European Journal of Orthopaedic Surgery and Traumatology最新文献

{"title":"Relation between tibia malalignment after tibia nailing and foot pressure pattern.","authors":"Chiranjivi Jani, AnilKumar Sharda, Punit Tank, ShailendraSinh Gohil, Harshil Barot","doi":"10.1007/s00590-025-04335-z","DOIUrl":"https://doi.org/10.1007/s00590-025-04335-z","url":null,"abstract":"<p><strong>Purpose: </strong>Intramedullary (IM) nailing in tibia fractures has been reported to have the potential to cause coronal plane malalignment that can be detrimental to foot pressure distribution and gait characteristics. The purpose of this paper was to explore tibia malalignment after tibia nailing and its association with foot pressure distribution using pedobarographic analysis.</p><p><strong>Methods: </strong>42 patients aged 18-80 years who sustained a tibia shaft fracture and who were operated with IM nailing were divided into three groups based on the degree of post-operative coronal plane angulation of the tibia: valgus malalignment (> 5° lateral angulation), varus malalignment (> 5° medial angulation), and normal alignment (< 5° angulation) as was measured on long leg scanograms. The patient was assessed over dynamic pedobarography system, which calculates the parameters like forefoot/hindfoot peak pressure ratio and PSI (pronation-supination index). The control involved a comparison between the affected foot and the unaffected foot of same patient.</p><p><strong>Results: </strong>Comparing the ratio of forefoot/hindfoot peak pressure and PSI of the three groups, using paired t tests, the mean scores reveal that even with tibial coronal plane malalignment of  < 10°, the overall position of the foot did not differ significantly (p value > 0.5). However, in some patients, the peak pressure distribution in the hindfoot region of the affected side was higher compared to the contralateral side, suggesting Calacaneal gait due to triceps surae injury after initial trauma.</p><p><strong>Conclusion: </strong>There was no difference in the forefoot/hindfoot peak pressure ratio and PSI and the mean of pronation-supination index between valgus, varus, and normal ankle alignment.</p><p><strong>Study design: </strong>A prospective, open-label, retrospective investigation.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"35 1","pages":"210"},"PeriodicalIF":1.4,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144121339","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":"Mapping the importance of each individual element accounted by HOOS and VR-12 on 1-year patient satisfaction after primary total hip arthroplasty: a prospective institutional analysis.","authors":"Brian Benyamini, Ahmed K Emara, Ignacio Pasqualini, Alvaro Ibaseta, Alison K Klika, Shujaa T Khan, Matthew R Zielinski, Cleveland Clinic Adult Reconstruction Research, Nicolas S Piuzzi","doi":"10.1007/s00590-025-04311-7","DOIUrl":"10.1007/s00590-025-04311-7","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to determine the significance of individual questions from the hip osteoarthritis outcome score (HOOS), HOOS Physical Function Shortform (PS), HOOS Joint Replacement (JR), and Veterans-Rand (VR)-12 mental composite score (MCS) in achieving a patient acceptable symptom state (PASS).</p><p><strong>Methods: </strong>A retrospective study of a prospectively collected cohort of 8236 unilateral elective primary THAs was analyzed. Responses were collected for 18 HOOS questions (pain, PS, and JR) and 6 VR-12 questions used to calculate MCS preoperatively and 1-year postoperatively. PASS was assessed through a positive response to a binary satisfaction-related question. The association between responses to questions and outcomes was examined via multivariable logistic regression models stratified by sex.</p><p><strong>Results: </strong>Sex-specific differences in PASS attainment were observed. In males, a poorer preoperative response in HOOS-PS assessing a patient's difficulty to sit or run comfortably due to their hip was independently associated with reduced odds of achieving PASS at 1-year post-THA (odds ratio [OR] = 0.66 [95% confidence interval [CI] 0.52-0.83], P = 0.001, and OR = 0.83 [0.73-0.95], P = 0.01, respectively). Additionally, a more favorable preoperative response in the MCS metric of feeling down and blue (OR = 1.15 [95% CI 1.03-1.28], P = 0.01) was associated with increased PASS attainment, whereas a poorer preoperative response to having energy (OR = 0.86 [95% CI 0.76-0.97], P = 0.02) was associated with reduced PASS attainment. In females, only a poorer preoperative response in feeling calm and peaceful (OR = 0.87 [95% CI 0.78-0.96], P = 0.01) was associated with reduced odds of PASS attainment.