European Journal of Orthopaedic Surgery and Traumatology最新文献

{"title":"Hamate metacarpal injury: a case series and suggested algorithm for treatment.","authors":"Mojahed Sakhnini, George Karkabi, Andrei Nassar, Raphael Lotan, Oded Hershkovich","doi":"10.1007/s00590-025-04275-8","DOIUrl":"https://doi.org/10.1007/s00590-025-04275-8","url":null,"abstract":"<p><strong>Introduction: </strong>Ulnar-sided carpometacarpal fractures and fracture-dislocations are relatively rare but significant injuries due to their impact on hand function. Hamate metacarpal injury represents a trauma to the ulnar corner of the hand. It could lead to fracture of the base of the fourth and fifth metacarpals with associated dislocation. The fourth and fifth carpometacarpal joints have a unique saddle-shaped structure consisting of the metacarpal bases and the distal articular surfaces of the hamate bone. This anatomical design ensures high congruence and significant stability while allowing a variety of movements essential for grip strength and hand dexterity. In this case series, we suggest the term \"hamate metacarpal injury\" to describe this injury better, as the injury includes dislocation, fracture-dislocation, or impaction to the joint.</p><p><strong>Methods: </strong>We present and discuss six cases representing the various forms of this injury and the surgical approach and outcome. We propose a classification to sort the different injury patterns and help build a surgical plan.</p><p><strong>Results: </strong>All six cases recovered with good outcomes. All patients gained a full range of motion with a powerful grip.</p><p><strong>Conclusion: </strong>The hamate metacarpal injury classification introduces a structured, mechanism-based, and treatment-oriented approach to a complex, often overlooked injury pattern. While further validation in larger cohorts is needed, this system has the potential to streamline diagnosis, guide appropriate interventions, and improve patient outcomes in US-CMC injuries.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"35 1","pages":"151"},"PeriodicalIF":1.4,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143812631","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":"Porous threaded titanium implant screws have higher insertional torque compared to standard screws.","authors":"Andrew P Collins, Stephen J Wallace, Graham J DeKeyser, David W Polly, Reza Firoozabadi","doi":"10.1007/s00590-025-04279-4","DOIUrl":"10.1007/s00590-025-04279-4","url":null,"abstract":"<p><strong>Purpose: </strong>Posterior pelvic ring screw back out and loss of fixation may result from poor screw purchase, prevalent in geriatric pelvic ring injuries where the cancellous bone is often osteoporotic. To reduce screw back out, there has been increasing use of porous threaded titanium implant (PTTI) screws for posterior pelvic fixation rather than standard cannulated, buttress threaded screws. This study aims to assess the insertional torque of PTTI screws compared to standard cannulated screws as there is limited evidence regarding the biomechanical fixation profiles among screws.</p><p><strong>Methods: </strong>Fifteen orthopedic trauma surgeons inserted screws into a validated surrogate for osteoporotic cancellous bone. Insertional torque was measured during screw placement in three separate scenarios for each surgeon: (1) placement of a standard 7.3 mm (mm) screw into a new bone model, (2) placement of a PTTI screw into a new bone model, and (3) placement of a PTTI screw through a previously placed 7.3 mm screw hole from which it was removed (rescue screw). The insertional torque was calculated across all surgeons and analyses were conducted comparing scenarios (1) and (2), and (1) and (3).</p><p><strong>Results: </strong>The average insertional torque of 7.3 mm screws was 0.358 ± 0.223 Nm, and the maximum insertional torque was 0.627 ± 0.365 Nm. The average insertional torque for the PTTI screws was 0.929 ± 0.551 Nm, 2.59 times more than that of the 7.3 mm screw (p < 0.001) while the maximum insertional torque was 1.877 ± 0.671 Nm, 2.99 times that of the standard screw (p < 0.001). When placed into the prior 7.3 mm screw hole (rescue), the PTTI screws generated an average insertional torque of 0.711 ± 0.405, still 1.99 times greater than that of the 7.3 mm screw (p < 0.001), and maximum torque of 1.607 ± 0.427 Nm, 2.56 times greater than the standard screw (p < 0.001).</p><p><strong>Conclusion: </strong>Significantly greater maximum and average insertional torque were generated with the PTTI screws compared to the standard screws, even when used as a rescue screw in cancellous bone models. Further studies assessing clinical outcomes and failure rates with PTTI screws will better define their clinical utility.