Chinese Journal of Traumatology最新文献

{"title":"Advances in understanding mitophagy's role in lung injury.","authors":"Wenyu Du, Youjing Yang, Tao Zhang, Junyu Jiang, Dingyuan Du, Guangbin Huang, Shasha Tao","doi":"10.1016/j.cjtee.2025.06.004","DOIUrl":"https://doi.org/10.1016/j.cjtee.2025.06.004","url":null,"abstract":"<p><p>Mitophagy has emerged as a key regulator in lung injury, presenting new avenues for therapeutic intervention. Lung injury, often caused by infections, trauma, or inhalation of toxic gases, disrupts lung tissue integrity and function, frequently leading to pulmonary fibrosis. Mitophagy serves a dual purpose: it removes damaged mitochondria, reducing oxidative stress and preventing cell death, thereby offering protection in acute lung injury. However, excessive mitophagy can deplete mitochondria, impair energy metabolism, and aggravate tissue damage. Throughout the progression of lung injury, mitophagy finely tunes inflammation, immune responses, and cell survival, helping to modulate cytokine storms and delay fibrosis. Additionally, it influences metabolic reprogramming and intercellular communication, affecting critical cell types such as alveolar epithelial cells, macrophages, and fibroblasts, which are essential for tissue repair and regeneration. Although the precise molecular mechanisms remain under investigation, mitophagy is increasingly recognized as a promising therapeutic target for lung injury and fibrosis. The future challenge lies in achieving a precise balance in the regulation of mitophagy to maximize its protective effects while minimizing potential harm, thereby opening new pathways for innovative therapeutic strategies.</p>","PeriodicalId":51555,"journal":{"name":"Chinese Journal of Traumatology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147678398","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":"Percutaneous autologous bone marrow injection accelerates bone synthesis during bone transport using the Ilizarov system after recurrence: case report and literature review.","authors":"Mohamed Issa, Alaa Alsarhan, Linda Alkhouri, Muhammad Yaman Al-Zamout, Ali Faraj, Hamza Hendi, Hamza Warda","doi":"10.1016/j.cjtee.2026.01.005","DOIUrl":"https://doi.org/10.1016/j.cjtee.2026.01.005","url":null,"abstract":"<p><p>Open tibial fractures with major bone loss, especially from high-energy trauma, are prone to atrophic nonunion, pseudoarthrosis, infection, and limb shortening. Standard methods like Ilizarov fixation often fail when healing is poor or infection persists, making adjunctive biological therapies necessary. Although the Ilizarov technique is established for tibial nonunion, evidence on mesenchymal stem cell (MSC)-rich bone marrow injections remains limited. We reported 2 young male patients with open tibial fractures and substantial bone loss. Both were initially managed with Ilizarov fixation for 7 - 8 months but subsequently developed atrophic nonunion, pseudoarthrosis, persistent infection with fistula, and limb shortening. Examination showed abnormal motion and absence of bone fragments, and labs confirmed ongoing infection. The definitive management involved a staged surgery, augmented by dual intraosseous injections of autologous MSC-rich bone marrow. This protocol successfully achieved bony union. The Ilizarov frame was then replaced with an AO fixator for consolidation. Both patients regained full limb length and infection resolution, with minor fibrotic tissue formation. Tibial pseudoarthrosis with infection and bone loss is challenging. In our cases, combining Ilizarov distraction with MSC-rich marrow enhanced osteogenesis, leading to union in a shorter time and full recovery. This synergy highlights the potential of regenerative strategies in complex orthopedic trauma.