</p><p><strong>Conclusion: </strong>Individual questions of the HOOS and VR-12 MCS were identified as being independently associated with achieving patient satisfaction at one-year following THA. Notably, predictors of satisfaction differed by sex, with both physical function and mental health factors playing a larger role in males, while mental health alone was predictive in females. Understanding specific aspects that matter most to patients, such as mental health, allows healthcare providers to tailor their care to better meet patients' needs. This approach could involve counseling, stress management techniques, and interventions aimed at reducing feelings of depression and anxiety.</p><p><strong>Level of evidence: </strong>III.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"35 1","pages":"209"},"PeriodicalIF":1.4,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12095405/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144121303","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":"Management of sacroiliac joint pain: current concepts.","authors":"Filippo Migliorini, Ludovico Lucenti, Tommaso Bardazzi, Andreas Bell, Federico Cocconi, Nicola Maffulli","doi":"10.1007/s00590-025-04308-2","DOIUrl":"10.1007/s00590-025-04308-2","url":null,"abstract":"<p><strong>Introduction: </strong>Managing sacroiliac joint (SIJ) pain is challenging and unpredictable. There are no internationally accepted recommendations. In light of the lack of global consensus and guidelines and the ongoing advancements in management options, a widely accepted treatment algorithm remains absent. This systematic review updates and evaluates the existing evidence on strategies for managing SIJ pain.</p><p><strong>Methods: </strong>This study followed the guidelines defined in the 2020 PRISMA statement. All clinical studies concerning the clinical management of SIJ pain were considered. Web of Science, PubMed, and Embase were accessed in January 2025 without additional filters or temporal constraints. The risk of bias evaluation and statistical analysis followed the guidelines described in the Cochrane Handbook for Systematic Reviews of Interventions.</p><p><strong>Results: </strong>Fifteen randomised controlled trials, 13 clinical trials, and 10 retrospective studies were included. Data from 2666 patients (1429 women) were retrieved. The mean length of follow-up was 14.7 ± 15.2 months. The mean age was 54.0 ± 5.8 years, and the mean BMI was 28.5 ± 2.5 kg/m². Non-surgical options primarily focus on physical therapy to relieve discomfort. Different medications aim to decrease inflammation and pain at the SIJ. Fluoroscopically guided SIJ injections allow for directly administering steroids or mesenchymal stem cells into the joint. Radiofrequency denervation is frequently used to address SIJ pain, while surgical fusion is usually reserved for cases where conservative treatment is ineffective.</p><p><strong>Conclusion: </strong>Managing SIJ pain is challenging due to limited and inconsistent evidence. Treatment progresses from conservative options, physiotherapy, lifestyle changes, and non-steroidal anti-inflammatory drugs to more invasive approaches like injections, radiofrequency denervation, and, in severe cases, surgical management. Research limitations include small sample sizes, short follow-ups, and inconsistent methodologies. Future high-quality studies are needed to establish clear diagnostic and treatment guidelines, compare techniques, and explore new therapies like regenerative medicine.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"35 1","pages":"208"},"PeriodicalIF":1.4,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12095441/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144112716","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":"Evaluation of bony features associated with hip instability in hip dysplasia.","authors":"Takeshi Shoji, Hideki Shozen, Shinichi Ueki, Hiroki Kaneta, Hiroyuki Morita, Yosuke Kozuma, Nobuo Adachi","doi":"10.1007/s00590-025-04336-y","DOIUrl":"10.1007/s00590-025-04336-y","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the morphological and radiographic features of hip instability in hip dysplasia.</p><p><strong>Methods: </strong>Eighty-four patients who had ultrasonography for the assessment of hip instability and computed tomography scan for the assessment of bony morphology were included. The lateral center-edge angle (LCEA), vertical-center-anterior angle (VCA), acetabular roof obliquity (ARO), acetabular head index (AHI), and acetabular version angle (AVA) were calculated as pelvic parameters. Neck shaft angle (NSA), α-angle, femoral offset (FO), and femoral anteversion (FA) were obtained as femoral parameters. The combined anteversion angle (CAA) was defined as the sum of AVA and FA.</p><p><strong>Results: </strong>Pelvic morphology analysis revealed that LCEA, VCA, and AHI were significantly lower, whereas ARO and AVA were significantly higher in the hip instability group. Furthermore, NSA, FO, and CAA were significantly higher in the hip instability group. The cutoff values for LCEA, VCA, and AHI were 17.6°, 34.7°, and 73.6%, respectively. Multivariate analysis revealed that LCEA and VCA were significantly associated with hip instability, with odds ratios of 1.57 and 1.56, respectively. Hip instabilities were associated with lateral/anterior/superior coverage deficiencies in the pelvis and with the NSA, FO, and CAA in the femur. Furthermore, a correlation between pelvic and femoral morphological parameters suggests that hip instability evaluations should include the evaluation of the anterior/lateral coverage of the acetabulum and femoral parameters.