Orthopaedics & Traumatology-Surgery & Research最新文献

{"title":"Articular and extra-articular scapula fracture","authors":"Guillaume Villatte ,&nbsp;Maxime Antoni ,&nbsp;Mathieu Girard ,&nbsp;Pierre-Sylvain Marcheix","doi":"10.1016/j.otsr.2025.104438","DOIUrl":"10.1016/j.otsr.2025.104438","url":null,"abstract":"<div><div>Scapular fracture is varied but rare, and studies have only low levels of evidence. Surgical indications are increasingly numerous, but non-operative treatment with early rehabilitation is the gold-standard in the majority of cases, showing good results. Surgery is indicated according to the patient’s functional demand, on certain anatomic criteria evaluated on CT: glenopolar angle &lt;20 °, &gt;10 mm frontal displacement (medialization) and sagittal angulation &gt;40 ° for fractures of the scapular neck and body, and &gt;4 mm joint displacement, involvement of more than 30% of the joint surface and persistent subluxation for glenoid fractures. Surgery provides good functional results but is technically difficult, with high rates of complications. Acromion fracture, and particularly stress fracture following reverse total arthroplasty, is difficult to treat and incurs frequent sequelae of pain and non-union. Conservative treatment is recommended only in non-displaced lateral fracture (Levy 1). In more medial fracture, osteosynthesis with one or two plates should be considered. Prosthetic revision is indicated in fewer than 10% of cases, for instability or glenoid loosening. The superior shoulder suspensory complex must be analyzed in the bone (scapular neck and clavicle) and ligaments (acromioclavicular and coracoclavicular). The extent of neck fracture displacement dictates surgical management, either (most frequently) by fixation of the clavicle alone or by double clavicular and scapular fixation.</div></div>","PeriodicalId":54664,"journal":{"name":"Orthopaedics & Traumatology-Surgery & Research","volume":"112 1","pages":"Article 104438"},"PeriodicalIF":2.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145151940","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neonatal separation of the distal humeral epiphysis can be treated orthopedically without reduction","authors":"Malek Brichni ,&nbsp;Marine De Tienda ,&nbsp;Manon Bachy ,&nbsp;Gauthier Caillard ,&nbsp;Emeline Bourgeois ,&nbsp;Clément Jeandel ,&nbsp;Stéphanie Pannier ,&nbsp;Marion Delpont","doi":"10.1016/j.otsr.2025.104382","DOIUrl":"10.1016/j.otsr.2025.104382","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Neonatal separation of the distal humeral epiphysis (NSDHE) is a very rare injury. On one hand, anatomical reduction is usually required in pediatric elbow fractures due to limited remodeling potential at the distal humerus. But on the other hand, neonatal fractures often show favorable evolution without reduction, even in cases of severe displacement. NSDHE, often associated with traumatic deliveries, remains underreported, controversial, and its management lacks standardized protocols. Furthermore, its diagnosis can be difficult on X-rays as the distal humeral epiphysis is not ossified at birth.&lt;/div&gt;&lt;div&gt;The study questions are: Can non-reduction orthopedic treatment of distal humeral epiphyseal separation yield good clinical and radiological outcomes? Are there risk factors for distal humeral epiphyseal separation? What relevant additional examinations should be performed?&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Hypothesis&lt;/h3&gt;&lt;div&gt;Orthopedic treatment without reduction may yield satisfactory clinical and radiological outcomes in NSDHE.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Patients and methods&lt;/h3&gt;&lt;div&gt;This multicenter retrospective study included patients with NSDHE with at least two years of follow-up from four university hospitals. Data on delivery, diagnostic methods, and treatment types were collected. At the last follow-up, joint range of motion, clinical outcomes, and elbow radiographs were evaluated.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Fifteen patients were included, with a mean age of 8,8 years at the last follow-up (ranging from 2 years to 29 years). All patients underwent an initial elbow radiograph, which was misinterpreted as an elbow dislocation in two cases. Two radiographs were initially deemed normal, necessitating further examinations (ultrasound, arthrography, Magnetic Resonance Imaging). Twelve patients were treated by immobilization without reduction, while two underwent surgical treatment with reduction under general anesthesia and percutaneous pinning. The non-operated patients had complete and symmetrical range of motion without complications, except for one case of resolving cubitus varus. One of the operated patients developed osteitis that required reoperation and also presented with resolving cubitus varus at 4 years old.