European Journal of Orthopaedic Surgery and Traumatology最新文献

{"title":"Complications associated with postoperative stiffness following rotator cuff repair.","authors":"Sarah K Thomas, Vivek N Pandey, John W Moore, Alexander S Guareschi, Brandon L Rogalski, Josef K Eichinger, Richard J Friedman","doi":"10.1007/s00590-025-04212-9","DOIUrl":"https://doi.org/10.1007/s00590-025-04212-9","url":null,"abstract":"<p><strong>Purpose: </strong>Shoulder stiffness is a common complication following rotator cuff repair (RCR) surgery. However, there is a paucity of literature on the short-term effects of postoperative stiffness on outcomes following RCR. The purpose of this study is to analyze the effect of postoperative shoulder stiffness on short-term outcomes following RCR.</p><p><strong>Methods: </strong>The Nationwide Readmissions Database (NRD) was queried from 2015 to 2020 for primary RCR patients. Stiffness was defined using International Classification of Disease Clinical Modification and Procedure Coding System codes for arthrofibrosis, adhesive capsulitis, stiffness, synovitis, or contracture of the shoulder. Patients were separated into stiff and non-stiff cohorts and a case-control match was performed based upon age, sex, and Charlson Comorbidity Index (CCI) for a total number in the control group of 358 and a total subject count of 489. Postoperative complications, reoperations, readmissions, mortality, and hospital cost metrics were compared between cohorts using t-test and fisher's exact test.</p><p><strong>Results: </strong>Rates of complications, reoperation, readmission, and death were similar between the stiff and non-stiff cohorts and there were likely no clinically significant differences. Stiff patients were more likely to be discharged to home and less likely to be discharged to another type of facility (p = 0.007).</p><p><strong>Conclusion: </strong>Postoperative stiffness was not predictive of increased complications, readmissions, or healthcare costs following RCR. These findings suggest that stiffness may not represent a significant clinical or economic burden, helping to guide patient expectations and management strategies. However, stiff patients were more likely to be discharged home and less likely to require facility-based care, suggesting potential differences in postoperative recovery or support needs.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"35 1","pages":"101"},"PeriodicalIF":1.4,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574543","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early functional outcomes following open reconstruction of the triangular fibrocartilage complex.","authors":"Michał Chęciński, Marcin Syrko, Szymon Manasterski, Patryk Ostrowski, Piotr Węgrzyn, Maja Smorąg, Jędrzej Króliński, Paweł Stajniak, Ahmed Elsaftawy","doi":"10.1007/s00590-025-04232-5","DOIUrl":"https://doi.org/10.1007/s00590-025-04232-5","url":null,"abstract":"<p><strong>Introduction: </strong>The triangular fibrocartilage complex (TFCC) plays a pivotal role in wrist stability and function. TFCC injuries are a common cause of ulnar-sided wrist pain and distal radioulnar joint (DRUJ) instability, often requiring surgical intervention when conservative treatments fail. This study evaluates the outcomes of open surgical repair of TFCC injuries, with a focus on functional recovery between 6 and 18 months postoperatively.</p><p><strong>Methods: </strong>A total of 17 patients (10 males, seven females; mean age: 39.9 years) underwent open surgical repair for TFCC injuries between February 2022 and December 2023. The procedure, performed via a dorsal approach, utilized long-absorbable sutures and, when indicated, supplemental stabilization with a Kirschner wire. Patients followed a postoperative protocol of 6 weeks of immobilization (3 weeks in a forced supination cast followed by 3 weeks in a neutral position), with rehabilitation initiated 7 weeks postoperatively. Functional outcomes were assessed using the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire, along with measurements of grip strength and range of motion.</p><p><strong>Results: </strong>The mean DASH score was 14.69, with grip strength recovery averaging 92.38% compared to the contralateral hand. All patients returned to work within 10.2 weeks and resumed amateur sports after 12.3 weeks. No reoperations or complications were reported. The procedure yielded significant improvements in grip strength and range of motion.