Chinese Journal of Traumatology最新文献

{"title":"Perspectives for using platelet-rich plasma in the treatment of knee osteoarthritis: Can it be improved through modifications of the protocol?","authors":"Mikhail S Bozhokin, Svetlana A Bozhkova, Julia V Sopova, Elena I Leonova, Maxim I Shubniakov, Aleksandr A Rubel, Mario Simental-Mendía","doi":"10.1016/j.cjtee.2024.12.004","DOIUrl":"https://doi.org/10.1016/j.cjtee.2024.12.004","url":null,"abstract":"<p><strong>Purpose: </strong>Autologous platelet-rich plasma (PRP) injections are widely used in regenerative medicine, including the knee osteoarthritis (OA) therapy. This study reviews methods to enhance PRP therapy for knee OA, aiming to boost articular cartilage recovery.</p><p><strong>Methods: </strong>The search was conducted in the eLIBRARY, PubMed (MEDLINE), Ovid, ScienceDirect, and Google Scholar databases extracting publications available by the end of 2023. Studies were included if they simultaneously met the following criteria: (1) effect of using PRP in the recovery of hyaline cartilage damage after OA; (2) at least one way to modify the PRP protocol aimed to increase its efficiency; (3) data on the molecular mechanisms underlying the increase in efficiency of the modified PRP therapy in OA.</p><p><strong>Results: </strong>The findings of this study highlight the significant role that the composition and modification of PRP protocols play in enhancing chondrogenesis for cartilage repair. Beyond the activation or non-activation of platelets or the inclusion or removal of leukocytes, which are factors that could somehow affect the effectiveness of PRP formulations, the elimination of growth factors such as VEGF and EGF, which negatively influence cartilage regeneration, offers a promising approach to optimize PRP therapy. While growth factors like TGF-β3, PDGF, and IGF have been shown to promote chondrogenesis, the removal of detrimental factors that could contribute to chronic inflammation or OA progression could significantly improve treatment outcomes. Practices such as combining with hyaluronic acid, pre-injection PRP activation, and multiple administrations are clinically common, while other methods like adjusting growth factors concentration are still in development.</p><p><strong>Conclusion: </strong>Various modifications of this technology allow to use molecular mechanisms involved in the restoration of hyaline cartilage and improve the effectiveness of PRP for the treatment of OA. However, significant challenges remain in standardizing PRP preparation and administration protocols. Variability in platelet concentration, growth factor composition, and activation methods complicate the assessment of efficacy and reproducibility.</p>","PeriodicalId":51555,"journal":{"name":"Chinese Journal of Traumatology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144095731","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Frequency and pattern of skull base and vault fracture in isolated head trauma.","authors":"Emir Bayram Malcı, Dilek Durak, Vahide Aslıhan Durak, Recep Fedakar, Nursel Türkmen İnanır, Oğuz Altunyuva, Selçuk Yılmazlar","doi":"10.1016/j.cjtee.2025.01.002","DOIUrl":"https://doi.org/10.1016/j.cjtee.2025.01.002","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Purpose: &lt;/strong&gt;In the literature, the number of studies on cases of injury due to isolated head trauma is limited. In addition, there are very few studies and publications on skull base and vault fractures in the forensic literature. This study aims to investigate the frequency and pattern of skull base and vault fractures in individuals exposed to isolated fatal and non-fatal head trauma.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This retrospective cross-sectional and descriptive study includes 1260 cases who were injured due to isolated head trauma during the 10-year period between Jan 1, 2010 and Nov 30, 2019. In cases of fatal head trauma, only cases in which isolated head injury was reported as the cause of death in the autopsy report were included. In cases of non-fatal head trauma, cases with life-threatening injuries in areas other than the head (such as chest, abdomen, and extremities), and cases without cranial CT images and reports on the Hospital Information Management System were excluded from the study. Our cases were divided into 2 