European Journal of Orthopaedic Surgery and Traumatology最新文献

{"title":"Use of expandable lateral lumbar interbody devices to restore disc height and segmental lordosis: a cadaveric study.","authors":"Luiz Pimenta, Gabriel Pokorny, Sarah Miles","doi":"10.1007/s00590-026-04771-5","DOIUrl":"https://doi.org/10.1007/s00590-026-04771-5","url":null,"abstract":"<p><strong>Introduction: </strong>Lateral lumbar interbody fusion (LLIF) is a well-established and efficient technique for treating various thoracolumbar spine pathologies. However, in some scenarios, the amount of segmental lordosis achieved is insufficient. Two main strategies have been used to address this: disruption of the anterior longitudinal ligament (ALL) via anterior column realignment and, more recently, the use of expandable interbody cages that allow intraoperative adjustment of segmental lordosis without requiring ALL release.</p><p><strong>Methods: </strong>Twelve expandable lateral interbody devices were placed in seven fresh-frozen cadaveric specimens in the prone position. Segmental lordosis (degrees), anterior disc height, and posterior disc height (both in arbitrary units normalized to the L4 vertebral body height) were assessed before and after cage expansion. Because of the small number of clusters, generalized estimating equations (GEE) with Mancl-DeRouen small-sample correction were used as the primary analysis; disc height ratios were modeled on the log scale and the lordosis angle on a Gaussian scale.</p><p><strong>Results: </strong>Seven specimens were included in the study. Two patients underwent three-level instrumentation, one underwent two-level instrumentation, and four underwent one-level instrumentation, totaling 12 instrumented levels. The mean segmental lordosis increased from 4.5° (± 4.3°) pre-expansion to 11.8° (± 4.2°) post-expansion. Small-sample-corrected GEE models confirmed significant postoperative improvements across all three outcomes: segmental lordosis increased by a mean of 7.25° (post-pre; 95% CI, 1.6-12.9; p = 0.020), posterior disc height by 61% (post/pre ratio, 1.61; 95% CI, 1.30-1.92; p < 0.0001), and anterior disc height by 122% (post/pre ratio, 2.22; 95% CI, 1.31-3.12; p = 0.001). Complete ALL rupture occurred in two of the 12 levels (17%).</p><p><strong>Conclusion: </strong>Within the limitations of a small cadaveric feasibility study, the placement of an expandable lateral interbody device in the prone position was associated with immediate increases in segmental lordosis and both anterior and posterior disc heights. These findings should be considered exploratory and hypothesis-generating in nature. Because the study design cannot separate the effect of cage expansion from that of prone positioning and because no static cage control was included, adequately powered prospective clinical studies are required before any claim of superiority can be made.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"36 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147864746","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":"Weight based dosing of prophylactic enoxaparin was not associated with reduced venous thromboembolism events following open reduction and internal fixation of acetabular fractures.","authors":"Patrick Nian, Anna Meyer, Mohamed Said, Roberto Hernandez-Irizarry, Adam Boissonneault, Michael Maceroli","doi":"10.1007/s00590-026-04770-6","DOIUrl":"https://doi.org/10.1007/s00590-026-04770-6","url":null,"abstract":"<p><strong>Purpose: </strong>To compare venous thromboembolism (VTE) events in patients undergoing open reduction and internal fixation (ORIF) of acetabular fractures who did and did not receive weight-based dosing of prophylactic enoxaparin.</p><p><strong>Methods: </strong>This retrospective cohort study included patients with acetabular fractures treated with ORIF between 2013 and 2020 at a single level-1 trauma center. Patients with pre-existing VTE, allergy, no enoxaparin use, or receipt of other prophylactic agents were excluded. Patients were categorized as having received appropriate or inappropriate weight-based enoxaparin dosing based on institutional BMI-tiered protocol. The primary outcome was incidence of VTE, including deep vein thrombosis (DVT) and pulmonary embolism (PE). Group comparisons were performed with Pearson's Chi-square, and binomial logistic regression was used to adjust for additional VTE risk factors.</p><p><strong>Results: </strong>Among 363 patients, 198 (54.5%) received appropriate weight-based dosing and 165 (45.5%) did not. Overall, 20 patients (5.5%) developed VTE (4 PE, 11 DVT, 3 both PE and DVT). Of these, 13 had received appropriate dosing. VTE incidence did not differ significantly between groups (6.6% vs. 4.2%, p = 0.334). Rates of isolated PE, isolated DVT, and combined events were also not significantly different (all p > 0.05). Logistic regression confirmed no significant association between weight-based dosing and VTE when adjusting for patient and clinical risk factors.