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Discussion&lt;/h3&gt;&lt;div&gt;Orthopedic treatment through immobilization without reduction appears to be a viable option for neonatal epiphyseal separation of the distal humeral, which are frequently mistaken for elbow dislocations on initial radiographs. Complementary examinations, such as ultrasound, can be useful to confirm the diagnosis. This series yields promising results, although the sample size remains limited.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;Neonatal separation of the distal humeral epiphysis may represent an exception among displaced elbow fractures, as conservative management without reduction can lead to good clinical and radiological outcomes.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Level of","PeriodicalId":54664,"journal":{"name":"Orthopaedics & Traumatology-Surgery & Research","volume":"112 1","pages":"Article 104382"},"PeriodicalIF":2.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144979233","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Complications of distal femur megaprostheses","authors":"Valérie Dumaine","doi":"10.1016/j.otsr.2025.104527","DOIUrl":"10.1016/j.otsr.2025.104527","url":null,"abstract":"<div><div>Initially indicated for tumor surgery only, the reliability and modularity of megaprostheses of the knee, and in particular of the distal femur, have broadened indications for revision of standard knee prostheses with significant bone destruction and for trauma surgery, particularly in elderly patients. In oncologic surgery, implant survival is 80% at 5 years, but almost half will be revised by 15 years, sometimes with multiple revision. Complications are numerous; infection is the most common and the main cause of amputation. Mechanical stress is significant and, despite technological progress, no ideal implant exists. Although design is simple, the technique is demanding, to limit risk of loosening, fracture and patellar complications. Managing these complications requires good knowledge of knee prostheses in general and of techniques specific to megaprostheses.</div><div>Level of evidence: V; expert opinion</div></div>","PeriodicalId":54664,"journal":{"name":"Orthopaedics & Traumatology-Surgery & Research","volume":"112 1","pages":"Article 104527"},"PeriodicalIF":2.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145423459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cut-Off values for PFNA nail and blade protrusion predicting postoperative pain in intertrochanteric fractures","authors":"Saran Tantavisut ,&nbsp;Chavarin Amarase ,&nbsp;Napol Ratanasermsub ,&nbsp;Sanzhar Artykbay ,&nbsp;Sorn Banpapong","doi":"10.1016/j.otsr.2025.104552","DOIUrl":"10.1016/j.otsr.2025.104552","url":null,"abstract":"<div><h3>Background</h3><div>Proximal femoral nail antirotation (PFNA) fixation for intertrochanteric fractures often results in nail or blade protrusion, particularly in Asian populations, and is associated with postoperative lateral hip pain. However, not all patients with protrusion experience pain. The specific lengths and locations causing clinically significant pain remain unclear. This study aims to determine the cut-off values and locations of PFNA nail and blade protrusions that predict lateral hip pain and to evaluate their relationship with functional outcomes.</div></div><div><h3>Hypothesis</h3><div>Protrusion of the PFNA-II nail and blade beyond specific radiographic cut-off values is associated with increased lateral hip pain after intertrochanteric fracture fixation.</div></div><div><h3>Methods</h3><div>In this comparative observational study, 226 patients with intertrochanteric fractures treated with PFNA-II fixation were recruited from August 2021 to December 2023. Inclusion criteria included age ≥60 years, ≥6 months post-fixation, and radiographic fracture union. Lateral hip pain was evaluated using the Visual Analog Scale (VAS, 0–10) at two sites: the nail tip (greater trochanter) and the end of the blade. The patients were divided into four groups according to VAS scores: Group A (nail tip pain, VAS &lt; 4), Group B (nail tip pain, VAS ≥ 4), Group C (blade end pain, VAS &lt; 4), and Group D (blade end pain, VAS ≥ 4). Protrusion lengths (medial/lateral nail, superior/inferior blade) were measured radiographically. The Receiver Operating Characteristics (ROC) analysis determined the cut-off values, and multivariate logistic regression evaluated the risk factors. The Harris Hip Score (HHS) was used to evaluate functional outcomes.