European Journal of Orthopaedic Surgery and Traumatology最新文献

{"title":"Unrestricted weightbearing and ability to achieve postoperative ambulation after distal femur fracture fixation in elderly patients is not associated with decreased mortality.","authors":"Erin Stockwell, Nathanael Urban, Matthew Hays, Meghan McCaskey, Meghan Maseda, Matthew Mormino, Justin Siebler, Hassan Mir, Sara Putnam","doi":"10.1007/s00590-025-04189-5","DOIUrl":"10.1007/s00590-025-04189-5","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study is to evaluate the association between 1) early postoperative mobilization on 30-day and 1-year mortality in patients ≥ 65 years who underwent fixation of distal femur fractures and 2) postoperative weightbearing instructions and early postoperative mobilization in this patient population.</p><p><strong>Methods: </strong>A multicentre, retrospective review of all patients ≥ 65 years of age who underwent operative fixation of a distal femur fracture between August 2012 and June 2023 at two academic level 1 trauma centres and one academic level 2 trauma centre was conducted. Univariate comparisons and binary logistic regression analyses were performed to identify factors associated with postoperative weightbearing instruction, postoperative mobilization, and mortality.</p><p><strong>Results: </strong>Three hundred and forty-seven patients were included in final analyses, with 347 patients included in the all-comer group and 274 patients included in the isolated distal femur fracture group. After adjusting for demographics and modified 5-factor frailty index (mFI-5) score, unrestricted postoperative weightbearing was associated with achievement of early postoperative mobilization in both the all-comer (p = 0.005, OR = 3.159 [95% CI 1.412-7.067]) and isolated fracture groups (p = 0.001, OR = 4.735 [95% CI 1.869-11.992]). Thirty-day mortality occurred in only 10 patients, therefore, analyses were not independently performed for this time point. After adjusting for demographics, mFI-5 score, and postoperative weightbearing instruction, postoperative mobilization was not associated with survival at one year in neither the all-comer (p = 0.281, OR = 0.589 [95% CI 0.225-1.542] nor isolated fracture groups (p = 0.432, OR = 0.664 [95% CI 0.240-1.841).</p><p><strong>Conclusion: </strong>Patients with unrestricted postoperative weightbearing instructions were more likely to achieve early postoperative mobilization; however, early mobilization after fixation of distal femur fractures in patients ≥ 65 years does not appear to correlate with 1-year mortality.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"35 1","pages":"70"},"PeriodicalIF":1.4,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143411048","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":"Postoperative outcomes linked to congestive heart failure in arthroscopic rotator cuff repair.","authors":"Rachel A Loyst, Steven H Liu, Rustin Mahboubiardakani, Patricia Cerri-Droz, Paul Walker, David E Komatsu, Edward D Wang","doi":"10.1007/s00590-025-04192-w","DOIUrl":"10.1007/s00590-025-04192-w","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to explore potential complications and risk factors associated with arthroscopic rotator cuff repair (aRCR) in patients with congestive heart failure (CHF).</p><p><strong>Methods: </strong>This study examined all individuals who underwent aRCR from 2015 to 2021, sourced from the American College of Surgeons National Surgical Quality Improvement database. The analysis encompassed patient demographics, comorbidities, and 30-day postoperative complications. Logistic regression was employed to analyze the postoperative complications linked to patients with CHF.</p><p><strong>Results: </strong>Compared to patients without CHF, patients with CHF undergoing aRCR were independently associated with a significantly greater likelihood of experiencing any complication (OR 3.21, 95% CI 1.89-5.48; P < .001), sepsis (OR 13.04, 95% CI 2.45-69.31; P = .003), cardiac event (OR 7.76, 95% CI 1.59-37.97; P = .011), readmission (OR 3.61, 95% CI 1.78-7.35; P < .001), and nonhome discharge (OR 5.43, 95% CI 2.27-13.02; P < .001).</p><p><strong>Conclusion: </strong>CHF was identified as an independent risk factor for experiencing any complication, sepsis, cardiac event, readmission, and nonhome discharge in patients undergoing aRCR. The increased risk of postoperative complications in CHF patients after aRCR highlights the need for diligent preoperative management of these patients to reduce the risk of severe complications and enhance surgical outcomes.