Journal of Orthopaedics and Traumatology最新文献

{"title":"Risk factors for proximal radial abnormalities in children with untreated chronic Monteggia fractures: a review of 142 cases.","authors":"WenTao Wang, QianQian Mei, Hang Liu, YueMing Guo, HaiBo Mei, Federico Canavese, Antonio Andreacchio, HanQing Lyu, ShunYou Chen, ShengHua He","doi":"10.1186/s10195-024-00793-z","DOIUrl":"10.1186/s10195-024-00793-z","url":null,"abstract":"<p><strong>Background: </strong>The risk factors for proximal radial abnormalities (PRA) in paediatric patients with untreated chronic Monteggia fractures (CMFs) are unclear. This multicentre study aimed to evaluate the risk factors for PRA in children with untreated CMFs.</p><p><strong>Materials and methods: </strong>The clinical data of 142 patients (mean age at the time of injury: 5.73 years) with untreated unilateral CMFs were retrospectively reviewed. The radial neck-shaft angle (RNS_AP) and radial head size (RH_L) were measured on anteroposterior (AP) and lateral (L) radiographs, respectively. The RH_L size was the ratio of the widest width of the proximal radial metaphysis to the narrowest radial neck width. The En-RNS_AP and En-RH_L were the ratios of the enlargement (En) of the RNS_AP angle and RH_L size of the injured elbow to those of the uninjured elbow, respectively. Paired-sample t-tests, single-factor analyses and multiple linear regression analyses were performed to evaluate the correlation between the differences in these parameters between the injured and uninjured elbows and the assessed risk factors. These risk factors included institution, sex, laterality, age at injury, time from injury to diagnosis, direction of RH dislocation, distance of RH dislocation (DD-RH), presence of radial or median nerve injury, heterotopic ossification and immobilization of the elbow after injury.</p><p><strong>Results: </strong>In children with untreated CMFs (mean time from injury to diagnosis: 14.6 months), Student's t-test revealed a significant difference in the RH_L size (P < 0.001) but not in the RNS_AP angle (P = 0.075) between the injured and uninjured elbows. Pearson correlation analysis revealed a potential correlation between En-RH_L and age at the time of injury (P = 0.069), time from injury to diagnosis (P < 0.001) and DD-RH (P < 0.001), excluding other risk factors (P > 0.05). Multiple linear regression analysis revealed that age at the time of injury (P = 0.047), time from injury to diagnosis (P = 0.007) and DD-RH (P = 0.001) were risk factors for an increased En-RH_L in patients with untreated CMFs; the variability in En-RH_L among the other three risk factors was 21.4%.</p><p><strong>Conclusions: </strong>In paediatric patients with unilateral untreated CMFs, PRA of the injured elbow consisted mainly of RH enlargement or radial neck narrowing rather than valgus deformities of the proximal radius. Older age at injury, increased time from injury to diagnosis and DD-RH were risk factors for more severe PRA.</p><p><strong>Level of evidence: </strong>III.</p>","PeriodicalId":48603,"journal":{"name":"Journal of Orthopaedics and Traumatology","volume":"25 1","pages":"60"},"PeriodicalIF":3.0,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11607283/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142755372","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":"Biomechanical evaluation of percutaneous compression plate and femoral neck system in Pauwels type III femoral neck fractures.","authors":"Xiaoping Xie, Songqi Bi, Qingxu Song, Qiong Zhang, Zhixing Yan, Xiaoyang Zhou, Tiecheng Yu","doi":"10.1186/s10195-024-00792-0","DOIUrl":"10.1186/s10195-024-00792-0","url":null,"abstract":"<p><strong>Background: </strong>The optimal treatment for Pauwels type III femoral neck fractures remains contentious. We aim to compare the biomechanical properties of three inverted cannulated compression screw (ICCS), femoral neck system (FNS), and percutaneous compression plate (PCCP) to determine which offers superior stability for unstable femoral neck fractures.