Orthopaedics and Trauma最新文献

Minimally invasive foot surgery: what is it and what are the gains and pitfalls? 微创足部手术：什么是微创足部手术？它的优点和缺点是什么？

Orthopaedics and Trauma Pub Date : 2025-10-01 DOI: 10.1016/j.mporth.2025.08.003

Chi Fung Antony Yiu, Catherine Flood, Joël Vernois, Stephen Bendall

引用次数: 0

An overview of tendon physiology: the impact of injury and disease on structure, function and healing 肌腱生理学综述：损伤和疾病对结构、功能和愈合的影响

Orthopaedics and Trauma Pub Date : 2025-10-01 DOI: 10.1016/j.mporth.2025.08.006

Rianna Graham, Chido Donald Nwankwo

{"title":"An overview of tendon physiology: the impact of injury and disease on structure, function and healing","authors":"Rianna Graham, Chido Donald Nwankwo","doi":"10.1016/j.mporth.2025.08.006","DOIUrl":"10.1016/j.mporth.2025.08.006","url":null,"abstract":"<div><div>Tendons are vital structures that connect muscle to bone, enabling movement while maintaining joint stability. Their highly specialized architecture, comprising aligned type I collagen, proteoglycans, glycoproteins, elastin and a unique extracellular matrix ensures a balance between mechanical strength and flexibility. When disrupted by acute trauma, chronic overuse, or systemic diseases, tendon integrity is compromised, leading to pain, functional deficits, and a significant healthcare burden. This review synthesizes current knowledge on tendon anatomy, cellular and molecular regulation, and the multi-phase repair process following injury. It also explores contemporary diagnostic methods, management strategies, from conservative treatments and rehabilitation to advanced surgical interventions. As well as emerging biological therapies such as platelet-rich plasma (PRP), stem cell applications and gene modulation. Furthermore, this review highlights the challenges inherent in tendon regeneration, the impact of systemic conditions like diabetes, rheumatoid arthritis and chronic kidney disease (CKD) on tendon integrity. By bridging laboratory findings with clinical practice, this article offers a comprehensive resource intended to support informed decision-making and enhance patient outcomes in orthopaedic care.</div></div>","PeriodicalId":39547,"journal":{"name":"Orthopaedics and Trauma","volume":"39 5","pages":"Pages 302-307"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145247920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The gait cycle and its disorders 步态周期及其紊乱

Orthopaedics and Trauma Pub Date : 2025-10-01 DOI: 10.1016/j.mporth.2025.08.004

Simon John Federer

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A review of the basic science of the diabetic foot and its complications 糖尿病足及其并发症的基础科学综述

Orthopaedics and Trauma Pub Date : 2025-10-01 DOI: 10.1016/j.mporth.2025.08.002

Catherine Flood, David Okata, Valliammai Muthuganesan, Chi Fung Antony Yiu, Stephen Bendall

{"title":"A review of the basic science of the diabetic foot and its complications","authors":"Catherine Flood, David Okata, Valliammai Muthuganesan, Chi Fung Antony Yiu, Stephen Bendall","doi":"10.1016/j.mporth.2025.08.002","DOIUrl":"10.1016/j.mporth.2025.08.002","url":null,"abstract":"<div><div>Diabetes mellitus (DM) is a chronic metabolic disorder of impaired glucose metabolism, leading to widespread systemic complications. Among these, diabetic foot pathology contributes to severe morbidity. This review explores the underlying mechanisms of diabetic foot complications, including diabetic neuropathy, diabetic foot ulcer (DFU), infection, impaired wound healing, fracture healing, and Charcot neuroarthropathy (CNA). Diabetic neuropathy contributes to loss of protective sensation, balance impairment, ulcer formation, and an increased risk of lower limb amputations. DFUs arise from synergistic ischemia, neuropathy, and infection, often progressing to chronic wounds with poor healing capacity. Infections in diabetic feet are frequently caused by <em>Staphylococcus aureus</em> and other pathogens, often leading to severe complications, including osteomyelitis and amputations. Diabetes adversely affects bone health, resulting in delayed fracture healing through disrupted osteoblast activity, chronic inflammation, and oxidative stress. CNA remains a challenging condition, characterized by excessive local inflammation, bone resorption, and progressive joint destruction, leading to deformity and ulceration. Currently, management of diabetic foot complications is preventative, including glycaemic control, pressure offloading, infection management, and surgical interventions when necessary. Despite advancements in understanding pathology, there remain significant gaps in treatment strategies, necessitating further research into targeted therapies to mitigate neuropathy, enhance wound healing, and preserve limb function.</div></div>","PeriodicalId":39547,"journal":{"name":"Orthopaedics and Trauma","volume":"39 5","pages":"Pages 276-281"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145247902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