</p><p><strong>Conclusion: </strong>Our findings suggest that the LCEA, VCA, and AHI could serve as diagnostic markers for hip instability.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"35 1","pages":"206"},"PeriodicalIF":1.4,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12092558/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144112714","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":"Dehydration independently predicts prolonged hospital stay following aseptic revision total shoulder arthroplasty.","authors":"Steven H Liu, Allen Bramian, Rachel A Loyst, Edward D Wang","doi":"10.1007/s00590-025-04323-3","DOIUrl":"10.1007/s00590-025-04323-3","url":null,"abstract":"<p><strong>Background: </strong>This study investigates the association between preoperative dehydration and 30-day postoperative complications following aseptic revision total shoulder arthroplasty (TSA).</p><p><strong>Methods: </strong>The American College of Surgeons National Surgical Quality Improvement Program database was queried for all patients who underwent aseptic revision TSA from 2015 to 2022. The study population was divided into two groups based on preoperative hydration status: normal (blood urea nitrogen (BUN)/creatinine (Cr) < 25) and dehydration (BUN/Cr ≥ 25). Logistic regression analysis was conducted to investigate the relationship between preoperative dehydration and postoperative complications.</p><p><strong>Results: </strong>Compared to normal hydration, dehydration was associated with a significantly greater likelihood of experiencing any complication (P = 0.004), nonhome discharge (P = 0.002), and length of stay (LOS) > 2 days (P < 0.001). After controlling for potential confounding variables with multivariate analysis, dehydration was independently significantly associated with LOS > 2 days (odds ratio 1.50, 95% confidence interval 1.05-2.14; P = 0.028).</p><p><strong>Conclusion: </strong>Preoperative dehydration status is associated with a greater rate of early postoperative complications and is an independent predictor of LOS exceeding two days following aseptic revision TSA. A better understanding of dehydration as a risk factor for postoperative complications may help surgeons better select surgical candidates and improve surgical outcomes in the setting of aseptic revision TSA.</p><p><strong>Level of evidence: </strong>Level III; Retrospective Cohort Comparison; Prognosis Study.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"35 1","pages":"207"},"PeriodicalIF":1.4,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12092495/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144112712","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 sacroiliac joint reduction quality and acetabular fracture alignment: a comparative study of the lateral window and pararectus approaches.","authors":"Ping-Jui Tsai, I-Jung Chen, Chih-Yang Lai, Yung-Heng Hsu, Ying-Chao Chou, Steve W N Ueng, Yi-Hsun Yu","doi":"10.1007/s00590-025-04333-1","DOIUrl":"10.1007/s00590-025-04333-1","url":null,"abstract":"<p><strong>Purpose: </strong>Simultaneous ipsilateral sacroiliac joint (SIJ) injury and acetabular fracture are relatively common. Inadequate SIJ reduction may compromise the anatomical alignment of associated acetabular fractures. However, the optimal surgical approach for managing both injuries remains uncertain. In this study, we aimed to compare the efficacy of pelvic ring injury reduction using either the lateral window or the pararectus approach and to analyze associated radiological outcomes in patients with concurrent SIJ injury and acetabular fracture.</p><p><strong>Methods: </strong>This retrospective study included 44 patients who underwent open reduction and internal fixation (ORIF) for SIJ injury. Patients were divided into two groups based on the surgical approach: L group (lateral window of the ilioinguinal approach) and P group (pararectus approach). A subgroup of patients with simultaneous ipsilateral SIJ injury and acetabular fracture was selected for comparative analysis using postoperative computed tomography (CT) to assess SIJ reduction and acetabular fracture alignment.</p><p><strong>Results: </strong>Improvements in SIJ distance on axial and coronal CT planes were observed in both groups, with greater reductions observed in the P group. Among patients with combined injuries, the P group demonstrated significantly improved SIJ reduction in the coronal plane (P = 0.008), which was associated with smaller residual fracture gaps and articular step-offs in the axial, coronal, and sagittal planes.