Journal of Clinical Orthopaedics and Trauma最新文献

{"title":"Outcomes of posterior wall acetabular fractures with marginal impaction using greater trochanter autografting: A prospective cohort study","authors":"Dharmendra Kumar,&nbsp;Pranav Raghuwanshi,&nbsp;Ankit Sriwastava,&nbsp;Ravindra Mohan,&nbsp;Arpit Singh,&nbsp;Ashish Kumar","doi":"10.1016/j.jcot.2025.103029","DOIUrl":"10.1016/j.jcot.2025.103029","url":null,"abstract":"<div><h3>Background</h3><div>Posterior wall acetabular fractures with marginal impaction pose significant challenges, mainly because of the risk of joint incongruity and the potential for developing post-traumatic arthritis. Restoration of the articular surface and stability are essential to achieve good outcomes. This study investigates the surgical outcomes of posterior wall acetabular fractures with marginal impaction using the Kocher-Langenbeck (KL) approach, buttress plating, and greater trochanter autografting.</div></div><div><h3>Methods</h3><div>This prospective cohort study was conducted on 19 patients aged 18–60 years who were treated at a tertiary care center in North India. Fractures were confirmed by radiographic imaging and CT scans. The surgical procedure included articular dis-impaction, void filling with autografts, and fixation with anatomical reconstruction using plates and screws with mean Follow-up period was (mean ± SD) 1.86 ± 0.77 (Ranges:1–3 Years) The outcome was measured using Matta's criteria for radiological evaluation, and functional outcome using the Modified Merle d'Aubigné and Postel Score. Complications were noted, including infection, avascular necrosis (AVN), myositis ossificans, and secondary surgeries.</div></div><div><h3>Results</h3><div>The mean age was 37.58 ± 9.08 years, with a male predominance of 89.5 %. The most common cause was road traffic accidents, at 94.7 %. The most common fracture pattern noted was transverse with posterior wall fracture, with marginal impaction at 47.36 %, followed by isolated posterior wall fractures with marginal impaction at 42.10 %. Anatomical reduction was achieved in 73.7 % of cases, and the radiological outcomes at one year were excellent or good in 78.9 % of cases. Functional scores were excellent or good in 73.65 %. Complications included avascular necrosis with arthritis (21.1 %), myositis ossificans (10.5 %), infection (5.3 %), and conversion to total hip replacement in 10.5 % of cases.</div></div><div><h3>Conclusion</h3><div>Correction of impaction injuries with subchondral autografting and buttress plating via the KL approach provides satisfactory radiologic and functional results. However, associated injuries, particularly head injuries, are associated with poorer recovery outcomes.</div></div>","PeriodicalId":53594,"journal":{"name":"Journal of Clinical Orthopaedics and Trauma","volume":"65 ","pages":"Article 103029"},"PeriodicalIF":0.0,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143907856","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 retrospective comparison of open and arthroscopic surgery for elbow joint stiffness; a single centre pragmatic study over 15 years","authors":"Andrew P Dekker ,&nbsp;Jamie Hind ,&nbsp;Neil Ashwood","doi":"10.1016/j.jcot.2025.103031","DOIUrl":"10.1016/j.jcot.2025.103031","url":null,"abstract":"<div><h3>Background</h3><div>There is ample evidence but conflicting reports to justify decision making for open versus arthroscopic elbow debridement and release for stiffness and pain once non-surgical measures have failed. The aim of this retrospective study is to report the clinical and functional outcomes of arthroscopic and open surgery for patients presenting with elbow pain, stiffness and loss of function.</div></div><div><h3>Methods</h3><div>A consecutive series of patients who had completed a minimum of 6 months of non-surgical treatment of elbow stiffness were identified over a 15-year period between July 2008 and January 2023 from a single centre.