European Journal of Orthopaedic Surgery and Traumatology最新文献

{"title":"Ten-year migration analysis of a cementless metaphyseal-anchored short femoral stem in total hip arthroplasty.","authors":"Daksha Lässer, Marco Rohner, Christoph Kellner, Christian von Deimling, Näder Helmy, Titus Thut","doi":"10.1007/s00590-026-04937-1","DOIUrl":"10.1007/s00590-026-04937-1","url":null,"abstract":"<p><strong>Purpose: </strong>Short-stem total hip arthroplasty aims to improve metaphyseal load transfer while enabling minimally invasive implantation via the direct anterior approach. Long-term migration and clinical data for these implants remain limited. This study evaluated 10-year femoral stem migration, periprosthetic radiolucency, and clinical outcomes for a cementless, metaphyseal-anchored short stem.</p><p><strong>Methods: </strong>In this single-center retrospective study, 66 hips in 57 patients underwent primary THA with the AMIStem-H (Medacta International) between 2010 and 2012. Stem subsidence was measured serially using EBRA-FCA, radiolucency was graded by Gruen zone, and clinical function was assessed with the Harris Hip Score (HHS).</p><p><strong>Results: </strong>Median stem subsidence increased from 0.51 mm at 3 months to 1.45 mm (IQR 0.72-2.12 mm) at 10 years, with most migration occurring in the first five years; 33.3% of stems subsided > 2 mm. Radiolucency > 2 mm was present in 33.3% of hips, without progression between 5 and 10 years or correlation with clinical outcome. Median HHS at final follow-up was 97, with 89.2% of hips rated good or excellent. Two implants (one stem, one acetabular component) required revision for aseptic loosening.</p><p><strong>Conclusion: </strong>The AMIStem-H demonstrated durable fixation and excellent clinical outcomes at 10 years, with limited, predominantly early axial migration; neither subsidence nor periprosthetic radiolucency was associated with functional outcome. As many patients who received an AMIStem-H are now entering long-term follow-up, surveillance should prioritize new symptoms or progressive radiographic change over isolated, low-magnitude subsidence.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"36 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148851268","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":"Long-term outcomes of radial head arthroplasty for complex radial head fractures.","authors":"Nicolas Vittet, Antoine Piercecchi, Alice Bordet, Omar Rajillah, Ludovic Labattut, Pierre Martz","doi":"10.1007/s00590-026-04928-2","DOIUrl":"10.1007/s00590-026-04928-2","url":null,"abstract":"<p><strong>Purpose: </strong>Radial head arthroplasty is widely used for unreconstructable radial head fractures, particularly in complex elbow trauma, yet long-term outcomes remain poorly documented. This study aimed to assess implant survival and clinical outcomes after radial head arthroplasty performed for traumatic fractures.</p><p><strong>Methods: </strong>This retrospective monocentric study included patients who underwent radial head arthroplasty between 1997 and 2017 with a minimum follow-up of seven years. The primary outcome was implant survival, defined as absence of revision or implant removal. Secondary outcomes included pain (numerical rating scale), range of motion, grip strength, functional scores (MEPS, Broberg-Morrey, QuickDASH), and radiographic findings.</p><p><strong>Results: </strong>Fifty-four patients underwent radial head arthroplasty, and 47 were included in the survival analysis. At a mean follow-up of 142.7 ± 52.5 months, implant survival was 91.5%, with four revisions (8.5%), all within the first postoperative year. Clinical evaluation was available for 28 patients at a mean follow-up of 144.2 ± 56.9 months. Mean pain score was 0.57 ± 1.53, flexion-extension arc 112° ± 18, and grip strength 83.7% of the contralateral side. Mean MEPS was 93.4 ± 12.6, Broberg-Morrey score 82.8 ± 12.9, and QuickDASH 15.4 ± 16.1. Radiographic changes were frequent, including capitellar erosion (60%), heterotopic ossification (60%), and humeroulnar osteoarthritis (55%).</p><p><strong>Conclusion: </strong>Radial head arthroplasty provides excellent long-term implant survival with satisfactory functional outcomes. Failures occur early, whereas long-term function remains preserved despite frequent radiographic degenerative changes.</p><p><strong>Level of evidence: </strong>IV - retrospective cohort study.