</p><p><strong>Conclusion: </strong>When ORIF is indicated for SIJ injury, the pararectus approach may offer enhanced SIJ reduction in the coronal plane. This technique is also associated with improved acetabular fracture alignment in patients with simultaneous ipsilateral injuries.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"35 1","pages":"205"},"PeriodicalIF":1.4,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12089231/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144095540","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":"Impact of pre-surgical reduction methods on soft tissue healing and surgical timing in ankle fractures.","authors":"Idan Strul, Oren Ben-Lulu, Ranin Simaan, Alexey Semenistyy, Ariel D Levine","doi":"10.1007/s00590-025-04301-9","DOIUrl":"10.1007/s00590-025-04301-9","url":null,"abstract":"<p><strong>Background: </strong>Early closed reduction and immobilization are essential in managing unstable ankle fractures to mitigate soft tissue swelling prior to surgery. This retrospective, single-center, preliminary study compares the effect of two reduction maintenance techniques, plaster U-splinting and Quigley's skin traction suspension, on time to surgery.</p><p><strong>Methods: </strong>A retrospective observational review was conducted on 54 patients (aged 18-65) with unstable ankle fractures (Weber B/C). Surgical timing served as the dependent variable; reduction technique and patient variables were independent variables. Both Bayesian estimation and frequentist methods, including t tests and correlation analyses, were employed.</p><p><strong>Results: </strong>Patients treated with Quigley's skin traction experienced shorter median times to surgery (5.3 days, SD = 2.8) compared to the U-splint group (10.7 days, SD = 3.9). This difference was statistically significant (p < 0.001). Bayesian analysis (posterior mean difference: 5.4 days, 95% CrI: 3.2-7.5; Bayes Factor = 12.6) supported these findings. However, patients in traction were hospitalized throughout, introducing inherent bias.</p><p><strong>Conclusions: </strong>Preliminary findings suggest that the inpatient use of Quigley's technique, likely through continuous elevation and regular monitoring, was associated with shorter time to surgery, though causality cannot be established due to confounding. This advantage must be weighed against the costs of hospitalization and potential complications. More extensive, prospective studies with standardized follow-up and complication reporting are needed.</p><p><strong>Level of evidence: </strong>III.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"35 1","pages":"204"},"PeriodicalIF":1.4,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12089230/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144095472","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":"Postoperative swelling: influence of a negative pressure application in comparison to manual lymphatic drainage after total knee arthroplasty-a randomized controlled trial.","authors":"Maximilian Weber, Johannes Oppermann, Christine Lummer, Klaus Dresing, Sebastian Wegmann, Peer Eysel, Lars Müller, Andreas Harbrecht","doi":"10.1007/s00590-025-04313-5","DOIUrl":"10.1007/s00590-025-04313-5","url":null,"abstract":"<p><strong>Purpose: </strong>Postoperative soft tissue swelling is a significant factor influencing outcome after total knee arthroplasty (TKA). This prospective study aims to investigate the influence of technical device assisted negative pressure therapy (NP) on early functional outcome after TKA. NP was therefore compared to manual lymphatic drainage (MLD).</p><p><strong>Methods: </strong>A total of 50 consecutive patients undergoing primary TKA were enrolled. 25 subjects per group were either treated by conventional MLD or NP. Primary outcome parameter was defined as circumference of the affected limb in cm postoperative up to seven days postoperatively. Secondary outcome parameters were: Duration of hospitalization, subjective perception of pain (measured via visual analogue scale, VAS), affected limb's ROM.</p><p><strong>Results: </strong>NP showed an overall equivalent influence compared to MLD in reducing lower limb swelling, recovering of mobility and length of hospital stay after TKA. Moreover, the application of NP showed a significant decrease in overall pain perception compared to manual lymphatic drainage on day 2 and forth after surgery (p < .05).</p><p><strong>Conclusions: </strong>Our findings show that NP could be a useful device in clinical routine treating postoperative swelling after TKA. Its application is simple and effective for the patient. Particularly given the shortage of healthcare workers and physical therapists, there is a need for supportive measures that NP could fulfil.