with CTS, TF, or both conditions. Demographic characteristics, comorbidities, and clinical variables were analyzed. Group differences were assessed using chi-square tests and one-way analysis of variance. Multivariable logistic regression analysis was performed to identify factors associated with concurrent CTS and TF.</p><p><strong>Results: </strong>A total of 138 patients were included. Among them, 82 (59.4%) had CTS, 48 (34.8%) had TF, and 8 (5.8%) had both conditions. Significant differences between groups were observed for sex (p = 0.001), ethnicity (p < 0.001), diabetes mellitus (p = 0.008), thyroid disease (p = 0.010), and hormone therapy (p = 0.030). In multivariable logistic regression analysis, diabetes mellitus was strongly associated with concurrent CTS and TF (OR = 72.96; 95% CI 2.41-2208.9; p = 0.014), whereas increasing age was associated with lower odds of coexistence (OR = 0.77; 95% CI 0.63-0.92; p = 0.005).</p><p><strong>Conclusions: </strong>Concurrent CTS and TF were identified in a limited number of patients in this cohort. Diabetes mellitus and age were associated with their coexistence. These findings provide clinical data from an understudied Kazakhstani population.</p>","PeriodicalId":19669,"journal":{"name":"Orthopedic Reviews","volume":"18 ","pages":"166445"},"PeriodicalIF":1.6,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13496980/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148796325","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":"The Infraneural Approach to Lumbar Transforaminal Epidural Steroid Injections: A Practical Review for Trainees and Interventionalists.","authors":"Jamal Hasoon, Christopher L Robinson, Cyrus Yazdi, Ivan Urits, Alan D Kaye","doi":"10.52965/001c.166794","DOIUrl":"10.52965/001c.166794","url":null,"abstract":"<p><p>Lumbar transforaminal epidural steroid injections (TFESIs) are commonly performed for the treatment of lumbosacral radicular pain related to disc herniation, foraminal stenosis, lateral recess stenosis, and degenerative spinal conditions. The conventional supraneural or subpedicular approach targets the superior aspect of the neural foramen, historically described as the \"safe triangle.\" This is what is commonly taught in pain medicine fellowships. However, this region may contain radicular or radiculomedullary arteries, and inadvertent intra-arterial injections have been implicated in rare but catastrophic complications, including spinal cord infarction and paralysis. The infraneural approach, often described in relation to Kambin's triangle, targets the lower portion of the neural foramen below the exiting nerve root. This technique is a valuable alternative route that may reduce needle placement in the superior-anterior foraminal region while maintaining targeted delivery to the affected nerve root and ventral epidural space. This concise review examines the anatomic rationale, technical considerations, potential advantages, limitations, and safety implications of the infraneural approach for lumbar TFESIs. Although available evidence suggests that infraneural TFESI can provide similar clinical outcomes to traditional approaches in appropriately selected patients, the literature remains limited by technique, injectate selection, and outcome reporting. Careful preprocedural imaging review, fluoroscopic guidance, contrast injection, and preferential use of non-particulate steroid remain essential regardless of approach.</p>","PeriodicalId":19669,"journal":{"name":"Orthopedic Reviews","volume":"18 ","pages":"166794"},"PeriodicalIF":1.6,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13496982/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148796273","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":"Calcified Thoracic Disc Herniation: Surgical Management, Surgical Approaches, and Decision-Making.","authors":"Stylianos Kapetanakis, Mikail Chatzivasiliadis, Benjamin Cappin, Paschalis Tsioulas, Lazaros Poultsides, Panagiotis Konstantinou, Christos Siopis, Iosafat Pinto, Konstantinos Ditsios","doi":"10.52965/001c.166441","DOIUrl":"https://doi.org/10.52965/001c.166441","url":null,"abstract":"<p><p>Calcified thoracic disc herniation is an uncommon but clinically important spinal pathology that may cause progressive myelopathy, neurological deterioration, and complex ventral spinal cord compression. Compared with non-calcified thoracic disc disease, calcified lesions are often more rigid, centrally located, and adherent to the dura, making surgical management technically demanding. Although anterior, anterolateral, posterolateral, minimally invasive, and endoscopic approaches have all been described, no universally accepted surgical strategy exists. Approach selection remains dependent on lesion morphology, degree of calcification, canal compromise, neurological status, patient