World Journal of Orthopedics最新文献

{"title":"Medial cortical reduction does not influence outcomes in geriatric intertrochanteric femur fractures treated with proximal femoral nail.","authors":"Prabu Mounisamy, Hanoop Suresh, Sushma Chandrashekar, Udayakumar D, Naveen Jeyaraman, Madhan Jeyaraman, Sathish Muthu","doi":"10.5312/wjo.v16.i4.106862","DOIUrl":"https://doi.org/10.5312/wjo.v16.i4.106862","url":null,"abstract":"<p><strong>Background: </strong>In intertrochanteric fractures, the positive medial cortex support reduction is considered to provide a non-anatomical buttress that helps in controlled collapse.</p><p><strong>Aim: </strong>To analyze the concept of medial cortical reduction (MCR) and its clinical and radiological association in geriatric intertrochanteric femur fractures.</p><p><strong>Methods: </strong>Geriatric patients who presented with AO/OTA 31A1 and 31A2 femur fractures and treated with proximal femoral nailing between July 2021 and June 2023 were include in this prospective cohort study. Based on the degree of MCR, they were divided into positive, neutral, or negative MCR groups. The demographic baseline characteristics, postoperative radiographic femoral neck-shaft angle and neck length were analyzed at 6, 12 and 24 weeks post-surgery. Functional outcomes such as modified Harris Hip Score (HHS) and time to full-weight bearing were also analyzed.</p><p><strong>Results: </strong>47 patients (Male: Famale 35:12) with mean age of 65.8 ± 4.2 years were included in this study. Twenty-two cases had neutral support, nine had negative support, and sixteen had positive support in the medial cortex post-operatively. Baseline characteristics of the three groups were comparable. No significant differences were found in the femur neck length and femur neck-shaft angle changes post-surgery between the groups. The modified HHS was not found to be significant between the groups (<i>P</i> = 0.883) as that of the time to full weight bearing (<i>P</i> = 0.789).</p><p><strong>Conclusion: </strong>The type of reduction achieved based on medial cortical alignment does not affect the femur neck length shortening or varus collapse. Future randomized controlled trials are needed to validate the findings noted in the study.</p>","PeriodicalId":47843,"journal":{"name":"World Journal of Orthopedics","volume":"16 4","pages":"106862"},"PeriodicalIF":2.0,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12019145/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143992219","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":"First metatarsophalangeal joint: Embryology, anatomy and biomechanics.","authors":"Osama M Embaby, Mohamed M Elalfy","doi":"10.5312/wjo.v16.i4.102506","DOIUrl":"https://doi.org/10.5312/wjo.v16.i4.102506","url":null,"abstract":"<p><p>The first metatarsophalangeal (MTP) joint plays a crucial role in foot biomechanics, particularly in weight-bearing activities such as walking and running. It is frequently affected by conditions like hallux valgus (HV) and hallux rigidus, with HV impacting approximately 23%-35% of the population. This narrative review explores the embryology, anatomy, and biomechanics of the first MTP joint (MTPJ), highlighting its significance in maintaining foot stability and function. A comprehensive literature search was conducted using PubMed, Scopus, and Google Scholar, analyzing 50 relevant studies, including 12 clinical trials. The joint's complex structure and mechanical demands make it susceptible to degenerative and structural disorders. Studies indicate that 25%-40% of individuals with HV experience significant pain and functional impairment, affecting mobility and quality of life. Biomechanical stress, abnormal gait patterns, and joint instability contribute to disease progression. Understanding the anatomical and biomechanical properties of the first MTPJ is essential for improving diagnostic and therapeutic approaches. Emerging surgical techniques, such as osteotomy and joint resurfacing, show promise in reducing recurrence rates and enhancing long-term outcomes. Further research is needed to refine minimally invasive interventions and optimize treatment strategies for first MTPJ disorders.</p>","PeriodicalId":47843,"journal":{"name":"World Journal of Orthopedics","volume":"16 4","pages":"102506"},"PeriodicalIF":2.0,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12019138/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144045046","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":"Accuracy of artificial intelligence in prediction of osteoporotic fractures in comparison with dual-energy X-ray absorptiometry and the Fracture Risk Assessment Tool: A systematic review.","authors":"Mir Sadat-Ali, Bandar A Alzahrani, Turki S Alqahtani, Musaad A Alotaibi, Abdallah M Alhalafi, Ahmed A Alsousi, Abdullah M Alasiri","doi":"10.5312/wjo.v16.i4.103572","DOIUrl":"https://doi.org/10.5312/wjo.v16.i4.103572","url":null,"abstract":"<p><strong>Background: </strong>Osteoporotic fractures, whether due to postmenopausal or senile causes, impose a significant financial burden on developing countries and diminish quality of life. Recent advancements in artificial intelligence (AI) algorithms have demonstrated immense potential in predicting osteoporotic fractures.