Orthopaedics & Traumatology-Surgery & Research最新文献

{"title":"Orthopedic complications of sickle-cell disease in children.","authors":"Anne-Laure Simon, Lucrezia Montanari, Cindy Mallet, Brice Ilharreborde","doi":"10.1016/j.otsr.2025.104416","DOIUrl":"10.1016/j.otsr.2025.104416","url":null,"abstract":"<p><p>Sickle cell disease is the most common serious genetic disease in the world. It is a systemic disease, characterized by vaso-occlusive phenomena, especially in the bone capillary network. Orthopedic complications are thus the most common, with a strong impact on quality of life. In children, these complications mainly comprise bone infarction, epiphyseal aseptic osteonecrosis, and bone and joint infection: acute or chronic osteomyelitis, osteoarthritis and septic arthritis. Aseptic osteonecrosis mainly involves the proximal extremities of the femur and humerus. It may be completely asymptomatic in childhood, but almost systematically deteriorates during the 3rd decade without early management, while in childhood there are opportunities for revascularization and remodeling. Prognosis is more severe in sickle-cell-related than community-based childhood bone and joint infection, as treatment is often delayed by diagnostic difficulties due to the absence of specific clinical and paraclinical signs differentiating it from an acute vaso-occlusive crisis. The most common pathogens are minor Salmonella and Staphylococcus aureus. Due to high rates of iterative surgery and sequelae, systematic radio-clinical monitoring is required. Any surgery in children with sickle-cell disease requires special precautions, based primarily on preventive measures to avoid dehydration, hypoxia, hypothermia, acute anemia and pain that can trigger a life-threatening vaso-occlusive crisis. All orthopedic complications should be managed in a specialized reference center with experienced multidisciplinary medical-surgical teams. LEVEL OF EVIDENCE: : V, expert opinion.</p>","PeriodicalId":54664,"journal":{"name":"Orthopaedics & Traumatology-Surgery & Research","volume":" ","pages":"104416"},"PeriodicalIF":2.2,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145034692","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":"How does subscapularis repair affect joint loads? Effect of humeral tray thickness in Reverse Total Shoulder Arthroplasty (rTSA).","authors":"Alexandre Caubère, Stella Rutigliano, Samuel Bourdon, John Erickson, Moreno Morelli, Moby Parsons, Lionel Neyton, Marc-Olivier Gauci","doi":"10.1016/j.otsr.2025.104413","DOIUrl":"10.1016/j.otsr.2025.104413","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to evaluate how subscapularis tendon repair influences joint loads in relation to humeral offset and arm position.</p><p><strong>Patients and methods: </strong>Two fresh-frozen, whole-body cadaveric shoulders underwent a reverse total shoulder arthroplasty (rTSA) on the humeral side using an internal proprietary load-sensing system (LSS) (Goldilocks, Statera Medical, Montreal, Canada). In addition to three \"complex\" Activity Daily Life positions (\"behind the back\", \"overhead reach\", and \"across the chest\"), four standard postures (external rotation, extension, abduction, and flexion) were used to record the glenohumeral loads (Newtons) and their locations applied to the implant. The humeral system's adjustability function was used to gradually raise the thickness for each setting from 0 to 6 mm. The first part of the tests consisted of taking these measurements with the repaired subscapularis tendon. Once all the measurements had been taken, the tendon was detached, and the same measurements were repeated in the same order. Load and contact point were measured using the load centroid radial distance (|r|).</p><p><strong>Results: </strong>The measurements showed good repeatability with an intra-class correlation coefficient (ICC) greater than 0.9 for all positions. Increasing the thickness of the humeral implant from 0 to 6 mm, without subscapularis, resulted in a refocusing of loads on the humeral cup for several positions, except for abduction at 60° (|r|_0mm = 1 mm VS |r|_6mm = 0.9 mm; p = 0.570), cross body (|r|_0mm = 0.7 mm VS |r|_6mm = 0.5 mm; p = 0.413) and overhead reach (|r|_0mm = 1 mm VS |r|_6mm = 0.9 mm; p = 0.284). Subscapularis repair enhances this recentering effect for all positions, with a particularly significant influence on abduction at 60°, \"behind back\" and \"overhead reach\" (|r|_6mm = 0.2 mm VS 0.9 mm, p < 0.001). Subscapularis repair also significantly increased joint loads for these positions at 6 mm humeral lateralization.