World Journal of Orthopedics最新文献

{"title":"Gut microbiome and orthopaedic health: Bridging the divide between digestion and bone integrity.","authors":"Naveen Jeyaraman, Madhan Jeyaraman, Priya Dhanpal, Swaminathan Ramasubramanian, Lavanya Ragavanandam, Sathish Muthu, Gabriel Silva Santos, Lucas Furtado da Fonseca, José Fábio Lana","doi":"10.5312/wjo.v15.i12.1135","DOIUrl":"10.5312/wjo.v15.i12.1135","url":null,"abstract":"<p><p>The gut microbiome, a complex ecosystem of microorganisms in the digestive tract, has emerged as a critical factor in human health, influencing metabolic, immune, and neurological functions. This review explores the connection between the gut microbiome and orthopedic health, examining how gut microbes impact bone density, joint integrity, and skeletal health. It highlights mechanisms linking gut dysbiosis to inflammation in conditions such as rheumatoid arthritis and osteoarthritis, suggesting microbiome modulation as a potential therapeutic strategy. Key findings include the microbiome's role in bone metabolism through hormone regulation and production of short-chain fatty acids, crucial for mineral absorption. The review also considers the effects of diet, probiotics, and fecal microbiota transplantation on gut microbiome composition and their implications for orthopedic health. While promising, challenges in translating microbiome research into clinical practice persist, necessitating further exploration and ethical consideration of microbiome-based therapies. This interdisciplinary research aims to link digestive health with musculoskeletal integrity, offering new insights into the prevention and management of bone and joint diseases.</p>","PeriodicalId":47843,"journal":{"name":"World Journal of Orthopedics","volume":"15 12","pages":"1135-1145"},"PeriodicalIF":2.0,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11686522/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142915607","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":"Specific approach to total hip arthroplasty in patients with childhood hip disorders sequelae.","authors":"Katarina Barbaric Starcevic, Goran Bicanic, Luka Bicanic","doi":"10.5312/wjo.v15.i12.1118","DOIUrl":"10.5312/wjo.v15.i12.1118","url":null,"abstract":"<p><p>Hip arthroplasty in patients with a history of paediatric hip disorders presents a significant challenge for orthopaedic surgeons. These patients are typically younger and have greater functional demands. Therefore, achieving optimal biomechanical conditions is crucial, involving placement of the acetabulum at the ideal centre of rotation and securing a stable femoral component with good offset to preserve abductor muscle function and restore leg length. The altered anatomy in these cases makes total hip arthroplasty more complex, necessitating thorough preoperative imaging and an individualised surgical approach. Various techniques may be employed to optimise biomechanical outcomes. We propose a modified lateral hip approach, offering exceptional visualisation of the acetabulum and femur while preserving the continuity of the abductor muscles without requiring trochanteric osteotomy. To achieve the most biomechanically advantageous acetabular position, cotyloplasty is our preferred method.</p>","PeriodicalId":47843,"journal":{"name":"World Journal of Orthopedics","volume":"15 12","pages":"1118-1123"},"PeriodicalIF":2.0,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11686524/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142915965","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":"Total hip arthroplasty preoperative planning for childhood hip disorders' sequelae: Focus on developmental dysplasia of the hip.","authors":"Saran S Gill, Valerio Pace","doi":"10.5312/wjo.v15.i12.1112","DOIUrl":"10.5312/wjo.v15.i12.1112","url":null,"abstract":"<p><p>Developmental dysplasia of the hip (DDH) poses significant challenges in both childhood and adulthood, affecting up to 10 per 1000 live births in the United Kingdom and United States. While newborn screening aims to detect DDH early, missed diagnoses can lead to severe complications such as hip dysplasia and early onset osteoarthritis in adults. Treatment options range from less invasive procedures like hip-preserving surgery to more extensive interventions such as total hip arthroplasty (THA), depending on the severity of the condition. Preoperative planning plays a critical role in optimizing surgical outcomes for DDH patients undergoing THA. This includes accurate imaging modalities, precise measurement of acetabular bone stock, assessment of femoral head subluxation, and predicting prosthesis size and leg length discrepancy. Recent advancements artificial intelligence and machine learning offer promising tools to enhance preoperative planning accuracy. However, challenges remain in validating these technologies and integrating them into clinical practice. This editorial highlights the importance of ongoing research to refine preoperative strategies and improve outcomes in DDH management through evidence-based approaches and technological innovations.