</p><p><strong>Conclusion: </strong>Open surgical repair of TFCC injuries is an effective and safe procedure for patients unresponsive to conservative treatment. This technique provides favorable functional outcomes and can be performed reliably in most trauma surgery departments without the need for advanced equipment or specialized expertise.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"35 1","pages":"98"},"PeriodicalIF":1.4,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Concordance of three different methods to obtain samples for culture in reverse total shoulder arthroplasty: a prospective study.","authors":"Carlos Torrens, Raquel Companys, Amaya Suárez-López, Daniel Pérez-Prieto, Fernando Santana, Albert Alier","doi":"10.1007/s00590-025-04206-7","DOIUrl":"https://doi.org/10.1007/s00590-025-04206-7","url":null,"abstract":"<p><strong>Purpose: </strong>The objective of this study was to analyze the concordance of the results obtained when culturing samples that are obtained with three different methods.</p><p><strong>Methods: </strong>Prospective study that includes primary Reverse shoulder arthroplasties. From all the patients, 9 cultures were obtained. There were 3 cultures obtained from skin at the beginning of surgery, 3 from the tissue around the insertion of the long biceps on the glenoid side, and 3 from the tissue around the greater tuberosity on the humeral side. At each location, one culture was obtained from a swab, another one was obtained from the instruments on the table, and another one was obtained from a newly-opened set of instruments.</p><p><strong>Results: </strong>There were 87 patients included, leaving 783 culture samples for the analysis. Of those 783 samples, 69 turned to be positive: 57 were positive for C. acnes, 5 for S. epidermidis, 4 for other coagulase-negative staphylococcus, and 3 were positive for other indolent microorganisms. Comparing the results obtained with the three different methods, the kappa coefficient for all positive cultures was 0.1894 for cultures taken from skin, 0.4891 for cultures from the glenoid and 0.5456 for cultures from the greater tuberosity. Therefore, the kappa coefficient obtained for the three different locations ranged from poor to moderate.</p><p><strong>Conclusion: </strong>The analysis of the concordance of the samples obtained with swab, tissue cultures taken with the instruments of the table and tissue cultures taken with new sets of instruments lead to different culture results in shoulder arthroplasty.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"35 1","pages":"100"},"PeriodicalIF":1.4,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574544","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgeon experience in multi-ligament knee injury reconstruction is associated with decreased complications and surgical time.","authors":"Emily Berzolla, Bradley A Lezak, Steven Magister, Michael Moore, Eric J Strauss, Laith M Jazrawi, Michael J Alaia","doi":"10.1007/s00590-025-04233-4","DOIUrl":"https://doi.org/10.1007/s00590-025-04233-4","url":null,"abstract":"<p><strong>Introduction: </strong>Operative management of multi-ligament knee injuries (MLKI) is technically challenging, with high complication rates. However, the impact of surgeon experience on surgical outcomes remains underreported. This purpose of this study was to examine how surgeon experience impacts operative time and complication rates. It was hypothesized that increased surgeon experience in MLKI correlates with reduced surgical duration and postoperative complications.</p><p><strong>Methods: </strong>A retrospective review of MLKI patients who underwent reconstruction from 2011 to 2024 by fellowship-trained sports medicine surgeons at two high-volume level 1 trauma centers was conducted. Patient demographics, surgical procedure characteristics, complications, and surgeon experience (defined by years in practice postfellowship) were analyzed. Correlations were examined using linear regression for continuous variables and binary logistic regression for binary variables.</p><p><strong>Results: </strong>There were 191 MLKI patients meeting inclusion criteria, with a 25.7% overall complication rate. Arthrofibrosis (16.2%) was most common, followed by recurrent instability (3.7%), infection (3.7%), revision surgery (2.7%), and hardware removal (1.0%). Controlling for age, sex, BMI, and number of ligaments reconstructed, we found a significant negative correlation between surgeon experience and both surgical duration (ß =  - 0.28, p < .001) and complication risk (OR 0.92, p = 0.024).