Journal of Clinical Orthopaedics and Trauma最新文献

{"title":"Simulation-based learning in orthopaedics: A qualitative systematic review","authors":"Mainak Roy ,&nbsp;Priyadarshini T ,&nbsp;M.S. Ashika ,&nbsp;Gurudip Das ,&nbsp;Bishnu Prasad Patro ,&nbsp;Sanjeevi Bharadwaj","doi":"10.1016/j.jcot.2025.102986","DOIUrl":"10.1016/j.jcot.2025.102986","url":null,"abstract":"<div><h3>Introduction</h3><div>Simulation-based learning has emerged as a transformative tool in orthopaedic education, significantly improving surgical training and patient safety. This systematic review examines the role of simulation in enhancing technical skills, decision-making, and clinical competence among orthopaedic trainees.</div></div><div><h3>Methods</h3><div>A systematic review was conducted to assess the effectiveness of simulation-based training in orthopaedics. Various simulation modalities, including virtual reality (VR), augmented reality (AR), haptic feedback systems, and task-based trainers, were analyzed for their impact on skill acquisition and retention. The study was registered with PROSPERO (ID: CRD420250652679).</div></div><div><h3>Results</h3><div>Key findings suggest that simulation-based training leads to reduced surgical errors, faster learning curves, and better skill retention. However, challenges such as high costs, limited access to advanced simulation tools, and difficulties in integrating these technologies into traditional curricula persist.</div></div><div><h3>Conclusion</h3><div>Simulation is expected to play a crucial role in modernizing orthopaedic education by providing safe, repeatable practice opportunities. Future directions include AI-driven training modules and collaborative VR platforms to further enhance training efficacy and patient outcomes.</div></div>","PeriodicalId":53594,"journal":{"name":"Journal of Clinical Orthopaedics and Trauma","volume":"65 ","pages":"Article 102986"},"PeriodicalIF":0.0,"publicationDate":"2025-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143684244","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":"Tailoring the approach: Management of femur fractures in post-polio syndrome patients","authors":"Venkatesan Senthil Kannan,&nbsp;Singanallur Palanivelayutham Sivakumar,&nbsp;Jayaramaraju Dheenadhayalan,&nbsp;Shanmuganathan Rajasekaran","doi":"10.1016/j.jcot.2025.102979","DOIUrl":"10.1016/j.jcot.2025.102979","url":null,"abstract":"<div><h3>Background</h3><div>Post-polio syndrome (PPS) can significantly alter lower limb anatomy and function. Femur is the most commonly fractured bone in post-polio patients. This study aimed to investigate the surgical challenges, fixation techniques employed, and functional outcomes in PPS patients with femoral fractures.</div></div><div><h3>Methods</h3><div>A retrospective analysis was conducted on 38 PPS patients diagnosed with femoral fractures. We assessed the underlying injury mechanism, anatomical variations (e.g., valgus neck deformity, hypoplastic greater trochanter, narrow canal, fixed knee flexion), and employed fixation techniques. Union time and functional recovery were evaluated.</div></div><div><h3>Results</h3><div>Trivial falls were the most frequent cause of fracture. Notably, various anatomical variations were observed, potentially influencing treatment strategies. Intramedullary nailing was the preferred fixation method; however, some cases necessitated alternative extramedullary fixation techniques due to anatomical constraints. The average time for fracture union was 24 weeks, with all patients regaining their pre-fracture functional status.</div></div><div><h3>Conclusion</h3><div>Femoral fracture management in PPS patients requires meticulous consideration of unique anatomical challenges and patient-specific factors. A multidisciplinary approach emphasizing preoperative planning, intraoperative adaptability in fixation techniques, and comprehensive postoperative rehabilitation is crucial for optimal outcomes and minimizing complications.