</p><p><strong>Materials and methods: </strong>Finite element analysis and artificial bone models were used to establish Pauwels III femoral neck fracture models. They were divided into ICCS, FNS, and PCCP groups based on respective internal fixation assemblies. The models were subjected to vertical axial loads (2100 N) and torsional forces (10 N × mm) along the femoral neck axis in the finite element analysis. The primary outcomes such as the Z axis fragmentary displacements, as well as displacements and the von Mises stress (VMS) distributions of internal fixations, were analyzed. Additionally, the artificial bones were subjected to progressively increasing vertical axial pressures and torsional moments at angles of 2°, 4°, and 6°, respectively. The vertical displacements of femoral heads and the required torque values were recorded.</p><p><strong>Results: </strong>Finite element analysis revealed that under single-leg stance loading, the maximum Z-axis fragmentary displacements were 5.060 mm for ICCS, 4.028 mm for FNS, and 2.796 mm for PCCP. The maximum displacements of internal fixations were 4.545 mm for ICCS, 3.047 mm for FNS, and 2.559 mm for PCCP. Peak VMS values were 512.21 MPa for ICCS, 242.86 MPa for FNS, and 413.85 MPa for PCCP. Under increasing vertical loads applied to the artificial bones, the average vertical axial stiffness for the ICCS, FNS, and PCCP groups were 244.86 ± 2.84 N/mm, 415.03 ± 27.10 N/mm, and 529.98 ± 23.08 N/mm. For the torsional moment tests, the PCCP group demonstrated significantly higher torque values at 2°, 4°, and 6° compared with FNS and ICCS, with no significant difference between FNS and ICCS (P > 0.05).</p><p><strong>Conclusions: </strong>Finite element analysis and artificial bone models indicated that PCCP offers the best compressive and rotational stability for fixing Pauwels type III femoral neck fractures, followed by FNS and then ICCS. No significant difference in rotational resistance was observed between FNS and ICCS in synthetic bones. Level of Evidence Level 5.</p>","PeriodicalId":48603,"journal":{"name":"Journal of Orthopaedics and Traumatology","volume":"25 1","pages":"61"},"PeriodicalIF":3.0,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11607197/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142755369","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":"The international Hip Outcome Tool 12 questionnaire (iHOT-12): an Italian language cross-cultural adaptation and validation.","authors":"Filippo Randelli, Alberto Fioruzzi, Alice Clemente, Alessandra Radaelli, Alessandra Menon, Danilo Di Via, Clemente Caria, Manuel Giovanni Mazzoleni, Claudio Buono, Paolo Di Benedetto, Michele Paciotti, Rocco Papalia, Gennaro Fiorentino, Marco Collarile, Manlio Panasci, Christian Carulli, Marco Rosolani, Federico Della Rocca, Simona Cerulli, Domenico Potestio, Michele Conati, Alberto Costantini, Gian Nicola Bisciotti, Alessandro Aprato, Loris Perticarini, Nicola Santori, Mattia Loppini, Giuseppe Solarino, Giovanni Vicenti, Vito Pavone, Alberto Di Martino, Fabrizio Rivera","doi":"10.1186/s10195-024-00796-w","DOIUrl":"10.1186/s10195-024-00796-w","url":null,"abstract":"<p><strong>Background: </strong>Patient-reported outcome (PRO) measures are essential for evaluating disease-related quality of life. The International Hip Outcome Tool 12 (iHOT12) assesses various aspects of hip-related symptoms, function, sports participation, and social limitations. This study aimed to adapt and validate an Italian version of the iHOT12 according to COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) guidelines.</p><p><strong>Materials and methods: </strong>A multicenter observational cohort study was conducted to translate and validate the iHOT-12 into Italian (iHOT-12-ita) and assess its psychometric properties. Following international guidelines, we translated and culturally adapted the iHOT-12-ita. Patients with hip pain included in the study completed the iHOT-12-ita and mHHS-ita questionnaires at three timepoints: initial consultation (T0), 10-20 days later (T1), and at least 2 months after treatment (T2): hip injection, hip arthroscopy or total hip replacement. The evaluation of the iHOT-12-ita psychometric properties was conducted following the COSMIN checklist, assessing its reliability, responsiveness, interpretability, and acceptability.