groups: fatal head trauma (n = 783) and non-fatal head trauma (n = 477). All cases (n = 1260) were evaluated retrospectively in terms of age, gender, cause of trauma, skull base fracture, skull vault fracture, facial bone fracture, intracranial injury, and scalp injury. While examining the distribution of categorical variables, Chi-square tests were applied and the appropriate one was reported from Pearson Chi-square test, Yates Chi-square test, Fisher's exact test, and likelihood ratio test. The coefficients of the models, the odds ratio of the factors in the model, 95% confidence interval, Hosmer-Lemeshow statistics, and the correct classification rate were accorded. The statistical significance level in the study was accepted as p &lt; 0.05.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Base fractures were observed in 87.5% of cases with fatal head trauma and in 32.3% of cases with non-fatal head trauma. Vault fracture was observed in 88.4% of cases with fatal head trauma and in 75.3% of cases with non-fatal head trauma. The middle fossa was more fractured than the anterior and posterior fossa. Anterior and middle fossa combined fracture and anterior, middle, and posterior fossa combined fracture were significantly higher in the fatal head trauma than in the non-fatal head trauma. Base fracture was strongly associated with death (odd ratio = 15.253, p &lt; 0.001) and vault fracture did not have a statistically significant effect on death (odd ratio = 1.052, p = 0.805). While intracranial injury was found to be significantly higher in patients with base fractures (p &lt; 0.001), no significant difference was found in patients with vault fractures (p = 0.229).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;In conclusion, it was observed that skull base fractures were frequently associated with especially fatal head traumas and this fracture was strongly associated with death. In the antemortem and postmortem examination of cases inju","PeriodicalId":51555,"journal":{"name":"Chinese Journal of Traumatology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143991769","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The value of ultrasonography in predicting the outcomes of simple long bone fractures treated by closed intramedullary nail fixation","authors":"Tilak Rommel Pinto ,&nbsp;Chiranjeevi Srinivasa Gowda ,&nbsp;Anston Vernon Braggs ,&nbsp;Kiyana Mirza ,&nbsp;Aravinda Hegde K","doi":"10.1016/j.cjtee.2023.11.007","DOIUrl":"10.1016/j.cjtee.2023.11.007","url":null,"abstract":"<div><h3>Purpose</h3><div>Ultrasonography has been used increasingly in orthopaedic practice credited to its low cost, easy accessibility, non-invasiveness, reproducibility, and safety from radiation. The purpose of this study was to test the validity and efficacy of ultrasonography as an adjunct in the assessment of fracture healing in long bones treated with intramedullary interlocking devices and its predictive value in determining the need for a secondary surgical procedure.</div></div><div><h3>Methods</h3><div>This was a descriptive longitudinal study of 40 skeletally mature patients from November 2016 to February 2019, who sustained long bone fractures of the tibia or femur treated using intramedullary interlocking nails. Patients with comminuted and segmental fracture patterns were excluded from the study. Each patient was evaluated at 6- and 12-week post-surgery using standard orthogonal radiographs and ultrasonography to assess fracture healing. Patients were then followed up until fracture union. Quantitative data was analyzed using frequency statistics and descriptive data with inferential statistics.</div></div><div><h3>Results</h3><div>Ultrasonography predicted 87.5% union and 12.5% delayed or non-union as early as 6 weeks after surgery, while radiographs predicted 22.5% union as late as 3 months of follow-up. The sensitivity and specificity of ultrasonography in assessing fracture healing were 100% and 97.2%, respectively, with a positive predictive value of 80.0%. Vascular resistance index was less than 0.5 in all patients who developed delayed or non-union.</div></div><div><h3>Conclusion</h3><div>Ultrasonography is able to predict fracture outcomes much earlier than standardized radiographs with comparable sensitivity and specificity. Vascular resistance index is an objective parameter in assessing callus quality and predicting fracture outcomes.