Journal of Orthopaedics and Traumatology最新文献

{"title":"Clinical examination findings were not associated with isometric strength or functional performance in adults with groin pain.","authors":"Matheus Oliveira Branco, Tamiris Beppler Martins, Guilherme Vinicius da Costa, Vitor Mateus Madruga de Sousa, Alan Immich, Kaue Bertoto Dutra, Filippo Migliorini, Nicola Maffulli, Rodrigo Okubo","doi":"10.1186/s10195-026-00971-1","DOIUrl":"10.1186/s10195-026-00971-1","url":null,"abstract":"<p><strong>Objectives: </strong>The aim of this study was to investigate whether positive clinical examination findings were associated with selected measures of lower-limb isometric strength or functional performance in physically active adults with groin pain.</p><p><strong>Methods: </strong>This was a cross-sectional, observational and exploratory study with blinded outcome assessment. A total of 37 physically active adults (18-45 years) with clinically diagnosed groin pain (≥ 6 weeks) underwent standardised orthopaedic testing (flexion, abduction and external rotation [FABER]; flexion, adduction and internal rotation [FADIR]; scour; squeeze), targeted palpation (adductors, pubic symphysis), isometric hip and knee strength testing using a handheld dynamometer and functional performance tests (modified Star Excursion Balance Test [mSEBT], cross-over hop). Associations between clinical findings and strength/performance measures were analysed using adjusted binary logistic regression models controlling for age, body mass index and height, with false discovery rate correction.</p><p><strong>Results: </strong>Participants demonstrated broadly similar right- and left-side performance in the mSEBT and cross-over hop tests, with strength ratios close to 1.0. Positive clinical examination findings were common, particularly for left adductor-region palpation (74.3% of valid observations) and the left FABER test (70.3%). After adjustment for multiple comparisons, no significant associations were found between positive clinical tests and functional or strength measures.</p><p><strong>Conclusions: </strong>In this exploratory sample of physically active adults with groin pain, positive orthopaedic and palpation tests were not significantly associated with deficits in dynamic balance or isometric strength. These findings are limited to the selected isometric and general functional measures and reinforce the importance of a multi-modal assessment that incorporates clinical classification, eccentric adductor strength testing and sport-specific functional evaluations to guide rehabilitation and return-to-sport decisions.</p>","PeriodicalId":48603,"journal":{"name":"Journal of Orthopaedics and Traumatology","volume":"27 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13672736/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149197176","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":"Increasing mobility while in hospital after hip fracture: even the best evidence may not translate to all national health services.","authors":"Nicola Maffulli, Fabrizio Rivera, Giovanna Truda, Filippo Migliorini, Francesco Oliva","doi":"10.1186/s10195-026-00969-9","DOIUrl":"10.1186/s10195-026-00969-9","url":null,"abstract":"<p><p>Hip fracture rehabilitation is strongly influenced by the healthcare system in which postoperative care is delivered. The WHiTE 15: INITIATE trial represents an important pragmatic attempt to determine whether increasing the frequency and duration of in-hospital physiotherapy after hip fracture improves days at home within 30 days of admission. However, the transferability of such evidence to the Italian National Health System is limited by structural, regulatory and sociocultural factors. Italy has one of the oldest populations in Europe, a high annual burden of proximal femoral fractures, a limited public physiotherapy workforce capacity and a care model in which transfer to inpatient rehabilitation facilities is frequently shaped by patient and family preferences rather than clinical indication alone. Current evidence supports early mobilisation and structured rehabilitation, but it does not establish that a single discharge pathway is universally superior across all healthcare systems. In Italy, direct discharge home is often constrained by insufficient community-based rehabilitation services and strong expectations for post-acute institutional care. Therefore, intensifying in-hospital physiotherapy alone may not increase the number of days at home unless discharge preferences, family support and community rehabilitation capacity are addressed simultaneously. Future research should evaluate Italian-specific discharge pathways, psychosocial determinants of rehabilitation preferences, cost-effectiveness of supported discharge models and policy strategies that align rehabilitation intensity with clinical need.