Efort Open Reviews最新文献

{"title":"Surgical approaches for the treatment of posterior malleolar fracture: which one to choose?","authors":"Enrique Fernández-Rojas, Lily Fletcher, Mario Herrera-Pérez, Jesús Vilá-Rico","doi":"10.1530/EOR-2025-0157","DOIUrl":"10.1530/EOR-2025-0157","url":null,"abstract":"<p><p>Evidence suggests that posterior approaches may be superior to the anterior percutaneous approach in terms of reduction quality and functional outcomes. There is no consensus regarding the definition of the posteromedial approach and its modifications, which can cause confusion when evaluating outcomes. Several variables must be considered when choosing a surgical approach, with particular importance given to the morphology of the posterior malleolus fracture, the presence of a complex fibula fracture, and the presence of Tillaux-Chaput or Le Fort-Wagstaffe fractures. This article provides an overview of approaches to posterior malleolus fractures and presents recommendations for approach selection in specific clinical scenarios.</p>","PeriodicalId":48598,"journal":{"name":"Efort Open Reviews","volume":"11 6","pages":"464-469"},"PeriodicalIF":4.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13240627/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148145202","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Economic evaluation of robotic-assisted versus manual total hip arthroplasty: a systematic review of cost and clinical outcomes.","authors":"Warran Wignadasan, Christos Dragonas, Andreas Fontalis, Marc Jean Berna, Pit Putzeys, Romir Patel, Fares S Haddad","doi":"10.1530/EOR-2025-0179","DOIUrl":"10.1530/EOR-2025-0179","url":null,"abstract":"<p><strong>Introduction: </strong>Total hip arthroplasty (THA) is a widely performed, cost-intensive procedure with growing demand due to an aging population. While manual THA (mTHA) offers reliable outcomes, robotic-arm-assisted THA (RATHA) has emerged as a technologically advanced alternative with potential clinical advantages. However, its economic value remains uncertain due to high capital and maintenance costs. This systematic review aimed to compare the economic and clinical outcomes of RATHA versus mTHA.</p><p><strong>Methods: </strong>A systematic search of MEDLINE, Embase, and Cochrane Library was conducted (1990-May 2024) following PRISMA guidelines. Studies comparing RATHA and mTHA in adult populations were included. Quality was assessed using the Newcastle-Ottawa scale, and data on costs, clinical outcomes, and patient-reported outcome measures (PROMs) were extracted and synthesized.</p><p><strong>Results: </strong>Seven studies (two Markov models, one prospective cohort, and four retrospective analyses) covering over 1.3 million patients were included. RATHA was associated with higher procedural costs but often yielded lower total 90-day care costs due to shorter hospital stays, fewer readmissions, and reduced rehabilitation needs. Cost-utility analyses showed favorable incremental cost-effectiveness ratios (ICERs), particularly in high-volume centers. Clinical outcomes were comparable or slightly better for RATHA, with some evidence of improved PROMs.</p><p><strong>Conclusion: </strong>RATHA may be cost-effective in high-volume settings, with potential for long-term clinical and financial benefits. However, variation in cost methodologies and healthcare models, along with high initial investment, highlights the need for further high-quality studies with standardized economic reporting and patient-centered outcomes.</p>","PeriodicalId":48598,"journal":{"name":"Efort Open Reviews","volume":"11 6","pages":"553-560"},"PeriodicalIF":4.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13240625/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148145097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of dual mobility cemented versus cementless cups in primary total hip arthroplasty: a systematic review and meta-analysis.","authors":"Michael Silveira Santiago, Fatemeh Akbarpoor, Felipe J Aidar, Obada Tarabichi, Carlos Lopez-Villalobos, Reuthemann Esequias Teixeira Tenorio Albuquerque Madruga","doi":"10.1530/EOR-2025-0039","DOIUrl":"10.1530/EOR-2025-0039","url":null,"abstract":"<p><strong>Purpose: </strong>With the increased use of dual mobility primary hip arthroplasty with cementless and cemented cups, we found different clinical and radiographic responses. The goal of this systematic review is to compare the types of acetabular fixation according to clinical and radiographic changes.