</p>","PeriodicalId":51555,"journal":{"name":"Chinese Journal of Traumatology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147624747","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":"Anterior column acetabular fractures extending to the sacroiliac region: A case series defining an atypical injury pattern.","authors":"Mahmoud Fahmy, Mostafa Ahmed Shawky","doi":"10.1016/j.cjtee.2026.03.001","DOIUrl":"https://doi.org/10.1016/j.cjtee.2026.03.001","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Purpose: &lt;/strong&gt;Anterior-column acetabular fractures extending posteriorly toward the sacroiliac (SI) region without SI joint disruption represent a rare and under-recognized fracture pattern. It remains unclear whether these fractures behave as atypical anterior-column fractures or as combined pelvic-acetabular injuries that necessitate sacroiliac fixation. This study addresses the lack of systematic data on this morphology and provides a biomechanical insight that the continuity of the SI ligamentous complex preserves pelvic stability despite posterior extension. This study aims to evaluate clinical, radiological, and functional outcomes of this fracture type and to clarify whether posterior fixation is necessary.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A retrospective case series was conducted, including 19 adult patients with anterior-column acetabular fractures that extended posteriorly toward the SI region, while the posterior ligamentous complex remained intact between January 2015 and January 2022. Inclusion criteria were: (1) adults aged ≥ 18 years, (2) patients diagnosed with acute anterior column acetabular fractures confirmed on CT, (3) fractures demonstrating posterior extension toward the SI region without evidence of diastasis or ligamentous injury. Fractures associated with SI dissociation or pelvic-ring instability, both-column fractures with complete posterior involvement, pathological fractures secondary to tumor or infection, prior ipsilateral hip or pelvic surgery, and inadequate imaging or follow-up shorter than 24 months were all excluded. Preoperative evaluation included thin-slice CT with 3-dimensional reconstruction to confirm SI integrity. All patients underwent anterior fixation via either the ilioinguinal (n = 11) or modified Stoppa approach (n = 8). Reduction quality, fracture union, SI stability, and functional outcomes (Harris hip score, modified Merle d'Aubigné-Postel, and Western Ontario and McMaster Universities Osteoarthritis Index scores) were assessed over a mean follow-up of (39.8 ± 13.5) months. Statistical analyses were performed with SPSS (version 27). Mean ± standard deviation was used to describe continuous variables, while categorical variables were presented as frequency and percentage. Comparisons between subgroups were carried out using Student's t-test or Mann-Whitney U test for continuous variables, and Chi-square or Fisher's exact test for categorical variables. A p &lt; 0.05 was considered statistically significant.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The mean age of the included patients was (45.7 ± 11.8) years. The mean union time of all fractures was (4.8 ± 0.7) months. Anatomical reduction was achieved in 16 patients (84.2%) and imperfect reduction in 3 (15.8%). No patient required SI fixation, and SI joint congruity was maintained in all cases. Functional outcomes were favorable. The mean Harris hip score at final follow-up was 88.9 ± 6.8. According to the Western Ontario and McMaster Univers","PeriodicalId":51555,"journal":{"name":"Chinese Journal of Traumatology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147619188","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":"Engineering-based statistical analysis of amputation prevalence and the impact of contributing factors in 4 Iraqi cities (1980-2024).","authors":"Samer A Kokz, Amer Matrood Imran, Adnan K Shathir","doi":"10.1016/j.cjtee.2025.06.003","DOIUrl":"https://doi.org/10.1016/j.cjtee.2025.06.003","url":null,"abstract":"<p><strong>Purpose: </strong>The number of amputations, which rises during specific periods in most countries, is due to numerous causes and is accompanied by continuous psychological, social, and economic effects for patients. This study aims to construct a data bank of amputees for the first time by collecting and analyzing data from 4 centres in Iraq (the health centres of the amputee in Karbala, Najaf, Babylon, and Wasit cities).</p><p><strong>Methods: </strong>This study was conducted retrospectively on all amputees in dataset for the period from January 1980 to December 2024. The inclusion criteria for the data bank include clinical and demographic data for amputation cases, such as sex, age, ID, type of amputation, date of amputation, cause of amputation, level of amputation, name of health center, etc. Amputation cases were excluded from this study that had missing data, unclear records, outside the chosen cities, and redundant or repeated records.