</p>","PeriodicalId":48603,"journal":{"name":"Journal of Orthopaedics and Traumatology","volume":"27 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13672716/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149197088","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":"Antibiofilm-coated intramedullary nailing for tibial and femoral diaphyseal fractures at high-risk infection: outcomes of 103 consecutive patients.","authors":"Giovanni Vicenti, Filippo Migliorini, Michele Loiodice, Alessandro Scarpino, Priscilla D'attis, Luise Schäfer, Giulia Colasuonno, Giuseppe Solarino","doi":"10.1186/s10195-026-00967-x","DOIUrl":"10.1186/s10195-026-00967-x","url":null,"abstract":"<p><strong>Background: </strong>Fracture-related infection (FRI) is a devastating complication of intramedullary nailing of tibial and femoral diaphyseal fractures. The present study evaluates the clinical efficacy of an antibacterially coated intramedullary nail in patients with high-risk tibial and femoral diaphyseal fractures. Open fractures, fractures requiring fasciotomy or closed fractures with Tscherne grade II or III soft-tissue damage were considered fractures at high risk of infection.</p><p><strong>Methods: </strong>A single-centre observational study was conducted between January 2022 and December 2024, in accordance with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. Patients who underwent definitive intramedullary nailing with Bactiguard (Bactiguard AB, Tullinge, Sweden)-coated Natural Nail (Zimmer Biomet, Warsaw, IN, USA) for tibial or femoral diaphyseal fractures at high risk of infection were included. The primary outcome was the incidence of FRI, defined according to the internationally validated consensus criteria. Secondary outcomes included time to union, rates of nonunion, malunion, unplanned secondary procedures and functional outcomes at a minimum follow-up of 12 months.</p><p><strong>Results: </strong>A total of 103 patients were enrolled: 55 with tibial fractures and 48 with femoral fractures. The combined cohort comprised 90 males and 13 females, with a median age of 40 years (tibial) and 32.5 years (femoral). Open fractures accounted for 38.2% and 16.7% of tibial and femoral cases, respectively; the remaining patients presented closed fractures with severe soft-tissue involvement (Tscherne grade II-III). FRI was diagnosed in 6 of 103 patients (5.8%): 4 of 55 in the tibial cohort (7.3%) and 2 of 48 in the femoral cohort (4.2%). All FRI cases were successfully managed without sepsis or limb amputation. Fracture union was achieved in 94.5% of tibial and 95.8% of femoral cases, with mean times to union of 9.8 ± 3.2 and 8.4 ± 2.3 months, respectively. No malunion was recorded in either cohort. Open reduction was significantly associated with FRI in both the tibial (p = 0.001) and femoral (p = 0.03) cohorts; articular extension of the fracture was associated with FRI in femoral fractures (p = 0.01).</p><p><strong>Conclusions: </strong>Intramedullary nailing with a Bactiguard-coated implant yielded an overall FRI rate of 5.8% in a consecutive series of 103 high-risk tibial and femoral diaphyseal fractures. Open reduction was identified as a significant independent risk factor for FRI in both cohorts. These findings are hypothesis-generating and support the rationale for prospective, controlled studies to establish the efficacy of biofilm-inhibiting coatings in orthopaedic trauma.</p>","PeriodicalId":48603,"journal":{"name":"Journal of Orthopaedics and Traumatology","volume":"27 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13586100/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148992081","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":"Orthopaedic publications receive fewer citations than general medicine articles: a scientometric analysis of temporal trends.","authors":"Filippo Migliorini, Raju Vaishya, Nicola Maffulli, Jörg Eschweiler, Philipp Kobbe, Marcel Betsch, Luise Schäfer, Francesco Oliva, Fabrizio Rivera","doi":"10.1186/s10195-026-00958-y","DOIUrl":"10.1186/s10195-026-00958-y","url":null,"abstract":"<p><strong>Background: </strong>Orthopaedics, as a surgical speciality with a structurally narrower citing audience and lower citation density than general medicine, is systematically disadvantaged in any cross-disciplinary comparison relying on absolute citation counts. Whether this disadvantage is stable or has changed over time has not been previously quantified.</p><p><strong>Methods: </strong>The 100 most-cited articles indexed in the Web of Science Core Collection were identified for medicine and orthopaedics in 2014 and 2024. Citation data were extracted from a single snapshot taken on 19 January 2026. Total citations and citation velocity, defined as citations per year since publication, were compared between fields and across time points using Mann-Whitney U tests. Ratio-based analyses and distributional characteristics were also assessed.