comorbidity, and surgeon experience. This narrative review summarizes the current evidence on surgical management of calcified thoracic disc herniation, with emphasis on preoperative evaluation, decision-making variables, indications, limitations, and outcomes of the major operative corridors. Central, giant, densely calcified lesions may favor anterior or anterolateral access for direct ventral decompression, whereas paracentral or lateral lesions may be suitable for posterolateral, minimally invasive, or endoscopic approaches in selected patients. Emerging evidence suggests that posterior and endoscopic techniques may also be feasible in more complex calcified lesions when performed by experienced surgeons. Optimal management should therefore be individualized, balancing adequate neural decompression with approach-related morbidity and the technical capabilities of the treating team.</p>","PeriodicalId":19669,"journal":{"name":"Orthopedic Reviews","volume":"18 ","pages":"166441"},"PeriodicalIF":1.6,"publicationDate":"2026-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13475797/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148765229","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":"Comparative Effectiveness of Nonpharmacological Therapies for Pregnancy-Related Low Back and Pelvic Pain: A Systematic Review and Meta-analysis of Randomized Controlled Trials.","authors":"Ayesha Alnashwan","doi":"10.52965/001c.165086","DOIUrl":"https://doi.org/10.52965/001c.165086","url":null,"abstract":"<p><strong>Background: </strong>Pregnancy-associated low back and pelvic pain is a common musculoskeletal condition associated with substantial pain, impaired mobility, and functional limitation during pregnancy. Pharmacologic pain management is constrained by maternal and fetal safety considerations, increasing reliance on conservative musculoskeletal interventions.</p><p><strong>Methods: </strong>A systematic review and meta-analysis of randomized controlled trials was conducted in accordance with PRISMA 2020. PubMed/MEDLINE, Scopus, and Web of Science were searched from database inception through February 2026. Eligible studies included pregnant women with pregnancy-associated low back pain, pelvic girdle pain, or mixed lumbopelvic pain syndromes receiving conservative musculoskeletal interventions. Primary outcomes were pain intensity and functional disability assessed using validated instruments. Random-effects meta-analysis using standardized mean differences with Hedges g correction and 95% confidence intervals was performed.</p><p><strong>Results: </strong>Six randomized controlled trials met inclusion criteria for qualitative synthesis, of which four studies involving 254 participants contributed directly extractable data for the primary quantitative meta-analyses. Conservative musculoskeletal interventions were associated with significant reductions in pain intensity (SMD -0.85, 95% CI -1.18 to -0.53; P < 0.001; I² = 34%) and functional disability (SMD -0.84, 95% CI -1.31 to -0.37; P < 0.001; I² = 66%). Subgroup analysis demonstrated numerically larger pain effects for device-assisted interventions, followed by acupuncture-based and manual or manipulative approaches, although subgroup differences were not statistically significant (P = 0.26). One trial was judged at high risk of bias, while the remaining studies were classified as having some concerns.</p><p><strong>Conclusions: </strong>Conservative musculoskeletal interventions were associated with improvements in pain intensity and functional disability among women with pregnancy-associated low back and pelvic pain. However, limited trial numbers, methodological heterogeneity, and risk of bias constrain treatment-specific conclusions. Larger, adequately powered, methodologically rigorous randomized controlled trials are needed to inform higher-confidence clinical recommendations.</p>","PeriodicalId":19669,"journal":{"name":"Orthopedic Reviews","volume":"18 ","pages":"165086"},"PeriodicalIF":1.6,"publicationDate":"2026-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13475796/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148760892","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":"osteopoikilosis and fracture healing: the bone quantity-quality paradox-a case report and systematic review with synthesis without meta-analysis.","authors":"Rathapoom Suwanaratana, Pichaya Thanindratarn, Nuttawut Chanalithichai","doi":"10.52965/001c.165508","DOIUrl":"10.52965/001c.165508","url":null,"abstract":"<p><strong>Introduction: </strong>Osteopoikilosis is a rare sclerosing bone dysplasia that may mimic osteoblastic metastases and complicate fracture assessment. Its influence on bone quality, fixation stability, and fracture healing remains unclear.