</p><p><strong>Level of evidence: </strong>Level III; Retrospective Cohort Comparison Using Large Database; Prognosis Study.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"35 1","pages":"71"},"PeriodicalIF":1.4,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143411042","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":"Post-fasciotomy complications in lower extremity acute compartment syndrome: a systematic review and proportional meta-analysis.","authors":"Garikai Kungwengwe, Douglas Donnachie, Kinseng Tong, David Bodansky","doi":"10.1007/s00590-025-04186-8","DOIUrl":"https://doi.org/10.1007/s00590-025-04186-8","url":null,"abstract":"<p><strong>Purpose: </strong>This meta-analysis aims to update the evidence on post-fasciotomy outcomes in lower limb acute compartment syndrome (ACS) by quantifying pooled prevalence rates for amputation and mortality and evaluating the impact of key risk factors.</p><p><strong>Methods: </strong>PRISMA-compliant search of Medline, Embase, CINAHL, and Web of Science was conducted from inception through July 2024. Risk of bias was assessed using the Joanna Briggs Institute and National Institutes of Health tools, with evidence certainty evaluated via the GRADE approach. Prevalence rates with 95% confidence intervals (CI) were calculated using the Freeman-Tukey double arcsine transformation, accounting for between- and within-study variance. Logistic regression models estimated odds ratios (OR) using a random-effects model, with sensitivity analyses excluding low-sample-size studies.</p><p><strong>Results: </strong>Eleven studies encompassing 2504 patients were included. The pooled prevalence of post-fasciotomy mortality was 7.7% (95% CI, 4.6-11.5%) across eight studies, while amputation prevalence was 10.5% (95% CI, 7.8-13.5%) across 10 studies. Vascular compromise increased amputation odds (OR 1.88, 95% CI 1.03-3.43) but showed no statistically significant association with mortality (OR 2.67, 95% CI 0.77-9.24). Early fasciotomy (< 6 h) reduced amputation odds (OR 0.31, 95% CI 0.13-0.75) and showed a modest trend towards lower mortality. Intracompartmental pressure monitoring (ICPM) was associated with reduced amputation odds (OR 0.23, 95% CI 0.10-0.54), although its effect on mortality was inconclusive.</p><p><strong>Conclusion: </strong>This meta-analysis demonstrates that early fasciotomy, particularly within six hours, and ICPM may mitigate amputation risk in lower limb ACS. While vascular compromise significantly increases the risk of amputation, its link to mortality remains uncertain. These findings emphasise the importance of timely surgical intervention and suggest potential benefits of ICPM for risk stratification. However, the reliance on observational studies, aggregate data, and retrospective research limits causal inferences. Further high-quality research is needed to validate these associations and inform clinical decision-making.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"35 1","pages":"69"},"PeriodicalIF":1.4,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143400622","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: Influence of platelet-rich plasma (PRP) analogues on healing and clinical outcomes following anterior cruciate ligament (ACL) reconstructive surgery: a systematic review.","authors":"Jonathon McRobb, Khawaja Hasan Kamil, Imran Ahmed, Fatema Dhaif, Andrew Metcalfe","doi":"10.1007/s00590-024-04171-7","DOIUrl":"10.1007/s00590-024-04171-7","url":null,"abstract":"","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"35 1","pages":"67"},"PeriodicalIF":1.4,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11814046/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143392394","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 elastic properties of the tendinous and capsular layers of the rotator cuff complex using fresh tissue-a biomechanical study.","authors":"Jessica Y Cronje, Nkhensani Mogale, Shavana Govender, Mathys A de Beer, Abrie J Oberholster, Chris McDuling, Rudi Verbeek, Tshifhiwa Nkwenika, Natalie Keough","doi":"10.1007/s00590-024-04168-2","DOIUrl":"10.1007/s00590-024-04168-2","url":null,"abstract":"<p><strong>Background: </strong>Elastic modulus is an important biomechanical component that indicates stiffness or elasticity of biological material. Recently the use of digital image correlation (DIC) in elastic modulus studies on fresh tissue has shown great accuracy in estimating elastic properties; thus, the aim of this study was to investigate the elasticity of capsular and tendinous layers of the rotator cuff complex employing this method.