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"36 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148851236","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":"Long-term outcomes of three-corner fusion versus four-corner fusion in the treatment of SLAC and SNAC wrist stage 3: a single-center retrospective study with a median follow-up of 7 years.","authors":"Solene Armand, Maxime Leroy, Christophe Chantelot, Marc Saab","doi":"10.1007/s00590-026-04927-3","DOIUrl":"10.1007/s00590-026-04927-3","url":null,"abstract":"<p><strong>Purpose: </strong>Partial wrist arthrodesis is currently the gold standard for advanced wrist arthritis secondary to SLAC or SNAC wrist stage 3. Three-corner fusion (3-CF) and four-corner fusion (4-CF) are two available options, but no study has directly compared them with sufficient follow-up in a homogeneous population.</p><p><strong>Methods: </strong>This is a single-center retrospective study comparing the long-term functional outcomes of 3-CF and 4-CF. The primary endpoint was the PRWE score. The following were also collected: QuickDASH score, MAYO wrist score, range of motion, grip strength, pain, satisfaction, non-union rate, secondary osteoarthritis, complications, and revision surgery.</p><p><strong>Results: </strong>Thirty-four patients with SLAC or SNAC wrist stage 3, including 16 3-CF and 18 4-CF, were evaluated, with an overall median follow-up of 86 (53; 139) months. No significant difference was found for adjusted PRWE (47.3 (95% CI 14.7; 75.4) in the 3-CF group and 70.7 (95% CI 49.7; 100.1) in the 4-CF group (p = 0.11)) nor for the adjusted QuickDASH score (30.1 (95% CI 7.9; 52.1) in the 3-CF group and 54.4 (95% CI 36.3; 68.1) in the 4-CF group (p = 0.11)). Complication and revision rates were comparable.</p><p><strong>Conclusion: </strong>Both techniques provide similar functional outcomes. The results are consistent with the concept that limited midcarpal fusion may represent a valid alternative in stage 3 SLAC/SNAC wrist surgery. Level of Evidence IV, retrospective cohort study.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"36 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148842142","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":"Gastric emptying after athletic carbohydrate supplementation: implications for orthopaedic trauma patients.","authors":"Arissa M Torrie, Scott Tindal, Zachary Wilhelm, Karan Kommu, Anthony D Harris, Gerard P Slobogean, Robert V O'Toole, Nathan N O'Hara","doi":"10.1007/s00590-026-04932-6","DOIUrl":"10.1007/s00590-026-04932-6","url":null,"abstract":"<p><strong>Purpose: </strong>Preoperative carbohydrate drinks are standard protocols for elective cases, but are often avoided before orthopaedic trauma surgery over concern for delayed gastric emptying and aspiration risk. Endurance-athlete carbohydrate formulations are engineered for rapid gastric emptying and may offer metabolic support without added aspiration risk. This study assessed gastric emptying in healthy volunteers to establish baseline profiles before trauma-patient testing.</p><p><strong>Methods: </strong>Sixteen healthy adults received 1 or 2 products (Maurten or Precision Fuel & Hydration [PFH]). In carbohydrate gel supplementation phase, participants consumed a gel, fasted ≥ 8 h, then underwent baseline gastric ultrasound. In carbohydrate liquid supplementation phase, they consumed a 500 mL drink, with gastric ultrasounds every 15 min for up to 2 h. The primary endpoint was gastric volume < 1.5 mL/kg (low aspiration risk); the secondary endpoint additionally required clear or empty gastric content. Gastric volumes were compared with linear regression; time to threshold used restricted mean time estimation.</p><p><strong>Results: </strong>In phase 1, 15/16 (94%) had gastric volumes < 1.5 mL/kg after gel (median, 0.7 mL/kg; IQR, 0.5 to 1.1), with no significant difference between products (mean difference, 0.1 mL/kg; 95% CI - 0.2 to 0.4; p = 0.45). In phase 2, 14/16 (88%) reached the threshold within a restricted mean time of 68 min (95% CI 49 to 88). Maurten reached it 33 min faster than PFH (95% CI 0 to 66; p = 0.05).</p><p><strong>Conclusions: </strong>In healthy volunteers, these gels and drinks reached low-aspiration-risk gastric volumes within clinically meaningful timelines, supporting evaluation for preoperative metabolic support in orthopaedic trauma patients.