</p><p><strong>Results: </strong>Between May 2019 to September 2022, 104 patients were included, from two tertiary hip surgery referral center clinics, they completed both questionnaires and were available for data analysis. The psychometric evaluations revealed robust test-retest reliability on 27 patients at T1, with a Lin coefficient of 0.709 [95% confidence interval (CI) 0.553-0.888] and a high Pearson correlation coefficient of 0.745. At T2 after treatment, there was significant responsiveness (p < 0.001, n = 72), with excellent correlation observed between the iHOT-12-Ita and mHHS-Ita questionnaires (pwcorr = 0.7971). All predefined hypotheses were confirmed.</p><p><strong>Conclusions: </strong>The Italian iHOT-12-ita proved reliable, valid, and responsive in assessing hip disease-related quality of life. Its implementation in routine clinical practice and research can enhance patient care and research quality in hip preservation surgery for the Italian orthopedic community.</p><p><strong>Level of evidence: </strong>II.</p>","PeriodicalId":48603,"journal":{"name":"Journal of Orthopaedics and Traumatology","volume":"25 1","pages":"59"},"PeriodicalIF":3.0,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11602895/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142740536","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":"Comparison of survival, function and complication between intercalary frozen autograft versus massive allograft reconstruction after malignant bone tumors resection.","authors":"Zhuoyu Li, Haoyu Guo, Zhiping Deng, Yongkun Yang, Qing Zhang, Weifeng Liu","doi":"10.1186/s10195-024-00807-w","DOIUrl":"10.1186/s10195-024-00807-w","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to compare the clinical outcomes of intercalary frozen autograft and allograft reconstruction for primary malignant bone tumors.</p><p><strong>Methods: </strong>A retrospective study was conducted on 144 patients who underwent intercalary biological reconstruction for primary malignant bone tumors at a single institution between January 2012 and July 2023. Seventy-two patients underwent intercalary liquid nitrogen-frozen autograft reconstruction, and 72 patients underwent intercalary allograft reconstruction in this study. A modified International Society of Limb Salvage classification system was used to evaluate the complications.</p><p><strong>Results: </strong>The mean follow-up time was 60.2 ± 32.1 (range, 12-149) months. The mean union time was 9.6 months in the frozen autograft group and 15.9 months in the allograft group (p < 0.001). The 5-year overall survivorship was 86.8% in the frozen autograft group and 73.2% in the allograft group (p = 0.017). The average MSTS-93 score was comparable between the two groups (89.7% by autograft versus 87.6% by allograft, p > 0.05). Of the patients, 48.6% (70/144) had at least one complication. The most common complications were bone nonunion (20.8%, 30/144), followed by structural failure (17.4%, 25/144), tumor progression (10.4%, 15/144), infection (10.4%, 15/144), and soft tissue failures (5.6%, 8/144). Higher rates of bone nonunion (type 4B; p = 0.002) and structural failure (type 3B; p = 0.004) were obtained in the allograft group than in the frozen autograft group.</p><p><strong>Conclusions: </strong>The intercalary frozen autografts had shorter union time and lower complication rates than allograft reconstruction. Therefore, we recommend that frozen autograft reconstruction be considered when the tumor bone has not suffered severe osteolytic injury or pathological fracture.</p><p><strong>Level of evidence: </strong>level III, case-control study.</p>","PeriodicalId":48603,"journal":{"name":"Journal of Orthopaedics and Traumatology","volume":"25 1","pages":"58"},"PeriodicalIF":3.0,"publicationDate":"2024-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11586317/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142711455","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":"TikTok and frozen shoulder: a cross-sectional study of social media content quality.","authors":"Riccardo D'Ambrosi, Enrico Bellato, Gianluca Bullitta, Antonio Benedetto Cecere, Katia Corona, Angelo De Crescenzo, Valentina Fogliata, Gian Mario Micheloni, Maristella Francesca Saccomanno, Fabrizio Vitullo, Andrea Celli","doi":"10.1186/s10195-024-00805-y","DOIUrl":"10.1186/s10195-024-00805-y","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to assess the validity and informational value of the material provided on TikTok regarding frozen shoulders. The hypothesis was that the video content on this platform would not provide adequate and valid information.