</div></div>","PeriodicalId":51555,"journal":{"name":"Chinese Journal of Traumatology","volume":"28 3","pages":"Pages 181-186"},"PeriodicalIF":1.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139022719","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intramedullary administration of tranexamic acid reduces bleeding in proximal femoral nail antirotation surgery for intertrochanteric fractures in elderly individuals: A randomized controlled trial","authors":"Xiang-Ping Luo,&nbsp;Jian Peng,&nbsp;Ling Zhou,&nbsp;Hao Liao,&nbsp;Xiao-Chun Jiang,&nbsp;Xiong Tang,&nbsp;Dun Tang,&nbsp;Chao Liu,&nbsp;Jian-Hui Liu","doi":"10.1016/j.cjtee.2024.01.006","DOIUrl":"10.1016/j.cjtee.2024.01.006","url":null,"abstract":"<div><h3>Purpose</h3><div>Intertrochanteric fractures undergoing proximal femoral nail antirotation (PFNA) surgery are associated with significant hidden blood loss. This study aimed to explore whether intramedullary administration of tranexamic acid (TXA) can reduce bleeding in PFNA surgery for intertrochanteric fractures in elderly individuals.</div></div><div><h3>Methods</h3><div>A randomized controlled trial was conducted from January 2019 to December 2022. Patients aged over 60 years with intertrochanteric fractures who underwent intramedullary fixation surgery with PFNA were eligible for inclusion and grouped according to random numbers. A total of 249 patients were initially enrolled, of which 83 were randomly allocated to the TXA group and 82 were allocated to the saline group. The TXA group received intramedullary perfusion of TXA after the bone marrow was reamed. The primary outcomes were total peri-operative blood loss and post-operative transfusion rate. The occurrence of adverse events was also recorded. Continuous data was analyzed by unpaired <em>t</em>-test or Mann-Whitney <em>U</em> test, and categorical data was analyzed by Pearson Chi-square test.</div></div><div><h3>Results</h3><div>The total peri-operative blood loss (mL) in the TXA group was significantly lower than that in the saline group (577.23 ± 358.02 <em>vs.</em> 716.89 ± 420.30, <em>p</em> = 0.031). The post-operative transfusion rate was 30.67% in the TXA group and 47.95% in the saline group (<em>p</em> = 0.031). The extent of post-operative deep venous thrombosis and the 3-month mortality rate were similar between the 2 groups.</div></div><div><h3>Conclusion</h3><div>We observed that intramedullary administration of TXA in PFNA surgery for intertrochanteric fractures in elderly individuals resulted in less peri-operative blood loss and decreased transfusion rate, without any adverse effects, and is, thus, recommended.</div></div>","PeriodicalId":51555,"journal":{"name":"Chinese Journal of Traumatology","volume":"28 3","pages":"Pages 201-207"},"PeriodicalIF":1.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140013740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mechanisms of the Masquelet technique to promote bone defect repair and its influencing factors","authors":"Jiang-Hong Wu ,&nbsp;Quan-Wei Bao ,&nbsp;Shao-Kang Wang ,&nbsp;Pan-Yu Zhou ,&nbsp;Shuo-Gui Xu","doi":"10.1016/j.cjtee.2024.04.003","DOIUrl":"10.1016/j.cjtee.2024.04.003","url":null,"abstract":"<div><div>The Masquelet technique, also known as the induced membrane technique, is a surgical technique for repairing large bone defects based on the use of a membrane generated by a foreign body reaction for bone grafting. This technique is not only simple to perform, with few complications and quick recovery, but also has excellent clinical results. To better understand the mechanisms by which this technique promotes bone defect repair and the factors that require special attention in practice, we examined and summarized the relevant research advances in this technique by searching, reading, and analysing the literature. Literature show that the Masquelet technique may promote the repair of bone defects through the physical septum and molecular barrier, vascular network, enrichment of mesenchymal stem cells, and high expression of bone-related growth factors, and the repair process is affected by the properties of spacers, the timing of bone graft, mechanical environment, intramembrane filling materials, artificial membrane, and pharmaceutical/biological agents/physical stimulation.