</p><p><strong>Conclusion: </strong>This study demonstrates that increased surgeon experience in operative management of MLKI is associated with decreased complication rates and shorter procedure duration. Additional risk factors for complications included the number of ligaments injured and concomitant knee dislocation.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"35 1","pages":"97"},"PeriodicalIF":1.4,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associated peritoneostomy and pelvic ring fractures: prognostic factors in mortality and morbidity.","authors":"Uheyna Gancedo Ruzon, Thayná Caroline Da Silva, Christiano Saliba Uliana, Matheus Senedese Rampazzo, Rodrigo Sippel Cruz, Silvania Klug Pimentel","doi":"10.1007/s00590-025-04213-8","DOIUrl":"https://doi.org/10.1007/s00590-025-04213-8","url":null,"abstract":"<p><strong>Background: </strong>High-energy polytrauma can be presented as an abdominal injury associated with a pelvic ring fracture. In the case of concomitant pelvic ring fracture peritoneostomy at admission, high morbidity and mortality rates could be expected.</p><p><strong>Objectives: </strong>The main objective of this study is to assess prognostic factors that could contribute to the outcome of polytrauma patients who presented with pelvic ring fractures and were submitted to a peritoneostomy at admission. As a secondary aim, the functional outcome of the survivors was evaluated.</p><p><strong>Materials and methods: </strong>A retrospective, cross-sectional, observational study was conducted. Polytrauma patients who were submitted to a peritoneostomy at admission due to high-energy abdominal injury and presented with concomitant pelvic ring fracture were included. Demographics data and prognostic factors related to \"death\" and infection were assessed. We applied the Majeed score for functional evaluation.</p><p><strong>Results: </strong>A total of 29 patients were included in the study. The mortality rate was 58.6% (n = 17). Considering only patients older than 45 years, the death rate was 90%. The variables with positive correlation to death were: (1) age > 45 years (p < 0.017) and (2) the absence of internal fixation (p < 0.011). Patients undergoing internal fixation had more infection rates (60%) compared to noninternal fixation group (11%) (p < 0.011). The average Majeed score was 54.7 points.</p><p><strong>Conclusion: </strong>The predictive factors associated with increased mortality were age greater than 45 years and the absence of internal fixation. Concomitant pelvic ring fracture and peritoneostomy in admission implicate on high mortality and morbidity rates.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"35 1","pages":"99"},"PeriodicalIF":1.4,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574542","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Utilizing 3d-printed patient-specific porous titanium cones in complex primary and revision total knee arthroplasty.","authors":"Arash Sharafat Vaziri, Ghazaleh Moradkhani, Farzam Farahmand, Morad Karimpour, Mohammad Naghi Tahmasebi, Fardis Vosoughi, Maryam Salimi, Ramin Shayan-Moghadam","doi":"10.1007/s00590-025-04229-0","DOIUrl":"https://doi.org/10.1007/s00590-025-04229-0","url":null,"abstract":"<p><strong>Introduction: </strong>Effective management of bone defects is crucial in revision total knee arthroplasty (rTKA) to ensure implant stability in low-density bone environments, especially following prosthesis removal. While various reinforcement techniques exist, such as allografts, augments, metal cones, sleeves, or combinations thereof, metal cones are increasingly favored for their ability to reconstruct significant bone defects. A prominent challenge with off-the-shelf (OTS) cones is their unsuitability for Asian and specifically Iranian anatomies due to mismatched sizes and smaller medullary canals. This study explores the application of customized 3D-printed porous titanium cones, tailored to individual patient anatomy, for bone defect reconstruction in complex primary or revision total knee arthroplasty (TKA).</p><p><strong>Materials and methods: </strong>Utilizing CT scans for 3D preoperative planning, porous cones were individually designed to fit each patient's anatomy. A novel aspect of these cones is their dual functionality: promoting bone ingrowth while preventing cement infiltration. The cones were fabricated using selective laser melting with medical-grade Ti6Al4V alloy. To aid in surgical preparation, single-use polyamide trials were also 3D-printed.