</p><p><strong>Materials and methods: </strong>The supraspinatus, infraspinatus, and subscapularis from eight (n = 8) fresh/frozen tissue shoulders were reverse dissected from their origins. The muscles were separated from one another and dissected to produce 20 × 20 mm tendinous and capsular strips for each muscle. DIC was employed to measure the strain of the tendinous and capsular portions of each of the muscles during tensile testing, and tangent elastic modulus values were obtained.</p><p><strong>Results: </strong>The tendinous layers for supraspinatus, infraspinatus, and subscapularis yielded higher average tangent elastic moduli readings (62.1 MPa, 67.1 MPa, and 59.6 MPa, respectively) compared to their capsular counterparts (29.0 MPa, 32.5 MPa, and 41.5 MPa, respectively).</p><p><strong>Conclusion: </strong>Different elastic moduli findings for the tendinous and capsular layers suggest these layers should be considered independently during surgical repair to avoid biomechanical imbalance which may result if these layers were to be repaired as one singular layer.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"35 1","pages":"68"},"PeriodicalIF":1.4,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11814050/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143392396","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":"Clinical and epidemiological differences in staphylococcal osteoarticular infections: insights for developing hospital-based infection control interventions.","authors":"João Figueiredo, Jorge Lindo, Catarina Chaves, Célia Nogueira","doi":"10.1007/s00590-025-04184-w","DOIUrl":"10.1007/s00590-025-04184-w","url":null,"abstract":"<p><strong>Purpose: </strong>Osteoarticular infections (OAI) are serious clinical conditions with Staphylococcus aureus and Coagulase-negative Staphylococcus (CoNS) responsible for up to two-thirds of cases. This work aimed to compare the epidemiological, clinical, and microbiological characteristics of OAI caused by S. aureus versus CoNS to aid in clinical management and infection control strategies.</p><p><strong>Methods: </strong>A single-centre retrospective study was performed at the Centro Hospitalar e Universitário de Coimbra for the period of January 2011 to December 2021. A total of 458 cases of OAI were gathered. Data was retrieved from medical records and statistical analysis was performed with SPSS.</p><p><strong>Results: </strong>S. aureus accounted for 60.7% of infections, followed by S. epidermidis (29.9%). Independent risk factors for S. aureus infections included being male (p < 0.001; OR = 0.47) and a history of osteomyelitis (p < 0.001; OR = 0.18). In contrast, CoNS infections were associated with older age (p = 0.018), carrying a prosthetic device (p < 0.001; OR = 2.92), and a prior periprosthetic infection (p = 0.023; OR = 1.86). Both groups exhibited significant antimicrobial resistance, with CoNS showing greater resistance to gentamicin, linezolid, teicoplanin and trimethoprim-sulfamethoxazole, while S. aureus was more commonly resistant to clindamycin.</p><p><strong>Conclusion: </strong>Our findings show the distinct characteristics of OAI caused by S. aureus and CoNS, highlighting the need for targeted risk factor management and tailored empiric antibiotic therapy to reduce incidence and improve outcomes.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"35 1","pages":"66"},"PeriodicalIF":1.4,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11807055/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143374962","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":"One-stage posterior-only correction in severe and rigid scoliosis exceeding 90°: radiographic and surgical outcomes.","authors":"Sergio De Salvatore, Leonardo Oggiano, Paolo Brigato, Davide Palombi, Sergio Sessa, Cloe Curri, Caterina Fumo, Gian Mario Sangiovanni, Pier Francesco Costici, Laura Ruzzini","doi":"10.1007/s00590-025-04187-7","DOIUrl":"10.1007/s00590-025-04187-7","url":null,"abstract":"<p><strong>Purpose: </strong>Scoliosis, if left untreated, can lead to severe curvatures exceeding 90°, causing devastating functional impairments. Various surgical methods exist, but the optimal approach is still debated. One-stage posterior spinal fusion (PSF)-only surgery is gaining favor for its comparable outcomes and reduced morbidity. This study, focusing on radiographic and surgical outcomes, evaluates the efficacy and safety of one-stage PSF for scoliosis curves over 90° in pediatric patients.