</div></div>","PeriodicalId":51555,"journal":{"name":"Chinese Journal of Traumatology","volume":"28 3","pages":"Pages 157-163"},"PeriodicalIF":1.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140786844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"FM1-Editorial board","authors":"","doi":"10.1016/S1008-1275(25)00035-5","DOIUrl":"10.1016/S1008-1275(25)00035-5","url":null,"abstract":"","PeriodicalId":51555,"journal":{"name":"Chinese Journal of Traumatology","volume":"28 3","pages":"Page i"},"PeriodicalIF":1.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144105394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Novel approach of plate assisted buttressing in Hoffa fracture","authors":"Amit Singh ,&nbsp;Nirottam Singh ,&nbsp;Gaurav Siwach ,&nbsp;Mohit Bansal ,&nbsp;Hemant Jain ,&nbsp;Kishore Raichandani","doi":"10.1016/j.cjtee.2024.02.003","DOIUrl":"10.1016/j.cjtee.2024.02.003","url":null,"abstract":"<div><h3>Purpose</h3><div>Hoffa fracture is a femoral condyle fracture in the coronal plane. The lateral condyle is more commonly involved. The diagnosis is often difficult to detect with routine radiographs. Conservative management in this type of fracture resulted in nonunion, malunion, and other complications, such as stiff knee. Therefore, surgical management is mandatory in displaced fractures. Previous studies suggest only application of cancellous screw fixation, but these are not enough to counter vertical shear stress. Therefore, this study will evaluate the clinical outcomes of open reduction and internal fixation of Letenneur type I Hoffa fracture using cancellous screws with posterior buttressing plate.</div></div><div><h3>Method</h3><div>This was a prospective cohort study conducted from March 2017 to July 2022 in orthopaedics department of tertiary care center after approval of institutional ethical committee. The study included 36 patients with Letenneur type I fractures treated by open reduction and internal fixation using posterior buttress plate and cancellous screws. Radiographs and clinical outcomes, range of movement (ROM), bone union, and knee society score (KSS) of patients were assessed at the end of 4 and 12 months in the follow-ups. All statistical analysis was done using Epi info version 7.2.1.0.</div></div><div><h3>Results</h3><div>In the 36 patients with Letenneur type I fracture, the majority belong to younger age group between 25 and 54 years with 22 males and 14 females. The modes of injury were road traffic accidents in 25 patients and fall from height in 11 patients. The right knee was involved in 21 cases and left was involved in 15 cases. Lateral condyle involvement was seen in 27 cases and medial condyle in 9 cases. All 36 patients with Letenneur type I Hoffa fracture were evaluated 4 months after surgical intervention. The notable improvements were observed in terms of ROM 120.4° ± 5.0° and KSS 85.0 ± 4.2. At the 12-month follow-up, considerably better outcomes were maintained regarding ROM 128.1° ± 5.2° and KSS 89.3 ± 4.8 with <em>p</em> &lt; 0.05 which was statistically significant. At the final follow-up, all patients had routine fracture healing with a union time of (3.2 ± 3.4) months.</div></div><div><h3>Conclusions</h3><div>Fixation of Letenneur type I Hoffa fracture with cancellous screws and posterior buttress plate is effective, reliable and capable of providing adequate stability. Buttress plate assisted fixation is a valuable enhancement of the conventional technique of lag screw fixation of Hoffa fractures.</div></div>","PeriodicalId":51555,"journal":{"name":"Chinese Journal of Traumatology","volume":"28 3","pages":"Pages 175-180"},"PeriodicalIF":1.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140133248","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Frequency of concomitant injuries in maxillofacial trauma in a tertiary health care centre in India: A 5-year retrospective study","authors":"Saubhik Dasukil,&nbsp;Shiwangi Verma,&nbsp;Ashok Kumar Jena,&nbsp;Mounabati Mohapatra","doi":"10.1016/j.cjtee.2024.03.008","DOIUrl":"10.1016/j.cjtee.2024.03.008","url":null,"abstract":"<div><h3>Purpose</h3><div>Road traffic accidents (RTA), assaults, falls, and sports-related injuries are the leading causes of maxillofacial trauma. Due to quite different geographical environment and fast urbanization, the use of various protective equipment is restricted in India. Thus, compared to other countries, there might be a significant difference in the pattern and frequency of associated injuries among subjects with maxillofacial trauma. The present study was conducted to identify the causes and pattern of various maxillofacial fractures and the frequency of other related injuries among subjects with maxillofacial trauma.