</div></div>","PeriodicalId":53594,"journal":{"name":"Journal of Clinical Orthopaedics and Trauma","volume":"65 ","pages":"Article 102979"},"PeriodicalIF":0.0,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143683804","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":"Effect of tranexamic acid on blood loss during THR in patients with inflammatory versus degenerative hip arthritis: A retrospective cohort study","authors":"Mohabey Ankush,&nbsp;Sah Saurabh,&nbsp;Dwidmuthe Samir,&nbsp;Kotangale Pratik,&nbsp;Sahare Pratik","doi":"10.1016/j.jcot.2025.102977","DOIUrl":"10.1016/j.jcot.2025.102977","url":null,"abstract":"<div><h3>Background</h3><div>Tranexamic acid (TXA) is increasingly used to minimize blood loss associated with total hip replacement (THR), yet its comparative efficacy in inflammatory versus degenerative arthritis during THR remains underexplored in Indian patients. The objective of this study was to evaluate and compare the estimated intraoperative blood loss in patients undergoing THR with and without TXA administration, stratified by underlying degenerative and inflammatory joint conditions.</div></div><div><h3>Methods</h3><div>This retrospective cohort study analyzed medical records of patients undergoing THR at a single center from October 2020 to October 2023. Patients were stratified by TXA usage and the type of arthritis (inflammatory and degenerative). The primary outcome was intraoperative blood loss, while secondary outcomes included operative time and time to full weight-bearing.</div></div><div><h3>Results</h3><div>The study enrolled 126 patients, including 21 with inflammatory arthritis and 105 with degenerative arthritis, of whom 106 received TXA (n = 19, inflammatory arthritis; n = 87, degenerative arthritis).</div><div>The primary outcome of mean intraoperative blood loss was lower in the TXA group (350.57 ± 162.36 mL) compared to the non-TXA group (380.00 ± 192.22 mL), although this difference did not reach statistical significance (p = 0.472).</div><div>Secondary outcome, operative time was significantly shorter in patients receiving TXA (88.53 ± 24.38 min) compared to those who did not receive TXA (102.58 ± 45.27 min, p = 0.046). While the time to full weight-bearing was comparable between the TXA users and non-users (p = 0.341).</div><div>Subgroup analysis suggested a more pronounced reduction in blood loss with TXA use among patients with degenerative arthritis than those with inflammatory arthritis, though the difference was not statistically significant.</div></div><div><h3>Conclusion</h3><div>TXA administration in THR significantly reduced operative time but showed no significant difference in blood loss or postoperative recovery. The results suggest a potential for more pronounced benefits in patients with degenerative arthritis.</div></div>","PeriodicalId":53594,"journal":{"name":"Journal of Clinical Orthopaedics and Trauma","volume":"65 ","pages":"Article 102977"},"PeriodicalIF":0.0,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143683805","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 3D CT morphometric analysis of the medial pelvic terrain: New insights into quadrilateral plate and medial acetabular surface","authors":"Abhay Elhence,&nbsp;Ashraf Jamal,&nbsp;Sandeep Kumar Yadav","doi":"10.1016/j.jcot.2025.102978","DOIUrl":"10.1016/j.jcot.2025.102978","url":null,"abstract":"<div><h3>Background</h3><div>The medial bony hemipelvis has been defined as quadrilateral plate (QP). Any isolated or combined injuries to QP, often lead to early degenerative arthritis of hip joint. Conventionally defined QP and its delineation of fixation zones from non-fixation zone or medial acetabular surface (MAS) will lead to novel Pentagonal Plate (PP).</div></div><div><h3>Methodology</h3><div>3D reconstructions of the pelvic CT scans were created, focusing on right hemipelvis for all patients. The dimensions of the QP and novel PP in the right hemipelvis were defined and measured using RadiAnt DICOM Viewer software. Statistical analysis was conducted using latest version of SPSS software.</div></div><div><h3>Results</h3><div>This study included 100 adults (42 females and 58 males) who underwent CT scans of pelvis for non traumatic non orthopedic reasons like gynaecological, general surgical and urological reasons between July 2019 and December 2020. Average dimensions of the sides of conventional QP were found to be 4.95 ± 0.85 cm, 3.98 ± 0.73 cm, 4.03 ± 0.78 cm, and 5.48 ± 0.91 cm. The study identifies 3 triangular fixation zones within conventional QP, corresponding to the sciatic buttress, part of anterior column, and part of the posterior column. These zones were excluded from conventional QP, resulting in definition of a novel pentagonal plate (PP) with a 34 % smaller surface area, precisely delineating true medial surface of acetabular socket.