</p><p><strong>Discussion: </strong>The findings of this biomechanical study provide substantial evidence to support the hypothesis that the subscapularis muscle plays a pivotal role in the process of refocusing joint loads in rTSA. Consequently, subscapularis repair may exert a biomechanical effect on rTSA stabilisation.</p><p><strong>Level of evidence: </strong>V; Biomechanical study.</p>","PeriodicalId":54664,"journal":{"name":"Orthopaedics & Traumatology-Surgery & Research","volume":" ","pages":"104413"},"PeriodicalIF":2.2,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145024811","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":"Comments on: \"Change in standing acetabular orientation 2 years postoperatively after surgical correction of adult spinal deformity\" by Prost S, Ambrosino R, Pesenti S, Fuentes S, Tropiano P, Blondel B, et al., published in Orthop Traumatol Surg Res 2025;111:104087. doi: 10.1016/j.otsr.2024.104087.","authors":"Javed Iqbal, Brijesh Sathian, Syed Muhammad Ali, Ayesha Parvaiz Malik","doi":"10.1016/j.otsr.2025.104411","DOIUrl":"10.1016/j.otsr.2025.104411","url":null,"abstract":"","PeriodicalId":54664,"journal":{"name":"Orthopaedics & Traumatology-Surgery & Research","volume":" ","pages":"104411"},"PeriodicalIF":2.2,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145014448","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":"Comments on: \"Assessment of chronic ankle instability: are functional scores relevant enough?\" by Caubère A, Viricel C, Garcia-Jaldon F, Afonso S, Bilichtin E, Choufani C, et al., published in Orthop Traumatol Surg Res. 2025;111(4):104167. doi:10.1016/j.otsr.2025.104167.","authors":"Dazhi Li","doi":"10.1016/j.otsr.2025.104412","DOIUrl":"10.1016/j.otsr.2025.104412","url":null,"abstract":"","PeriodicalId":54664,"journal":{"name":"Orthopaedics & Traumatology-Surgery & Research","volume":" ","pages":"104412"},"PeriodicalIF":2.2,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145014427","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":"Computer-assisted surgery and planning in percutaneous pelvic screw fixation.","authors":"Mehdi Boudissa, Gael Kerschbaumer, Jérôme Tonetti","doi":"10.1016/j.otsr.2025.104392","DOIUrl":"10.1016/j.otsr.2025.104392","url":null,"abstract":"<p><p>Percutaneous pelvic screwing (PPS) enables fixation of traumatic or atraumatic fractures with little or no displacement, or displaced but reduced fractures, and preventive fixation of primary or secondary tumoral lesions. It is a relatively recent technique, and indications are evolving with progress in pre- and intra-operative imaging. Morbidity is lower than with open surgery. PPS is classically performed under fluoroscopy; computer-assisted surgery is of great interest, enabling analysis of safe bone corridors. Planning is based on image processing tools included in CT DICOM viewer packages. The aim of the present study was to review PPS. What are the indications for PPS? All pelvic ring fractures are in principle concerned if the reduction allows passage of a K-wire and then a screw. A distinction is to be made between, on the one hand, young patients, able to support a variable period of non-weight-bearing, in whom PPS stabilizes an unstable fracture, relieves pain on motion and prevents non-union, and, on the other hand, older patients for whom PPS enables optimally early resumption of weight-bearing. How to plan posterior PPS? The principal procedures are iliosacral screwing (ISS), trans-sacral screwing (TSS) and supra-acetabular screwing (SAS). How to plan anterior PPS? The principal procedures are anterior column/superior pubic ramus (AC/SPR) screwing, iliac wing screwing (IWS) and gluteal pillar screwing. How to plan percutaneous acetabular screwing (PAS)? The principal procedures are transverse acetabular screwing (TAS) and retrograde posterior column screwing (RPCS) or \"butt screw\". Fixation is demanding. PPS requires rigorous preoperative planning using CT DICOM viewer software. The principle consists in multiplane reconstruction of bone corridors, to assess the feasibility of PPS and analyze implant diameters, tracing lines to measure implant trajectory and length, and 3D reconstruction using the measurements, to assess entry and exit points and forecast intraoperative fluoroscopic views. What results, what complications, what innovations? Results are comparable to those of open surgery, with significantly less morbidity. The main complications are implant malpositioning and fixation failure, with secondary displacement of the fracture and/or implants. 