</p><p><strong>Methods: </strong>We conducted a pairwise analysis comparing cementless versus cemented cups in a dual mobility hip arthroplasty. The outcomes of interest were pain at rest, pain during activity, functional score, wear rate, and cup migration up to 7 years of follow-up. Of the 596 studies identified, only 3 were eligible for inclusion in the study. Our search strategy was broad and carefully designed to capture all relevant studies.</p><p><strong>Results: </strong>We included two randomized controlled trials and one cohort study, amounting to 233 patients, of which 108 used cemented cups and 125 received cementless cups. There was no statistical significance (P > 0.05) in all outcomes analyzed between both types of acetabular fixation: pain at rest (SMD: 0.17; 95% CI: - 0.21 to 0.56), pain during activity (SMD: 0.36; 95% CI: - 0.03 to 0.74), functional score (MD: 1.72; 95% CI: - 0.51 to 3.95), cup migration (SMD: - 0.45; 95% CI:-0.96 to 0.05), and wear rate (MD: -0.13; 95% CI: -0.40 to 0.13).</p><p><strong>Conclusion: </strong>Dual mobility primary total hip arthroplasty, whether using a cemented or uncemented cup, represents an effective treatment option, yielding similar clinical and radiographic outcomes.</p>","PeriodicalId":48598,"journal":{"name":"Efort Open Reviews","volume":"11 6","pages":"545-552"},"PeriodicalIF":4.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13238971/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148145125","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recent advances in diagnostic methodologies for tibiofibular syndesmosis injuries.","authors":"Jiaoyang Chen, Zhuan Zhong, Hanyang Zhang, Bingzhe Huang, Zhaoyan Li, Zhende Jiang, Fei Chang","doi":"10.1530/EOR-2025-0140","DOIUrl":"10.1530/EOR-2025-0140","url":null,"abstract":"<p><p>This article focuses on the various diagnostic methods for tibiofibular syndesmosis injuries, as well as the advantages and disadvantages of each diagnostic method. The purpose of this study is to help clinicians make a more accurate diagnosis, so as to improve the prognosis of patients with tibiofibular syndesmosis injuries. Diagnostic methods for injury to the tibiofibular syndesmosis include physical examination, imaging techniques, arthroscopy, and novel kinematic assessment. Radiographic examination serves as the foundational diagnostic tool. CT imaging has significantly advanced in detecting minor injuries of the tibiofibular syndesmosis. MRI is currently recognized as the most sensitive and specific imaging modality, capable of accurately diagnosing ligament injuries. Ultrasonography is a valuable tool for demonstrating significant diagnostic utility in chronic tibiofibular syndesmosis injuries. Arthroscopy is the gold standard for diagnosing tibiofibular syndesmosis injuries. The modified stability test appears to be more aligned with current clinical diagnostic requirements. Its reliability and accuracy surpass those of traditional imaging techniques. Tibiofibular syndesmosis injuries, often resulting from high-energy trauma or rotational forces, represent a significant subset of ankle injuries that may occur either concurrently with or independently of ankle fractures. This condition can lead to ankle instability and secondary osteoarthritis, which severely impact patients' functional recovery and quality of life. Due to the anatomical complexity and varied injury patterns, accurately diagnosing tibiofibular syndesmosis injuries remains a clinical challenge. This review summarizes current diagnostic methods and research advancements in tibiofibular syndesmosis injuries, encompassing physical examination, imaging techniques, arthroscopy, and novel kinematic assessment, to assist clinicians in achieving more precise diagnoses and ultimately improving patient outcomes.</p>","PeriodicalId":48598,"journal":{"name":"Efort Open Reviews","volume":"11 6","pages":"456-463"},"PeriodicalIF":4.