</p><p><strong>Methods: </strong>Thirty-five pediatric patients with scoliosis (Cobb angle ≥ 90°) who underwent one-stage posterior spinal fusion (PSF)-only surgery from January 2020 to December 2023 were included. Patients with idiopathic, neuromuscular, or syndromic scoliosis were included. The primary outcome was the correction rate (CR) of scoliosis curves. Secondary outcomes included major postoperative complications, surgery duration, blood loss, and hospital stay length. Preoperative and postoperative radiographic and clinical data were analyzed.</p><p><strong>Results: </strong>The mean CR for major and minor curves was 65.2 ± 10.5% and 57.9 ± 12.8%, respectively. The mean preoperative and postoperative Cobb angle of major and minor curves was 102.6° and 35.6°, 68.6° and 28.8°, respectively. There were 13 recorded complications, with only one being life-threatening. Mean blood loss was 787 ± 437 ml. Total surgical time was roughly 5 h per case. The mean length of hospital stay (LOS) was 9 days.</p><p><strong>Conclusions: </strong>PSF-only surgery for severe scoliosis over 90° is effective and safe. It supports using posterior-only methods as a viable alternative to combined approaches, suitable for patients with even more severe curves when their condition allows.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"35 1","pages":"65"},"PeriodicalIF":1.4,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143366778","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":"Metaphyseal distal radius fractures in adolescents: is closed reduction and casting sufficient for most?","authors":"Daniel William Hancock, Joe Jordan Thomas Barrett-Lee, Ahmed Mohamed Ahmed Abdellatif, Sophie White, Perry Liu, Darren Roberts","doi":"10.1007/s00590-025-04182-y","DOIUrl":"https://doi.org/10.1007/s00590-025-04182-y","url":null,"abstract":"<p><strong>Purpose: </strong>There is limited evidence to support decision-making in adolescents with metaphyseal distal radius fractures. This study aims to review injury patterns, treatments, and clinical outcomes in this age group.</p><p><strong>Methods: </strong>Patients aged 11-16 years presenting with metaphyseal distal radius fractures were obtained from our institutional trauma database. Radiographs and records were reviewed to obtain injury details, management, complications, and long-term sequelae.</p><p><strong>Results: </strong>One hundred and five fractures were included. Mean age was 12.6 years and 79% occurred in males. 75.2% were angulated and 24.8% off-ended. The median initial angulation was 22.1° (2.3-46.7), and the majority were dorsally displaced (74.3%). Emergent management for 91 (86.7%) patients was surgical with either manipulation under anaesthesia (MUA) and cast in theatre (59.3%), Kirschner wire (K-wire) fixation (35.8%), or open reduction internal fixation (ORIF) (3.3%). Fourteen patients were initially managed non-operatively, and 71.4% of these re-displaced requiring surgery. There was no statistical difference in final angulation of fractures managed with MUA and cast or fixation (5.35 vs. 5.5°, respectively). Complications occurred in 14.3%, including two cases of osteomyelitis. Twenty cases had final angulation of greater than 9°, but none underwent corrective osteotomy.</p><p><strong>Conclusion: </strong>In adolescents, metaphyseal distal radius fractures have a higher risk of early re-displacement when not reduced in theatre; however, both casting and fixation resulted in similar final angulation. Complications were common at 14.3%, but only occurred in those that underwent fixation. Few long-term issues were observed in those treated in cast, even with up to 20° of residual angulation.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"35 1","pages":"64"},"PeriodicalIF":1.4,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143366777","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":"Outcomes of intramedullary nailing versus plate fixation for humeral shaft fractures: a retrospective cohort study.","authors":"Jawad Derbas, Isam Moghamis, Osama Alzobi, Amgad Elshoeibi, Abdullah Murshid, Ghalib Ahmed","doi":"10.1007/s00590-025-04181-z","DOIUrl":"10.1007/s00590-025-04181-z","url":null,"abstract":"<p><strong>Background: </strong>Humeral shaft fractures account for 1-3% of all bone fractures. Conservative treatment often leads to complications such as non-union and shoulder stiffness. Surgical fixation with a dynamic compression plate (DCP) has been the gold standard treatment. Intramedullary nailing (IMN) has recently gained popularity due to its minimally invasive approach and reduced risk of radial nerve injury. This study aims to compare the outcomes of IMN and plate fixation for humeral shaft fractures.