</p><p><strong>Results: </strong>A total of nineteen cones/half cones (four diaphyseal, twelve metaphyseal, and three meta-diaphyseal) for femoral and tibial applications were successfully designed and implanted across ten cases. There was a perfect alignment between preoperative planning and intraoperative outcomes, with precise defect reconstruction achieved in all cases. Early follow-ups indicated no loosening or implant migration.</p><p><strong>Conclusions: </strong>Customized patient-specific porous cones offer not only the long-term benefits of OTS options, such as osseointegration and biological fixation but also accurately address a wide range of complex metaphyseal and diaphyseal defects. This approach preserves residual bone stock and streamlines the surgical process, presenting a promising advancement in bone defect management in rTKA.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"35 1","pages":"96"},"PeriodicalIF":1.4,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568753","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Soluble urokinase plasminogen activator receptor biomarker is not a predictor of mortality in high-risk hip fracture patients.","authors":"Konstantinos Avgerinos, Spyridon Katsanos, Pavlos Altsitzioglou, Alexandros Zikopoulos, Anastasios Roustemis, Orestis Konstantas, Ioannis Zafeiris, Fotini Soucacos, Dimitrios Serenidis, Dimitrios Mastrokalos, Dimitrios Koulalis, Andreas Mavrogenis","doi":"10.1007/s00590-025-04211-w","DOIUrl":"https://doi.org/10.1007/s00590-025-04211-w","url":null,"abstract":"<p><strong>Background: </strong>The soluble urokinase plasminogen activator receptor (SuPAR) is a biomarker of inflammation and immune activation that has been related with mortality in a vast spectrum of diseases in the elderly. Its prognostic value in preoperative evaluation for non-cardiac surgery has been promising. However, up to date there are no studies in high-risk patients undergoing hip fracture surgery. Therefore, we performed this prospective study aims to evaluate the prognostic value of SuPAR and other common clinical, echocardiographic, and blood biomarkers for the 1-year survival of high-risk hip fracture surgery patients.</p><p><strong>Methods: </strong>We studied 46 patients with hip fracture that underwent hip fracture surgery from 2019 to 2024. There were 10 men and 36 women, over 65 years of age (mean, 85 ± 8 years) with at least one high-risk characteristic (dementia, chronic immobilization, age > 90 years). Upon admission, complete clinical and laboratory assessments, including electrocardiogram and cardiac ultrasonography, radiographs, and blood sampling, were conducted. Serum blood levels of SuPAR as well as natriuretic peptides and troponin I were measured. The Katz index of frailty was calculated. The patients were followed for 1 year after admission and hip fracture surgery. At that time, the patients or their relatives were contacted through telephone, and their 1-year survival was documented.</p><p><strong>Results: </strong>Overall, 25 (54.3%) patients were dead at 1-year examination. There was no significant difference in baseline values of SuPAR between patients dead or alive at follow-up (6.30 ng/dl [range, 4.95-7.05 ng/dl] vs. 6.25 ng/dl [4.25-9.05 ng/dl], respectively; p value = 0.767), and SuPAR has not been related to 1-year mortality (HR 0.802; 95% CI 0.248-2.595; p value = 0.712). The only univariate and multivariate predictors of survival were age (HR 1.098; 95% CI 1.003-1.181; p = 0.041) and Katz index ≤ 4 (HR 4.490; 95% CI 1.180-17.093; p = 0.028).</p><p><strong>Conclusion: </strong>This study showed that SuPAR is not a predictive factor for 1-year mortality in high-risk patients undergoing hip fracture surgery. Older age and Katz index score ≤ 4 were the only independent predictors of 1-year mortality. Therefore, although no definite conclusion can be drawn from such a small number of patients, no trend in mortality for this measurement has been observed, suggesting SuPAR and similar biomarkers should not be considered in the evaluation of mortality in high-risk hip fracture patients.