</p><p><strong>Aim: </strong>To assess and compare the efficacy of AI models against dual-energy X-ray absorptiometry (DXA) and the Fracture Risk Assessment Tool (FRAX) in predicting fragility fractures.</p><p><strong>Methods: </strong>We conducted a literature search in English using electronic databases, including PubMed, Web of Science, and Scopus, for studies published until May 2024. The keywords employed were fragility fractures, osteoporosis, AI, deep learning, machine learning, and convolutional neural network. The inclusion criteria for selecting publications were based on studies involving patients with proximal femur and vertebral column fractures due to osteoporosis, utilizing AI algorithms, and analyzing the site of fracture and accuracy for predicting fracture risk using SPSS version 29 (Chicago, IL, United States).</p><p><strong>Results: </strong>We identified 156 publications for analysis. After applying our inclusion criteria, 24489 patients were analyzed from 13 studies. The mean area under the receiver operating characteristic curve was 0.925 ± 0.69. The mean sensitivity was 68.3% ± 15.3%, specificity was 85.5% ± 13.4%, and positive predictive value was 86.5% ± 6.3%. DXA showed a sensitivity of 37.0% and 74.0%, while FRAX demonstrated a sensitivity of 45.7% and 84.7%. The <i>P</i> value for sensitivity between DXA and AI was < 0.0001, while for FRAX it was < 0.0001 and 0.2.</p><p><strong>Conclusion: </strong>This review found that AI is a valuable tool to analyze and identify patients who will suffer from fragility fractures before they occur, demonstrating superiority over DXA and FRAX. Further studies are necessary to be conducted across various centers with diverse population groups, larger datasets, and a longer duration of follow-up to enhance the predictive performance of the AI models before their universal application.</p>","PeriodicalId":47843,"journal":{"name":"World Journal of Orthopedics","volume":"16 4","pages":"103572"},"PeriodicalIF":2.0,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12019139/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144045035","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":"Senility, defecation disorders, sleep disorders, and non-operative spinal infections: A single-center retrospective analysis.","authors":"Ling-Ling Guo, Hong-Kun Liu, Jin-Feng Cao, Hai-Xia Zhang, Bo Li, Tong Li, Liang Li","doi":"10.5312/wjo.v16.i4.103388","DOIUrl":"https://doi.org/10.5312/wjo.v16.i4.103388","url":null,"abstract":"<p><strong>Background: </strong>Non-operative spinal infections (NOSI) are caused by tuberculosis, brucella, and other specific bacteria. The etiology of the disease is insidious, the onset is slow and the diagnosis and treatment are difficult. Identifying the factors associated with spinal infection and early intervention can reduce the occurrence of the disease. At present, the research mainly focuses on the accurate diagnosis and treatment of spinal infection, and there are few studies on the prevention of spinal infection. The concept of \"preventive treatment of diseases\" in traditional Chinese medicine may help identify the causes and reduce the occurrence of NOSI.</p><p><strong>Aim: </strong>To determine the association of age, bowel movements, and sleep patterns with NOSI.</p><p><strong>Methods: </strong>Data of 69 NOSI patients and 84 healthy controls in a tertiary hospital from January 2019 to June 2024 were collected. Patients with NOSI had imaging evidence (magnetic resonance imaging) of spinal infections (including infections caused by tuberculosis, brucopathy, and other pathogens) and had no history of spinal surgery in the last 1 year were included in the analysis. Patients with spinal infection due to spinal surgery are excluded in the study. Data including age, sex, place of residence, sleeping status, and bowel movements were collected. SPSS22.0 was used for correlation analysis of all data.