</div></div><div><h3>Results</h3><div>96 patients were treated with arthroscopic surgery with 75 open surgery. Mean age was 51 years. Pre-operative pathology included osteoarthritis, inflammatory arthropathy and post-traumatic stiffness. Post-traumatic stiffness was more commonly treated with open surgery. The flexion-extension arc, pronosupination arc, pain score, Mayo elbow performance score (MEPS) and satisfaction scores improved in all patients (p &lt; 0.05). The arthroscopic group had a lower pain score (p &lt; 0.05), a higher satisfaction score (p &lt; 0.05), higher MEPS (p &lt; 0.05), greater flexion-extension arc (P &lt; 0.01), greater pronosupination arc (P &lt; 0.01) and fewer patients had ongoing symptoms of pain and stiffness which limited function (P &lt; 0.05) with fewer repoerations (p &gt; 0.05) than the open group.</div></div><div><h3>Conclusions</h3><div>Both arthroscopic and open surgical approaches for elbow stiffness improved elbow range of movement and function. Arthroscopic treatment was better than open surgery and may represent a more favorable approach.</div></div><div><h3>Level of evidence</h3><div>Level 4 (case series)</div></div>","PeriodicalId":53594,"journal":{"name":"Journal of Clinical Orthopaedics and Trauma","volume":"66 ","pages":"Article 103031"},"PeriodicalIF":0.0,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143902547","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":"Trends in surgical stabilization of rib fractures: A contemporary literature review","authors":"Matthew Masoudi ,&nbsp;Ropafadzo Muchabaiwa ,&nbsp;Elizabeth Wake ,&nbsp;Bhavik Patel","doi":"10.1016/j.jcot.2025.103028","DOIUrl":"10.1016/j.jcot.2025.103028","url":null,"abstract":"<div><h3>Background</h3><div>Blunt chest trauma leading to rib fractures is a common injury, accounting for 20 % of thoracic trauma cases. Surgical Stabilization of Rib Fractures (SSRF) has gained popularity due to advancements in surgical techniques and multidisciplinary care, resulting in improved patient outcomes. Despite a growing body of literature on SSRF, inconsistencies in study design and outcome reporting limit the synthesis of findings and the establishment of clear clinical guidelines. This scoping review aims to provide an overview of the existing SSRF literature, identifying prevalent trends and reported outcomes.</div></div><div><h3>Methods</h3><div>A systematic scoping review was conducted following Arksey and O'Malley's framework and the Preferred Reporting Items for Scoping Reviews (PRISMA) guidelines. The study was registered with Open Science Framework (8V9KN). A comprehensive search of MEDLINE, EMBASE, CINAHL, and Cochrane CENTRAL was performed from inception to March 1, 2025. Studies were included if they reported on SSRF for blunt chest trauma in human patients. Data extraction focused on study characteristics, patient demographics, reported outcomes, and methodological rigor.</div></div><div><h3>Results</h3><div>A total of 1462 articles were screened, with 185 studies meeting the inclusion criteria. The majority (N = 162, 88 %) were published between 2015 and 2025, with the highest number in 2022. Most studies (N = 144, 78 %) employed a cohort study design, predominantly retrospective (N = 115, 80 %), while randomized controlled trials (RCTs) constituted only 8 % (N = 15). Hospital outcomes, including length of stay (N = 112) and ICU stay (N = 97), were the most frequently reported measures. Complications were documented in 124 studies, with pneumonia (N = 90) and mortality (N = 94) being the most common. Patient-reported outcomes (PROMs) were included in 60 studies (32 %), with pain (N = 46, 78 %) and quality of life (N = 23, 39 %) as key measures. Device and procedural details were reported in 70 studies (38 %), with 62 using the same device. However, variations in outcome measurement and a predominance of retrospective designs limit comparability.</div></div><div><h3>Conclusion</h3><div>SSRF literature has expanded significantly over the past decade, yet inconsistencies in study design and outcome reporting hinder the development of standardized clinical guidelines. Future research should prioritize prospective, multi-center trials with uniform reporting standards to enhance the reliability and applicability of findings.