</p><p><strong>Methods: </strong>The current study focused on frozen shoulder videos on the TikTok social media platform. The terms \"frozen shoulder\" and/or \"adhesive capsulitis\" were used as keywords for an extensive online search of video content on TikTok, and the first 100 videos were included. Out-of-topic, non-English, and duplicated videos were excluded from the analysis. The duration and numbers of likes, shares, and views were recorded for each video. Further, videos were categorized based on the source (physiotherapist/osteopath, medical doctor, or private user), type of information (physical therapy, etiopathogenesis, anatomy, clinical examination, patient experience, or symptoms), video content (rehabilitation, education, or patient experience/testimony), and the presence of music or a voice. The assessment of the video content's quality and reliability was performed by two experienced shoulder surgeons using the DISCERN instrument, the Journal of the American Medical Association (JAMA) benchmark criteria, and the Global Quality Score (GQS).</p><p><strong>Results: </strong>A total of 100 videos were included in the analysis, of which 86 (86.0%) were published by physiotherapists/osteopaths. Most of the information and video content focused on physical therapy and rehabilitation (83.0% and 84.0%, respectively). Eighty-four (84.0%) videos included voice comments, while the remaining featured music. The mean number of views was 2,142,215.32 ± 6,148,794.63, while the mean numbers of likes, comments, and shares were 58,438.67 ± 201,863.54, 550.81 ± 1712.22, and 3327.43 ± 7320.81, respectively. The mean video duration was 110.20 ± 116.43 s. The mean DISCERN score, JAMA score, and GQS were 16.17 ± 2.36, 0.61 ± 0.51, and 1.18 ± 0.41, respectively. Videos posted by medical doctors or private users received higher scores than those posted by physiotherapists/osteopaths (p < 0.05).</p><p><strong>Conclusions: </strong>The educational value of videos published on TikTok was poor; videos posted by medical doctors exhibited better quality and educational value than those of physiotherapists or osteopaths. It is the responsibility of orthopedic surgeons to investigate the potential benefits, consequences, and implications of TikTok video content for the health of frozen shoulder patients and to propose necessary adjustments. Given the rapid growth of TikTok, further research is needed.</p><p><strong>Level of evidence: </strong>Level IV-cross-sectional study.</p>","PeriodicalId":48603,"journal":{"name":"Journal of Orthopaedics and Traumatology","volume":"25 1","pages":"57"},"PeriodicalIF":3.0,"publicationDate":"2024-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11586316/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142711461","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":"Magnesium degradation-induced variable fixation plates promote bone healing in rabbits.","authors":"Jian Wen, Yu Zeng, Shenghui Su, Meiling Song, Zhe Wang, Xiaofan Chen, Xieping Dong","doi":"10.1186/s10195-024-00803-0","DOIUrl":"10.1186/s10195-024-00803-0","url":null,"abstract":"<p><strong>Background: </strong>Both initial mechanical stability and subsequent axial interfragmentary micromotion at fracture ends play crucial roles in fracture healing. However, the conversion timing of variable fixation and its effect on and mechanism of fracture healing remain inadequately explored.</p><p><strong>Methods: </strong>A magnesium degradation-induced variable fixation plate (MVFP) for femurs was designed, and its conversion timing was investigated both in vitro and in vivo. Then, locking plates and MVFPs with and without a magnesium shim were implanted in rabbit femur fracture models. X-ray photography and micro computed tomography (micro-CT) were performed to observe the healing of the fracture. Toluidine blue and Masson's trichrome staining were performed to observe new bone formation. The torsion test was used to determine the strength of the bone after healing. Finally, reverse transcription-polymerase chain reaction (RT-PCR) and western blotting were used to detect the expression of osteogenesis-related genes in the three groups.