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13240285/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148145102","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of periprosthetic fractures around cemented femoral stems: osteosynthesis and revision strategies.","authors":"Jeffrey W Kwong, Cary S Politzer, Stefano A Bini, Paul Toogood, Claudio Diaz-Ledezma","doi":"10.1530/EOR-2024-0205","DOIUrl":"10.1530/EOR-2024-0205","url":null,"abstract":"<p><p>Periprosthetic femur fractures most often occur in elderly, frail patients and represent a devastating injury with high rates of morbidity and mortality even with appropriate surgical management. Hip arthroplasties with cemented femoral fixation have a decreased risk of periprosthetic fracture relative to cementless designs, especially when composite beam stems are used compared to polished, taper-slip stems. Early mobilization is the primary goal of treatment for periprosthetic femur fractures, which can be achieved either through open reduction internal fixation or through revision arthroplasty. Where the pattern is reconstructable, such as in most B1 patterns and some B2 fractures around polished, taper-slip stems, open reduction internal fixation of fractures around cemented stems has been associated with decreased perioperative complications compared to revision arthroplasty. In the setting of a compromised bone-cement interface, inadequate metaphyseal bone stock, or implant breakage, revision arthroplasty is the preferred treatment strategy.</p>","PeriodicalId":48598,"journal":{"name":"Efort Open Reviews","volume":"11 6","pages":"648-659"},"PeriodicalIF":4.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13238977/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148145050","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Here today, gone tomorrow: the transformative role of biodegradable materials in modern trauma care.","authors":"Miguel Marta, Pedro Miguel Machado, Luís Oliveira, Isabel Marcos Miranda, M Fátima Vaz, Sofia Costa de Oliveira","doi":"10.1530/EOR-2025-0060","DOIUrl":"10.1530/EOR-2025-0060","url":null,"abstract":"<p><strong>Purpose: </strong>This systematic review examines the role of biodegradable implants in orthopaedic traumatology, focusing on their advantages, limitations, and clinical applications compared to traditional non-biodegradable implants. Key factors such as biocompatibility, mechanical performance, and degradation were evaluated to understand their impact on fracture healing and patient outcomes.</p><p><strong>Methods: </strong>A systematic search of the current literature and clinical studies between 2010 and 2024 was conducted. Comparative data between biodegradable (polymeric and metallic) and non-biodegradable metallic implants were assessed, particularly concerning clinical outcomes and patient satisfaction. The review process was conducted according to the PRISMA guidelines.</p><p><strong>Results: </strong>Forty studies were selected for analysis out of 1,366 studies. Biodegradable implants demonstrated effective mechanical support during bone healing, with gradual load transfer to the regenerating bone. They reduced the need for secondary surgeries, particularly in paediatric cases, where they mitigated growth disturbances associated with metallic implants. However, challenges such as implant-related inflammation and premature degradation were noted. Comparative studies revealed similar or superior clinical outcomes with biodegradable implants, although mechanical strength remained a concern in specific applications.</p><p><strong>Conclusion: </strong>Biodegradable implants can represent a transformative shift in orthopaedic traumatology, not only offering advantages over metallic implants but also supporting a broader conceptual evolution in fracture fixation. Future research and development of advanced materials are essential to address current limitations. Emerging technologies, such as complex alloys, the addition of reinforcements, new manufacturing techniques, and a focus on biocompatibility, bone regeneration, and functionalisation of the implant, may offer controlled biodegradation, superior biocompatibility, antimicrobial properties, and tailored mechanical performance.</p>","PeriodicalId":48598,"journal":{"name":"Efort Open Reviews","volume":"11 6","pages":"660-675"},"PeriodicalIF":4.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13238980/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148145045","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intraosseous platelet-rich plasma for osteoarthritis: a comprehensive review.","authors":"Luis García Bordes, Roberto Seijas Vázquez, Pedro Álvarez Díaz, Anna Castelló Egea, Xavier Cuscó Segarra, David Barastegui Fernández, Miguel Vázquez Gómez, Iker Ayestaran Calero, Silvia Vizcaíno Navarro, Patricia Laiz Boada, Alfred Ferré-Aniorte, Paula Velasco Alcalde, Montserrat García Balletbó, Ramón Cugat Bertomeu","doi":"10.1530/EOR-2025-0137","DOIUrl":"10.1530/EOR-2025-0137","url":null,"abstract":"<p><p>Intraosseous platelet-rich plasma (IO-PRP) therapy is an emerging