</p>","PeriodicalId":47843,"journal":{"name":"World Journal of Orthopedics","volume":"15 12","pages":"1112-1117"},"PeriodicalIF":2.0,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11686519/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142915967","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":"Low back pain in China: Disease burden and bibliometric analysis.","authors":"Wei-Lin Yang, Wen-Cai Jiang, Yan-Hua Peng, Xian-Jie Zhang, Rui Zhou","doi":"10.5312/wjo.v15.i12.1200","DOIUrl":"10.5312/wjo.v15.i12.1200","url":null,"abstract":"<p><strong>Background: </strong>Low back pain has become a global problem. Since many traditional Chinese therapies are helpful for low back pain, the current status of low back pain in China may provide some insights to this issue.</p><p><strong>Aim: </strong>To demonstrate the disease burden of low back pain in China and the response of Chinese scholars to this issue.</p><p><strong>Methods: </strong>The burden of low back pain in China was estimated using the Global Burden of Disease Study 2021 released by the American Institute for Health Metrics and Evaluation. The incidence, prevalence and disability-adjusted life years were analyzed. We also performed a bibliometric analysis to analyzed the publication trend, changes of cooperation models and research topics on low back pain.</p><p><strong>Results: </strong>Prevalence of low back pain increased from 69.61 million in 1990 to 102.96 million in 2021. New cases increased by a stunning 44.50 million in 2021. Low back pain led to an increase of 4.16 per 1000000 population in terms of disability-adjusted life years from 1990 to 2021. But the increase in China was slower than that of world average. As a response, publications of low back pain published by Chinese scholars were stably raised. From 1990 to 2023, domestic cooperation significantly increased, while international cooperation and no cooperation decreased. However, domestic cooperation decreased between 2021 and 2023. The number of studies on prevention and treatment of low back pain reduced from 1990 to 2023, while the mechanism, etiology and other aspects of low back pain augmented.</p><p><strong>Conclusion: </strong>The burden of low back pain in China is heavy. Together with the government, Chinese institutions of medical science should do more in declining the impacts of low back pain.</p>","PeriodicalId":47843,"journal":{"name":"World Journal of Orthopedics","volume":"15 12","pages":"1200-1207"},"PeriodicalIF":2.0,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11686520/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142915771","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":"Utilization of artificial intelligence in the diagnosis of pes planus and pes cavus with a smartphone camera.","authors":"Samir Ghandour, Anton Lebedev, Wei-Shao Tung, Konstantin Semianov, Artem Semjanow, Christopher W DiGiovanni, Soheil Ashkani-Esfahani, Lorena Bejarano Pineda","doi":"10.5312/wjo.v15.i12.1146","DOIUrl":"10.5312/wjo.v15.i12.1146","url":null,"abstract":"<p><strong>Background: </strong>Pes planus (flatfoot) and pes cavus (high arch foot) are common foot deformities, often requiring clinical and radiographic assessment for diagnosis and potential subsequent management. Traditional diagnostic methods, while effective, pose limitations such as cost, radiation exposure, and accessibility, particularly in underserved areas.</p><p><strong>Aim: </strong>To develop deep learning algorithms that detect and classify such deformities using smartphone cameras.</p><p><strong>Methods: </strong>An algorithm that integrated a deep convolutional neural network (CNN) into a smartphone camera was utilized to detect pes planus and pes cavus deformities. This case control study was conducted at a tertiary hospital with participants recruited from two orthopaedic foot and ankle clinics. The CNN was trained and tested using photographs of the medial aspect of participants' feet, taken under standardized conditions. Participants included subjects with standard foot alignment, pes planus, or pes cavus determined by an expert clinician using the foot posture index. The model's performance was assessed in comparison to clinical assessment and radiographic measurements, specifically lateral tarsal-first metatarsal angle and calcaneal inclination angle.