</div></div>","PeriodicalId":53594,"journal":{"name":"Journal of Clinical Orthopaedics and Trauma","volume":"66 ","pages":"Article 103028"},"PeriodicalIF":0.0,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143886363","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":"Plate vs. Nail: Is there a more effective implant for extreme tibia fractures?","authors":"Abhishek Ganta ,&nbsp;Fiona K. Cherry ,&nbsp;Nirmal C. Tejwani ,&nbsp;Sanjit R. Konda ,&nbsp;Kenneth A. Egol","doi":"10.1016/j.jcot.2025.103025","DOIUrl":"10.1016/j.jcot.2025.103025","url":null,"abstract":"<div><h3>Background</h3><div>The purpose of this study is to determine differences in outcomes between “extreme” tibial metaphyseal fractures treated with intramedullary nailing (IMN) or plate osteosynthesis.</div></div><div><h3>Methods</h3><div>545 prospectively collected patients were reviewed by two board-certified orthopedic trauma surgeons to identify extreme tibial shaft fractures (defined as most proximal or distal segments that involved or would have involved the area encompassed by the nail locking bolts). Fifty-one patients were identified. Twenty-five patients treated with an intramedullary nail were compared to 24 patients treated with plate and screws for similar patterns. Data collected included patient demographics, surgical details, and outcomes. Cohorts were compared using fisher's exact test, independent T tests, and multivariable linear regression.</div></div><div><h3>Results</h3><div>The mean age of all patients was 46.73 years. There were no differences in ASA, CCI, age, male/female composition, or BMI between cohorts. There were no differences in low vs. high-energy mechanism of injury between cohorts, however the IMN cohort had a greater proportion of open fractures (p = 0.018). When controlling for covariates, patients who underwent IMN were allowed earlier weight bearing on the operative extremity. There were no differences in ankle or knee range of motion at latest follow up. There was a greater incidence of total complications among IMN (p = 0.033). Single variable analysis revealed an association between IMN and nonunion (p = 0.050). IMN trended towards greater need for reoperation (p = 0.086).</div></div><div><h3>Conclusion</h3><div>Intramedullary nailing of “extreme tibia fractures” was associated with higher rates of total complications compared to plate osteosynthesis and trended with greater need for reoperation. However, it should be noted that there was a higher incidence of open fractures in this cohort. There were no differences in the rate of malalignment, range of motion, or time to healing between cohorts.</div></div>","PeriodicalId":53594,"journal":{"name":"Journal of Clinical Orthopaedics and Trauma","volume":"65 ","pages":"Article 103025"},"PeriodicalIF":0.0,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143898865","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":"Sacral dysmorphism and gender-specific variations: A CT-Based approach to safe percutaneous sacral screw placement – An ambispective study","authors":"Dinesh Kale ,&nbsp;Shubham Gupta ,&nbsp;Sahil Kale ,&nbsp;Dharmendra Kumar","doi":"10.1016/j.jcot.2025.103026","DOIUrl":"10.1016/j.jcot.2025.103026","url":null,"abstract":"<div><h3>Background</h3><div>Sacral fractures are associated with high-energy trauma and pose challenging surgical conditions due to anatomical variability. The presence of sacral dysmorphism with narrow corridors, acute alar slopes, and non-circular foramina further complicates the placement of ilio-sacral and trans-sacral screws. Gender-related differences also exist in sacral morphology, which can impact surgical planning and screw trajectory.</div></div><div><h3>Methods</h3><div>We reviewed data from 1000 pelvic CT scans among 652 males and 348 females aged 18–65 years from multiple centers to measure sacral morphometry along with the safe screw placement corridors. Quantification of S1 and S2 sacral segments was done using HOROS, Radiant, Iplan software tools in terms of anteroposterior breadth, height, and width of sacral corridors. The safe screw trajectory for 6.5 mm and 7.3-mm screws was established from the vestibular concept with 2 mm of safety margin. SPSS v22.0 was used for statistical analysis.