CME questions on Principles of Orthopaedics 关于骨科原理的CME问题

Orthopaedics and Trauma Pub Date : 2025-10-01 DOI: 10.1016/j.mporth.2025.08.008

引用次数: 0

Answers to the CME questions on The Wrist 关于the Wrist的CME问题解答

Orthopaedics and Trauma Pub Date : 2025-10-01 DOI: 10.1016/j.mporth.2025.08.007

引用次数: 0

Diabetes and obesity in orthopaedic patients 骨科患者的糖尿病和肥胖

Orthopaedics and Trauma Pub Date : 2025-10-01 DOI: 10.1016/j.mporth.2025.08.001

Danilo Vukanic, Sam Vollans

{"title":"Diabetes and obesity in orthopaedic patients","authors":"Danilo Vukanic, Sam Vollans","doi":"10.1016/j.mporth.2025.08.001","DOIUrl":"10.1016/j.mporth.2025.08.001","url":null,"abstract":"<div><div>Diabetes and obesity are becoming more prevalent globally. The burden of these diseases on modern healthcare systems is projected to rise. Diabetes has multiple effects on the trauma workload, with patients being more likely to sustain injuries and exhibit a disordered physiological response. When these patients require surgical intervention, they face a higher risk of postoperative infection and mortality. Hyperglycaemia, even without pre-existing diabetes, is associated with worse trauma and surgical outcomes, including increased mortality. Authors therefore advocate for aggressive blood glucose control both preoperatively and postoperatively. There is an elevated risk of complications for patients with shoulder and elbow conditions, but not for those with wrist and hand conditions. Patients undergoing spinal, hip, knee, and especially foot and ankle procedures have a greater risk of prolonged surgical time, non-union, infection, and amputation. Medical interventions aimed at managing obesity appear to reduce the risk of complications, and certain medications are thought to influence bone healing. Bariatric surgery is advantageous, but the timing of orthopaedic surgery must be carefully planned to minimize risks. Research into the impact of diabetes and obesity in orthopaedics is expanding as the anticipated costs associated with managing diabetic patients have increased the pressure on healthcare systems.</div></div>","PeriodicalId":39547,"journal":{"name":"Orthopaedics and Trauma","volume":"39 5","pages":"Pages 269-275"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145247901","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Minding the gap: management of bone defects after trauma 注意缝隙：创伤后骨缺损的处理

Orthopaedics and Trauma Pub Date : 2025-10-01 DOI: 10.1016/j.mporth.2025.08.005

Babajide Simon Taiwo, Princewill Chiemelu Okoye, Anthony Rayner, Enis Guryel, Alastair Robertson

{"title":"Minding the gap: management of bone defects after trauma","authors":"Babajide Simon Taiwo, Princewill Chiemelu Okoye, Anthony Rayner, Enis Guryel, Alastair Robertson","doi":"10.1016/j.mporth.2025.08.005","DOIUrl":"10.1016/j.mporth.2025.08.005","url":null,"abstract":"<div><div>Bone defects which constitute a major orthopaedic challenge can arise from various causes, including trauma, infection, tumours, or surgical resections. These defects can lead to significant functional impairment and disability, particularly when they are classified as critical-sized defects. Treatment modalities for bone defects are influenced by factors such as defect size, the condition of adjacent soft tissue, and patient-specific considerations including age and co-morbidities. Therapeutic options include bone grafting techniques, distraction osteogenesis, and the Masquelet technique, each with its advantages and limitations. Recent advancements have improved surgical techniques and biomaterials, facilitating limb salvage and functional restoration. Emerging trends highlight the combination of treatment methods like the induced membrane technique and the use of titanium mesh cages, which enhance healing outcomes by providing stability and promoting vascular ingrowth. Innovative approaches in bone tissue engineering also offer promise in optimizing treatment for orthopaedic trauma patients with critical-sized defects. Future directions in research must focus on tailoring treatment options to individual patient needs while integrating advanced bone tissue engineering techniques to improve healing and restore functionality.</div></div>","PeriodicalId":39547,"journal":{"name":"Orthopaedics and Trauma","volume":"39 5","pages":"Pages 295-301"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145247919","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Complications of distal radius fractures in the skeletally mature patient 骨成熟患者桡骨远端骨折的并发症

Orthopaedics and Trauma Pub Date : 2025-07-14 DOI: 10.1016/j.mporth.2025.06.001

Madeleine Bickley, Hannah James, Michael David

引用次数: 0

Wrist denervation: surgical decision-making and technical considerations 腕部去神经支配：手术决策和技术考虑

Orthopaedics and Trauma Pub Date : 2025-07-14 DOI: 10.1016/j.mporth.2025.06.003

Suzanne E Thomson, Chrishan Mariathas, Robert Farnell

{"title":"Wrist denervation: surgical decision-making and technical considerations","authors":"Suzanne E Thomson, Chrishan Mariathas, Robert Farnell","doi":"10.1016/j.mporth.2025.06.003","DOIUrl":"10.1016/j.mporth.2025.06.003","url":null,"abstract":"<div><div>Wrist pain, secondary to trauma or degeneration, impacts an increasing number of individuals, resulting in reduced function, psychosocial impact and an associated socioeconomic cost. Wrist denervation is a motion-preserving surgical option in the management of chronic wrist pain. It relies on an understanding of wrist anatomy to selectively disconnect distal radio-ulnar and carpal articular branches of the median, radial and, or without, ulnar nerves. Several surgical variations have been described and the reasons for our preferred method is outlined here. Surgical indications include following scaphoid trauma, Kienbock's disease, inflammatory arthritis, ulnocarpal abutment and occupation-associated vibration hand syndrome. Appropriate patient selection relies on a detailed history and evaluation. Preoperative local anaesthetic may be administered in clinic to simulate and predict surgical outcomes. Both partial and total denervation results in improvement of objectively measured grip strength and pain scales, and this is reflected by the high return to work rate postoperatively. The duration of relief is variable and the surgery does not influence disease progression, so patients should be counselled that further, function limiting surgeries may be required. Postoperative complications include recurrence, scar tenderness and rarely neuroma. Partial neurectomy can be performed alongside other motion-preserving surgical interventions and it may delay or obviate the need for function-reducing surgeries. As such it is a key tool in the wrist surgeon's armamentarium.</div></div>","PeriodicalId":39547,"journal":{"name":"Orthopaedics and Trauma","volume":"39 4","pages":"Pages 214-218"},"PeriodicalIF":0.0,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144723214","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0