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"35 1","pages":"95"},"PeriodicalIF":1.4,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: Arthroscopic ACL repair with suture tape augmentation: clinical, functional, and gait analysis outcomes at minimum 3-year follow-up.","authors":"Rachit Saggar, Vikram Arun Mhaskar, Rohit Bansal","doi":"10.1007/s00590-025-04235-2","DOIUrl":"https://doi.org/10.1007/s00590-025-04235-2","url":null,"abstract":"","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"35 1","pages":"93"},"PeriodicalIF":1.4,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568621","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: Urinary bladder matrix versus dermal regeneration template for lower extremity wound coverage.","authors":"Helene Retrouvey, Ye Joon Kim, Alexander Lauder, Benjamin D Pesante, Joshua Alan Parry","doi":"10.1007/s00590-025-04204-9","DOIUrl":"https://doi.org/10.1007/s00590-025-04204-9","url":null,"abstract":"","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"35 1","pages":"94"},"PeriodicalIF":1.4,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568748","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact on outcomes of a personalized educational intervention for surgeons in the management of open tibial fractures in Latin America: a before-and-after study in three low- and middle-income countries.","authors":"William Dias Belangero, José Ricardo Lenzi Mariolani, Carlos Mario Olarte Salazar, Jose Arturo Xicará Rodriguez, Mario Rigoberto Portillo Miranda, Miguel Ángel Vides Lemus, Julio Cesar Landrón de la Rosa, Gustavo Nahum Hernández Vivas, Gerardo Alfonso Escobar Soriano, Ricardo Arturo Flores McLeod, Hector José López, Walter Ramón Caraccioli, Nelson Ismael Nolasco Portillo, Ángel Ramón Gil de la Cruz, Jose Francisco Cruz Cardona, Francisco Alberto Santos, Hugo Omar Marroquín Martínez, José Javier Ardón Dubón, Camilo Garcia, Abimael Osias Izaguirre Osorio, Victor Rosario Suazo, Jorge Luis Cruz Coto, Jorge Rojas-Lievano, Emilio Fantin","doi":"10.1007/s00590-024-04172-6","DOIUrl":"https://doi.org/10.1007/s00590-024-04172-6","url":null,"abstract":"<p><strong>Purpose: </strong>Open tibial fractures are a major cause of disability in low- and middle-income countries (LMICs), with high rates of complications such as non-union, infection, and delayed healing. This study aimed to assess the impact of a targeted educational intervention for surgeons on improving clinical outcomes in the management of open tibial fractures in LMICs.</p><p><strong>Methods: </strong>A prospective, non-controlled before-and-after study was conducted across four hospitals in El Salvador, Honduras, and the Dominican Republic. Surgeons participated in a tailored AO Foundation course that included both online and hands-on cadaveric training in open fracture management, with techniques such as debridement, external fixation, and intramedullary nailing. Data were collected pre- and post-intervention, with consecutive sampling of patients based on eligibility criteria. The primary outcomes were return to work, return to recreational activities, and SF-12 physical and mental health scores at 180 days post-treatment. Secondary outcomes included bone healing (RUST score), infection and malunion rates.</p><p><strong>Results: </strong>A total of 159 patients with open tibial fractures were enrolled, with 99 completing the 180-day follow-up (50 pre-intervention and 49 post-intervention). Post-intervention, the use of reamed intramedullary nails for definitive fracture treatment increased significantly (44.0% vs. 67.3%, p = 0.019), and antibiotic regimens were better aligned with recommended practices (p < 0.001). The return-to-work rate improved significantly after the intervention (44.0% vs. 65.3%, p = 0.033), as did participation in recreational activities (28.0% vs. 55.1%, p = 0.006). Fracture healing rates also improved (28.0% vs. 53.1%, p = 0.011). There was a trend towards improvement in the SF-12 Physical Component Score (PCS) (median 36.9 vs. 46.8, p = 0.06), while the SF-12 Mental Component Score (MCS) showed no significant difference between the groups.</p><p><strong>Conclusion: </strong>The tailored educational intervention significantly improved clinical outcomes for patients with open tibial fractures, particularly in return-to-work rates, recreational activity participation, and fracture healing. These findings highlight the potential of tailored educational programs for surgeons in LMICs to enhance patient outcomes, even in resource-limited settings. Further research is needed to evaluate the long-term impact and sustainability of such interventions.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"35 1","pages":"92"},"PeriodicalIF":1.4,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143558703","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}