</div></div><div><h3>Results</h3><div>Medial nail protrusion ≥3.775 mm (sensitivity 91%, specificity 61%) and lateral nail protrusion ≥8.015 mm (sensitivity 85%, specificity 65%) predicted nail tip pain. The superior blade protrusion ≥10.95 mm (sensitivity 56%, specificity 70%) and the inferior blade protrusion ≥3.265 mm (sensitivity 60%, specificity 66%) predicted blade end pain. Medial nail protrusion increased pain risk (odds ratio 17.17, 95% CI 7.68–38.39). HHS did not show a significant correlation with protrusion, except for a weak negative correlation with inferior blade protrusion (<em>r</em> = −0.39, <em>p</em> = 0.032).</div></div><div><h3>Conclusion</h3><div>Distinct radiographic cut-off values of PFNA-II protrusion predict postoperative lateral hip pain. While pain is mainly associated with medial nail and superior blade protrusion, excessive inferior blade protrusion may slightly impair hip function. The refinement of the PFNA II design and surgical technique to minimize protrusion could further improve postoperative outcomes in Asian patients.</div></div><div><h3>Level of evidence</h3><div>II.</div></div>","PeriodicalId":54664,"journal":{"name":"Orthopaedics & Traumatology-Surgery & Research","volume":"112 1","pages":"Article 104552"},"PeriodicalIF":2.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145589900","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Modified Elastic Stable Intramedullary Nailing: A New Approach for Metaphyseal-Diaphyseal Fractures of the Forearm in Children","authors":"Elie Saliba ,&nbsp;Clement Munoz ,&nbsp;Aren Joe Bizdikian ,&nbsp;Yan Lefevre","doi":"10.1016/j.otsr.2025.104549","DOIUrl":"10.1016/j.otsr.2025.104549","url":null,"abstract":"<div><div>Elastic Stable Intramedullary Nailing (ESIN) is the treatment of choice for forearm fractures in children. However, fractures occurring at the distal metaphyseal-diaphyseal junction (DMDJ) of the radius are notoriously difficult to treat. This paper presents a modified ESIN method to treat these fractures.</div><div>Surgical intervention was considered for fractures with angulation &gt;10 ° in the coronal plane, 20 ° in the sagittal plane, &gt;1 cm of bayoneting, and instability after reduction. A radial approach is used. Once the nail is at the biceps tuberosity, it is retracted by 4 cm and at bent 90 °, and reinserted so that the nail lies against the medial cortex, thereby stabilizing the fracture.</div><div>Twenty-seven patients were treated, all showing &lt;5° of coronal and sagittal tilt as well as &lt;5 mm of coronal translation and &lt;5° of difference in pronation-supination. This new ESIN method is an effective technique for the treatment of DMDJ fractures on the radius in children.</div></div><div><h3>Level of evidence</h3><div>IV; Technical note and case series</div></div>","PeriodicalId":54664,"journal":{"name":"Orthopaedics & Traumatology-Surgery & Research","volume":"112 1","pages":"Article 104549"},"PeriodicalIF":2.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145472325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reasons for malpractice claims after first revision of total hip arthroplasty in France: Insurance data from 263 consecutive claims from 2010 to 2023","authors":"Frédéric Sailhan ,&nbsp;Pierre-Jean Garnier ,&nbsp;Christian Delaunay","doi":"10.1016/j.otsr.2025.104423","DOIUrl":"10.1016/j.otsr.2025.104423","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introduction&lt;/h3&gt;&lt;div&gt;With an increasing number of surgical procedures, particularly due to the aging population, we are facing an increase in the number of total hip arthroplasty (THA) revisions and, consequently, conflicts between surgeons and patients. There are very little data specifically dedicated to THA revisions in the international literature. Therefore, we conducted a retrospective study to identify the most common causes of lawsuits following THA revision in France.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Materials and methods&lt;/h3&gt;&lt;div&gt;We reviewed 263 consecutive complaint files following a THA first revision between 2010 and 2023 from the Cabinet Branchet (CB) database. Collected data included: nature of the pathology leading to the revision, time between revision and complaint, American Society of Anesthestiologists (ASA) score, age and sex of patients, any complications following the revision, nature of the procedure, attribution of responsibilities, and amount of poured compensation.