</p><p><strong>Results: </strong>The mean age of the NOSI group and the control group was 63.55 ± 14.635 years and 59.18 ± 17.111 years, respectively, without statistical difference (<i>P</i> = 0.096). There was also no statistically significant difference in gender between the two groups. In the NOSI group, 45 (65.22%) were over 60 years old, and 44 (63.77%) were rural residents. Compared with the control group, the NOSI group had more patients with sleep disorder and defecation disorder, accounting for 69.57% and 68.12%, respectively, with significant statistical difference (both <i>P</i> < 0.001). Regression analysis showed that defecation and sleep disorders were closely related to NOSI (both <i>P</i> < 0.001).</p><p><strong>Conclusion: </strong>Most patients with NOSI are older and have sleep disorders and abnormal defecation.</p>","PeriodicalId":47843,"journal":{"name":"World Journal of Orthopedics","volume":"16 4","pages":"103388"},"PeriodicalIF":2.0,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12019144/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144046710","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":"Validity of the Arabic version of AAOS-foot and ankle outcomes questionnaire in patients with traumatic foot and ankle injuries.","authors":"Sulaiman A AlMousa, Mohammad M Alzahrani, Bandar A Alzahrani, Ahmed K Alsenan, Abdulraheem A Altalib, Hashem Abdulkarim Alkhamis","doi":"10.5312/wjo.v16.i4.103463","DOIUrl":"https://doi.org/10.5312/wjo.v16.i4.103463","url":null,"abstract":"<p><strong>Background: </strong>Arabic-speaking patients are underrepresented in orthopedic clinical studies, particularly in foot and ankle trauma research. The lack of validated Arabic language tools hinders their inclusion, creating a need for culturally and linguistically adapted instruments. The American Academy of Orthopedic Surgeons Foot and Ankle Outcomes Questionnaire (AAOS-FAOQ) is a widely used tool but has not been adapted for Arabic-speaking patients.</p><p><strong>Aim: </strong>To translate, cross-culturally adapt, and validate the AAOS-FAOQ for Arabic-speaking patients with traumatic foot and ankle injuries.</p><p><strong>Methods: </strong>The cross-cultural adaptation followed established guidelines, involving forward and backward translations, expert review, and pre-testing. The final Arabic version was administered alongside the Arabic Short-Form 36 (SF-36) to 100 patients for validity testing. Reliability was assessed through test-retest methods with 20 patients completing the questionnaire twice within 48 hours. Pearson correlation coefficients measured convergent and divergent validity with SF-36 subscales, while Cronbach's alpha and intraclass correlation coefficients (ICC) determined internal consistency and reliability.</p><p><strong>Results: </strong>Out of 100 patients, 92 completed the first set of questionnaires. The Arabic AAOS-FAOQ showed strong correlations with the SF-36 subscales, particularly in physical function and bodily pain (<i>r</i> > 0.6). Test-retest reliability was robust, with ICCs of 0.69 and 0.66 for the Global Foot and Ankle Scale and Shoe Comfort Scale, respectively. Cronbach's alpha for internal consistency ranged from 0.7 to 0.9.</p><p><strong>Conclusion: </strong>The Arabic version of the AAOS-FAOQ demonstrated validity and reliability for use in Arabic-speaking patients with traumatic foot and ankle injuries. This adaptation will enhance the inclusion of this population in orthopedic clinical studies, improving the generalizability of research findings and patient care.</p>","PeriodicalId":47843,"journal":{"name":"World Journal of Orthopedics","volume":"16 4","pages":"103463"},"PeriodicalIF":2.0,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12019141/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143990826","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":"Effectiveness of oral <i>vs</i> intravenous acetaminophen on pain management following total joint arthroplasty: A systematic review and meta-analysis.","authors":"Bin Lu, Ai-Xian Tian, Zheng-Rui Fan, Xing-Wen Zhao, Hong-Zhen Jin, Jian-Xiong Ma, Xin-Long Ma","doi":"10.5312/wjo.v16.i4.104452","DOIUrl":"https://doi.org/10.5312/wjo.v16.i4.104452","url":null,"abstract":"<p><strong>Background: </strong>In the management of postoperative pain following total joint arthroplasty (TJA), the use of nonsteroidal anti-inflammatory drugs, including acetaminophen, plays a key role in alleviating pain. However, the comparison between intravenous and oral acetaminophen administration in patients undergoing full joint replacement surgery remains controversial.</p><p><strong>Aim: </strong>To assess the effectiveness of intravenous and oral acetaminophen in alleviating pain and supporting rehabilitation following TJA.