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"35 1","pages":"150"},"PeriodicalIF":1.4,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143796531","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":"Comparison of autograft and allograft outcomes in adolescent ACL reconstruction: a propensity score analysis.","authors":"Daniele Screpis, Luca De Berardinis, Fjorela Qordja, Gianluca Piovan, Emanuele Giannini, Antonio Pompilio Gigante, Claudio Zorzi","doi":"10.1007/s00590-025-04244-1","DOIUrl":"10.1007/s00590-025-04244-1","url":null,"abstract":"<p><strong>Purpose: </strong>To assess 3-year clinical and functional outcomes, complication rates and graft survival in adolescents with closed growth plates subjected to primary unilateral anterior cruciate ligament reconstruction (ACLR) with a hamstring autograft or an allograft. The failure rate reported in the literature reaches up to 20%.</p><p><strong>Methods: </strong>We reviewed the records of 170 patients subjected to ACLR with a single-bundle autograft or an allograft from 2017 to 2020 with 3-year follow-up. Application of 1:2 Propensity Score Matching (PSM) considering age, sex, body mass index, injury to surgery interval, graft diameter and pre-injury Tegner Activity Scale (TAS) scores and Lysholm Knee Score (LKS) yielded 38 allografts and 62 autografts. We compared functional outcomes using the TAS, LKS and International Knee Documentation Committee (IKDC) at 18 and 36 months and the failure rates, defined as need for revision surgery, before and after PSM.</p><p><strong>Results: </strong>Mean age ranged from 15.8 (standard deviation [SD], 1.2) to 15.9 (SD, 0.9) years and the pre-injury TAS ranged from 7.3 (SD, 1.0) to 7.3 (SD, 1.2) in allograft and autograft patients, respectively. Analysis of the LKS, TAS and IKDC values demonstrated comparable levels both before and after PSM, except for the pre-matching IKDC score and the post-matching TAS score at 36 months, which were significantly higher in autograft than allograft patients (p = 0.024 and p = 0.039, respectively). As regards graft failure, before PSM significantly more allografts (12/54) than autografts (5/116) required revision surgery (p < 0.001). After matching, the difference (6/38 vs 3/62, p = 0.079) was no longer significant.</p><p><strong>Conclusion: </strong>Our cohort of active adolescent who underwent primary unilateral ACLR had a higher absolute number of failures in the allograft group compared to the autograft group, emphasizing the need for careful clinical consideration. However, after applying PSM, this difference, while numerically still present, lost statistical significance. This finding may suggest that when an allograft is deemed the most appropriate choice based on patient characteristics, its use may not necessarily expose the patient to a definitively higher risk of failure.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"35 1","pages":"149"},"PeriodicalIF":1.4,"publicationDate":"2025-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11972989/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143796460","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":"Surgical treatment of fibrous dysplasia in the proximal femur: a literature review.","authors":"Tiago Soveral Pereira, Nuno Malheiro, Daniel Gonçalves, Catarina Rodrigues, Paulo Jorge Gonçalves","doi":"10.1007/s00590-025-04271-y","DOIUrl":"https://doi.org/10.1007/s00590-025-04271-y","url":null,"abstract":"<p><strong>Purpose: </strong>Fibrous dysplasia is an uncommon disease with heterogeneous presentations and patterns of bone involvement. Lesions around the proximal femur are the most common. The article reviews the different surgical options described in the literature and summarizes recent recommendations in managing proximal femoral lesions.</p><p><strong>Methods: </strong>A comprehensive review of the literature was conducted to analyze surgical techniques, including curettage with bone grafting, osteotomies for deformity correction, fixation methods for fractures, and total hip arthroplasty (THA).</p><p><strong>Results: </strong>Curettage and bone grafting, while traditionally used, are largely discouraged due to high recurrence rates and limited efficacy. Osteotomies, particularly valgus intertrochanteric and subtrochanteric osteotomies, are effective for correcting deformities such as the Shepherd's crook deformity, with intramedullary fixation currently being considered the gold standard. Fracture fixation remains individualized, with a range of implants, including intramedullary nails and fixed-angle devices, chosen according to the fracture pattern, localization of the lesion within the proximal femur and patient age. THA is a viable option for end-stage osteoarthritis as well as select cases of acute fractures, with cementless components, augmented by bone grafts when necessary, showing favorable results.