</p><p><strong>Results: </strong>There were 9030 subjects (7446 male and 1584 female) included in this research. The results show that the highest rates of amputation were noticed in (40-69 years) for the age groups. Furthermore, it significantly indicated that females had a lower amputation rate compared to males. Also, the largest percentage of amputation was in Babylon followed by Najaf, Karbala, and Waist among the 4 selected cities. The major reason for amputation was the wars in Iraq. The below-knee amputation was the most common. Additionally, most of the decades that occurred amputations were in the years 2010-2019 that followed 1980-1989. We also noted that Iraq has the largest number of amputees compared to the other countries included in the investigation.</p><p><strong>Conclusion: </strong>Based on these results, future potentials must focus on planting a national Iraqi database for amputees every year. Also, it should find the premature diagnosis of all diseases that cause amputations. All these processes can be performed through the cooperation between health centres, research centres in the universities, and the government of Iraq.</p>","PeriodicalId":51555,"journal":{"name":"Chinese Journal of Traumatology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147576261","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":"Early post traumatic seizure as severity predictor of traumatic brain injury: A meta-analysis and systematic review.","authors":"Dewa Gede Chriswidarma, Putu Ijiya Danta Awatara","doi":"10.1016/j.cjtee.2025.05.008","DOIUrl":"https://doi.org/10.1016/j.cjtee.2025.05.008","url":null,"abstract":"<p><strong>Purpose: </strong>Traumatic brain injury (TBI) is a severe public health problem worldwide. Early post-traumatic seizures (EPTSs) are acute symptomatic events corresponding to the brain's response to the physical effects of TBI. Although there are ongoing findings regarding the association between EPTS and TBI, the correlation between EPTS occurrence and the severity of TBI remains unknown. The lack of knowledge regarding such mechanisms can also explain ineffective management. This systematic review and meta-analysis aimed to determine whether EPTS became a predictor of severity in patients with TBI.</p><p><strong>Methods: </strong>We performed a meta-analysis between November 2023 - January 2024. The keywords of \"Early Post Traumatic Seizure\" and \"Traumatic Brain Injury\" were searched in the PubMed, PMC, Science Direct, Cochrane Library, and Taylor and Francis databases. Only studies published in English were included. If duplicate publications were identified, the study with the larger sample size was selected. The comparison of severe TBI with EPTS was assessed using a Z test.</p><p><strong>Result: </strong>We included 588 TBI patients with EPTS and 1610 patients without EPTS, retrieved from 9 papers. We found that EPTS patients had a 1.170-fold and 0.840-fold increased risk of developing severe TBI in adults (risk ratio: 1.170, 95% confidence interval: 1.000 - 1.370) and pediatric patients (risk ratio: 0.840; 95% confidence interval: 0.380 - 1.840). The research identified no significant evidence of publication bias (p > 0.05) in EPTS data.</p><p><strong>Conclusion: </strong>EPTS are associated with increased severity and may serve as an independent predictor in adult TBI patients; however, this association is not statistically supported in pediatric populations and warrants further investigation.</p>","PeriodicalId":51555,"journal":{"name":"Chinese Journal of Traumatology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147516662","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":"Piezo1 mediates electrotaxis of alveolar epithelial cells via calcium-dependent PI3K/Akt signaling.","authors":"Huanyu Luo, Yang Dai, Conghua Lu, Chengjun Shi, Wenyi Liu, Wanda Bi, Juan Du, Li Li","doi":"10.1016/j.cjtee.2026.01.004","DOIUrl":"https://doi.org/10.1016/j.cjtee.2026.01.004","url":null,"abstract":"<p><strong>Purpose: </strong>Alveolar type II (AT2) epithelial cells play a vital role in lung injury repair, where their directed migration toward damaged regions is essential for epithelial regeneration. However, the underlying regulatory mechanisms remain poorly understood. This study aimed to determine whether direct-current electric fields (EFs) act as directional cues for AT2 cell migration and to identify the key molecular mediators and intracellular signaling pathways involved.