</div></div><div><h3>Results</h3><div>Sacral dysmorphism was found in 31.58 % males and 18.42 % females. Male dimensions of the sacrum were higher, more sagittal height at S1 (12.01 ± 1.83 mm vs. 10.76 ± 1.13 mm, p &lt; 0.001), and axial width (23.66 ± 3.32 mm vs. 13.3 ± 2.9 mm, p &lt; 0.001), compared to women. Measurements made at S2 were similar among genders. Safe placement of 7.3 mm S1 trans-sacral screws was possible in 84.21 % males and 47.37 % females, and 6.5 mm screws were applicable in 10.53 % of males and 26.32 % of females. For S2, 68.42 % of males and 31.58 % females were amenable to 7.3 mm screws, while 6.5 mm screws were feasible in 10.53 % of males and 23.68 % of females. Dysmorphic sacrum required a specific approach with a bias towards the use of 6.5 mm screws.</div></div><div><h3>Conclusion</h3><div>The study highlights gender variations and sacral dysmorphism impacts the safety of screw placement in Indian patients. The possibility of individualized planning before surgery by CT-based morphometry will improve safety as well as effectiveness in sacral fracture fixation.</div></div>","PeriodicalId":53594,"journal":{"name":"Journal of Clinical Orthopaedics and Trauma","volume":"66 ","pages":"Article 103026"},"PeriodicalIF":0.0,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143868635","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":"Development of a cost-effective osteoporosis risk scoring system for early detection in low-resource settings: A community-based approach","authors":"Muhammad Muzzammil ,&nbsp;Muhammad Owais Minhas ,&nbsp;Amna Jamil","doi":"10.1016/j.jcot.2025.103018","DOIUrl":"10.1016/j.jcot.2025.103018","url":null,"abstract":"<div><h3>Background</h3><div>Osteoporotic fractures pose a significant public health burden, particularly in resource-constrained settings where diagnostic tools like DXA scans are unavailable. This study aimed to develop and validate a simple, community-based osteoporosis risk scoring system that incorporates demographic, clinical, and radiographic parameters to identify high-risk individuals for early intervention.</div></div><div><h3>Methods</h3><div>A cross-sectional study was conducted in Karachi, Pakistan, involving 750 participants aged 40 years and above. Data on demographic characteristics, clinical risk factors, and lifestyle habits were collected using a structured questionnaire. Radiographic assessments identified vertebral compression fractures, generalized osteopenia, and trabecular bone loss. Participants were stratified into four risk categories: low, moderate, high, and very high risk. The predictive validity of the scoring system was evaluated using logistic regression and receiver operating characteristic (ROC) curve analysis.</div></div><div><h3>Results</h3><div>The developed tool classified participants into low (38 %), moderate (32 %), high (20 %), and very high (10 %) risk groups. Fracture incidence ranged from 11.29 % in the low-risk group to 28.23 % in the very high-risk group. The scoring system demonstrated strong predictive accuracy, with a sensitivity of 83 %, specificity of 75 %, and an area under the curve (AUC) of 0.82. Odds ratios for fractures progressively increased with higher risk categories, confirming the model's validity.</div></div><div><h3>Conclusion</h3><div>This Muzzammil's osteoporosis risk scoring system is a cost-effective and practical tool for early identification of high-risk individuals in low-resource settings. Its implementation could aid in targeted prevention strategies, reducing osteoporotic fracture incidence and improving public health outcomes. Further validation in diverse populations is recommended to optimize its utility.</div></div>","PeriodicalId":53594,"journal":{"name":"Journal of Clinical Orthopaedics and Trauma","volume":"65 ","pages":"Article 103018"},"PeriodicalIF":0.0,"publicationDate":"2025-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143912991","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":"Finite element analysis of sliding vs static configuration of partial threaded cannulated compression screws for Pauwels type III fracture neck of femur","authors":"Amit Kumar ,&nbsp;Somesh Kumar ,&nbsp;Ajeet Kumar ,&nbsp;Kumar Keshav ,&nbsp;Anurag Baghel ,&nbsp;Pulak Sharma","doi":"10.1016/j.jcot.2025.103024","DOIUrl":"10.1016/j.jcot.2025.103024","url":null,"abstract":"<div><h3>Background</h3><div>Cannulated Cancellous Screws fixation is done either as a sliding or static configuration according to the number, thread length and orientation of the screws. This study aims to compare the biomechanical properties of 3-CCS as sliding configuration and BDSF &amp; 4-CCS (Alpha configuration) as static configuration, by finite element analysis for Pauwels type III fracture neck of femur.