</p><p><strong>Conclusions: </strong>Surgical management of proximal femoral FD is multifaceted and tailored to individual patient presentations. Despite advancements, there is still no standardized approach, emphasizing the need for high-quality studies to establish consensus guidelines.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"35 1","pages":"148"},"PeriodicalIF":1.4,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143789201","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":"Assessing the utility of routine postoperative radiographs in pelvic and acetabular trauma Surgery.","authors":"Alexander Berk, Logan Good, Harkirat Jawanda, Samuel Florentino, Spencer Albertson, Robert Clark, Marsalis Brown, Grant Nelson, Robert Wetzel","doi":"10.1007/s00590-025-04266-9","DOIUrl":"https://doi.org/10.1007/s00590-025-04266-9","url":null,"abstract":"<p><strong>Purpose: </strong>Early postoperative x-rays are frequently ordered after fracture fixation surgery without clear indication. The purpose of this study was to investigate the utility of early formal x-rays compared to intraoperative fluoroscopy in patients undergoing surgical fixation of pelvic and acetabular fractures.</p><p><strong>Methods: </strong>Adult patients undergoing surgical fixation of pelvic and acetabular fractures at a Level 1 Trauma Center were identified. Early postoperative x-rays were defined as x-rays ordered within 48 h of surgery without clear indication. Two blinded orthopedic surgeons assessed x-rays and fluoroscopic imaging for reduction quality (within 2 mm of anatomic) and accuracy of implant placement. Accuracy of implant placement was categorized as safe, suspicious, or definite implant malposition.</p><p><strong>Results: </strong>Patients received early postoperative x-rays in 117 cases (53.9%) and fluoroscopy only in 100 cases (46.1%). Among patients undergoing postoperative x-ray, 100% of reductions deemed to have imperfect reduction quality were also deemed to be imperfect on intraoperative fluoroscopy. Similarly, 100% of implants deemed to be of inconclusive safety on postoperative x-ray were also deemed inconclusive on intraoperative fluoroscopy. Considering all patients, 4/117 (3.4%) in the postoperative x-ray group experienced an unplanned change of care within 1 week of surgery vs. 1/100 (1.0%) in the fluoroscopy only group (p = 0.38).</p><p><strong>Conclusion: </strong>The acquisition of early postoperative x-rays and implant placement accuracy are not reliable predictors of change in care among patients with pelvic and acetabular fractures. Early postoperative x-rays may be unnecessary and should only be ordered with clear clinical indications to improve cost-effectiveness and reduce radiation exposure.</p><p><strong>Level of evidence: </strong> Retrospective cohort study; III.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"35 1","pages":"146"},"PeriodicalIF":1.4,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143781528","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":"Overcoming the weight of reconstruction-anterolateral thigh flap reconstructions of the weight-bearing surface within the foot. Outcome assessment using foot function index.","authors":"Jakub Opyrchal, Dominika Krakowczyk, Daniel Bula, Krzysztof Dowgierd, Lukasz Krakowczyk","doi":"10.1007/s00590-025-04270-z","DOIUrl":"https://doi.org/10.1007/s00590-025-04270-z","url":null,"abstract":"<p><strong>Purpose: </strong>Weight-bearing region among the plantar surface of the foot is critical for proper functioning of the lower limb and serves as a point of resistance and support for the weight of the whole body. However, when foot injury is more complex as well as involves exposure of bones, tendons or joints-the adequate soft tissue coverage is needed to facilitate healing and prevent future cutaneous fistulas. Free flaps meet all of these criteria and with current advances within the field of microsurgery-it is not disfiguring, nor does it bring any additional burden to the patient.</p><p><strong>Methods: </strong>Informations concerning extensive plantar reconstructions in adolescent patients, using free fasciocutaneous flaps were gathered retrospectively by the authors. The mean follow-up was 47 months. To examine the functional outcome-all patients patient were assessed using foot function index (FFI).</p><p><strong>Results: </strong>In all cases soft tissue coverage of the defect and appropriate function were provided. No postoperative complications were reported apart from minor pressure ulcer which was treated conservatively. The mean FFI score was 8.9%, which is considered as a very good functional outcome. No patient reported cutaneous fistulas in the late postoperative period.</p><p><strong>Conclusions: </strong>Reconstructions of the weight-bearing surface of the foot with anterolateral thigh free flaps provide durable and functionally satisfactory outcome. However, in some cases they may require flap adjustment in the second surgical procedure, to fit the healthy, untreated foot. In all cases, the outcome was fully accepted both by young patients as well as their parents.