</p><p><strong>Conclusions: </strong>Only half of patients with operative acetabular fractures received appropriate weight-based dosing of enoxaparin. Weight-based dosing was not associated with reduced VTE incidence, suggesting that receipt of prophylaxis itself may be the most important factor. Larger studies are warranted to verify these findings.</p><p><strong>Level of evidence: 3: </strong></p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"36 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845590","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":"Evaluation of preoperative screw planning and X-ray simulation for iliosacral and transsacral screw placement.","authors":"Stien Hoskens, Kobe Bamps, Michiel Herteleer","doi":"10.1007/s00590-026-04768-0","DOIUrl":"https://doi.org/10.1007/s00590-026-04768-0","url":null,"abstract":"<p><strong>Objectives: </strong>The percutaneous placement of iliosacral (IS) and transsacral (TS) screws has become a standard practice for the treatment of pelvic fractures. Due to the complex sacral anatomy, accurate screw placement is essential to avoid complications, such as neurovascular injury. The goal of this study was to quantify the deviation between planned and executed screw trajectories and to identify associated factors.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study on treating 51 patients with pelvic fractures from August 2021 to December 2023, using a total of 95 IS and TS screws. Preoperative planning was performed to generate a volume-rendered reconstruction that replicates standard intraoperative fluoroscopic views (lateral, inlet, outlet). These simulated images served as references during surgery. Postoperative Computed Tomography (CT) data were integrated with the preoperative plan to quantify screw deviations through accuracy metrics.</p><p><strong>Results: </strong>Median deviation from the planned entry point was 8.8 mm (6.2-12.8) for IS and 6.2 mm (4.2-9.0) for TS. Average distances were 5.7 mm (3.5-8.0) for IS and 4.8 mm ± 2.0 for TS. Angle deviation was 8.2° (4.6-12.8) for IS and 3.9° ± 1.8 for TS. One patient experienced loss of sensibility due to an IS screw conflicting with the L5 nerve root, needing revision surgery. A positive association was observed between BMI and the distance between entry points for TS screws. Learning curve analysis showed no significant change in accuracy over time.</p><p><strong>Conclusion: </strong>Preoperative navigation using volume-rendered virtual imaging could not guarantee a precise positioning of IS and TS screws. Although geometric deviations were observed between planned and placed screws, clinical outcomes were favourable, with a very low complication rate. The technique proved feasible and safe in clinical practice, achieving moderate overall accuracy, and may therefore be particularly valuable for less-experienced surgeons.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"36 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845581","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":"Anterior approach and robotic assistance associated with shorter operative times and lower transfusion requirements in conversion total hip arthroplasty.","authors":"Ryan Riley, Ellen Lutnick, Nicholas Frappa, Jacob Geiger, Amelia Simpson, Aaron Leininger, Evgeny Dyskin","doi":"10.1007/s00590-026-04765-3","DOIUrl":"10.1007/s00590-026-04765-3","url":null,"abstract":"<p><strong>Background: </strong>This study aims to describe a cohort of patients who underwent conversion to total hip arthroplasty (THA), comparing surgical approach and robotic assistance.</p><p><strong>Methods: </strong>Patients ≥ 18 years who underwent conversion to THA between January 1, 2015 and May 6, 2024, were retrospectively reviewed, and additionally contacted via telephone for updated patient reported outcome measures (PROMs), including the Hip Disability and Osteoarthritis Outcome Score, Joint Replacement (HOOS, JR) questionnaire. Surgical approach and robotic assistance were per surgeon preference, with consideration for the approach of the previous hip surgery. Descriptive statistics were calculated, and continuous variables analyzed using the Student's T-Test, the Wilcoxon Ranked Sum Test. Categorical variables were compared using Chi-Squared Tests and Fisher's Exact Tests, and outcomes analyzed with logistic regression in R statistical software.