</div></div><div><h3>Methods</h3><div>DICOM format images of saw-bone were used to build the 3-D geometric models, which were hypermeshed to create models of Pauwels type III FNF with an angle of 65°. CAD models of three configurations were created as per AO specifications and analysed for stress distribution of bone &amp; implant, relative displacement between fracture planes &amp; stiffness.</div></div><div><h3>Results</h3><div>The peak stress at the fracture surface was found to be low in 4-CCS, which promotes fracture healing. 4-CCS had a decreased chance of failure due to lower implant stress and fracture surface displacement, indicating improved length stability. Overall, 4-CCS had the maximum construct stiffness, indicating a stable and rigid fixation.</div></div><div><h3>Conclusion</h3><div>The static configuration of 4-CCS showed superior biomechanical properties in terms of low stress of bone &amp; implant, and lower relative displacement of the fracture surface with high construct stiffness over other configurations. So, 4-CCS (Alpha configuration) should be the preferred configuration for the Pauwels type III FNF.</div></div>","PeriodicalId":53594,"journal":{"name":"Journal of Clinical Orthopaedics and Trauma","volume":"66 ","pages":"Article 103024"},"PeriodicalIF":0.0,"publicationDate":"2025-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143868633","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":"Surgical management for distal phalanx osteomyelitis: A narrative review","authors":"J. Terrence Jose Jerome ,&nbsp;Arun Kumar ,&nbsp;Dr Mauli Chandar","doi":"10.1016/j.jcot.2025.103021","DOIUrl":"10.1016/j.jcot.2025.103021","url":null,"abstract":"<div><div>Distal phalanx osteomyelitis, although rare, represents a challenging infection that can have devastating functional and cosmetic consequences if inadequately managed. In patients with comorbidities—most notably diabetes mellitus—the infection may progress rapidly, causing bone destruction, soft tissue involvement, and ultimately, joint destruction. This review discusses the pathophysiology, diagnosis, and surgical management of distal phalanx osteomyelitis. It also highlights key gaps in the current literature, particularly the lack of standardized treatment protocols and limited long-term outcome data, aiming to provide a more consolidated approach to this complex condition. Drawing on current literature and our clinical experience, we outline indications and contraindications for surgery, evaluate imaging modalities and diagnostic criteria, describe detailed surgical techniques (including debridement, dead space management, and reconstruction), and examine the role of antibiotic therapy. We also propose a surgical algorithm based on the extent of infection and review potential complications and outcomes. The article emphasizes that early recognition and aggressive surgical management—coupled with culture-directed antibiotics—are key to optimizing hand function and preventing recurrence.</div></div>","PeriodicalId":53594,"journal":{"name":"Journal of Clinical Orthopaedics and Trauma","volume":"66 ","pages":"Article 103021"},"PeriodicalIF":0.0,"publicationDate":"2025-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143864375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influence of femoral component downsizing on knee extension and resultant extension gap in TKA","authors":"Anoop Jhurani,&nbsp;Piyush Agarwal,&nbsp;Gaurav Ardawatia,&nbsp;Hardik Sahni,&nbsp;Mudit Srivastava","doi":"10.1016/j.jcot.2025.103023","DOIUrl":"10.1016/j.jcot.2025.103023","url":null,"abstract":"<div><h3>Background</h3><div>Downsizing of femur is often considered during TKA to increase the flexion space or to reduce the mediolateral overhang of the femoral component. This leads to an obvious opening up of flexion space by 2–3 mm. However, the effect of downsizing of the femur component on knee extension and final sagittal correction are unknown. This CAS based prospective study aims to find out change in knee extension caused as a result of downsizing the femur component through objective data from computer navigation.