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;These 263 procedures involved 256 patients, 144 men (56.2%) and 112 women (43.7%), with an average age of 61.4 years (27–92) and an average ASA score of 2. The clinical situations leading to THA revision, that eventually resulted in a patient complaint, were: aseptic loosening (70/263, 26.6%), Surgical Site Infection (SSI, 46, 17.5%), dislocation (32, 12.2%), or implant fracture (23, 8.7%). However, in 160 cases (61%), these are the complications following the revision surgery that led to the patient’s complaint. These complications were: SSI in 52.5% of cases (93/177), neurological deficit in 12.4% of cases (22/177), death (17 patients, 9.6%), persistent pain (12, 6.7%), and leg length discrepancy (LLD, 11, 6.2%). The 263 final legal proceedings were distributed as follow: 137 in French Commission for Conciliation and Compensation for Medical Accidents (CCI, 52%), 97 in judicial court (36.9%), 26 amicable settlements (9.9%), and 3 others. In 192 cases (73%), the surgeon’s legal responsibility was not retained. The average compensation amount was €60,000, and &gt;€100,000 in 6 cases (2.3%).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Discussion&lt;/h3&gt;&lt;div&gt;French orthopaedic surgeons are frequently sued. CB data indicates a frequency of one implication every 27 months, excluding the field of spine surgery. Some causes of revision seem to be less well tolerated by patients than others, such as implant fractures or LLD. Nevertheless, our study shows that SSIs are the main cause of litigation, accounting for 52.9% of cases (139/263), either as the primary cause or as secondary cause following complications after first revision surgery.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;Aseptic loosening, surgical site infection, recurrent dislocation, and implant fractures are the primary causes of complaints leading to a lawsuit after THA revision in France. These data must be communicated to orthopaedic surgeons to better guide preoperative inform consent discussi","PeriodicalId":54664,"journal":{"name":"Orthopaedics & Traumatology-Surgery & Research","volume":"112 1","pages":"Article 104423"},"PeriodicalIF":2.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145056319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Demographic and radiographic predictors of failed internal fixation in subcapital femoral neck fractures","authors":"Shelly Feygelman ,&nbsp;Dror Ronel ,&nbsp;David Maman ,&nbsp;Bezalel Peskin ,&nbsp;Nabil Ghrayeb ,&nbsp;Jackob Shapira","doi":"10.1016/j.otsr.2025.104562","DOIUrl":"10.1016/j.otsr.2025.104562","url":null,"abstract":"<div><h3>Background</h3><div>Internal fixation with three screws remains a common treatment for subcapital femoral neck fractures, particularly when preservation of the native joint is preferred. However, failure rates remain significant, and identifying risk factors for failure is crucial for patient selection and surgical planning. This study aimed to define demographic, laboratory, and radiographic risk factors associated with failed osteosynthesis of intra-capsular femoral neck fractures.</div></div><div><h3>Methods</h3><div>We conducted a retrospective case-control study at a single tertiary trauma center in northern Israel, including 735 patients treated between 2004 and 2020. All patients underwent internal fixation using three cannulated screws. Variables analyzed included patient demographics, comorbidities, laboratory values, and radiographic features. Radiographic analysis was performed on all failed cases and a sample of 98 successful cases. Multivariate logistic regression and ROC analysis were used to identify independent predictors of fixation failure.</div></div><div><h3>Results</h3><div>Of the 735 patients included, 40 (5.4%) experienced fixation failure requiring conversion to total hip arthroplasty. Univariate analysis revealed several associated factors, including smoking, hemoglobin, eGFR, fracture classification, calcar impairment, reduction type, screw convergence, and VN angle as demonstrated in Table <span><span>1</span></span>. Multivariate analysis identified younger age, convergent screw configuration, and increased VN angle as independent risk factors. Thresholds were determined as &gt;2.5 ° of screw convergence and VN angle &gt;13.25 °.