</p><p><strong>Results: </strong>Median citation counts were substantially higher in medicine than in orthopaedics in both years, reaching 5055 versus 288 in 2014 and 720.5 versus 34.0 in 2024, corresponding to 17.6- and 21.2-fold differences, respectively. Citation velocity followed the same pattern, with medicine maintaining an approximately 17- to 21-fold advantage at both time points. Within-field temporal analysis showed that citation velocity remained broadly stable in medicine between cohorts, whilst orthopaedics demonstrated reduced early citation accrual in the more recent cohort. Citation distributions were more right-skewed in medicine, with a small number of articles accounting for a disproportionate share of total citations, whereas orthopaedic citations were more evenly distributed across the top 100.</p><p><strong>Conclusions: </strong>Orthopaedics demonstrated substantially lower citation performance than general medicine articles, and this gap appeared to persist over time.</p>","PeriodicalId":48603,"journal":{"name":"Journal of Orthopaedics and Traumatology","volume":"27 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13401584/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148594260","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":"Clinical predictors of pathological femoral fractures in children: a retrospective comparative study.","authors":"Tanja Kraus, Clemens Clar, Jürgen Rünk, Patrick Reinbacher, Vanessa Sackl, Georg Singer, Magdalena Rusch, Andreas Leithner","doi":"10.1186/s10195-026-00954-2","DOIUrl":"10.1186/s10195-026-00954-2","url":null,"abstract":"<p><strong>Background: </strong>Femoral fractures in children are uncommon and are usually trauma-related; however, some occur secondary to underlying bone pathology. Early differentiation between traumatic and pathological fractures is essential to avoid delayed diagnosis. This study aimed to identify clinical predictors associated with pathological femoral fractures in children.</p><p><strong>Material and methods: </strong>In this retrospective single-center comparative study, 432 pediatric patients (0-17 years) with femoral fractures were included. These fractures were classified as traumatic (n = 386, 89.4%; treated between 2011 and 2023) or pathological (n = 46, 10.6%; treated between 2002 and 2021) on the basis of radiological findings, advanced imaging, or histopathological confirmation. Demographic, anatomical, and injury-related variables were compared between the two groups using Mann-Whitney U or chi square tests.</p><p><strong>Results: </strong>Patients with pathological fractures tended to be older (10.1 ± 4.3 years versus 8.3 ± 5.9 years, p = 0.090) and age-group distribution differed significantly between the two groups (p < 0.001). Traumatic fractures showed a bimodal age distribution, whereas pathological fractures followed a unimodal pattern. Both groups most commonly sustained diaphyseal fractures (58.7% pathological versus 59.8% traumatic). Low-energy trauma mechanisms were significantly more common in pathological fractures (78.9% versus 49.5%, p = 0.001).</p><p><strong>Conclusions: </strong>Pathological femoral fractures in children differ from traumatic fractures with respect to age distribution, anatomical location, and injury mechanism. They are more likely to occur following low-energy trauma and demonstrate a different age distribution to traumatic fractures. Careful assessment of patient age, fracture location, and trauma mechanism may aid in the early identification of underlying bone pathology and support appropriate diagnostic evaluation.</p>","PeriodicalId":48603,"journal":{"name":"Journal of Orthopaedics and Traumatology","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13669268/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148498319","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":"Conclusiveness of biopsy techniques for diagnosis of bone and soft tissue tumours: a retrospective, single-centre observational study.","authors":"Maria Anna Smolle, Johannes Rauscher, Florian Alexander Wenzl, Jasminka Igrec, Joanna Szkandera, Bernadette Liegl-Atzwanger, Andreas Leithner, Dimosthenis Andreou","doi":"10.1186/s10195-026-00956-0","DOIUrl":"10.1186/s10195-026-00956-0","url":null,"abstract":"<p><strong>Background: </strong>Given the differences between biopsy techniques, especially regarding the representativeness and amount of tissue obtained upon diagnostic workup of suspicious bone and soft tissue lesions, this study aimed at evaluating the diagnostic conclusiveness of different biopsy techniques at a tertiary sarcoma centre.