</div></div><div><h3>Methods</h3><div>This is a cross-sectional retrospective study recording 2617 subjects with maxillofacial trauma from October 2017 to October 2022. The patient demographics, causes of trauma, types of maxillofacial injury, and associated soft and hard tissue injuries were recorded. The types of maxillofacial and associated injuries were diagnosed from details of clinical examinations and the interpretation of various radiographs available in the file. The associated injuries were divided into head injury, other bony injuries, and soft tissue and vital structure injuries. Descriptive statistics and the test of proportion were used. A <em>p</em> value &lt; 0.05 was considered as a level of significance.</div></div><div><h3>Results</h3><div>The maxillofacial injuries were significantly common in patients aged 16 – 45 years (66.7%) than in patients aged ≤ 15 and &gt; 46 years (33.3%) (<em>p</em> &lt; 0.001). The RTA was the most common cause of maxillofacial injury (<em>n</em> = 2139, 81.7%), followed by fall (<em>n</em> = 206, 7.9%), other causes of injury (<em>n</em> = 178, 6.8%), and assaults (<em>n</em> = 94, 3.6%). The maxillofacial injury by 2-wheel vehicle accidents was significantly higher than that by 4-wheel vehicle and other vehicle accidents (<em>p</em> &lt; 0.001). There was a significant correlation between alcohol and RTA (<em>p</em> &lt; 0.001). The head injury (<em>n</em> = 931, 61.1%) was the most common associated injury, followed by soft tissue and vital structures injuries (<em>n</em> = 328, 21.5%) and other bone injuries (<em>n</em> = 264, 17.3%).</div></div><div><h3>Discussion</h3><div>Head injury was the most common associated injury followed by soft tissue and vital structures and bone injuries among subjects with maxillofacial trauma. Clavicle fracture and injury to the lower extremities were the most common hard and soft tissue-associated injuries.</div></div>","PeriodicalId":51555,"journal":{"name":"Chinese Journal of Traumatology","volume":"28 3","pages":"Pages 216-219"},"PeriodicalIF":1.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140282025","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A systematic analysis on global epidemiology and burden of foot fracture over three decades","authors":"Cheng Chen ,&nbsp;Jin-Rong Lin ,&nbsp;Yi Zhang ,&nbsp;Tian-Bao Ye ,&nbsp;Yun-Feng Yang","doi":"10.1016/j.cjtee.2024.03.001","DOIUrl":"10.1016/j.cjtee.2024.03.001","url":null,"abstract":"<div><h3>Purpose</h3><div>To comprehensively analyze the geographic and temporal trends of foot fracture, understand its health burden by age, sex, and sociodemographic index (SDI), and explore its leading causes from 1990 to 2019.</div></div><div><h3>Methods</h3><div>The datasets in the present study were generated from the Global Burden of Diseases Study 2019, which included foot fracture data from 1990 to 2019. We extracted estimates along with the 95% uncertainty interval (<em>UI</em>) for the incidence and years lived with disability (YLDs) of foot fracture by location, age, gender, and cause. The epidemiology and burden of foot fracture at the global, regional, and national level was exhibited. Next, we presented the age and sex patterns of foot fracture. The leading cause of foot fracture was another focus of this study from the viewpoint of age, sex, and location. Then, Pearson's correlations between age-standardized rate (ASR), SDI, and estimated annual percentage change were calculated.