biologic approach targeting the osteochondral unit in osteoarthritis (OA), especially of the knee and hip, by addressing subchondral bone pathology implicated in disease progression. This review synthesizes clinical and preclinical evidence on IO-PRP from PubMed and Scopus (up to May 2025), focusing on its biological rationale, therapeutic efficacy, and applications in osteoarticular disease. Evidence from randomized trials, observational studies, and experimental models indicates that IO-PRP - particularly when combined with intra-articular PRP - improves pain, function, and joint structure in moderate-to-severe OA. Preclinical studies demonstrate IO-PRP's role in subchondral bone remodelling, mesenchymal stromal cell modulation, and inflammation reduction, supporting its disease-modifying potential. IO-PRP represents a promising, biologically grounded intervention for OA management; however, further standardized, long-term clinical trials are needed to determine optimal protocols and validate long-term benefits.</p>","PeriodicalId":48598,"journal":{"name":"Efort Open Reviews","volume":"11 6","pages":"512-523"},"PeriodicalIF":4.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13240282/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148145082","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient-reported outcomes in randomized controlled trials of spinal disorders: a methodological quality assessment and recommendations for future research.","authors":"Wenbo He, Rui Liu, Jinyi Ma, Weihan Hou, Zhengchi Li, Liang Du","doi":"10.1530/EOR-2025-0171","DOIUrl":"10.1530/EOR-2025-0171","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to assess the types of PRO instruments used and evaluate the overall quality of PRO reporting in RCTs addressing spinal disorders.</p><p><strong>Methods: </strong>A systematic literature search of PubMed and Web of Science was conducted to identify RCTs reporting PROs in spinal conditions. Trials were screened according to PRISMA guidelines, and the quality of PRO reporting was evaluated using the ISOQOL-recommended checklist. Descriptive analyses and multivariable linear regression were performed to explore predictors of reporting quality.</p><p><strong>Results: </strong>A total of 42 RCTs involving 8,669 participants were included. Most trials (95.2%) designated PROs as primary outcomes, with lumbar degenerative diseases being the most common focus (45.2%). Across studies, 25 distinct PRO tools were identified and grouped into five domains: pain, functional disability, quality of life, patient experience, and psychological assessment. The Visual Analog Scale (VAS) and Oswestry Disability Index (ODI) were the most frequently used instruments. However, tools assessing psychological domains were underutilized. Reporting adherence was higher when PROs were primary outcomes, but only 27.2% of studies met high-quality reporting standards. Critical deficiencies were noted in justifying instrument selection, data collection modalities, and handling of missing data. Regression analysis revealed no statistically significant predictors of reporting quality.</p><p><strong>Conclusion: </strong>Despite the widespread inclusion of PROs in spinal disorder RCTs, major methodological gaps persist in reporting practices. Enhancing standardization in PRO tool selection, data collection methods, and statistical handling of missing data is essential for improving the validity, comparability, and clinical impact of PRO-based evidence in spinal health research.</p>","PeriodicalId":48598,"journal":{"name":"Efort Open Reviews","volume":"11 6","pages":"627-636"},"PeriodicalIF":4.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13240631/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148145066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Necrosis following neoadjuvant radiotherapy and its association with oncological outcome in soft tissue sarcoma patients: a systematic literature review and meta-analysis.","authors":"Maria Anna Smolle, Florian Alexander Wenzl, Fabrice A Scheurer, Jasminka Igrec, Andreas Leithner, Daniel Andreas Müller","doi":"10.1530/EOR-2025-0198","DOIUrl":"10.1530/EOR-2025-0198","url":null,"abstract":"<p><strong>Purpose: </strong>Neoadjuvant radiotherapy (NRTX) is recommended for soft tissue sarcomas (STS) by current European Society of Medical Oncology (ESMO) guidelines. Histological response to preoperative treatment (including NRTX) is a well-established prognostic parameter in patients with osteosarcoma and Ewing sarcoma. In patients with STS, however, the relevance of histological - and radiological - necrosis rate following neoadjuvant treatment is less well known.