Orthopaedics & Traumatology-Surgery & Research最新文献

{"title":"Return to sport after arthroscopic double endo-button fixation for acute acromioclavicular dislocation: One-year functional outcomes.","authors":"Quentin Martial, Martin Renaud, Laurent Hubert, Romain Lancigu, Louis Rony, Guillaume David","doi":"10.1016/j.otsr.2025.104425","DOIUrl":"10.1016/j.otsr.2025.104425","url":null,"abstract":"<p><strong>Introduction: </strong>Acromioclavicular joint dislocation (ACJD) is a common injury among athletes. Few studies have investigated clinical outcomes following arthroscopic surgery for high-grade acute ACJD. This study aims to determine whether arthroscopic stabilization using a double-button fixation system enables an optimal return to sports in terms of timing and level, with a minimum follow-up of one year postoperatively.</p><p><strong>Materials and methods: </strong>This prospective, single-center study included patients who underwent arthroscopic stabilization with a double-button fixation system for severe acute ACJD (Rockwood grade ≥3) between 2016 and 2023. Return-to-sport timing and level of performance were assessed via questionnaire, clinical outcomes were evaluated using the self-reported Constant score, Subjective Shoulder Value (SSV), and a satisfaction score. Radiographic assessments were systematically performed, with a minimum follow-up of one year.</p><p><strong>Results: </strong>A total of 30 patients with Rockwood grade III to V ACJD were included. The mean time to return to sports was 5 months, and the mean self-reported Constant score was 96 at one year postoperatively, with no residual pain or limitations in range of motion. 82% of patients reported returning to a pre-injury level of sports. The average duration of work absence was 3 months. Smoking was identified as a factor correlating to a negative Constant score at the final follow-up.</p><p><strong>Conclusion: </strong>At more than one year of follow-up, arthroscopic surgery for acute ACJD allows a return to sports after an average of 5 months, with clinical outcomes comparable to open techniques. This approach offers a minimally invasive procedure, a single surgical intervention, and precise assessment of shoulder pathology.</p><p><strong>Level of evidence: </strong>IV; Descriptive, single-center, prospective observational study.</p>","PeriodicalId":54664,"journal":{"name":"Orthopaedics & Traumatology-Surgery & Research","volume":" ","pages":"104425"},"PeriodicalIF":2.2,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145058825","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":"Answer to the letter entitled: Sagittal Realignment Alters Hip Biomechanics: Revisiting Hip-Spine Syndrome in Native Hips.","authors":"Benjamin Blondel, Sébastien Pesenti","doi":"10.1016/j.otsr.2025.104420","DOIUrl":"10.1016/j.otsr.2025.104420","url":null,"abstract":"","PeriodicalId":54664,"journal":{"name":"Orthopaedics & Traumatology-Surgery & Research","volume":" ","pages":"104420"},"PeriodicalIF":2.2,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145058750","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":"Should Ceramic-on-Ceramic or Ceramic-on-Polyethylene Bearings Be Preferred in Revision Total Hip Arthroplasty After Ceramic Head or Liner Fracture? A Retrospective Multicenter Case-Control Study of 33 Cases.","authors":"Robin Oger, Christophe Hulet, Martin Tripon, Julien Dunet, Philippe-Alexandre Faure, Julien Dartus, Gaelle Maroteau, Henri Migaud","doi":"10.1016/j.otsr.2025.104426","DOIUrl":"10.1016/j.otsr.2025.104426","url":null,"abstract":"<p><strong>Introduction: </strong>Fracture of ceramic components in total hip arthroplasty (THA), although rare, remains a major concern. The optimal bearing choice in revision surgery following such fractures is still debated. Few studies have specifically compared ceramic-on-polyethylene (CoP) to ceramic-on-ceramic (CoC) in this context. Therefore we built up a retrospective comparative study aiming to compare the two bearing surfaces regarding: (1) complication rates, (2) implant survival, and (3) functional outcomes.</p><p><strong>Hypothesis: </strong>The use of CoP with a monoblock (single-mobility) design is associated with fewer complications than CoC bearings in revision THA for ceramic component fracture.</p><p><strong>Materials and methods: </strong>A retrospective multicenter analysis was conducted on 33 patients treated for ceramic component fractures (17 femoral heads, 16 liners), which occurred at a mean of 6 years and 8 months (range, 2 months to 25 years) after the index procedure. Sixteen patients received CoC bearings and 17 received CoP bearings. Patients were assessed at a mean follow-up of 8 years and 10 months (range, 1-21 years).