</p><p><strong>Materials and methods: </strong>Overall, 222 consecutive patients (50.9% males, median age 63.3 [IQR 47.4-71.8] years) undergoing biopsy for a suspected bone or soft tissue lesion at a single centre between December 2021 and December 2023 were included. Biopsy techniques included core needle biopsy in the outpatient setting (without image guidance), sonography-guided and CT-guided and open biopsy. The conclusiveness rate of the first biopsy was defined as a histologically plausible result that enabled subsequent treatment planning.</p><p><strong>Results: </strong>Soft tissue and bone lesions were present in 114 (51.4%) and 108 (48.6%) patients, respectively. Core needle (n = 85; 38.3%) and CT-guided biopsies (n = 61; 27.5%) were most commonly employed. Median interval from first presentation to biopsy was 14 (IQR 3-29) days for bone and 0 (IQR 0-17) days for soft tissue lesions, attributable to the long delay of CT-guided biopsies (bone: median 28 [IQR 15-47] days; soft tissue: median 18 [14-45] days; p < 0.001). Complications were highest following CT-guided biopsies for soft tissue lesions (n = 2/18; 11.1% [95% CI 1.4%-34.7%]) and sonography-guided biopsies for bone lesions (n = 1/5; 20.0% [95% CI 5.1%-71.6%]). Overall, the first biopsy was conclusive in 88.0% (95% CI 80.3%-93.4%; n = 95/108) and 88.6% (95% CI 81.3%-93.8%; n = 101/114) of bone and soft tissue lesions, respectively, with no difference between biopsy types. A repeated biopsy became necessary in 9.5% of patients (n = 21/222). None of the parameters investigated (BMI, age, lesion size, biopsy type, location) were associated with the conclusiveness rate of bone or soft tissue biopsies.</p><p><strong>Conclusions: </strong>The time delay from initial presentation to biopsy varies with the biopsy technique employed, as do complication rates. Yet, all biopsy techniques-when applied according to clinical indication-achieve high diagnostic conclusiveness rates.</p><p><strong>Level of evidence: </strong>IV.</p>","PeriodicalId":48603,"journal":{"name":"Journal of Orthopaedics and Traumatology","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13669256/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148498372","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":"Development and validation of a vision transformer model for radiographic assessment of pediatric humeroradial joint alignment.","authors":"WenTao Wang, ShengHua He, YiFan Rao, Federico Canavese, ShengPing Tang, ChongZhi Zhao, Hang Liu, Antonio Andreacchio, Maria Beatrice Michelis, Chiara Arrigoni, Nunzio Catena, Sandro Gregorio, Lorenza Marengo, ShunYou Chen, SuiGu Tang, QianQian Mei","doi":"10.1186/s10195-026-00955-1","DOIUrl":"10.1186/s10195-026-00955-1","url":null,"abstract":"<p><strong>Background: </strong>Whether the radiographic assessments of pediatric anatomical (A-HRJA) and nonanatomical humeroradial joint alignment (NA-HRJA) among pediatric orthopedic surgeons (POS) relies on clinical experience remains unknown. No vision transformer (ViT) model for automated and accurate radiographic pediatric HRJAs categorization has been developed and validated. This study aims to evaluate the radiographic assessment outcomes of pediatric A-HRJAs and NA-HRJAs among POS with varying levels of experience, and to develop and validate a model for automated and accurate categorization of pediatric HRJAs on radiographs.</p><p><strong>Materials and methods: </strong>A total of 294 pediatric radiographs were independently recorded by four junior-level, four mid-level, and three senior-level POS. Then, the performance of the POS with various levels of experience was evaluated. A total of 5118 pediatric radiographs (2932 A-HRJAs and 2186 NA-HRJAs) were prepared to construct the vision transfer (ViT) model. The ViT model's clinical efficacy was evaluated using an external testing dataset (84 A-HRJAs and 132 NA-HRJAs). A total of 11 POS independently recorded the HRJA types of the external testing dataset twice with a 1-month interval: first without ViT model assistance, and second with assistance. The rating performances of the POS without and with ViT model assistance were compared.</p><p><strong>Results: </strong>The accuracy, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were similar among junior-level, mid-level, and senior-level POS (P > 0.050). The ViT model's area under the receiver operating characteristic curve was 0.944. The ViT model's rating performance was significantly superior to that of POS in the first round regarding accuracy (P = 0.001), sensitivity (P = 0.001), and NPV (P < 0.001). However, no significant differences were found between the ViT model and POS in the second round. The accuracy (P = 0.008), PPV (P = 0.043), and NPV (P = 0.030) improved significantly in the second round compared with the first, as demonstrated by the following values: 86.9-92.6%, 88.3-93.6%, and 85.8-93.2%, respectively. The kappa value reflecting the reliability among POS improved by 24.8% in the second round.