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"36 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148834306","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":"Influence of patient-related factors and surgeon experience on functional outcomes in conservatively treated proximal humerus fractures: a retrospective cohort study.","authors":"Andrea Pautasso, Chiara Bernardi, Marco Assom, Davide Blonna, Federica Romano, Raffaele Garofalo, Alessandro Marinelli, Paolo Paladini, Filippo Castoldi, Enrico Bellato","doi":"10.1007/s00590-026-04920-w","DOIUrl":"10.1007/s00590-026-04920-w","url":null,"abstract":"<p><strong>Purpose: </strong>Proximal humerus fractures (PHFs) are common in the elderly population, but the optimal treatment strategy remains controversial. This study evaluated the long-term functional outcomes of non-surgically treated PHFs and assessed whether retrospective treatment recommendations made by experienced shoulder surgeons were associated with differences in clinical outcomes.</p><p><strong>Materials and methods: </strong>This retrospective cohort study included 150 PHFs in 149 patients treated nonoperatively between 2020 and 2021. Two-, three-, and four-part fractures with a minimum 12-month follow-up were analyzed. Outcome measures included QuickDASH, Oxford Shoulder Score (OSS), Subjective Shoulder Value (SSV), and SF-12. Demographic characteristics and radiographic fracture features were analyzed. In a second phase, five shoulder surgeons independently reviewed anonymized cases and retrospectively recommended surgical or conservative treatment while blinded to patient outcomes.</p><p><strong>Results: </strong>At a mean follow-up of 32.1 months, younger age, absence of comorbidities, better pre-injury physical status, and dominant limb involvement were independently associated with superior outcomes, whereas the number of fracture fragments did not. Displaced fractures showed worse outcomes than non-displaced fractures. However, among displaced fractures, no significant differences in SSV, OSS, QuickDASH, or SF-12 scores were found between fractures retrospectively considered surgical candidates and those deemed suitable for conservative management.</p><p><strong>Conclusions: </strong>Functional recovery following conservative treatment of PHFs appears to be influenced more by patient-related factors than by fracture morphology or surgeon experience. These findings suggest that carefully selected patients with displaced PHFs can achieve satisfactory outcomes with nonoperative treatment.</p><p><strong>Levels of evidence: </strong>IV.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"36 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13506630/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148819952","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":"Formal joint preparation appears to not be necessary for surgical treatment of ankle fractures with tibiotalocalcaneal nailing: a systematic review.","authors":"Maria LaMontagne, Anthony Baumann, Aryan Anaspure, Isaac Kipfer, Albert Anastasio","doi":"10.1007/s00590-026-04929-1","DOIUrl":"10.1007/s00590-026-04929-1","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study is to examine clinical outcomes among patients who underwent TTC nailing without any formal joint preparation to guide surgical decision-making.</p><p><strong>Methods: </strong>This study was a systematic review using three databases queried through December 27th, 2025. Articles were included if they reported outcomes for at least one cohort of patients undergoing TTC nail for ankle fractures without formal joint preparation. Clinical outcomes examined included reported fracture union rates, complications (infection, hardware related, and amputation), as well as the need for reoperation.</p><p><strong>Results: </strong>Seven articles were included out of 488 articles initially retrieved. Patients (n = 153) had a mean age of 73.8 (9.1) years old with a mean follow-up time of 22.2 (12.6) months. An overall fracture union rate of 85.7% was reported (n = 114 patients out of 133 patients). Studies reported a pooled total complication rate of 27.2% (n = 41 patients out of 151 patients), the most common being infection 17/34 (50%). Reoperation rates for unprepped TTC nailing was overall 17.4% (24/138), with only 1.5% of patients (2/138) reported across all studies requiring revision to formal ankle arthrodesis, suggesting treatment success irrespective of successful fusion.</p><p><strong>Conclusion: </strong>TTC nailing without formal joint preparation may be a reasonable treatment option for ankle fractures in low demand patients with significant comorbidities, with minimal occurrence of reported nonunion requiring revision as well as the added benefit of minimizing incisions and wound complications. More research is needed for corroboration due to low evidence certainty.