</p><p><strong>Results: </strong>The MVFP with sample 3 magnesium shim showed greater axial displacement within 15 days in vitro, and its variable capability was likewise confirmed in vivo. X-ray photography and micro-CT indicated increased callus formation in the variable fixation group. Toluidine blue and Masson's trichrome staining revealed less callus formation on the rigid fixation side of the locking plate, whereas the variable fixation group presented more callus formation, more symmetrical intraosseous calli, and greater maturity. The torsion test indicated greater torsional resistance of the healed bone in the variable fixation group. RT-PCR and western blotting revealed that the expression levels of BMP2 and OPG increased during early fracture stages but decreased in late fracture stages, whereas RANKL expression showed the opposite trend in the variable fixation group.</p><p><strong>Conclusions: </strong>MVFP promoted faster and stronger bone healing in rabbits, potentially by accelerating the expression of BMP2 and modulating the OPG/RANKL/RANK signaling axis. This study offers valuable insights for the clinical application of variable fixation technology in bone plates and contributes to the advancement of both internal fixation technology and theory.</p><p><strong>Level of evidence: </strong>level V.</p>","PeriodicalId":48603,"journal":{"name":"Journal of Orthopaedics and Traumatology","volume":"25 1","pages":"56"},"PeriodicalIF":3.0,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11582307/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142689355","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 coronoid-first repair through an anterior approach in patients with terrible triad injury of the elbow: a prospective study with a minimum 2-year follow-up.","authors":"Wen-Chieh Chang, Ming-Fai Cheng, Kuei-Hsiang Hsu, Yu-Ping Su","doi":"10.1186/s10195-024-00804-z","DOIUrl":"10.1186/s10195-024-00804-z","url":null,"abstract":"<p><strong>Background: </strong>In the treatment of terrible triad injury of the elbow (TTIE), the indication and the appropriate approach and sequence for coronoid process (CP) fixation remain debatable. No gold standard protocol has been established for CP fixation. In this study, we evaluated the midterm outcomes of coronoid-first repair through an anterior approach in patients with unstable TTIE.</p><p><strong>Materials and methods: </strong>This prospective observational study included patients with TTIE who exhibited posterior or posterolateral subluxation/dislocation during examination under anesthesia (EUA) at our institute between January 2019 and December 2021. All patients underwent coronoid-first repair through an anterior approach, regardless of fragment size. After CP fixation, radial head fixation/replacement and lateral ulnar collateral ligament repair were performed through the lateral Kocher approach. Radiographic and functional (Mayo Elbow Performance Score [MEPS] and Disabilities of Arm, Shoulder, and Hand score [DASH]) assessments were performed 3, 6, 12, and 24 months after surgery. Complications such as recurrent subluxation/dislocation, synostosis, heterotopic ossification, traumatic arthritis, and stiffness were examined at the follow-up visits.</p><p><strong>Results: </strong>The analysis included 27 patients. The mean follow-up duration was 29.9 (range 24-44) months. At the 3-, 6-, 12-, and 24-month follow-up, the mean flexion-extension arcs were 88.7° ± 14.7°, 107.9° ± 11.9°, 128.3° ± 15.5°, and 130.9° ± 15.3°; the mean supination-pronation arcs were 143.7° ± 9.9°, 160.4° ± 7.6°, 165.0° ± 6.0°, and 167.9° ± 4.9°; the mean DASH scores were 18.7 ± 5.7, 4.5 ± 6.1, 2.7 ± 6.5, and 2.0 ± 6.8; and the mean MEPS were 79.1 ± 10.3, 90.2 ± 8.3, 94.8 ± 6.6, and 95.9 ± 5.7, respectively. At the 24-month follow-up, 26 patients had excellent and 1 patient had good results according to MEPS. Only one patient had a complication: they exhibited stiffness and did not have a 30-130° flexion-extension arc at 24 months postoperatively.