</p><p><strong>Results: </strong>The CNN model demonstrated high accuracy in diagnosing both pes planus and pes cavus, with an optimized area under the curve of 0.90 for pes planus and 0.90 for pes cavus. It showed a specificity and sensitivity of 84% and 87% for pes planus detection, respectively; and 97% and 70% for pes cavus, respectively. The model's prediction correlated moderately with radiographic lateral Meary's angle measurements, indicating the model's excellent reliability in assessing food arch deformity (<i>P</i> < 0.05).</p><p><strong>Conclusion: </strong>This study highlights the potential of using a smartphone-based CNN model as a screening tool that is reliable and accessible for the detection of pes planus and pes cavus deformities, which is especially beneficial for underserved communities and patients with pain generated by subtle foot arch deformities.</p>","PeriodicalId":47843,"journal":{"name":"World Journal of Orthopedics","volume":"15 12","pages":"1146-1154"},"PeriodicalIF":2.0,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11686530/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142915969","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":"Femoral nerve palsy following Girdlestone resection arthroplasty: An observational cadaveric study.","authors":"Dominik Spuehler, Lukas Kuster, Oliver Ullrich, Karl Grob","doi":"10.5312/wjo.v15.i12.1175","DOIUrl":"10.5312/wjo.v15.i12.1175","url":null,"abstract":"<p><strong>Background: </strong>When patients with a failed hip arthroplasty are unsuitable for reimplantation, Girdlestone resection arthroplasty (GRA) is a viable treatment option. We report on a patient who was treated with a GRA due to a periprosthetic infection. We discovered partial paralysis of the quadriceps muscle in this patient. We investigated the femoral nerve anatomy, particularly the nerve entry points, to better understand this phenomenon.</p><p><strong>Aim: </strong>To reveal the femoral nerve anatomy with respect to severe proximal migration after GRA.</p><p><strong>Methods: </strong>Eight cadaveric hemipelves were investigated. The branches of the femoral nerve were dissected and traced distally. The GRA was performed by the direct anterior approach. Axial stress to the lower extremity was applied, and the relative movement of the femur was recorded. The femoral nerve and its entry points were assessed.</p><p><strong>Results: </strong>GRA led to a 3.8 cm shift of the femur in vertical direction, a 1.8 cm shift in the dorsal direction, and a 2.3 cm shift in the lateral direction. A 36.5° external shift was observed. This caused stress to the lateral division of the femoral nerve. We observed migration of the femoral nerve entry point at the following locations: (1) Vastus medialis (5.3 mm); (2) The medial part of the vastus intermedius (5.4 mm); (3) The lateral part of the vastus intermedius (16.3 mm); (4) Rectus femoris (23.1 mm); (5) Tensor vastus intermedius (30.8 mm); and (6) Vastus lateralis (28.8 mm).</p><p><strong>Conclusion: </strong>Migration of the femur after GRA altered the anatomy of the femoral nerve. Stress occurred at the lateral nerve division leading to poor functional results.</p>","PeriodicalId":47843,"journal":{"name":"World Journal of Orthopedics","volume":"15 12","pages":"1175-1182"},"PeriodicalIF":2.0,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11686531/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142915604","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":"Ipsilateral Rockwood type V acromioclavicular joint dislocation and midshaft clavicle fracture: A case report.","authors":"Abdulrahman Jalwi Korkoman, Abdullah Alhamodi, Saleh Alrusayni, Mohammed Musaed Almalki","doi":"10.5312/wjo.v15.i12.1208","DOIUrl":"10.5312/wjo.v15.i12.1208","url":null,"abstract":"<p><strong>Background: </strong>Clavicle fractures are among the most common fractures seen in the emergency department. While acromioclavicular (AC) joint injuries are much less common. However, ipsilateral combinations of these injuries are quite rare with only a few cases reported in the literature.</p><p><strong>Case summary: </strong>A 29-year-old man who sustained a combination of ipsilateral AC joint dislocation and midshaft clavicle fracture. He underwent open reduction and plate fixation of the clavicle fracture, as well as semi-rigid surgical implants used to restore both the AC ligaments and the coracoclavicular joint. one year follow-up revealed that the patient had a complete range of motion and excellent shoulder scores. This case presents a rare presentation of such combination of injuries, contributing valuable insights to the literature on such rare injuries.