</p><p><strong>Methods: </strong>We conducted a systematic PubMed search and obtained 2,433 potentially relevant entries, of which 30 original articles were finally included. Histological and radiological tumour necrosis following NRTX of STS was systematically studied, as was the potential association between the histological necrosis rate and oncological outcome (local recurrence-free survival (LRFS), distant metastasis-free survival (DMFS) and overall survival (OS)) using random-effects meta-analysis.</p><p><strong>Results: </strong>Information on 2,346 patients (1,257 males; 53.6%) of whom 2,228 (95.0%) had received NRTX was summarised. Most STS were located in the extremities (n = 2016; 85.9%). A histological necrosis rate of ≥90% was present in 22.8%. On imaging, the mean necrosis rate ranged between 14.7 and 67.7%. There was a significant association between higher histological necrosis rate and improved DMFS (HR = 0.29; 95% CI: 0.12-0.71; P = 0.018), while no associations for LRFS (HR = 0.54; 95% CI: 0.06-5.17; P = 0.181) or OS (HR = 0.60; 95% CI: 0.10-3.64; P = 0.437) were found.</p><p><strong>Conclusions: </strong>Tumour necrosis is frequently observed following NRTX in STS. Higher histological necrosis seems to be associated with improved DMFS. Overall, varying reporting of the histological and radiological necrosis rate following NRTX in STS calls for improved estimation of treatment response, considering histological and radiological features alike.</p>","PeriodicalId":48598,"journal":{"name":"Efort Open Reviews","volume":"11 6","pages":"605-613"},"PeriodicalIF":4.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13240626/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148145126","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of infected periprosthetic fracture of hip and knee: a systematic review of the literature.","authors":"Luigi Zagra, Mattia Alessio-Mazzola, Giulia D'Andrea, Giacomo Placella, Francesco Anzano, Vincenzo Salini","doi":"10.1530/EOR-2025-0278","DOIUrl":"10.1530/EOR-2025-0278","url":null,"abstract":"<p><strong>Purpose: </strong>The coexistence of periprosthetic joint infection (PJI) and periprosthetic fracture (PPFx) is one of the most challenging complications after total hip arthroplasty (THA) and total knee arthroplasty (TKA). Evidence regarding the management and outcomes of concomitant PJI and PPFx remains limited. This systematic review aimed to evaluate treatment strategies for infected PPFx in order to optimise infection eradication, fracture healing, implant survival, and limb function.</p><p><strong>Methods: </strong>A systematic review was conducted according to PRISMA and Cochrane guidelines and registered in the PROSPERO database (CRD420251051853). Studies of level II-V evidence reporting on the management of infected PPFx following THA or TKA were included. Extracted data comprised patient demographics, fracture classification, pathogens, treatment strategies, complications, infection control, and fracture healing outcomes.</p><p><strong>Results: </strong>Thirteen studies involving 210 patients were included, with a percentage of hip fractures of 81.9%. The most frequently isolated pathogens were Staphylococcus epidermidis, Staphylococcus aureus, and Cutibacterium acnes. Treatment strategies varied and included revision arthroplasty, plating, intramedullary fixation, distally locked stems, and staged reconstruction with antibiotic-loaded cement or spacers. Fracture union rates ranged from 58 to 100%, while reinfection or recurrence occurred in 6-28% of cases. Stable fixation was associated with improved outcomes, particularly in Vancouver B1 fractures, whereas B2 and B3 fractures showed higher mechanical complication rates. Mortality was reported up to 22% predominately in frail populations.</p><p><strong>Conclusion: </strong>Infected periprosthetic fractures remain rare but involve severe complications. Staged protocols combining infection eradication with stable fixation provide the most consistent outcomes, although treatment should be individualised.</p>","PeriodicalId":48598,"journal":{"name":"Efort Open Reviews","volume":"11 6","pages":"536-544"},"PeriodicalIF":4.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13240628/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148145089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}