3D printing, navigation and, recently, robotic surgery constitute the future of PPS. How PPS can go wrong? Difficulties or errors in planning, errors in patient positioning or errors in reading fluoroscopy are the main pitfalls. When available, intraoperative 3D imaging, associated to navigation or not, improves safety.</p>","PeriodicalId":54664,"journal":{"name":"Orthopaedics & Traumatology-Surgery & Research","volume":" ","pages":"104392"},"PeriodicalIF":2.2,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145008554","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 Kienböck's disease through distal radius sagittal plane analysis.","authors":"Uğur Bezirgan, Bedir Özgencil, Merve Dursun Savran, Yener Yoğun, Mehmet Armangil","doi":"10.1016/j.otsr.2025.104410","DOIUrl":"10.1016/j.otsr.2025.104410","url":null,"abstract":"<p><strong>Background: </strong>Kienböck's disease poses challenges in plate placement during radial shortening osteotomy due to steep metaphyseal inclination of the distal radius. While coronal plane analyses have been extensively studied, sagittal plane deformities remain underexplored. This study addresses the anatomical variations in the sagittal plane associated with Kienböck's disease. The primary questions include: (1) Are sagittal plane deformities more prevalent in Kienböck's disease? (2) Do these deformities influence treatment strategies or outcomes?</p><p><strong>Hypothesis: </strong>We hypothesize that anatomical variations in the sagittal plane of the distal radius are significantly associated with Kienböck's disease, potentially impacting surgical plate fitting and lunate loading.</p><p><strong>Patients and methods: </strong>This retrospective study included 43 patients with Kienböck's disease confirmed by imaging, compared to a matched control group of 43 individuals. Lateral wrist radiographs were analysed for palmar tilt (PT), teardrop angle (TDA), teardrop inclination angle (TIA), and tear height ratio (RTH). Lichtman stages were determined via MRI, and functional outcomes were assessed using the Patient-Rated Wrist Evaluation (PRWE). Statistical analyses compared these parameters between the groups.</p><p><strong>Results: </strong>Kienböck patients exhibited a significantly lower TDA (58.1 ± 7.9 vs 65.8 ± 3.4, p = 0.0001) and higher TIA (35.9 ± 5.0 vs 29.6 ± 3.53, p = 0.0000) compared to controls. PT and RTH did not differ significantly. These findings suggest distinct sagittal plane deformities in Kienböck's disease, with potential implications for surgical interventions.</p><p><strong>Discussion: </strong>While coronal plane parameters have been the focus in Kienböck's disease, this study highlights the importance of sagittal plane analyses. The identified differences in TDA and TIA may explain challenges in surgical plate fitting. Further biomechanical studies are required to validate these findings and optimise treatment strategies.</p><p><strong>Level of evidence: </strong>III; Diagnostic.</p>","PeriodicalId":54664,"journal":{"name":"Orthopaedics & Traumatology-Surgery & Research","volume":" ","pages":"104410"},"PeriodicalIF":2.2,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145008579","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":"Utilising an internal joint stabilizer to ensure post-release elbow stability for patients with severe post-traumatic elbow stiffness: A retrospective cohort study.","authors":"Cheng-You Wang, Yen-Chun Chiu, Chin-Hsien Wu, Chien-Cheng Jasper Liu, Kun-Ling Tsai, I-Ming Jou, Yuan-Kun Tu, Ching-Hou Ma","doi":"10.1016/j.otsr.2025.104393","DOIUrl":"10.1016/j.otsr.2025.104393","url":null,"abstract":"<p><strong>Objective: </strong>The treatment of severe post-traumatic elbow stiffness is extremely complex. Complete open release of the elbow joint and reconstruction of stiffness-related injuries are considered crucial; however, these procedures may lead to elbow instability, particularly chronic instability due to underlying conditions. This retrospective study aimed to assess the outcomes of using an internal joint stabilizer (IJS) to ensure post-release stability in these complex cases.