</p><p><strong>Results: </strong>At a mean follow-up of 8.9 years, the CoC group (mean follow-up 9.1 years) experienced significantly more complications than the CoP group (mean follow-up 8.7 years): 10/16 cases (62.5%) in the CoC group versus 3/17 cases (17.6%) in the CoP group (p = 0.013). Complications in the CoC group included: 5 dislocations (31%), 2 cases of squeaking (13%), 2 recurrent ceramic head fractures (13%), and 1 infection (6%). In the CoP group, complications included 2 dislocations (12%) and 1 aseptic loosening (6%). Mean Oxford Hip Scores at final follow-up were 21.7/60 (range, 12-47) for the CoP group and 23.1/60 (range, 12-45) for the CoC group, with no significant difference (p = 0.5).</p><p><strong>Discussion: </strong>The strength of this study lies in the direct comparison of CoC and CoP bearing surfaces, with a significantly lower complication rate observed in the CoP group. However, these results should be confirmed in larger cohorts to help standardize current practices, which are often guided by expert opinion rather than scientific evidence. CoC bearings did not prevent dislocations, squeaking, or recurrent fractures. CoP monoblock constructs may offer both durability and a reduced complication profile in these high-risk revision scenarios.</p><p><strong>Level of evidence: </strong>III; Retrospective comparative study.</p>","PeriodicalId":54664,"journal":{"name":"Orthopaedics & Traumatology-Surgery & Research","volume":" ","pages":"104426"},"PeriodicalIF":2.2,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145058821","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":"Combined ACL-PCL injuries predict poorer prognosis after MLKR: One-year results on work, sport, and muscle recovery.","authors":"Pierre-Henri Vermorel, Marion Ravelojaona, Gilles Bruyere, Antonio Klasan, Rémi Philippot, Sylvain Grange, Thomas Neri","doi":"10.1016/j.otsr.2025.104424","DOIUrl":"10.1016/j.otsr.2025.104424","url":null,"abstract":"<p><strong>Background: </strong>The prognosis of multi-ligament knee injury (MLKI) can be severe despite modern treatment approaches. It is influenced by the severity of associated damage, lesion pattern, and the course of pre-, peri-, and postoperative management.The aim of our study was to compare multiligament knee reconstruction (MLKR) cases involving both the ACL and PCL with those involving either the ACL or PCL in terms of one-year postoperative outcomes. Additionally, we assessed factors influencing outcomes at one year, functional and clinical results, as well as return to work (RTW) and return to sport (RTS) at the one-year follow-up.</p><p><strong>Hypothesis: </strong>We hypothesized that MLKR cases involving both the ACL and PCL would lead to poorer outcomes compared to those involving only one of the cruciate ligaments.</p><p><strong>Methods: </strong>Seventy-two patients were included in the study between October 2019 and April 2023. Diagnosis was based on a 3 T MRI combined with clinical examination, and MLKI was classified according to the five-level Schenck classification. Anatomical ligament reconstruction was performed, followed by a structured postoperative physiotherapy program in a specialized reference center. Functional outcomes were assessed using IKDC, KOOS, and Tegner, along with isokinetic muscle strength testing (quadriceps, hamstrings), VAS pain scores, and return to sport and work at the one-year follow-up. IKDC and KOOS scores were compared between patients with a single cruciate ligament injury (Schenck I) and those with both cruciate ligaments involved (Schenck > I). A multivariate analysis was conducted to identify factors associated with poor outcomes at one year postoperatively.</p><p><strong>Results: </strong>Patients with only one cruciate ligament involved in the MLKR had better IKDC and KOOS at one-year post- operative in comparison with patients with both cruciate ligaments involved (p < 0.05). Age has a negative correlation with KOOS and IKDC (p < 0.05), Tegner has a positive correlation with KOOS (p < 0.05). All patients had a strength deficit in quadriceps and hamstring contraction at one-year post-operative compared to the uninjured knee. Mean KOOS was 72.1 ± 20.1 [19;100], mean IKDC was 71.1 ± 19.9 [18;95.4] and mean VAS was 1.6 ± 1.9 [0;8]. Return to work was observed in 89% (n = 64), and 76.4% (n = 55) returned to sports.</p><p><strong>Conclusion: </strong>Combined injuries involving both the ACL and PCL are associated with a poorer prognosis compared to isolated injuries of either ligament. At one-year follow-up, MLKR allows most patients to return to work; however, return to physical activity remains more uncertain. Residual strength deficits persist in both the quadriceps and hamstring muscles.</p><p><strong>Level of evidence: </strong>III; Retrospective comparative study.