</p><p><strong>Methods: </strong>PubMed, Embase and the Cochrane Library were comprehensively searched to identify cohort studies. The effects of intravenous and oral acetaminophen for managing pain and supporting rehabilitation following TJA were analysed using randomized controlled trials. PRISMA guidelines were followed. The effectiveness of the administration routes was compared based on visual analogue scale (VAS) scores at 24 and 48 h, total morphine usage within 24 h, and total duration of hospital stay.</p><p><strong>Results: </strong>The meta-analysis included seven studies comparing intravenous acetaminophen groups and oral acetaminophen groups. The results demonstrated that oral acetaminophen was comparable to intravenous acetaminophen with regard to VAS scores at 24 h and 48 h (<i>P</i> = 0.76 and 0.08, respectively). The difference in total morphine use between the two groups was not significant (<i>P</i> = 0.22). However, the total hospital stay duration of the intravenous acetaminophen groups was significantly reduced compared to the oral acetaminophen groups (<i>P</i> = 0.0005), showing significant advantages in optimizing postoperative recovery and shortening hospitalisation time.</p><p><strong>Conclusion: </strong>After TJA surgery, intravenous injection of acetaminophen can shorten hospitalisation time and is suitable for rapid analgesia, Oral administration has become the preferred choice for mild cases due to its convenience and economy, providing a basis for clinical drug selection.</p>","PeriodicalId":47843,"journal":{"name":"World Journal of Orthopedics","volume":"16 4","pages":"104452"},"PeriodicalIF":2.0,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12019136/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144035163","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":"Impact of preoperative factors on clinical outcomes after total hip arthroplasty.","authors":"Toru Nishiwaki, Hisatoshi Ishikura, Yuji Masuyama, Sho Fujita, Rei Hirose","doi":"10.5312/wjo.v16.i4.105273","DOIUrl":"https://doi.org/10.5312/wjo.v16.i4.105273","url":null,"abstract":"<p><strong>Background: </strong>Although total hip arthroplasty (THA) is an established intervention for advanced hip disorders, not all patients achieve the anticipated functional improvements.</p><p><strong>Aim: </strong>To investigate the impact of various preoperative factors on clinical outcomes after THA.</p><p><strong>Methods: </strong>Data of 411 patients who underwent unilateral THA were retrospectively analyzed. The associations between preoperative factors, such as age, body mass index, pain severity, functional impairment, psychological status, neuropathic pain, and central sensitization, and clinical outcomes assessed six months postoperatively using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and modified Harris Hip Score were evaluated.</p><p><strong>Results: </strong>Our results indicated that age and the WOMAC, Center for Epidemiologic Studies Depression Scale, and Central Sensitization Index (CSI) scores significantly predicted the modified Harris Hip Score outcomes, whereas age and preoperative WOMAC, EuroQol 5 dimensions, Center for Epidemiologic Studies Depression Scale, CSI, and Pain Detect Questionnaire scores were significant predictors of WOMAC outcomes. Age, WOMAC, and CSI were consistently significant factors. There were no significant differences in the operative time or blood loss across the outcome categories.</p><p><strong>Conclusion: </strong>Our findings highlight the importance of preoperative assessment of central sensitization and psychological parameters. Patient-specific preoperative characteristics may play a greater role than intraoperative factors in determining recovery outcomes after THA.</p>","PeriodicalId":47843,"journal":{"name":"World Journal of Orthopedics","volume":"16 4","pages":"105273"},"PeriodicalIF":2.0,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12019137/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144053383","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":"Sixteen patients regarding the conservative treatment for hook of hamate fracture.","authors":"Toshikazu Tanaka, Yuichi Yoshii","doi":"10.5312/wjo.v16.i4.103795","DOIUrl":"https://doi.org/10.5312/wjo.v16.i4.103795","url":null,"abstract":"<p><strong>Background: </strong>Hook of hamate fractures occur either due to repetitive stress from gripping sports (<i>e.g.</i>, golf, tennis, and baseball), leading to fatigue fracture, or as a result of trauma from falls or other injuries. The recommended treatment involves the excision of bone fragments to facilitate athletes' early return to sports; excision surgery is also performed in trauma cases. However, some patients prefer nonsurgical treatment options, and conservative treatment should be considered.</p><p><strong>Aim: </strong>To present a case series of 16 patients conservatively treated for hook of hamate fractures.