</div></div><div><h3>Conclusion</h3><div>Novel PP identifies MAS with more precision and delineates 3 triangular fixation zones across sciatic buttress, anterior and posterior columns. This knowledge enables better understanding of fixation zones and force concentration due to antecedent injury which opens doors to newer plate designs, explaining why certain fractures involving the MAS undergo early degenerative arthritis and rationalizing alternative treatment strategies like fix and replace for even younger patients with adverse fracture configurations.</div></div>","PeriodicalId":53594,"journal":{"name":"Journal of Clinical Orthopaedics and Trauma","volume":"65 ","pages":"Article 102978"},"PeriodicalIF":0.0,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143683806","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":"Conservative and newer drug treatment for degenerative cervical myelopathy","authors":"Osita Ede ,&nbsp;Jason Pui Yin Cheung","doi":"10.1016/j.jcot.2025.102972","DOIUrl":"10.1016/j.jcot.2025.102972","url":null,"abstract":"<div><div>Degenerative cervical myelopathy (DCM) is the most common cause of non-traumatic spinal cord dysfunction in adults worldwide. Conservative treatments, such as physical therapy, activity modification, cervical traction, and the use of cervical collars, have been employed primarily for symptomatic relief in mild cases or for patients deemed unfit for surgery. Advances in our understanding of the molecular pathways involved in neuroinflammation and neuronal injury in DCM have spurred the development of newer pharmacological treatments aimed at neuroprotection and inflammation control. We found limited evidence that conservative treatment enhances functional recovery in patients with DCM. Patients with mild DCM who opt for conservative therapy should be aware of likely neurological deterioration and higher spinal cord injury risk following neck trauma. Nonoperative management could benefit patients with mild DCM who presented early (at least less than a year), have soft disc herniation as the cause of the myelopathy, have one level of myelopathic compression, and whose MRI does not show circumferential compression of the spinal cord. Riluzole did not replicate its promising animal results in human trials, using the modified Japanese Orthopaedic Association (mJOA) score as an outcome measure. Cerebrolysin is promising but needs more RCTs to define its role in the management algorithm. Limaprost Alfadex provided inconclusive evidence, however, is in an ongoing phase III trial. Erythropoietin showed benefit in animal and human trials but concerns over side effects may limit use. G-CSF demonstrated evidence of preserved neurological function in mice but needs human studies. Steroids did not show benefit and are likely deleterious to tissue healing and can increase infection risk. Anti-Fas ligand antibody has not been studied in humans but demonstrated benefit in animal models. Research should focus on large-scale RCTs for these drugs with careful attention to long-term effects, side effects, and finding the most effective doses.</div></div>","PeriodicalId":53594,"journal":{"name":"Journal of Clinical Orthopaedics and Trauma","volume":"64 ","pages":"Article 102972"},"PeriodicalIF":0.0,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143644244","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":"Readability of Orthopaedic Patient Educational Material: An artificial intelligence application","authors":"Miles LaNicca ,&nbsp;Ellis Wright ,&nbsp;Ellen Lutnick","doi":"10.1016/j.jcot.2025.102971","DOIUrl":"10.1016/j.jcot.2025.102971","url":null,"abstract":"<div><h3>Background</h3><div>This study aims to determine the efficacy of the use of artificial intelligence (AI) in rewriting orthopaedic trauma hospital patient educational materials to a patient-appropriate reading level.</div></div><div><h3>Materials and methods</h3><div>35 orthopaedic patient educational articles were identified from three hospital networks with Level 1 Trauma Centers, categorized based on average reading level. They were run through a formatting Python code, and then a secondary code to determine readability metrics outlined in Table 1. The articles were then rewritten via four iterations of Generative Pre-Trained Transformer (GPT) AI language models. Each model was given the same prompt, outlined in Fig. 1, to rewrite the articles to a 6th grade reading level per AMA recommendations. The rewritten articles were checked for accuracy and formatted and scored to determine mean reading level. Additional analysis was run comparing 9 different AI models from 3 different companies, using the same prompt, comparing cost and percent token reduction.