</p><p><strong>Methods: </strong>This retrospective study included patients with humeral shaft fractures treated with either IMN or DCP fixation at Hamad General Hospital between April 2015 and October 2018. Patient demographics, fracture characteristics, surgical outcomes, and complications were collected. Descriptive statistics were used to summarize patient information, and univariate analysis was conducted to compare both groups. A Cox proportional hazards model, adjusted for age, gender, and polytrauma status was applied to compare time to union between IMN and DCP groups.</p><p><strong>Results: </strong>Sixty five patients (25 IMN, 40 plate fixation) were included. Non-union rates were higher in the DCP group than in the IMN group (13% vs. 4%). Reoperation rates were also higher in the DCP group (20% vs. 4%). Postoperative neuropathy rates were 4% for IMN and 10% for DCP, with neuropathy resolution significantly higher in the IMN group (92% vs. 68%). Shoulder range of motion (ROM) and pain favored the DCP group, with 98% unaffected ROM in the plate group compared to 76% in the IMN group (p = 0.007), and a lower incidence of shoulder pain (28% vs. 98%, p < 0.001). Time to union was comparable between both groups, with an adjusted hazard ratio of 1.08 (95% CI 0.62-1.90; p = 0.776).</p><p><strong>Conclusion: </strong>IMN and plate fixation effectively achieved fracture union; however, plate fixation was associated with better shoulder function, reduced pain, and higher reoperation rates. IMN was linked to a lower risk of nerve injury but compromised shoulder ROM and resulted in more postoperative pain.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"35 1","pages":"63"},"PeriodicalIF":1.4,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11802612/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143365538","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":"Comparative analysis of modified posterior mini-open surgery versus standard open posterior approach for adolescent idiopathic scoliosis correction: a prospective study.","authors":"Leonardo Oggiano, Sergio De Salvatore, Davide Palombi, Paolo Brigato, Umile Giuseppe Longo, Pier Francesco Costici","doi":"10.1007/s00590-025-04185-9","DOIUrl":"https://doi.org/10.1007/s00590-025-04185-9","url":null,"abstract":"<p><strong>Purpose: </strong>Adolescent idiopathic scoliosis (AIS) surgery aims to achieve optimal deformity correction while minimizing complications. The standard open posterior approach (OS) is effective but associated with significant soft tissue disruption and prolonged recovery. The modified mini-open surgery (MS) technique offers a less invasive alternative, potentially reducing surgical morbidity while maintaining comparable correction.</p><p><strong>Methods: </strong>In this prospective comparative study, 60 Lenke type 1 AIS patients with single thoracic curves were randomized to MS (n = 30) or OS (n = 30) groups. The MS technique utilized three midline incisions, a muscle-splitting approach, and selective arthrodesis at instrumented levels. Outcomes included deformity correction, intraoperative blood loss, hospital stay, postoperative pain (VAS), scar satisfaction, fusion rates, and complications at 2 years.</p><p><strong>Results: </strong>Both groups achieved comparable correction with no loss at 2 years (MS: 79.7% ± 8.0%; OS: 85.0% ± 7.4%; p > 0.05). The MS group had reduced intraoperative blood loss (383.3 ± 82.9 mL vs. 720.2 ± 74.3 mL; p = 0.019), shorter hospital stays (6.2 ± 0.3 vs. 7.4 ± 1.2 days; p = 0.044), and lower VAS scores at discharge (2.9 ± 1.8 vs. 3.9 ± 1.4; p = 0.02) and 2 years (1.5 ± 0.5 vs. 2.0 ± 0.7; p = 0.03). Scar satisfaction was higher in the MS group (4.5 ± 0.3 vs. 2.8 ± 0.6; p = 0.02). No pseudoarthrosis or complications occurred in either group.</p><p><strong>Conclusion: </strong>The MS approach offers comparable correction to OS with reduced morbidity and superior cosmesis.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"35 1","pages":"62"},"PeriodicalIF":1.4,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143257223","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}