</p><p><strong>Methods: </strong>RNA-seq data from acute respiratory distress syndrome patient-derived AT2 cells were integrated with charged membrane protein signatures to identify candidate genes associated with electrotaxis. Cell migration and calcium dynamics were assessed using time-lapse imaging and live-cell calcium imaging, while pharmacological inhibition, quantitative polymerase chain reaction, and Western blot analyses were employed to investigate molecular mechanisms.</p><p><strong>Results: </strong>Integrative transcriptomic analysis identified Piezo1 as a candidate regulator associated with AT2 cell electrotaxis. Functional assays in A549 cells demonstrated that exposure to a direct-current EF (100 mV/mm) significantly promoted cathode-directed migration and increased Piezo1 expression at both mRNA and protein levels. Inhibition of Piezo1 using the specific antagonist GSMTx4, or chelation of intracellular calcium with BAPTA-AM, markedly disrupted EF-induced directional migration, as evidenced by reduced migration velocity and loss of directionality. Live-cell calcium imaging confirmed that Piezo1 is essential for EF-induced calcium influx. Moreover, Western blot analysis revealed that EF stimulation elevated the phosphorylation of phosphatidylinositol 3-kinase (PI3K) and protein kinase B (Akt), which was significantly attenuated upon Piezo1 inhibition.</p><p><strong>Conclusion: </strong>Piezo1-mediated calcium influx and subsequent PI3K/Akt activation drive the electrotaxis of AT2 cells. These findings identify Piezo1 as a key bioelectrical sensor linking EFs to intracellular calcium signaling and directional migration, and suggest its potential as a therapeutic target for promoting epithelial regeneration in acute lung injury.</p>","PeriodicalId":51555,"journal":{"name":"Chinese Journal of Traumatology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147678396","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 critical review on the effect of high-velocity ballistic impact loading on the personal armors used by the soldiers.","authors":"Suresh Kumar Sundaram, Maalolan Balaji, Harish Saravana Kumar","doi":"10.1016/j.cjtee.2025.05.007","DOIUrl":"https://doi.org/10.1016/j.cjtee.2025.05.007","url":null,"abstract":"<p><p>In the field of the defense industry, personal armor is defined as the protective covering designed commonly to withstand a particular type of attack for a soldier. Armors are generally designed to withstand the penetration of a bullet. Behind armor blunt trauma (BABT) is a non-penetrating injury caused by the fast deformation of the body armor. The impact of a bullet or projectile on an armor's front face distorts the surface as it encounters the body. The deformation occurs during the process of capturing the projectile by absorbing its kinetic energy and retarding it. In severe cases, even if the projectile does not penetrate the armor, the BABT can still cause death. As bullet energy increases and armor manufacturers aim to reduce weight, the danger of BABT in military and security personnel rises. BABT results from a combination of pressure waves caused by the rapid movement of the armor's rear and the shear deformation of internal organs due to significant deflection of the body wall. This review assesses the impact of BABT on internal organs and solutions to overcome BABT.</p>","PeriodicalId":51555,"journal":{"name":"Chinese Journal of Traumatology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147494363","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":"Prehospital care: Lessons learned from 311 mortalities at level I trauma center","authors":"Parvez Mohi Ud Din Dar ,&nbsp;Supreet Kaur ,&nbsp;Anand Kumar Katiyar ,&nbsp;Pratyusha Priyadarshani ,&nbsp;Subodh Kumar ,&nbsp;Amit Gupta ,&nbsp;Sushma Sagar","doi":"10.1016/j.cjtee.2025.02.011","DOIUrl":"10.1016/j.cjtee.2025.02.011","url":null,"abstract":"<div><h3>Purpose</h3><div>Trauma, a leading cause of disability and death globally, underscores the critical importance of timely medical intervention, particularly within the “golden hour” following injury. Yet, in low-middle-income countries, the absence or fledgling state of emergency medical systems (EMS) exacerbates mortality rates. This study aims to retrospectively analyze mortalities at a level 1 trauma center in India, comparing patients who received prehospital care with those who did not.