</p><p><strong>Conclusion: </strong>Combined midshaft clavicle fractures and AC joint dislocations are considered quite rare. Timely diagnosis of such injuries leads to great functional outcomes. AC joint dislocation should be suspected with midshaft clavicle fractures and should be investigated radiologically and clinically in an appropriate manner. Still, there is no consensus on the optimal management of such injuries.</p>","PeriodicalId":47843,"journal":{"name":"World Journal of Orthopedics","volume":"15 12","pages":"1208-1213"},"PeriodicalIF":2.0,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11686529/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142915630","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":"Impacts of mesenchymal stem cells and hyaluronic acid on inflammatory indicators and antioxidant defense in experimental ankle osteoarthritis.","authors":"Usama Ismaeil Hagag, Fatma Mohamed Halfaya, Hessah Mohammed Al-Muzafar, Suhailah Saud Al-Jameel, Kamal Adel Amin, Wael Abou El-Kheir, Emad A Mahdi, Gamal Abdel-Nasser Ragab Hassan, Osama Mohamed Ahmed","doi":"10.5312/wjo.v15.i11.1056","DOIUrl":"10.5312/wjo.v15.i11.1056","url":null,"abstract":"<p><strong>Background: </strong>No effective treatment guarantees full recovery from osteoarthritis (OA), and few therapies have disadvantages.</p><p><strong>Aim: </strong>To determine if bone marrow mesenchymal stem cells (BMMSCs) and hyaluronic acid (HA) treat ankle OA in Wistar rats.</p><p><strong>Methods: </strong>BMMSCs were characterized using flow cytometry with detection of surface markers [cluster of differentiation 90 (CD90), CD105, CD34, and CD45]. Fifty male Wistar rats were divided into five groups of 10 rats each: Group I, saline into the right tibiotarsal joint for 2 days; Group II, monosodium iodate (MIA) into the same joint; Groups III, MIA + BMMSCs; Group IV, MIA + HA; and Group V, MIA + BMMSCs + HA. BMMSCs (1 × 10⁶ cells/rat), HA (75 µg/rat), and BMMSCs (1 × 10⁶ cells/rat) alongside HA (75 µg/rat) were injected intra-articularly into the tibiotarsal joint of the right hind leg at the end of weeks 2, 3, and 4 after the MIA injection.</p><p><strong>Results: </strong>The elevated right hind leg circumference values in the paw and arthritis clinical score of osteoarthritic rats were significantly ameliorated at weeks 4, 5, and 6. Lipid peroxide significantly increased in the serum of osteoarthritic rats, whereas reduced serum glutathione and glutathione transferase levels were decreased. BMMSCs and HA significantly improved OA. The significantly elevated ankle matrix metalloproteinase 13 (MMP-13) mRNA and transforming growth factor beta 1 (TGF-β1) protein expression, and tumor necrosis factor alpha (TNF-α) and interleukin-17 (IL-17) serum levels in osteoarthritic rats were significantly downregulated by BMMSCs and HA. The effects of BMMSCs and HA on serum TNF-α and IL-17 were more potent than their combination. The lowered serum IL-4 levels in osteoarthritic rats were significantly upregulated by BMMSCs and HA. Additionally, BMMSCs and HA caused a steady decrease in joint injury and cartilage degradation.</p><p><strong>Conclusion: </strong>BMMSCs and/or HA have anti-arthritic effects mediated by antioxidant and anti-inflammatory effects on MIA-induced OA. MMP-13 and TGF-β1 expression improves BMMSCs and/or HA effects on OA in Wistar rats.</p>","PeriodicalId":47843,"journal":{"name":"World Journal of Orthopedics","volume":"15 11","pages":"1056-1074"},"PeriodicalIF":2.0,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11586742/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142733278","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":"Predictive factors for coronal and sagittal graft extrusion length after using tendon autograft for medial meniscus reconstruction.","authors":"Tian-Wang Zhu, Xian-Xiang Xiang, Chun-Hui Li, Rui-Xin Li, Nan Zhang","doi":"10.5312/wjo.v15.i11.1036","DOIUrl":"10.5312/wjo.v15.i11.1036","url":null,"abstract":"<p><strong>Background: </strong>Meniscus extrusion occurs in most elderly individuals and most patients after meniscus allograft transplantation. The risk factors and correlative factors of meniscus extrusion have been extensively studied. However, for using tendon autograft for meniscus reconstruction, both graft type and surgical method are different from those in previous studies on meniscus extrusion.</p><p><strong>Aim: </strong>To identify predictive factors for coronal and sagittal graft extrusion length after using tendon autograft for medial meniscus reconstruction.</p><p><strong>Methods: </strong>Ten patients who underwent medial meniscus reconstruction with tendon autograft were selected for this retrospective observational study. The graft extrusions and potential factors were measured and correlation and regression analyses were performed to analyze their relationships.