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"36 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148820005","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":"A modified lateral skin incision reduces wound complications and hospital stay in morbidly obese patients undergoing total knee arthroplasty: a propensity-matched cohort study.","authors":"Ibrahim Mahmoud Abdelmonem, Ahmed Saeed Younis, Sherif Mostafa Abdeldayem, Amr Amal Amin","doi":"10.1007/s00590-026-04912-w","DOIUrl":"10.1007/s00590-026-04912-w","url":null,"abstract":"<p><strong>Background: </strong>This prospective cohort study, with post-hoc 1:1 propensity score matching investigates whether a modified curved lateral skin incision in total knee arthroplasty (TKA) for morbidly obese patients reduces complications. We hypothesized that preserving the medial angiosomal blood supply would decrease wound issues, and a lateralized skin incision would decrease hypesthesia, and kneeling difficulties without impacting operative time or function.</p><p><strong>Methods: </strong>The study evaluated 124 morbidly obese patients undergoing primary TKA, comparing a modified curved lateral skin incision (n = 62) to a standard midline incision (n = 62). Following 1:1 propensity score matching for demographics and preoperative status, a single surgeon performed all procedures using curved lateral skin incision and then medial parapatellar arthrotomies. Patients were followed for 1 year postoperatively. Primary endpoints were wound complication rates and hospital stay length; secondary outcomes included hypesthesia, kneeling ability (VAS), Knee Society Scores (KSS), and operative metrics.</p><p><strong>Results: </strong>Both groups were well-balanced at baseline (SMD < 0.20). The lateral group showed a significantly lower overall wound complication rate (3.2% vs. 19.4%, p = 0.016), exclusively minor, with no major complications. Additionally, this cohort had shorter hospital stays (3.02 vs. 3.48 days, p = 0.021) and a markedly smaller area of hypesthesia. On multivariable logistic regression, the lateral incision was an independent protective factor against wound complications (OR 0.094; 95% CI 0.014-0.643; p = 0.016), while smoking was the strongest independent risk factor (OR 48.95; 95% CI 4.958-483.4; p < 0.001).</p><p><strong>Conclusion: </strong>In morbidly obese patients undergoing TKA, a modified curved lateral skin incision significantly reduces wound complications, hospital stay, and anterior knee hypesthesia compared to the standard midline approach. While the lateral technique improves early kneeling ability, long-term functional outcomes remain equivalent. The study concludes that the lateral incision is an effective strategy for this high-risk population.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"36 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148814828","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":"Vertebral body expansion and percutaneous short-segment posterior fixation of thoracic and lumbar fractures requiring corpectomy: a retrospective single-center study.","authors":"Samy Chaachoua-Mouffak, Maureen Pere, Josephine Mas, Sarah Uneisi, Gael Kerschbaumer, Jérôme Tonetti, Mehdi Boudissa","doi":"10.1007/s00590-026-04931-7","DOIUrl":"10.1007/s00590-026-04931-7","url":null,"abstract":"<p><strong>Background: </strong>Thoracic and lumbar fractures with a Load Sharing Classification (LSC) score ≥ 7 are considered at high risk of failure after isolated short posterior fixation, which historically led to systematic anterior reconstruction by corpectomy with substantial morbidity. Minimally invasive vertebral body expansion combined with short posterior fixation may restore anterior column support while limiting surgical aggressiveness. However, data remain limited for fractures with high LSC scores. This study addressed the following questions: (1) Does the combined strategy reduce the failure rate in thoracolumbar « burst » fractures with LSC ≥ 7? (2) Does it provide significant and sustained radiological correction at 1 year? (3) Are functional outcomes satisfactory at final follow-up?</p><p><strong>Hypothesis: </strong>The combination of percutaneous short posterior fixation and anterior vertebral body expansion reduces the expected failure rate in fractures with LSC ≥ 7 while providing satisfactory radiological and functional outcomes.