</p><p><strong>Conclusions: </strong>The accuracy of manually classifying radiographic pediatric HRJA types did not depend on clinical experience. The ViT model can accurately categorize radiographic pediatric HRJA types and significantly improve the POS's rating performance when categorizing A-HRJAs and NA-HRJAs.</p><p><strong>Level of evidence: </strong>III.</p>","PeriodicalId":48603,"journal":{"name":"Journal of Orthopaedics and Traumatology","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13654914/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148449814","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":"Sleep quality and nocturnal pain in patients with elbow disorders: a prospective multicenter study.","authors":"Marco M Schneider, Rainer Nietschke, Fillipo Migliorini, Christian Schoch, Klaus Burkhart, Boris Hollinger, Michael Kimmeyer, Lars Lehmann, Alexander Zimmerer","doi":"10.1186/s10195-026-00950-6","DOIUrl":"10.1186/s10195-026-00950-6","url":null,"abstract":"<p><strong>Background: </strong>Mental health disorders have become a growing global concern. Sleep quality is known to have a crucial impact on mental well-being. Poor sleep contributes to increasing economic costs owing to reduced productivity as well as the development of mental disorders. Conversely, anxiety and depression often lead to sleep disturbances. Pain is a key factor affecting sleep quality. Studies have shown that musculoskeletal disorders, especially in the shoulder, may cause sleep disturbances. Research on the relationship between elbow pain and sleep quality remains limited. This study aims to evaluate the impact of common elbow pathologies on sleep quality.</p><p><strong>Methods: </strong>This prospective multicenter cohort study used self-reported outcome measures in patients with elbow disorders, including the Pittsburgh Sleep Quality Index (PSQI), to assess sleep quality. The PSQI was compared with other outcome measures.</p><p><strong>Results: </strong>A total of 664 patients (284 female, 380 male) were included, of whom 81% reported nocturnal pain. The mean age was 47.9 ± 14.2 years, body mass index (BMI) 26.9 ± 6.7 kg/m² and symptom duration 15.8 ± 7.3 months. The most common diagnoses were lateral epicondylar pain (66%), medial epicondylar pain, arthritis, ulnar nerve entrapment and biceps/triceps tendinopathies. The overall PSQI was 7.3 ± 3.8, disabilities of arm, shoulder and hand questionnaire (DASH) 35.0 ± 19.8, sports/performing art module of disabilities of arm, shoulder and hand questionnaire (spa-DASH) 16.2 ± 13.8, work module of disabilities of arm, shoulder and hand questionnaire (w-DASH) 29.2 ± 15.8, single assessment numeric evaluation elbow (SANE-E) 54.9 ± 25.4 and numeric rate scale (NRS) 3.1 ± 2.7. No significant differences in other scores were observed between pathology subgroups. Correlation analysis showed a moderate association between PSQI and DASH score (r = -0.372, p < 0.001), as well as between PSQI and NRS for pain (r = 0.255, p = 0.002), while other variables showed no significant correlations.</p><p><strong>Conclusions: </strong>Nocturnal pain and sleep disturbances are highly prevalent in patients with elbow disorders. Evaluating and addressing sleep quality may improve functional outcomes and overall well-being. Future research should investigate how different treatment modalities affect pain, function and sleep quality.</p>","PeriodicalId":48603,"journal":{"name":"Journal of Orthopaedics and Traumatology","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13375990/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148449799","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":"A novel figure-of-eight polymeric cerclage wiring technique for greater trochanter fixation in revision arthroplasty and conversion of failed proximal femur fracture fixations to total hip arthroplasty.","authors":"Filippo Leggieri, Fernando N Martín Cocilova, Gregorio Secci, Davide Stimolo, Luigi Zanna, Roberto Civinini, Matteo Innocenti","doi":"10.1186/s10195-026-00952-4","DOIUrl":"10.1186/s10195-026-00952-4","url":null,"abstract":"<p><strong>Introduction: </strong>Periprosthetic femoral fractures occur in 0.8-10% of primary total hip arthroplasties (THA) and up to 17.5% for revision THA (revTHA), with isolated greater trochanter (GT) fractures being the most predominant pattern. This study aimed to evaluate a novel figure-of-eight cerclage wiring technique for greater trochanter fixation in hip replacement cases.