</p><p><strong>Objective: </strong>To report a tibial plateau fracture in a patient with osteopoikilosis and systematically synthesize published evidence on fracture characteristics, management, and healing outcomes in osteopoikilosis.</p><p><strong>Methods: </strong>We integrated an index case with a systematic review and synthesis without meta-analysis. The index case involved a 66-year-old woman with a Schatzker type II tibial plateau fracture and incidental osteopoikilosis, evaluated using dual-energy X-ray absorptiometry (DXA), trabecular bone score (TBS), and ¹⁸F-NaF PET/CT. A systematic literature search through January 2026 synthesized fracture characteristics and healing outcomes.</p><p><strong>Results: </strong>In the index case, the fracture occurred within intervening bone, sparing sclerotic lesions. This localization revealed a bone quantity-quality paradox: sclerotic lesions artifactually elevated BMD, whereas low TBS identified underlying systemic fragility. The systematic review (N=11) demonstrated fractures across the axial and appendicular skeletons, including both upper and lower extremities. Management ranged from conservative care to operative fixation with intramedullary nails, locking plates, and headless cannulated screws. Fracture union was consistently achieved, with no reported technical failures or delayed healing.</p><p><strong>Conclusion: </strong>Osteopoikilosis may mask underlying systemic osteoporosis, as evidenced by fractures occurring in the \"spared\" bone despite high BMD. TBS serves as a critical diagnostic safeguard to unmask this fragility. Clinically, however, the condition does not compromise biological repair; standard fracture management principles yield excellent outcomes without the need for modified fixation strategies.</p>","PeriodicalId":19669,"journal":{"name":"Orthopedic Reviews","volume":"18 ","pages":"165508"},"PeriodicalIF":1.6,"publicationDate":"2026-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13464400/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148725852","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":"Regional Anesthesia Strategies in Orthopedic Trauma.","authors":"Kashif Javid, Damon Ross, Muhammad J Abbas, Ali Mehaidli, Stefana Rafiroiu, Annamarie Pantuso, Joseph Hoegler, Patrick Forrest, Wililam M Hakeos, Stuart T Guthrie, Lindsay M Maier","doi":"10.52965/001c.166125","DOIUrl":"10.52965/001c.166125","url":null,"abstract":"<p><strong>Purpose: </strong>Orthopedic trauma patients have variable analgesic and anesthetic requirements dependent on injury pattern, severity, and comorbidities. Inadequate pain control can delay rehabilitation, prolong hospitalization, and contribute to chronic pain and opioid dependence. This review aims to summarize contemporary regional anesthesia (RA) strategies in orthopedic fracture care and highlight their indications, benefits, and limitations in the trauma setting.</p><p><strong>Methods: </strong>A comprehensive literature search was conducted across PubMed, Google Scholar, and Web of Science to identify relevant studies on regional anesthesia techniques in orthopedic trauma. Search terms included \"regional anesthesia,\" \"peripheral nerve block,\" \"orthopedic trauma,\" \"fracture,\" \"perioperative analgesia,\" and \"multimodal analgesia.\" Following initial broad search, focused secondary searches were conducted for specific regional techniques. Review articles, randomized controlled trials, prospective and retrospective cohort studies, and landmark technique descriptions were all considered.</p><p><strong>Results: </strong>Advances in ultrasound-guided regional anesthesia have significantly improved the precision, safety, and reliability of neuraxial and peripheral nerve block techniques. RA has been associated with superior early pain control, reduced opioid consumption, improved patient satisfaction, and facilitation of early mobilization when compared to systemic analgesia or general anesthesia alone. Although concerns persist regarding hemodynamic instability, masking of acute compartment syndrome, and peripheral nerve injury, current evidence supports the use of RA when appropriately indicated.</p><p><strong>Conclusion: </strong>RA is an increasingly important component of multimodal analgesia in orthopedic trauma care. Familiarity with available techniques, anatomic considerations, and injury-specific applications allows orthopedic surgeons to collaborate effectively with anesthesia teams and optimize perioperative pain management. These strategies can improve functional recovery while minimizing opioid requirements.</p>","PeriodicalId":19669,"journal":{"name":"Orthopedic Reviews","volume":"18 ","pages":"166125"},"PeriodicalIF":1.6,"publicationDate":"2026-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13464397/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148725047","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}