</div></div><div><h3>Conclusion</h3><div>Fixation failure was associated with both patient-related and technical factors. Younger age, fracture verticality, and convergent screw configuration significantly increased the risk of failure. Recognizing these variables may assist in preoperative decision-making and optimize treatment strategies for femoral neck fractures.</div></div><div><h3>Level of evidence</h3><div>III; Case control retrospective study.</div></div>","PeriodicalId":54664,"journal":{"name":"Orthopaedics & Traumatology-Surgery & Research","volume":"112 1","pages":"Article 104562"},"PeriodicalIF":2.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145688676","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"New insights in Orthopaedics & Traumatology: Surgery & Research: Editorial board, position of the journal regarding AI usage in editing, new features and ethical issues","authors":"Henri Migaud ,&nbsp;Philippe Clavert ,&nbsp;Gregoire Micicoi ,&nbsp;Baptiste Boukebous ,&nbsp;Patrick Haubruck","doi":"10.1016/j.otsr.2026.104580","DOIUrl":"10.1016/j.otsr.2026.104580","url":null,"abstract":"","PeriodicalId":54664,"journal":{"name":"Orthopaedics & Traumatology-Surgery & Research","volume":"112 1","pages":"Article 104580"},"PeriodicalIF":2.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145946545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Flatfoot: New diagnostic modalities","authors":"Matthieu Lalevée ,&nbsp;Louis Dagneaux ,&nbsp;François Lintz ,&nbsp;Cesar de Cesar Netto","doi":"10.1016/j.otsr.2025.104415","DOIUrl":"10.1016/j.otsr.2025.104415","url":null,"abstract":"<div><div>Adult acquired flatfoot deformity, recently renamed Progressive Collapsing Foot Deformity (PCFD), is challenging to diagnose and treat due to the still poorly understood nature of its pathogenesis, which involves a complex interaction between soft tissues and bony structures. Long regarded as being primarily linked to posterior tibial tendon dysfunction, PCFD is now considered a multifactorial deformity (osseous dysplasia, joint malposition, tendon muscle imbalance, etc.), with many aspects yet to be explored. This study aims to provide an update on this pathology by addressing the following five key questions: (1) Is flatfoot truly a problem? A stable congenital flatfoot is generally asymptomatic. However, a sagging foot, regardless of its flatness, characterized by a progressive arch collapse (PCFD), is painful. (2) What role do soft tissues play in its pathogenesis? The previously central role attributed to the posterior tibial tendon and its rupture, which was thought to trigger a chronological cascade of deformations, is now being reconsidered. (3) How should we classify a flatfoot? The Progressive Collapsing Foot Deformity (PCFD) classification distinguishes five types of deformities: hindfoot valgus, midfoot abduction, forefoot varus, peritalar subluxation, and tibiotalar valgus. These deformities can occur in isolation or in combination, without a predetermined chronological order, and each of them can be either flexible or rigid. (4) What is the contribution of modern imaging? Weightbearing Cone Beam CT enables the early identification of subluxations and joint impingements, clarifying the distinction between a stable flatfoot and PCFD while revealing complex deformities that conventional methods may not detect. (5) What are the current perspectives and future directions? Research aims to differentiate stable congenital flatfeet from PCFD in order to better identify risk factors for symptomatic progression. Dynamic imaging techniques, such as biplanar fluoroscopy, offer real time analysis of bone motions, while computational simulations, integrating both soft tissues and bony structures, contribute to a deeper understanding of the onset and progression of deformities.</div></div><div><h3>Level of evidence</h3><div>&gt;V.</div></div>","PeriodicalId":54664,"journal":{"name":"Orthopaedics & Traumatology-Surgery & Research","volume":"112 1","pages":"Article 104415"},"PeriodicalIF":2.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145042493","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to the letter from Bhumesh Tyagi, Leelabati Toppo and Aishwarya Biradar","authors":"Mathias Hengartner ,&nbsp;Marc-Olivier Kiss ,&nbsp;Vincent Massé ,&nbsp;Pierre Rousseau ,&nbsp;MartinLavigne ,&nbsp;Pascal-André Vendittoli","doi":"10.1016/j.otsr.2025.104570","DOIUrl":"10.1016/j.otsr.2025.104570","url":null,"abstract":"","PeriodicalId":54664,"journal":{"name":"Orthopaedics & Traumatology-Surgery & Research","volume":"112 1","pages":"Article 104570"},"PeriodicalIF":2.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145795310","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}