</p><p><strong>Results: </strong>The medial graft extrusion correlated with the preoperative bilateral hip-knee-ankle angle difference, preoperative Kellgren-Lawrence grade, preoperative relative joint space width, and preoperative bilateral medial edge incline angle difference. The anterior graft correlated with the anterior tunnel edge distance at 1 week after operation. The posterior graft extrusion correlated with the preoperative bilateral hip-knee-ankle angle difference, preoperative relative joint space width, and posterior tunnel edge distance at 1 week after operation. The mean graft extrusion correlated with the preoperative bilateral hip-knee-ankle angle difference and preoperative relative joint space width. The preoperative joint space width and anterior and posterior tunnel edge distance at 1 week can be used to predict the medial, anterior, posterior, and mean graft extrusion length.</p><p><strong>Conclusion: </strong>The preoperative joint space width and tunnel position can be used to predict the coronal and sagittal graft extrusion length after using tendon autograft for medial meniscus reconstruction.</p>","PeriodicalId":47843,"journal":{"name":"World Journal of Orthopedics","volume":"15 11","pages":"1036-1046"},"PeriodicalIF":2.0,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11586734/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142733376","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 negative pressure wound therapy in complex surgical treatment of necrotizing fasciitis of the upper limb.","authors":"Konstantin V Lipatov, Arthur Asatryan, George Melkonyan, Aleksandr D Kazantcev, Ekaterina I Solov'eva, Denis V Krivikhin, Irina V Gorbacheva, Urii E Cherkasov","doi":"10.5312/wjo.v15.i11.1015","DOIUrl":"10.5312/wjo.v15.i11.1015","url":null,"abstract":"<p><strong>Background: </strong>Necrotizing fasciitis (NF) of the upper extremities is a severe surgical pathology, and the incidence of this disease has been steadily increasing in recent decades. Surgical treatment is accompanied by the formation of extensive wounds, which can be treated with significant difficulties. In recent years, negative pressure wound therapy (NPWT) has proven to be highly effective. It is also promising for the treatment of NF.</p><p><strong>Aim: </strong>To explore the effectiveness of NPWT in the treatment of NF of the upper extremities.</p><p><strong>Methods: </strong>The results of the treatment of 36 patients with NF of the upper extremities in two groups (NPWT group and control group; 2022-2023) were retrospectively analyzed. In the NPWT group, the NPWT method (120 mmHg; constant mode) was used after surgical treatment. The number of vacuum-assisted dressings in patients ranged from 1 to 3, depending on the dynamics of the wound process. The duration of fixation of one bandage was up to 2-3 d. In the control group, conventional methods of local wound treatment were used. The following indicators were analyzed: The treatment delay, the prevalence of inflammation, the microbial landscape, the number of debridements, the duration of wound preparation for surgical closure, and the nature of skin plastic surgery.</p><p><strong>Results: </strong>Most patients experienced a significant treatment delay [4 d, interquartile range (IQR): 2-7 d], which led to the spread of the pathological process to the forearm and shoulder. The most common pathogens were <i>Staphylococcus aureus</i> (14; 38.9%) and <i>Streptococcus pyogenes</i> (22; 61.1%). The average number of debridements <i>per</i> patient was 5 (IQR: 3-7), with no difference between groups. The average time to prepare wounds for surgical closure was 11 ± 4 d in the NPWT group and 29 ± 10 d (<i>P</i> = 0.00001) in the control group. In the NPWT group, the wounds were more often closed with local tissues (15; 83.3%), and in the control group, split-thickness skin grafts were more often used (4; 50%).</p><p><strong>Conclusion: </strong>The predominant isolation of <i>Staphylococcus aureus</i> and/or <i>Streptococcus pyogenes</i> from the lesions allowed us to classify these patients as NF type II. Multiple debridement procedures have become a feature of this disease treatment. The use of NPWT has significantly reduced the time required to prepare wounds for surgical closure. Early closure of wounds allows for more frequent use of local tissue repair, which ensures better results. NPWT is a highly effective way to prepare wounds for early surgical closure in patients with upper extremity NF.</p>","PeriodicalId":47843,"journal":{"name":"World Journal of Orthopedics","volume":"15 11","pages":"1015-1022"},"PeriodicalIF":2.0,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11586739/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142733079","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}