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"35 1","pages":"147"},"PeriodicalIF":1.4,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143781655","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":"Osteonecrosis of the femoral head: treatment before the collapse. Experience with decompression and biological therapy.","authors":"Yuri Lara-Taranchenko, Iñaki Mimendia, Víctor Barro, María Guzmám, Margalida Hernández, Andrés Aliaga-Martínez, Diego Soza, Diego Collado, Ernesto Guerra Farfán, Alejandro Hernández","doi":"10.1007/s00590-025-04257-w","DOIUrl":"10.1007/s00590-025-04257-w","url":null,"abstract":"<p><strong>Introduction: </strong>Osteonecrosis is a disabling condition and one of the most frequent causes of hip arthroplasty in the young population. Early detection and treatment in stages prior to femoral head collapse are essential to prevent progression and conversion to total hip arthroplasty (THA). The present study aims to demonstrate the results obtained in the treatment of patients with initial stages of ONFH, treated with a decompression system that associates biologic therapy (platelet-rich plasma and mesenchymal stem cells) (PERFUSE).</p><p><strong>Methodology: </strong>Retrospective unicentric study, in which all patients with ONFH treated with decompression of the necrotic area and biological therapy between May 2018 and May 2023, was collected. Demographic data of the patients (age and gender), risk factors for AVN, area of necrosis (Kerboul), ARCO classification, collapse rate, and conversion to THA were obtained.</p><p><strong>Results: </strong>Twenty-four patients with ONFH were treated using the PERFUSE system. The mean age was 47.67 years old, and the mean follow-up was 26.1 months. The mean improvement in the modified Harris Hip Score (mHHS) was 10.11 (from 70.79 to 80.56; p = 0.018). Patients who developed femoral head collapse had worse mHHS scores. Six patients (25%) progressed to femoral head collapse, of which 2 (8.33%) were converted to total hip arthroplasty (THA). The probability of collapse-free survival at 12 months was 90.9% (SD 6.2; 95%CI, 79.5%-100%), and at 18 months, it was 85.2% (SD 8.0; 95%CI, 70.9%-100%), and at 24 months, it was 65.7% (SD 11.7; 95%CI, 46.3%-93.2%).</p><p><strong>Conclusion: </strong>Core decompression with bone aspirate marrow and platelet-rich plasma can enhance bone regeneration and delay femoral head collapse, especially when implemented in early-stage ONFH. In this sense, combining both, core decompression with biological support can offer a promising approach for managing early-stage ONFH. Despite encouraging outcomes, further research is needed to optimize treatment protocols and evaluate long-term efficacy.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"35 1","pages":"145"},"PeriodicalIF":1.4,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143774708","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":"Does surgical approach matter? Evaluating patient-reported outcomes in bilateral staged total hip arthroplasty.","authors":"Nicola Corradi, Alberto Trimarchi, Fabio Moreschini, Ilaria Martini, Alessandro Lorenzo Soldati, Andrea Colombelli","doi":"10.1007/s00590-025-04273-w","DOIUrl":"https://doi.org/10.1007/s00590-025-04273-w","url":null,"abstract":"<p><strong>Purpose: </strong>This study examines the impact of surgical approach on patient-reported outcomes in staged bilateral total hip arthroplasty (THA) performed in same patient using two different approaches: the direct anterior approach (DAA) on one side and posterolateral approach (PL) on other side.</p><p><strong>Methods: </strong>A retrospective analysis of 41 patients evaluated pain relief and functional outcomes using patient-reported outcome measures (PROMs) at 7 days, 6 months, and 12 months postoperatively.</p><p><strong>Results: </strong>The DAA demonstrated significantly better pain relief and functional outcomes during the first 7 days after surgery. However, no significant differences were found between the two approaches in long-term outcomes at 6 and 12 months.</p><p><strong>Conclusion: </strong>While the DAA may provide early recovery advantages, both approaches achieve comparable long-term results. The DAA could be a preferable option for patients prioritizing quicker recovery. Further research with larger sample sizes is warranted to confirm these findings and explore patient preferences.