</div></div><div><h3>Results</h3><div>The age-standardized incidence rate was 138.68 (95% <em>UI</em>: 104.88 − 182.53) per 100,000 persons for both sexes, 174.24 (95% <em>UI</em>: 134.35 − 222.49) per 100,000 persons for males, and 102.19 (95% <em>UI</em>: 73.28 − 138.00) per 100,000 persons for females in 2019. The age-standardized YLDs rate was 5.91 (95% <em>UI</em>: 3.58 − 9.25) per 100,000 persons for both genders, 7.35 (95% <em>UI</em>: 4.45 − 11.50) per 100,000 persons for males, and 4.51 (95% <em>UI</em>: 2.75 − 7.03) per 100,000 persons for females in 2019. The global incidence and YLDs of foot fracture increased in number and decreased in ASR from 1990 to 2019. The global geographical distribution of foot fracture is uneven. The incidence rate for males peaked at the age group of 20 – 24 years, while that for females increased with advancing age. The incidence rate of older people was rising, as younger age incidence rate declined from 1990 to 2019. Falls, exposure to mechanical forces, and road traffic injuries were the 3 leading causes of foot fracture. Correlations were observed between ASR, estimated annual percentage change, and SDI.</div></div><div><h3>Conclusions</h3><div>The burden of foot fracture remains high globally, and it poses an enormous public health challenge, with population aging. It is necessary to allocate more resources to the high-risk populations. Targeted realistic intervention policies and strategies are warranted.</div></div>","PeriodicalId":51555,"journal":{"name":"Chinese Journal of Traumatology","volume":"28 3","pages":"Pages 208-215"},"PeriodicalIF":1.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140177594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness and safety of augmentative plating technique in managing nonunion following intramedullary nailing of long bones in the lower extremity: A systematic review and meta-analysis","authors":"Cong-Xiao Fu ,&nbsp;Hao Gao ,&nbsp;Jun Ren ,&nbsp;Hu Wang ,&nbsp;Shuai-Kun Lu ,&nbsp;Guo-Liang Wang ,&nbsp;Zhen-Feng Zhu ,&nbsp;Yun-Yan Liu ,&nbsp;Wen Luo ,&nbsp;Yong Zhang ,&nbsp;Yun-Fei Zhang","doi":"10.1016/j.cjtee.2024.04.004","DOIUrl":"10.1016/j.cjtee.2024.04.004","url":null,"abstract":"<div><h3>Purpose</h3><div>To methodically assess the effectiveness of augmentative plating (AP) and exchange nailing (EN) in managing nonunion following intramedullary nailing for long bone fractures of the lower extremity.</div></div><div><h3>Methods</h3><div>PubMed, EMBASE, Web of Science, and the Cochrane Library were searched to gather clinical studies regarding the use of AP and EN techniques in the treatment of nonunion following intramedullary nailing of lower extremity long bones. The search was conducted up until May 2023. The original studies underwent an independent assessment of their quality, a process conducted utilizing the Newcastle-Ottawa scale. Data were retrieved from these studies, and meta-analysis was executed utilizing Review Manager 5.3.</div></div><div><h3>Results</h3><div>This meta-analysis included 8 studies involving 661 participants, with 305 in the AP group and 356 in the EN group. The results of the meta-analysis demonstrated that the AP group exhibited a higher rate of union (odds ratio: 8.61, 95% confidence intervals (<em>CI</em>): 4.12 − 17.99, <em>p</em> &lt; 0.001), shorter union time (standardized mean difference (SMD): -1.08, 95% <em>CI</em>: -1.79 − -0.37, <em>p</em> = 0.003), reduced duration of the surgical procedure (SMD: -0.56, 95% <em>CI</em>: -0.93 − -0.19, <em>p</em> = 0.003), less bleeding (SMD: -1.5, 95% <em>CI</em>: -2.81 − -0.18, <em>p</em> = 0.03), and a lower incidence of complications (relative risk: -0.17, 95% <em>CI</em>: -0.27 − -0.06, <em>p</em> = 0.001). In the subgroup analysis, the time for union in the AP group in nonisthmal and isthmal nonunion of lower extremity long bones was shorter compared to the EN group (nonisthmal SMD: -1.94, 95% <em>CI</em>: -3.28 − -0.61, <em>p</em> &lt; 0.001; isthmal SMD: -1.08, 95% <em>CI</em>: -1.64 − -0.52, <em>p</em> = 0.002).</div></div><div><h3>Conclusion</h3><div>In the treatment of nonunion in diaphyseal fractures of the long bones in the lower extremity, the AP approach is superior to EN, both intraoperatively (with reduced duration of the surgical procedure and diminished blood loss) and postoperatively (with an elevated union rate, shorter union time, and lower incidence of complications). Specifically, in the management of nonunion of lower extremity long bones with non-isthmal and isthmal intramedullary nails, AP demonstrated shorter union time in comparison to EN.</div></div>","PeriodicalId":51555,"journal":{"name":"Chinese Journal of Traumatology","volume":"28 3","pages":"Pages 164-174"},"PeriodicalIF":1.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140960786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}