</div></div><div><h3>Results</h3><div>All GPT AI models lowered the mean combined grade level (Table 2). Fig. 2 compares each GPT model's output to the original articles reading grade level. The oldest model (GPT-3.5-Turbo) was the least consistent and least effective. GPT-4o-Mini and GPT-4o were the most effective and consistent regardless of original article difficulty. Table 3 outlines the cost of running all 35 articles through each GPT model. The most accurate model (GPT-4o) was only $0.61; however, there was only a 0.421 % increase in effectiveness comparing GPT-4o vs. GPT-4o-Mini, at a 175.38 % increase in cost. All GPT rewritten articles were screened for accuracy and determined to have no falsified information or medical inaccuracies. Expanded analysis across 9 AI models is demonstrated in Fig. 4. Fig. 5 compares cost and percent token reduction.</div></div><div><h3>Conclusion</h3><div>AI is a viable option for reducing the reading difficulty of patient educational materials while maintaining accuracy. Of the models included for analysis, GPT-4o-Mini appears to be the most efficient language model when considering effectiveness, cost, and maintenance of the information included in the original articles.</div></div>","PeriodicalId":53594,"journal":{"name":"Journal of Clinical Orthopaedics and Trauma","volume":"64 ","pages":"Article 102971"},"PeriodicalIF":0.0,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143679454","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":"Predicting red blood cell transfusion for primary hip and knee arthroplasty: Designing a hub and spoke high-volume arthroplasty model","authors":"Edward Hayter ,&nbsp;Vijay Badial ,&nbsp;Reece Barter ,&nbsp;Harry Hodgson ,&nbsp;Raymond E. Anakwe","doi":"10.1016/j.jcot.2025.102974","DOIUrl":"10.1016/j.jcot.2025.102974","url":null,"abstract":"<div><h3>Background</h3><div>Waiting lists for elective surgery are at record levels. Consolidating elective care into superhubs where high-volume surgery can be undertaken efficiently is an attractive solution. These pathways should be safe but also efficient and convenient for patients.</div><div>We undertook this study to develop a model that would reliably predict healthy (American Society of Anaesthesiologists [ASA] class 1 and 2) patients who could be treated on a streamlined pathway and who would reliably not require red blood cell transfusion during their inpatient admission.</div></div><div><h3>Methods</h3><div>We retrospectively identified all patients undergoing primary total hip arthroplasty (THA) or total knee arthroplasty (TKA) at our centre over a five-year period. We used binary logistic regression to develop a predictive model based on these variables.</div></div><div><h3>Results</h3><div>We identified 13-preoperative candidate variables from our literature search and used these to construct our predictive model. The final validated model was highly effective in predicting those patients who would not need a red blood cell transfusion (area under curve = 0.945).</div></div><div><h3>Conclusion</h3><div>Our model reliably predicts those healthy (ASA 1 or 2) patients undergoing primary THA or TKA surgery who will not require a red blood cell transfusion during their admission. These patients are suitable for this streamlined pathway without the need for unnecessary preoperative patient tests and travel.</div></div><div><h3>Level of evidence</h3><div>III.</div></div>","PeriodicalId":53594,"journal":{"name":"Journal of Clinical Orthopaedics and Trauma","volume":"64 ","pages":"Article 102974"},"PeriodicalIF":0.0,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143637554","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":"Tuberculous osteomyelitis masquerading as tumors and tumor-like lesions: A clinico-radiological study of 20 patients","authors":"Zile Singh Kundu ,&nbsp;Kunika Kundu ,&nbsp;Parveen Rana ,&nbsp;Pankaj Kumar Sharma ,&nbsp;Lakshmana Das ,&nbsp;Jyoti Sharma","doi":"10.1016/j.jcot.2025.102973","DOIUrl":"10.1016/j.jcot.2025.102973","url":null,"abstract":"<div><h3>Background</h3><div>Tuberculous osteomyelitis is uncommon and may present with varied clinical and radiological presentations. This study aimed to elaborate on how these lesions mimicked different tumors or tumor-like lesions and their successful outcome with antitubercular therapy (ATT).</div></div><div><h3>Methods</h3><div>A retrospective review of 20 patients with tuberculous osteomyelitis who presented as tumors or tumor-like lesions of bone in the last 10 years. All these were histopathologically proven lesions. Eleven cases with sequestrations required curettage for the extensive lesions. All twenty received ATT for 12 months.