</div></div><div><h3>Methods</h3><div>Conducted at a level 1 trauma center in India from April 2019 to April 2020, this retrospective observational study included trauma patients who died during hospitalization. Exclusions comprised (1) patients deceased upon arrival, (2) patients receiving cardiopulmonary resuscitation, and (3) non-trauma deaths. Demographics, clinical profiles, causes of death, and transportation methods were scrutinized. Data encompassed patient transport details, clinical assessments, interventions, length of stay, and causes of death. Statistical analysis was performed using SPSS 14, with statistical significance set at <em>p</em>&lt;0.05.</div></div><div><h3>Results</h3><div>Among 55,277 trauma patients, 311 mortalities were recorded. Most were male (<em>n</em>=261, 83.9%), aged 21–40 years (<em>n</em>=133, 42.8%), with blunt trauma being the predominant cause (97.4%). The majority of patients had road traffic injuries (<em>n</em>=180, 57.9%) and falls (<em>n</em>=95, 30.5%). Threatened airway (<em>n</em>=144, 46.3%), tachycardia (<em>n</em>=159, 51.1%), and hypotension (<em>n</em>=74, 23.8%) were common on patients’ arrival. Traumatic brain injuries (70.4%) prevailed. Private vehicles transported 46.6% of patients, while only 7.0% arrived within the golden hour. Although patients who received prehospital care experienced delayed hospital arrival, they exhibited higher oxygen saturation and systolic blood pressure.</div></div><div><h3>Conclusion</h3><div>Augmentation of prehospital care and EMS infrastructure in low-resource settings is crucial to mitigating trauma mortality. Although prehospital care delayed hospital arrival, it positively impacted physiological parameters and potentially improved patient outcomes. This study underscores the imperative of timely interventions and comprehensive EMS development to address the global trauma burden effectively.</div></div>","PeriodicalId":51555,"journal":{"name":"Chinese Journal of Traumatology","volume":"29 2","pages":"Pages 90-95"},"PeriodicalIF":1.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145314375","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":"Fracture detection of distal radius using deep-learning-based dual-channel feature fusion algorithm","authors":"Jin Li ,&nbsp;Hao-Jie Shan ,&nbsp;Xiao-Wei Yu","doi":"10.1016/j.cjtee.2024.10.006","DOIUrl":"10.1016/j.cjtee.2024.10.006","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Purpose&lt;/h3&gt;&lt;div&gt;Distal radius fracture is a common trauma fracture and timely preoperative diagnosis is crucial for patient's recovery. With the rise of deep-learning applications in the medical field, utilizing deep-learning for diagnosing distal radius fractures has become a significant topic. However, previous research has suffered from low detection accuracy and poor identification of occult fractures. This study aims to design an improved deep-learning model to assist surgeons in diagnosing distal radius fractures more quickly and accurately.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;This study, inspired by the comprehensive analysis of anteroposterior and lateral X-ray images by surgeons in diagnosing distal radius fractures, designs a dual-channel feature fusion network for detecting distal radius fractures. Based on the Faster region-based convolutional neural network framework, an additional Residual Network 50, which is integrated with the Deformable and Separable Attention mechanism, was introduced to extract semantic information from lateral X-ray images of the distal radius. The features extracted from the 2 channels were then combined via feature fusion, thus enriching the network's feature information. The focal loss function was also employed to address the sample imbalance problem during the training process. The selection of cases in this study was based on distal radius X-ray images retrieved from the hospital's imaging database, which met the following criteria: clear anteroposterior and lateral X-ray images with a diagnosis of distal radius fractures confirmed by experienced radiologists. The exclusion criteria encompassed poor image quality, the presence of severe multiple or complex fractures, as well as non-adult or special populations (e.g., pregnant women). All cases meeting the inclusion criteria were labeled as distal radius fracture cases for model training and evaluation. To assess the model's performance, this study employed several metrics, including accuracy, precision, recall, area under the precision-recall curve, and intersection over union.