</p><p><strong>Patients and methods: </strong>A retrospective single-center study included 26 consecutive patients presenting with thoracic or lumbar burst fractures and LSC ≥ 7, treated between 2018 and 2025 with percutaneous short-segment posterior fixation combined with vertebral body expansion using SpineJack®. Failure was defined as secondary corpectomy or implant removal due to mechanical failure. Radiological parameters-local kyphosis (LK), regional kyphosis (RK), and vertebral height (VH)-were measured preoperatively, immediately postoperatively, and at 12 months. Functional outcomes included the Oswestry Disability Index (ODI) and visual analog scale (VAS). The minimum follow-up was 12 months.</p><p><strong>Results: </strong>One patient (3.8%) required secondary corpectomy. Significant postoperative correction of LK, RK, and VH was observed. At 1 year, RK remained stable, whereas a moderate but significant loss of LK correction (p = .002) and VH restoration (p = .004) occurred, without functional impact. Median ODI was 5 [0.5-16] and median VAS was 0.5 [0-1.75]. Operative sequence did not influence radiological or functional outcomes.</p><p><strong>Discussion: </strong>In thoracolumbar burst fractures with high LSC scores, the combined minimally invasive strategy was associated with a low failure rate and maintenance of regional sagittal alignment at 1 year. Restoration of anterior column support using vertebral expansion may represent an alternative to systematic anterior reconstruction. Comparative prospective studies are warranted.</p><p><strong>Level of evidence: </strong>IV: Retrospective single-center study.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"36 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148814845","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":"Prophylactic femoral neck fixation in distal femur fractures: evaluating protection against ipsilateral hip fracture.","authors":"Brian D Rust, Daniel E Pereira, David W Barton, Mitchel R Obey, Jenna-Leigh Wilson, Christopher M McAndrew, Marschall B Berkes","doi":"10.1007/s00590-026-04814-x","DOIUrl":"10.1007/s00590-026-04814-x","url":null,"abstract":"<p><strong>Purpose: </strong>Distal femur fractures occur in older, osteoporotic patients and carry a measurable risk of subsequent ipsilateral hip fracture. Prophylactic femoral neck screw placement is believed by many to mitigate this risk, but clinical evidence is limited. This study evaluates the association between prophylactic femoral neck fixation after distal femur fracture and future ipsilateral hip fracture.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted at a single Level 1 tertiary trauma center between 2018 and 2024. Adult patients (≥ 18 years) with AO 33A/B/C fractures and Su type 1-3 periprosthetic fractures of the distal femur fracture treated with operative fixation were included. Patients with pathologic fractures, prior hip arthroplasty, or isolated antegrade intramedullary nailing were excluded. Treatment was classified by the presence or absence of ipsilateral prophylactic femoral neck screw fixation. The primary outcome of interest was the incidence of subsequent ipsilateral hip fracture.</p><p><strong>Results: </strong>Of 395 patients, 163 (41%) received prophylactic femoral neck fixation. The prophylactic screw (PS +) cohort included more female patients (81.0% vs. 68.5%, p = 0.006) and more periprosthetic fractures (65.0% vs. 35.8%, p < 0.001). Fixation constructs differed significantly, with nail-plate combinations predominating in the PS + group (69.1% vs 26.4%, p < 0.001). Six patients (1.5%) sustained an ipsilateral hip fracture. No difference was observed in the incidence of ipsilateral hip fracture by prophylactic femoral neck fixation (1.2% vs 1.7%, p = 0.691) or fracture-free survival (p = 0.802).</p><p><strong>Conclusion: </strong>Prophylactic femoral neck screw placement was not associated with a reduced rate of ipsilateral hip fracture after distal femur ORIF. Hip fractures occurred in both groups, suggesting that screw placement alone may not be independently protective.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"36 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13498633/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148800893","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":"Toxic optimism in clinical trial design.","authors":"Angelina T Lam, Gerard P Slobogean, Nathan N O'Hara","doi":"10.1007/s00590-026-04911-x","DOIUrl":"10.1007/s00590-026-04911-x","url":null,"abstract":"","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"36 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148800929","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}