</div></div><div><h3>Methods</h3><div>Out of a total 1811 CAS knees operated between 2020 and 2022. 152 knees required downsizing of which 112 knees were included after applying exclusion criteria. The patients had average BMI of 28.2 ± 4.6 kg/m and average age of 62.5 ± 8 years.</div></div><div><h3>Results</h3><div>The average preoperative deformity was fixed flexion of 7.7 ± 4.3 (0.5–14) and varus of 8.6 ± 2.7 (3–13). The average difference of deformity in sagittal plane in extension between larger and downsized femur trial was 5.8° which was statistically significant (p = 0.001). Knee achieves more extension after downsizing possibly because of decrease in metallic volume in the joint capsule and soft tissue envelope. There was significant correction in coronal plane alignment (1°) on downsizing as the soft tissue envelope on the medial side relaxed due to decreased impingement (p = 0.001).</div></div><div><h3>Conclusion</h3><div>Surgeons should be aware that downsizing of the femur may increase the knee extension by 5.8° and this can be a strategy to increase both gaps specially when there is significant mediolateral overhang of the femoral component.</div></div><div><h3>Level of evidence</h3><div>Type IV.</div></div>","PeriodicalId":53594,"journal":{"name":"Journal of Clinical Orthopaedics and Trauma","volume":"65 ","pages":"Article 103023"},"PeriodicalIF":0.0,"publicationDate":"2025-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143912990","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":"Hemi-capitate arthroplasty for chronic unstable dorsal fracture-dislocations of the proximal interphalangeal joint: A retrospective analysis of functional and radiological outcomes","authors":"J. Terrence Jose Jerome","doi":"10.1016/j.jcot.2025.103020","DOIUrl":"10.1016/j.jcot.2025.103020","url":null,"abstract":"<div><h3>Background</h3><div>This retrospective study examined the clinical and radiological outcomes of hemi-capitate arthroplasty in treating chronic unstable dorsal fracture-dislocations of the proximal interphalangeal (PIP) joint.</div></div><div><h3>Methods</h3><div>Fifteen patients, aged 22–36 years, who underwent hemi-capitate arthroplasty for chronic unstable dorsal PIP joint fracture-dislocations between 2020 and 2022, were included in this review. Thirteen patients had nondominant hand involvement. Clinical outcomes were evaluated by assessing PIP joint range of motion (ROM), grip strength, pain using the Visual Analog Scale (VAS), and Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) scores. Radiographic evaluations focused on posttraumatic arthritis, graft integrity, and joint stability.</div></div><div><h3>Results</h3><div>The average time from injury to surgery was 79 days (range: 45–125 days), with a mean follow-up of 23 months (range: 18–36 months). At the final follow-up, the mean PIP joint ROM significantly improved from 3° preoperatively to 95° postoperatively (p &lt; 0.05), with a motion arc between 85° and 105°. The mean extension lag was 2° (range: 0°–10°). Postoperative grip strength reached 92 % (range: 78 %–100 %) of the contralateral hand. The QuickDASH score improved to a mean of 5.5 (range: 0–13.3), and mean pain score was low (mean VAS: 0.2, range: 0–4). Based on the Ishida and Ikuta scoring system, 13 patients had excellent outcomes. No patients developed postoperative osteoarthritis, graft collapse, donor-site problems, or wrist pain. Three patients had a mild extensor lag (approximately 10°), but all patients had returned to their previous activities by an average of 13 weeks (range: 11–16 weeks) after surgery.</div></div><div><h3>Conclusions</h3><div>Hemi-capitate arthroplasty consistently yielded positive functional and radiological outcomes in chronic unstable dorsal PIP joint fracture-dislocations. This technique effectively restores joint stability and a substantial range of motion, allowing patients to resume daily activities with few complications.</div></div>","PeriodicalId":53594,"journal":{"name":"Journal of Clinical Orthopaedics and Trauma","volume":"66 ","pages":"Article 103020"},"PeriodicalIF":0.0,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143852119","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}