</p><p><strong>Conclusions: </strong>The EUA findings, rather than fragment size alone, may be a good indicator of whether the CP needs to be repaired. Midterm follow-up results implied that coronoid-first repair through an anterior approach yields satisfactory functional outcomes with minimal complications.</p><p><strong>Level of evidence: </strong>Therapeutic level II.</p>","PeriodicalId":48603,"journal":{"name":"Journal of Orthopaedics and Traumatology","volume":"25 1","pages":"55"},"PeriodicalIF":3.0,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11582235/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142683211","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":"Novel perspectives on early diagnosis of acute compartment syndrome: the role of admission blood tests.","authors":"Tao Wang, Yubin Long, Qi Zhang","doi":"10.1186/s10195-024-00800-3","DOIUrl":"10.1186/s10195-024-00800-3","url":null,"abstract":"<p><strong>Purpose: </strong>The role of admission blood indicators in patients with acute compartment syndrome (ACS) remains debated. Our primary purpose was to observe variations of admission blood indicators in patients with ACS, while our secondary goal was to explore potential biomarkers related to ACS.</p><p><strong>Methods: </strong>We collected information on patients with tibial fracture between January 2013 and July 2023, and divided them into ACS and non-ACS groups. Propensity score matching (PSM) analysis was performed to lower the impact of potential confounding variables such as demographics and comorbidities. Admission blood indicators were analyzed using univariate, logistic regression, and receiver operating characteristic (ROC) curve analyses. Then, we established a nomogram prediction model by using R language software.</p><p><strong>Results: </strong>After propensity PSM analysis, 127 patients were included in each group. Although numerous blood indicators were found to be relevant to ACS on univariate analysis, logistic regression analysis showed that monocytes (MON, p = 0.015), systemic immune-inflammation index (SII, p = 0.011), and creatine kinase myocardial band (CKMB, p < 0.0001) were risk factors for ACS. Furthermore, ROC curve analysis identified 0.79 × 10⁹/L, 1082.55, and 20.99 U/L as the cut-off values to differentiate ACS patients from patients with tibial fracture. We also found that this combination had the highest diagnostic accuracy. Then, we constructed a nomogram prediction model with AUC of 0.869 for the prediction model, with good consistency in the correction curve and good clinical practicality by decision curve analysis.</p><p><strong>Conclusions: </strong>We found that the levels of MON, SII, and CKMB were related to ACS and may be potential biomarkers. We also identified their cut-off values to separate patients with ACS from those with tibial fracture, helping orthopedists promptly evaluate and take early measures. We established a nomogram prediction model that can efficiently predict ACS in patients with tibial fracture.</p>","PeriodicalId":48603,"journal":{"name":"Journal of Orthopaedics and Traumatology","volume":"25 1","pages":"54"},"PeriodicalIF":3.0,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11561211/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142630451","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":"Subsidence of the Corail stem in total hip arthroplasty: no influence of bony contact.","authors":"Filippo Migliorini, Nicola Maffulli, Marco Pilone, Daniel Kämmer, Ulf Krister Hofmann, Andrea Nobili, Erlis Velaj, Andreas Bell","doi":"10.1186/s10195-024-00794-y","DOIUrl":"10.1186/s10195-024-00794-y","url":null,"abstract":"<p><strong>Introduction: </strong>This study investigated stem subsidence following primary total hip arthroplasty (THA) with a Corail stem in patients who underwent two-staged bilateral THA. The second outcome of interest was to investigate whether a specific single cortical bone contact point might reduce postoperative stem subsidence.