</p><p><strong>Results: </strong>83 patients met inclusion (53% anterior approach; 26.5% robotic assistance). Conversion via anterior approach demonstrated shorter operative times than posterior (by 45.9 min; p < 0.001), in addition to fewer postoperative transfusions (22.7% vs. 53.8%; p = 0.006). Length of stay (LOS), and fluoroscopy time were not significant. When stratified by previous surgery 37 patients were converted from prior intramedullary nail, 16 via the anterior approach. Mean operative time remained shorter (p = 0.003) and transfusion remained less (p = 0.015) compared to posterior conversion in this subset. Robotic assistance was associated with shorter operative times (by 44.9 min p < 0.001), and shorter LOS (p < 0.001). Zero robotic-assisted patients required transfusion within 24 h postoperatively compared to 50.8% of non-robotic cases (p < 0.001), although transfusion risk was not significant considering approach or robotic assistance after multivariable regression controlling for preoperative hemoglobin. PROMs were equivocal between compared groups (mean HOOS Jr 11.0 ± 5.1, response rate 42.2%).</p><p><strong>Conclusion: </strong>Conversion THA demonstrates acceptable outcomes, with documented overall improvements in postoperative function. The anterior approach and robotic assistance were associated with significantly shorter surgical times, and less risk of transfusion, potentially demonstrating some advantage in this conversion scenario, although patient selection may have also influenced outcomes.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"36 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13149557/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between perioperative allogenic blood transfusion and risk of fracture related infection and nonunion in operatively treated tibial shaft fractures.","authors":"Jeremy M Adelstein, Tyler J Moon, Lucas R Haase, Victoria J Nedder, Anna M Swetz, Logan M Good, George Ochenjele, Robert J Wetzel, John K Sontich, Nicholas M Romeo, Joshua K Napora","doi":"10.1007/s00590-026-04759-1","DOIUrl":"10.1007/s00590-026-04759-1","url":null,"abstract":"","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"36 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13128742/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147788028","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"The double impact: insights into bilateral acetabulum fractures\".","authors":"Abhay Elhence, Sandeep Kumar Yadav, Amandeep Bains, Akshant Chandel, Laxman Choudhary, Rajesh Kumar Rajnish, Saurabh Gupta, Samarjanki Rymbai","doi":"10.1007/s00590-026-04763-5","DOIUrl":"https://doi.org/10.1007/s00590-026-04763-5","url":null,"abstract":"","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"36 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147788049","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":"Smoking, medial comminution, and single fixation as predictors of failure in the fixation of native distal femur fractures: a multicenter retrospective study over 109 fractures.","authors":"German Garabano, Andres Juri, Rafael Amadei Enghelmayer, Sebastian Pereira, Cesar Pesciallo, Fernando Bidolegui","doi":"10.1007/s00590-026-04761-7","DOIUrl":"https://doi.org/10.1007/s00590-026-04761-7","url":null,"abstract":"","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"36 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147788058","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":"Comparative glenoid reconstruction strategies in reverse shoulder arthroplasty: a meta-analysis of standard reconstruction, bony increased offset, and metal-augmented increased offset techniques.","authors":"Marc Boutros, Guy Awad, Jean-Pierre Saad, Kamal Bou Hamdan, Raphael Bou Rached, Bassem Elhassan","doi":"10.1007/s00590-026-04758-2","DOIUrl":"https://doi.org/10.1007/s00590-026-04758-2","url":null,"abstract":"","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"36 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147787996","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":"Controlling Nutritional Status (CONUT) score is associated with increased rates of mortality and postoperative complications following hip fracture surgery: a propensity-matched analysis.","authors":"Kyle Stump, Ty Langford, Nicolas Echeverria, Saqib Rehman","doi":"10.1007/s00590-026-04760-8","DOIUrl":"https://doi.org/10.1007/s00590-026-04760-8","url":null,"abstract":"","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"36 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13109153/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147788008","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Posterolateral plating increases peroneal tendon thickness without affecting clinical outcomes: a ultrasonographic comparative study of 76 SER ankle fractures.","authors":"Pedro José Labronici, Jonas Pessoa de Campos, João Pedro de Araújo Almeida, William Dias Belangero, Gustavo Waldolato, Robinson Esteves Pires, Antônio Tufi Neder Filho, Túlio Vinícius de Oliveira Campos, David Rojas, Anderson Freitas, Vincenzo Giordano, Alexandre Leme Godoy-Santos","doi":"10.1007/s00590-026-04736-8","DOIUrl":"https://doi.org/10.1007/s00590-026-04736-8","url":null,"abstract":"","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"36 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13106246/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147788071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}