</div></div><div><h3>Results</h3><div>There were 12 males and eight females, with ages ranging from 3 to 61 years (an average of 22.15). Eight cases presented like bone cysts in the metaphyseal area of the long bones, with one cystic lesion in the body of the talus. 2 mimicked chondroblastoma and one patient each, like giant cell tumors and osteoid osteomas, respectively. One patient had multifocal lytic lesions resembling metastasis or multiple myeloma. One patient had two lesions involving the clavicle and the proximal phalanx of the little finger). One lesion in the metatarsal and five in the phalanges of the hand mimicked chondromas. All resolved well, with no residual disability after receiving ATT.</div></div><div><h3>Conclusions</h3><div>In endemic countries, tuberculosis should always be considered one of the differential diagnoses for lytic bone lesions. Histopathological confirmation is the gold standard for the diagnosis. These can be effectively treated with anti-tubercular medication.</div></div>","PeriodicalId":53594,"journal":{"name":"Journal of Clinical Orthopaedics and Trauma","volume":"64 ","pages":"Article 102973"},"PeriodicalIF":0.0,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143628407","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":"Infection after shoulder replacement: A literature review and strategies on diagnosis, management, and clinical outcomes","authors":"Saheed Olanrewaju Akinola ,&nbsp;Hariharan Mohan ,&nbsp;Zaid Ali ,&nbsp;Siddhartha Murhekar ,&nbsp;Bijayendra Singh","doi":"10.1016/j.jcot.2025.102968","DOIUrl":"10.1016/j.jcot.2025.102968","url":null,"abstract":"<div><div>Infection following shoulder arthroplasty is on the rise as recent data have shown, potentially due to the increase in the number of shoulder arthroplasties being performed. Despite this increase, infective complications in lower limb procedure still exceed those of the upper limb. Infection in the shoulder usually occurs as a low-grade infection due to the most common causative pathogen (Propionibacterium acnes) and can be easily missed. Therefore, a high index of suspicion is needed to make the diagnosis. Furthermore, the use of MSIS criteria can greatly enhance the diagnosis of Periprosthetic Joint Infection (PJI) if appropriately utilised. There are a number of options in the treatment of PJIs; with the 2-stage procedure appearing to be the most commonly utilised, however, the 1-stage has been shown to have similar outcomes, if not superior. The choice of antibiotics should be determined by the antimicrobial susceptibility test and in conjunction with local guidelines and microbiology support. This is usually done as part of the preoperative work up from the pre-surgical aspirate/specimen cultures.</div></div>","PeriodicalId":53594,"journal":{"name":"Journal of Clinical Orthopaedics and Trauma","volume":"64 ","pages":"Article 102968"},"PeriodicalIF":0.0,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143628408","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":"Preventing complications during acetabular fracture surgery, a review","authors":"Rahul Vaidya ,&nbsp;Sasha Stine ,&nbsp;Kayo Medeiros ,&nbsp;Alyxandra Camello ,&nbsp;Kevin Blue ,&nbsp;Kodi Kojima ,&nbsp;Detroit Medical Center Trauma Clinic","doi":"10.1016/j.jcot.2025.102957","DOIUrl":"10.1016/j.jcot.2025.102957","url":null,"abstract":"<div><div>Complications after acetabular fracture surgery include: hemorrhage, nerve injury, infection, malreduction, heterotopic ossification, post-traumatic arthritis, and medical complications may reach an incidence of 30–50 %. Total hip arthroplasty can salvage a poor reduction or post-traumatic arthritis but has higher complication rates then a primary replacement and in many cases may have to last 50 years. Sciatic nerve palsy, which is often caused by the injury, and infection/osteomyelitis, which is often caused by the surgical intervention, result in universally poor outcomes and every effort should be aimed at avoiding these. Methods of avoiding complications and treatment once they occur are discussed.</div></div>","PeriodicalId":53594,"journal":{"name":"Journal of Clinical Orthopaedics and Trauma","volume":"64 ","pages":"Article 102957"},"PeriodicalIF":0.0,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143610383","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}