</p><p><strong>Methods: </strong>The present study was conducted following the STROBE guidelines. The records of patients who underwent THA between 2016 and 2023 were accessed. All patients who underwent two-staged bilateral THA were retrieved. The direct contact between the stem and the cortical bone was assessed at various points in the metaphysis and the distal portion of the stem (diaphysis) in both anteroposterior radiographs of the pelvis (medial and lateral bone contact) and a Lauenstein view of the hip (anterior and posterior bone contact). The following parameters were measured and compared to assess stem subsidence: distance from the proximal femur at the stem bone interface and the tip of the lesser trochanter (distance A); distance from the tip of the lesser trochanter and the tip of the femoral stem (distance B).</p><p><strong>Results: </strong>In total, 250 patients were included, 45% (149 of 250 patients) were women and 61% (153 of 250 THAs) were implanted primarily on the right side. The mean age of patients at the time of the first THA was 64.3 ± 10.0 years and the mean body mass index (BMI) was 28.0 ± 4.9 kg/m². The mean length of the follow-up was 14.1 ± 10.8 months. The overall stem subsidence following THA was 2.8 ± 0.7 mm (P < 0.006). A direct cortical bone-implant contact did not exert a statistically significant difference in subsidence of the THA stem at the metaphysis and diaphysis (P > 0.5). Stem subsidence following THA with a collarless cementless Corail stem was approximately 2.8 mm at 14 months.</p><p><strong>Conclusions: </strong>Direct cortical bone contact of the stem at diaphysis and metaphysis seems not to influence stem subsidence following THA using the Corail stem.</p>","PeriodicalId":48603,"journal":{"name":"Journal of Orthopaedics and Traumatology","volume":"25 1","pages":"53"},"PeriodicalIF":3.0,"publicationDate":"2024-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11551085/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142630466","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":"No difference in surgical time and total theatre time between robotically assisted and computer assisted total knee arthroplasty.","authors":"David Johannes Haslhofer, Victoria Anelli-Monti, Peter Hausbrandt, Christian Kammerlander, Antonio Klasan","doi":"10.1186/s10195-024-00798-8","DOIUrl":"10.1186/s10195-024-00798-8","url":null,"abstract":"<p><strong>Introduction: </strong>A number of studies have demonstrated a significant reduction of surgical time for robotically assisted surgery (RAS) total knee arthroplasty (TKA) after the learning curve between 6 and 43 cases. It is unknown if the logistics of RAS produce a longer total theatre time since published literature only reflects the surgical time. It is also unknown how RAS surgical and total theatre times compare with computer assisted surgery (CAS) TKA.</p><p><strong>Methods: </strong>This is a prospective study of 524 consecutive patients undergoing a CAS or a RAS TKA using the same cementless implant. We recorded age, sex, body mass index (BMI), incision time of the first case, total surgical time, total theatre time, length of stay and 90-day complication and readmission rate.</p><p><strong>Results: </strong>During the study period, 205 CAS and 199 RAS TKA were performed. There was no difference at baseline in age (p = 0.546), sex (p = 0.920) or BMI (p = 0.791). Surgical time for CAS was 78.3 (± 22.2) min and for RAS was 80.1 (± 25.7) min, p = 0.451. Total theatre time for CAS was 117.4 (± 27.8) min and 119.3 (± 30.7) min for RAS, p = 0.515. There was no difference in length of stay (p = 0.674), 90-day complication (p = 0.530) or readmission rate (p = 0.930). There was a difference in skin-incision average time for the first case (p = 0.022).</p><p><strong>Conclusions: </strong>Although theatre set-up for the first case is 5 min longer, RAS-TKA does not prolong the surgical time or total theatre time when compared with CAS-TKA. There was no reduction in case volume since the introduction of robotics.</p><p><strong>Level of evidence: </strong>III.</p>","PeriodicalId":48603,"journal":{"name":"Journal of Orthopaedics and Traumatology","volume":"25 1","pages":"52"},"PeriodicalIF":3.0,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11549068/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142630448","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}