</p>","PeriodicalId":54664,"journal":{"name":"Orthopaedics & Traumatology-Surgery & Research","volume":" ","pages":"104424"},"PeriodicalIF":2.2,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145058800","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, Pierre-Jean Garnier, Christian Delaunay","doi":"10.1016/j.otsr.2025.104423","DOIUrl":"10.1016/j.otsr.2025.104423","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&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;/p&gt;&lt;p&gt;&lt;strong&gt;Materials and methods: &lt;/strong&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;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&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;/p&gt;&lt;p&gt;&lt;strong&gt;Discussion: &lt;/strong&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;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&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 discussions with their patie","PeriodicalId":54664,"journal":{"name":"Orthopaedics & Traumatology-Surgery & Research","volume":" ","pages":"104423"},"PeriodicalIF":2.2,"publicationDate":"2025-09-10","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":"Association between dynamic hip motion during gait and passive hip range of motion and muscle strength before and after total hip arthroplasty.","authors":"Hideaki Matsuo, Masafumi Kubota, Yudai Watabe, Hiroaki Naruse, Kazuki Shoji, Makoto Kitade, Yasuo Kokubo, Akihiko Matsumine","doi":"10.1016/j.otsr.2025.104419","DOIUrl":"10.1016/j.otsr.2025.104419","url":null,"abstract":"<p><strong>Background: </strong>While total hip arthroplasty (THA) for osteoarthritis (OA) provides pain relief and functional improvement, the postoperative recovery of gait patterns remains challenging. Residual abnormalities in hip biomechanics during gait may persist beyond one year postoperatively and are associated with joint overload, implant wear, and fall risk. Passive hip range of motion (ROM) and muscle strength are important determinants of joint mechanics, and should be examined in detail in relation to gait parameters. Understanding these relationships both before and in the early postoperative period is essential for developing individualized rehabilitation strategies. This study aimed to answer the following question: Do the maximum hip extension and adduction angles during the stance phase associate with the passive hip ROM and muscle strength before and after THA? In addition, we explored the potential contribution of muscle strength to these gait parameters, particularly in the early postoperative period.</p><p><strong>Hypothesis: </strong>We hypothesized that reduced passive hip ROM would be associated with smaller maximum hip extension and adduction angles during the stance phase, both before and after THA.</p><p><strong>Patients and methods: </strong>Twenty-five patients undergoing THA (mean age 66.5 ± 9.4 years, 72% female) were evaluated preoperatively and at discharge (23.6 ± 4.1 days postoperatively). Three-dimensional gait analysis was performed to assess maximum hip extension and adduction angles during the stance phase. Passive hip ROM was measured with a goniometer, and muscle strength was assessed using the hand-held dynamometer. Univariate and multivariate regression analyses were conducted to examine associations between gait parameters and ROM or muscle strength.</p><p><strong>Results: </strong>Preoperatively, the hip extension and adduction angles during the stance phase were significantly associated with hip extension (r = 0.413, p = 0.040) and adduction (r = 0.575, p = 0.003) ROM, respectively, indicating that smaller joint angles were linked to reduced ROM. Conversely, in the early postoperative period, the hip extension angle was significantly associated with extension ROM (r = 0.480, p = 0.015) and extensor strength (r = 0.484, p = 0.014), such that smaller angles were observed in patients with reduced ROM and lower strength. However, the adduction angle was not associated with hip ROM and muscle strength.</p><p><strong>Discussion: </strong>This study suggests that rehabilitation should focus on hip extension ROM and extensor strength to improve gait patterns during the early postoperative period after THA. These results provide useful insights for the development of individualized postoperative rehabilitation plans.</p><p><strong>Level of evidence: </strong>III; single-center, retrospective observational study.</p>","PeriodicalId":54664,"journal":{"name":"Orthopaedics & Traumatology-Surgery & Research","volume":" ","pages":"104419"},"PeriodicalIF":2.2,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145042488","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":"Proximal tibial osteotomy for frontal plane deformities correction.","authors":"Matthieu Ollivier, Sébastien Parratte, Matthieu Ehlinger, Kristian Kley, Antoine Piercecchi","doi":"10.1016/j.otsr.2025.104414","DOIUrl":"10.1016/j.otsr.2025.104414","url":null,"abstract":"<p><p>Correction of frontal knee deformities by high tibial osteotomy (HTO) is a well-established surgical procedure used to correct specific lower limb deformities. This study aims to clarify, through six key questions, the indications, deformity analysis, surgical planning, technical execution, complication prevention, and postoperative management associated with HTO. HTO remains an effective treatment for frontal plane knee deformities, providing symptom relief and delaying osteoarthritis progression. Optimal outcomes depend on careful preoperative assessment, precise surgical execution, and vigilant postoperative follow-up.