</p><p><strong>Methods: </strong>This study included 16 (11 males and 5 females; right side, 6 cases; left side, 10) patients who desired conservative treatment and could be followed-up until bone union was achieved. The average age of the patients was 49.6 (range: 24-72) years. The average time from injury to consultation was 4.3 (range: 0.2-21.4) weeks. The treatment involved 4 weeks of casting from the forearm to the metacarpophalangeal joint, followed by 8 weeks of splint fixation of the wrist. Follow-up computed tomography scans were performed every 4 weeks.</p><p><strong>Results: </strong>Bone union was achieved in all patients. The average duration of casting was 3.7 (range: 0-5) weeks and that of splint fixation thereafter was 8.6 (range: 0-28) weeks. The patients did not exhibit joint contractures or range of motion restrictions due to prolonged immobilization.</p><p><strong>Conclusion: </strong>Conservative treatment with external fixation may be an option for hook of hamate fractures.</p>","PeriodicalId":47843,"journal":{"name":"World Journal of Orthopedics","volume":"16 4","pages":"103795"},"PeriodicalIF":2.0,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12019143/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144041956","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":"Pathophysiology and management of crush syndrome: A narrative review.","authors":"Shahnawaz Khan, Deepak Neradi, Nikhil Unnava, Mantu Jain, Sujit Kumar Tripathy","doi":"10.5312/wjo.v16.i4.104489","DOIUrl":"https://doi.org/10.5312/wjo.v16.i4.104489","url":null,"abstract":"<p><strong>Background: </strong>Crush syndrome refers to the traumatic rhabdomyolysis leading to a spectrum of disorders culminating in acute kidney injury. The burden of crush syndrome is high, and mortality can be as high as 20%. The significant bulk of knowledge is from old articles. Over the last 10 years new research has occurred on diagnosis and treatment in animal models.</p><p><strong>Aim: </strong>To overview of crush syndrome and discuss the newer advances related to the pathogenesis and management of a patient with crush syndrome.</p><p><strong>Methods: </strong>The search of databases such as MEDLINE, Google Scholar, Web of Science, and EMBASE revealed 8226 articles. A thorough screening culminated in 83 crush syndrome articles included in this study.</p><p><strong>Results: </strong>Acute kidney injury in crush syndrome is currently thought to be due to iron retention. The management of crush syndrome has also been updated with antioxidants, and several gases are being used to treat crush syndrome. In the end, treatment of crush syndrome also includes mental, social, and physical rehabilitation for better outcomes.</p><p><strong>Conclusion: </strong>The outcomes of crush syndrome have significantly improved with the introduction of newer treatment modalities, including antioxidants, hyperbaric oxygen therapy, and comprehensive mental, social, and physical rehabilitation.</p>","PeriodicalId":47843,"journal":{"name":"World Journal of Orthopedics","volume":"16 4","pages":"104489"},"PeriodicalIF":2.0,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12019140/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143990222","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":"Revisiting the debate on operative <i>vs</i> nonoperative management of humeral shaft fractures.","authors":"Yu-Fei Yuan, Jie Miao","doi":"10.5312/wjo.v16.i4.101392","DOIUrl":"https://doi.org/10.5312/wjo.v16.i4.101392","url":null,"abstract":"<p><p>Operative management of humeral shaft fractures demonstrates superior early functional recovery (6-month Disabilities of the Arm, Shoulder, and Hand scores) and significantly lower nonunion rates (63.9% reduction) compared to functional bracing, particularly in complex cases, while conservative treatment remains viable for low-demand patients. Surgical techniques, including open reduction internal fixation, intramedullary nailing, and minimally invasive plate osteosynthesis, offer trade-offs between anatomic precision and complication risks (<i>e.g.</i>, radial nerve injury <i>vs</i> rotator cuff damage), with over 90% of radial nerve injuries resolving spontaneously. Ultrasound-guided diagnosis (89% sensitivity, 95% specificity) optimizes decision-making for nerve entrapment. Individualized treatment selection, prioritizing fracture complexity and patient needs, is critical to balance accelerated rehabilitation with minimized complications.</p>","PeriodicalId":47843,"journal":{"name":"World Journal of Orthopedics","volume":"16 4","pages":"101392"},"PeriodicalIF":2.0,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12019142/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144004300","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}