</p><p><strong>Methods: </strong>These retrospectively collected data included 36 hips (36 patients) undergoing revision THA or conversion of failed intertrochanteric fracture to THA with figure-of-eight cerclage wiring between April 2021 and June 2023. Patients under 18 years, with incomplete records, or lost to follow-up before 24 months were excluded. Primary outcomes included Trendelenburg sign, periprosthetic infections, and hip dislocation rates. Secondary outcomes evaluated THA stem subsidence and trochanteric migration using calibrated digital imaging. Statistical analysis included descriptive statistics, independent t-tests, linear regression, and correlation analyses with significance set at p < 0.05.</p><p><strong>Results: </strong>Mean follow-up was 404.76 ± 22.51 days. Patient demographics showed mean age 76.5 ± 12.3 years, body mass index (BMI) 25.8 ± 4.5 kg/m², with 73.8% female patients. At final follow-up, one patient (2.8%) experienced post-surgical infection, one patient (2.8%) had dislocation, and three patients (8.3%) exhibited positive Trendelenburg sign. Mean trochanteric migration was 4.01 mm at 12 months (range 0.0-30.4 mm), with one clinically significant case (30.4 mm migration). Mean stem subsidence was 1.3 ± 2.7 mm (range 0.0-16.4 mm), with one clinically significant case (16.4 mm subsidence). No statistically significant differences were found between posterior-lateral and anterior approaches for migration (p = 0.276) or subsidence (p = 0.324). Linear regression analysis revealed no significant predictors of migration or subsidence among age, BMI, surgical approach, or treatment type.</p><p><strong>Conclusions: </strong>The figure-of-eight cerclage wiring technique with polymeric cerclages demonstrates promising results for greater trochanter fixation with low complication rates and adequate stability across different surgical approaches and patient populations.</p><p><strong>Level of evidence iv: </strong></p>","PeriodicalId":48603,"journal":{"name":"Journal of Orthopaedics and Traumatology","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13396082/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148431223","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":"Mattress impact on lifestyle and back pain: a 25-year orthopedic literature review guideline.","authors":"Caggiari Gianfilippo, Petrucci Filippo, Pescia Stefano, Arbau Alessandro, Fidanza Andrea, Ciatti Corrado, Puddu Leonardo, Delrio Giulia, Caria Elisa, Pinna Ilaria, Doria Carlo","doi":"10.1186/s10195-026-00945-3","DOIUrl":"10.1186/s10195-026-00945-3","url":null,"abstract":"<p><strong>Background: </strong>Sleep quality is influenced by several modifiable environmental factors, including the sleep surface. Low back pain, morning stiffness, shoulder discomfort, and muscle tightness on awakening may indicate inadequate bedding support. This systematic review evaluated whether mattress characteristics influence spinal alignment, sleep quality, and low back pain.</p><p><strong>Methods: </strong>A systematic literature search and qualitative synthesis were conducted for studies published from 1999 to 2023. PubMed, Cochrane Library, Web of Science, Scopus, EMBASE, PsycINFO, ScienceDirect, and Google Scholar were searched using terms related to mattress ergonomics, pain, vertebral-column alignment, sleep, and quality of life. Eligible studies evaluated adult or young-adult populations and reported outcomes related to low back pain, spinal alignment, pressure distribution, sleep comfort, or sleep quality. Methodological quality and risk of bias were appraised using literature evaluation and grading of evidence (LEGEND) and Critical Appraisal Skills Programme (CASP) tools.</p><p><strong>Results: </strong>A total of 47 studies were included. The evidence most consistently favored medium-firm mattresses over very firm or very soft surfaces. Medium-firm support was associated with better pressure distribution, improved sleep quality, reduced morning stiffness, and low back pain intensity. Zonal support, air-adjustable systems, customized designs, and thermal microclimate optimization showed potential benefits, but heterogeneity in materials, outcome measures, follow-up duration, and participant characteristics precluded meta-analysis.</p><p><strong>Conclusions: </strong>Medium-firm mattresses represent the most defensible general recommendation for adults with nonspecific low back pain or morning stiffness. Mattress selection should also consider body habitus, age, sex-related anthropometry, preferred sleep position, and thermal comfort. Smart and adaptive mattress systems are promising but require larger, methodologically rigorous clinical trials before routine recommendation.</p><p><strong>Level of evidence: </strong>Level III according to the Oxford 2011 Levels of Evidence.</p><p><strong>Review registration: </strong>Not registered.</p><p><strong>Trial registration: </strong>Not applicable.</p>","PeriodicalId":48603,"journal":{"name":"Journal of Orthopaedics and Traumatology","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13638900/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148425421","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}