</p>","PeriodicalId":54664,"journal":{"name":"Orthopaedics & Traumatology-Surgery & Research","volume":" ","pages":"104414"},"PeriodicalIF":2.2,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145042508","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, Louis Dagneaux, François Lintz, Cesar de Cesar Netto","doi":"10.1016/j.otsr.2025.104415","DOIUrl":"10.1016/j.otsr.2025.104415","url":null,"abstract":"<p><p>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. LEVEL OF EVIDENCE: >V.</p>","PeriodicalId":54664,"journal":{"name":"Orthopaedics & Traumatology-Surgery & Research","volume":" ","pages":"104415"},"PeriodicalIF":2.2,"publicationDate":"2025-09-09","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":"Evaluation of complex elbow dislocations outside of the triads. Comparison of Monteggia, transolecranon, and transulnar fractures.","authors":"Camille Bouteille, François Saade, Fabio Carminati, Laurent Obert","doi":"10.1016/j.otsr.2025.104418","DOIUrl":"10.1016/j.otsr.2025.104418","url":null,"abstract":"<p><strong>Introduction: </strong>Proximal ulna fractures account for approximately 10% of elbow fractures. Fracture-dislocations present a complex challenge due to their difficulty in analysis and repair. We compared fracture-dislocations according to the Mayo classification. The aim of this study was to compare the clinical and radiological outcomes of Monteggia, transolecranon, and transulnar fracture-dislocations, while excluding terrible triads (Mayo classification). We hypothesized that 46 transulnar fractures involving the basal coronoid would be associated with worse functional results, more advanced arthritis, and higher complication rates.</p><p><strong>Material and methods: </strong>We reviewed 36 patients who underwent surgery for proximal ulna fracture-dislocations between 2004 and 2019, with a minimum follow-up of 9 months. This was a monocentric retrospective study. We analyzed 9 Monteggia fractures, 13 true olecranon fractures, and 14 ulna fractures with basal coronoid fractures. Clinical parameters (MEPS, QDASH, range of motion), radiological criteria (osteoarthritis, heterotopic ossification, pseudarthrosis, quality of reduction), and complications (stiffness, pseudarthrosis, neurological complications, etc.) were analyzed.</p><p><strong>Results: </strong>Monteggia fractures had an average MEPS of 87 and an average QDASH of 21.3. The average range of motion for Flexion-Extension was 112 °. Six patients had arthritis at the last follow-up (67%). There were five cases of ossification (56%), one case of pseudarthrosis (11%), and two cases of stiffness (22%). For true olecranon fracture-dislocations, the average MEPS was 74 and the average QDASH was 31. The average range of motion for Flexion-Extension was 92 °. Eleven patients had arthritis at the last follow-up (87.5%). There were eight cases of ossification (62%), two cases of pseudarthrosis (15%), and four cases of stiffness (46%). For ulna fractures with basal coronoid fractures, the average MEPS was 68, and the average QDASH was 41.7. The average range of motion for Flexion-Extension was 85 °. Thirteen patients had arthritis at the last follow-up (93%). There were eight cases of ossification (57%), four cases of pseudarthrosis (29%), and nine cases of stiffness (64%).</p><p><strong>Discussion: </strong>Ulna fractures with basal coronoid fractures had worse functional outcomes and more complications. Therefore, a strict preoperative assessment of the lesions is necessary for optimal functional recovery.</p><p><strong>Level of evidence: </strong>IV.</p>","PeriodicalId":54664,"journal":{"name":"Orthopaedics & Traumatology-Surgery & Research","volume":" ","pages":"104418"},"PeriodicalIF":2.2,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145042455","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":"Techniques for correcting major lower limb deformities. Corrections of lower limb deformities.","authors":"Franck Launay","doi":"10.1016/j.otsr.2025.104417","DOIUrl":"10.1016/j.otsr.2025.104417","url":null,"abstract":"<p><p>Lower limb deformities can be simple when there is only one deformity but can be complex when there are up to four deformities in different planes (angulation, rotation, translation, length). The time frame must be considered because the deformities can be progressive in nature or can recur after the first correction attempt. No single strategy is best for a patient. Several strategies can be proposed to achieve the optimal result. However, strict technical specifications must be followed to achieve the desired correction: The end goal is optimal correction with the fewest inconveniences for the patient. If the technical specifications cannot be followed, one should propose the use of orthotics or refer the patient to a team having more experience with these deformities. LEVEL OF EVIDENCE: >V.</p>","PeriodicalId":54664,"journal":{"name":"Orthopaedics & Traumatology-Surgery & Research","volume":" ","pages":"104417"},"PeriodicalIF":2.2,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145042471","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}