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;The proposed dual-channel feature fusion network achieved an average precision (AP)50 of 98.5%, an AP75 of 78.4%, an accuracy of 96.5%, and a recall of 94.7%. When compared to traditional models, such as Faster region-based convolutional neural network, which achieved an AP50 of 94.1%, an AP75 of 70.6%, a precision of 91.1%, and a recall of 92.3%, our method shows notable improvements in all key metrics. Similarly, when compared to other classic object detection networks like You Only Look Once version 4 (AP50=95.2%, AP75=72.2%, precision=91.2%, recall=92.4%) and You Only Look Once version 5s (AP50=95.1%, AP75=73.8%, precision=93.7%, recall=92.8%), the dual-channel feature fusion network outperforms them in precision, recall, and AP scores. These results highlight the superior accuracy and reliability of the proposed method, particu","PeriodicalId":51555,"journal":{"name":"Chinese Journal of Traumatology","volume":"29 2","pages":"Pages 123-135"},"PeriodicalIF":1.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143788885","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":"Biomechanical performance of proximal tibia fracture plates: A review","authors":"Radovan Zdero ,&nbsp;Pawel Brzozowski ,&nbsp;Emil H. Schemitsch","doi":"10.1016/j.cjtee.2025.02.005","DOIUrl":"10.1016/j.cjtee.2025.02.005","url":null,"abstract":"<div><h3>Purpose</h3><div>Proximal fractures of the tibia (i.e., shin bone) are often treated using proximal tibia fracture plates (PTFPs) that are not always biomechanically optimal. This is a review of biomechanical papers that studied the effect of modifying PTFP plate and screw variables.</div></div><div><h3>Methods</h3><div>PubMed, Scopus, and Web of Science databases were searched for English-language papers published before February 2024 using the terms “biomechanics” plus “proximal or plateau” plus “tibia” plus “fracture or “plate.” Eligibility criteria were applied: (1) biomechanical studies only; (2) optimization studies that systematically permutated plate or screw variables; (3) plate-and-screw fixation only; (4) intra-articular or extra-articular fractures. The papers were examined for implant variables such as plate geometry, plate material, screw number, etc., while papers were also examined for outcome metrics like interfragmentary motion, plate stress, overall stiffness, etc.</div></div><div><h3>Results</h3><div>The 52 eligible PTFP papers considered the biomechanical effect of plate geometry, material, hole type, number, and position, while screw variables included geometry, number, and angle. Outcome metrics were interfragmentary motion (0–22.53 mm or 0°–60.1°), bone stress (1–1170 MPa), plate stress (3–586 MPa), and screw stress (3–1613 MPa), bone stress under the plate (2–11 MPa), number of loading cycles to failure (11,500–1,000,000), overall stiffness (22–24,869 N/mm or 0.4–63.8 Nm/degree), and failure strength (259–14,387 N). Reviewed papers showed that a PTFP's biomechanical stability could be maximized by using 1 or 2 plates that were contoured, larger, locking, metal, and/or placed on the largest surface of the bone fragment(s), while head, kickstand, and/or shaft screws should be longer, thicker, solid, metal, and/or angled. But more future work could be done on the biomechanical effect of plate design (e.g., alternative materials), bone quality (e.g., normal <em>vs.</em> osteoporotic), loading mode (i.e., axial, bending, torsion), etc.</div></div><div><h3>Conclusions</h3><div>PTFPs should have their plate and screw variables optimized to provide the best biomechanical performance and clinical outcomes, but more work is required to determine the optimal conditions. Engineers and surgeons may find this review beneficial for designing, analyzing, or utilizing PTFPs.</div></div>","PeriodicalId":51555,"journal":{"name":"Chinese Journal of Traumatology","volume":"29 2","pages":"Pages 106-117"},"PeriodicalIF":1.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144755091","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}