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"35 1","pages":"144"},"PeriodicalIF":1.4,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143765661","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":"Hypertensive status redicts 30-day postoperative complications following open reduction internal fixation of distal radius fractures.","authors":"Emma Smolev, Dorian Cohen, Nishank Mehta, Kenny Ling, Becka Konnayil, Samantha Muhlrad, Edward D Wang","doi":"10.1007/s00590-025-04214-7","DOIUrl":"https://doi.org/10.1007/s00590-025-04214-7","url":null,"abstract":"<p><strong>Background: </strong>The primary objective of this study was to investigate the association between preoperative hypertension and postoperative complications following open reduction internal fixation of distal radius fractures.</p><p><strong>Methods: </strong>All patients who underwent open reduction internal fixation (ORIF) for distal radius fractures (DRF) between 2015 and 2021 were queried from the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database. Postoperative complications were reported within 30 days of procedure. We identified a total of 26,138 patients, and 31.5% (n = 8,225) of patients had hypertension. Hypertension was defined as blood pressure greater than 140/90 as documented in the medical record, requiring the use of an antihypertensive medication within 30 days of the operation. Multivariate logistic regression adjusted for all significantly associated variables was used to identify postoperative complications associated with preoperative systemic hypertension.</p><p><strong>Results: </strong>Characteristics of patients significantly associated with systemic hypertension were age ≥ 65 (p < 0.001), female gender (p < 0.001), body mass index (BMI) ≥ 30 (p < 0.001), American Society of Anesthesiologist (ASA) ≥ 3 (p < 0.001), dependent functional status (p < 0.001), smoking (p < 0.001), non-insulin-dependent diabetes (p < 0.001), chronic obstructive pulmonary disease (p < 0.001), congestive heart failure (p < 0.001), chronic steroid use (p < 0.001), and bleeding disorder (p < 0.001). After controlling for significantly associated variables, postoperative complications significantly associated with systemic hypertensive status were major complication (OR 1.83, 95% CI 1.10-3.05; p = 0.020), urinary tract infection (OR 2.02, 95% CI 1.04-3.90; p = 0.037), and non-home discharge (OR 3.48, 95% CI 2.95-4.10; p < 0.001).</p><p><strong>Clinical relevance: </strong>Preoperative hypertension requiring medication is an independent predictor for major complication, urinary tract infection, and non-home discharge following ORIF for distal radius fractures. A better understanding of preoperative risk factors, such as a patient's hypertensive status, may aid physicians to identify patients at increased risk for postoperative complications and to better counsel patients prior to management of DRF.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"35 1","pages":"143"},"PeriodicalIF":1.4,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143765663","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":"Primary chest wall sarcoma: advances in surgical management and outcomes.","authors":"Shin Tanaka, Eiji Nakata, Tsuyoshi Ryuko, Takuto Itano, Yasuaki Tomioka, Kazuhiko Shien, Ken Suzawa, Kentaroh Miyoshi, Mikio Okazaki, Seiichiro Sugimoto, Toshifumi Ozaki, Shinichi Toyooka","doi":"10.1007/s00590-025-04260-1","DOIUrl":"10.1007/s00590-025-04260-1","url":null,"abstract":"<p><strong>Purpose: </strong>Although rare, primary chest wall sarcomas are complex malignancies necessitating optimal local control and comprehensive treatment. This study aimed to review 9 years of cases of primary chest wall sarcomas at a single institution, focusing on their histology, surgical management, and prognosis.</p><p><strong>Methods: </strong>A retrospective analysis was performed on 19 patients undergoing chest wall resection for sarcoma from 2012 to 2020. Data on demographics, tumor specifics, resection extent, and adjuvant therapies were collected. Surgical and postoperative outcomes were also assessed.</p><p><strong>Results: </strong>The median patient age was 64 years. Chondrosarcoma was the most common histology. R0 resection was achieved in all patients, with early postoperative complications occurring in 11% of the patients. Robust chest wall reconstruction was performed, resulting in minimal respiratory complications. The 5-year overall survival and disease-free survival rates were 94% and 68%, respectively. Tumor size and patient age were significant prognostic factors for local recurrence.</p><p><strong>Conclusion: </strong>Comprehensive surgical resection, coupled with multidisciplinary preoperative planning, achieves favorable outcomes. Patients aged ≥ 70 years and with tumor size ≥ 5 cm (P = .047) should be carefully followed up for local recurrence.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"35 1","pages":"141"},"PeriodicalIF":1.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11961459/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755620","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}