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"35 1","pages":"202"},"PeriodicalIF":1.4,"publicationDate":"2025-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12086113/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144095476","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":"Comparison of radiographic and functional outcomes of dorsal-only versus combined volar/dorsal plating in AO type C distal radius fracture.","authors":"Mehmet Yalçın, Yusuf Kıratlıoğlu, Furkan Mamak, Uğur Bezirgan","doi":"10.1007/s00590-025-04337-x","DOIUrl":"https://doi.org/10.1007/s00590-025-04337-x","url":null,"abstract":"<p><strong>Introduction: </strong>Distal radius fractures are commonly treated with open reduction and internal fixation, especially in younger adults. This study aims to compare the radiographic and functional outcomes, as well as complications, of dorsal-only plating versus combined volar/dorsal plating in treating AO type C distal radius fractures.</p><p><strong>Methods: </strong>This retrospective study included 18 patients with AO type C distal radius fractures, treated between 2021 and 2024. Patients were divided into two groups: Group A (12 patients) underwent dorsal-only plating, while Group B (six patients) received combined volar/dorsal plating. Radiographic assessments included radial inclination, radial height, palmar tilt, and ulnar variance. Clinical outcomes, including wrist range of motion, grip strength, Quick DASH, and Mayo Wrist Scores, were evaluated. Complications such as extensor tendon irritation, implant removal, and reflex sympathetic dystrophy were documented.</p><p><strong>Results: </strong>Radiographic outcomes were similar between the groups, with no significant differences in radial alignment or joint integrity. Both groups showed significant improvement in joint alignment from preoperative to postoperative evaluations. Clinically, grip strength was significantly higher in Group A (p = 0.037), though wrist range of motion and functional scores (Quick DASH and Mayo Wrist Score) showed no significant differences. Group B exhibited a higher complication rate, including compartment syndrome and reflex sympathetic dystrophy.</p><p><strong>Conclusion: </strong>Dorsal-only plating for AO type C distal radius fractures yields comparable radiographic and functional outcomes to combined volar/dorsal plating, with a lower incidence of complications. This approach may offer a functional advantage in terms of grip strength, and reduced implant-related complications suggest it as a viable treatment option. Further prospective studies are recommended to confirm these findings.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"35 1","pages":"203"},"PeriodicalIF":1.4,"publicationDate":"2025-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144095499","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 early surgery within 48 hours improve clinical outcomes in elderly hip fractures? A matched cohort study of 1776 hip fractures.","authors":"Zachary Chu, Julia Poh Hwee Ng, Tjun Huat Ivan Chua, Sean Wei Loong Ho","doi":"10.1007/s00590-025-04324-2","DOIUrl":"https://doi.org/10.1007/s00590-025-04324-2","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this study was to determine if a delay to surgery of more than 48 h was associated with poorer functional outcomes and increased 1-year mortality rates for elderly hip fractures.</p><p><strong>Methods: </strong>A retrospective review of surgically treated elderly (≥ 60 years old) hip fracture patients in a single institution was conducted. Patients were divided into 2 groups depending on hours from admission to surgery: Group 1 ( ≤ 48 h) and Group 2 (> 48 h); these groups were 1:1 matched for the initial Modified Barthel's Index (MBI) and Charlson Comorbidity Index (CCI).</p><p><strong>Results: </strong>2562 patients were eligible for the study. The cut-point value in a receiver operating curve analysis for 12-month MBI against time to surgery was not robust enough to determine an optimal time for surgery. Group 1 (n = 888) had significantly better MBI scores at 6-months [mean 78.7 (± 19.9) vs. mean 75.5 (± 20.6)] and 1-year [mean 80.4 (± 20.1) vs. mean 76.9 (± 22.3)] (p < 0.001). This difference in MBI scores between the groups did not meet the minimal clinically important difference of 10  points. There was no significant difference in 1-year mortality (3.7% vs. 4.4%) (p = 0.427). Delayed surgery past 48 h significantly increased the risk of post-operative complications. (Urinary tract infection, acute retention of urine and pneumonia) (p < 0.001).</p><p><strong>Conclusion: </strong>Delayed surgery for elderly hip fractures after 48 h increases the risk of acute post-operative complications. There is no increase in 1-year mortality and no clinically important deterioration of MBI if operated on after 48 h.</p><p><strong>Level of evidence: </strong>III.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"35 1","pages":"201"},"PeriodicalIF":1.4,"publicationDate":"2025-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144095505","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}