</p><p><strong>Hypothesis: </strong>IJS would demonstrate reliability as a treatment technique for severe elbow stiffness associated with intraoperative instability.</p><p><strong>Materials and methods: </strong>Overall, 15 patients (10 men and 5 women; mean age 42 years [range, 20-72 years]) treated for post-traumatic elbow stiffness between September 2016 and October 2020 developed instability following complete arthrolysis. The surgical procedures performed included ulnar nerve neurolysis followed by anterior transposition, comprehensive release of the surrounding soft tissue, heterotopic bone removal, bone reconstruction, concentric reduction of the elbow joint, and ligament repair. An IJS was used to maintain the stability of the elbow and protect the repaired soft tissue. The flexion arc, forearm rotation, Mayo Elbow Performance Score, and pain score were evaluated preoperatively and postoperatively. All patients were evaluated for ≥1 postoperative years.</p><p><strong>Results: </strong>The median follow-up duration was 34 months. Significant improvements were observed in the median (range) extension-flexion arc (from 50 ° [15-60 °] to 120 ° [80-140 °], difference of medians 70 °; p < 0.05), forearm rotation (from 85 ° [20-115 °] to 165 ° [145-180 °], difference of medians 80 °; p < 0.05), Mayo Elbow Performance Score (from 55 ° to 90 °, difference of medians 35; p < 0.05), and the pain score (from 5 to 1, difference of medians 4; p < 0.05) at the final follow-up visit. The complication rate was 33.3 % (n = 5).</p><p><strong>Conclusion: </strong>Despite the limited sample size, preliminary findings suggest that this technique may serve as a viable method to ensure elbow stability after arthrolysis for severe elbow stiffness, supporting postoperative rehabilitation and enhancing functional recovery.</p><p><strong>Level of evidence: </strong>IV.</p>","PeriodicalId":54664,"journal":{"name":"Orthopaedics & Traumatology-Surgery & Research","volume":" ","pages":"104393"},"PeriodicalIF":2.2,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145006882","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":"Ankle and foot tendon transfer (excluding paralytic foot and toe deformity).","authors":"Marion Di Schino, Linda Ferraz, Hachem Mahjoub","doi":"10.1016/j.otsr.2025.104391","DOIUrl":"10.1016/j.otsr.2025.104391","url":null,"abstract":"<p><p>It is essential to master the techniques of tendon transfer and to know the indications, so as to be able to treat tendinopathy, tendon tear or static deformity in the foot and ankle. The type of transfer depends on the pathology, with the aim of reconstructing or supplementing the affected muscle. Complete clinical and paraclinical assessment is needed to determine feasibility and draw up the preoperative plan according to axial deformity and associated retraction. Success depends on several factors: rigorous technique, fixation method, tension adjustment, immobilization, and rehabilitation. Stability is ensured by transosseous fixation with interference screw, or tenodesis. Tendon tension is crucial, but consensus is lacking; the general rule is to maximize tension according to the targeted effect. Postoperative immobilization is generally recommended, for 4-6 weeks, depending on associated procedures, indications and type of fixation. Rehabilitation is systematic, to reprogram gait with an altered motor schema. Muscle exercises against resistance should not be started before month 3. Once surgery has been indicated, the choice of transfer is made on a case-by-case basis. LEVEL OF EVIDENCE: >V: expert opinion.</p>","PeriodicalId":54664,"journal":{"name":"Orthopaedics & Traumatology-Surgery & Research","volume":" ","pages":"104391"},"PeriodicalIF":2.2,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145006902","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":"Mixed reality guidance enhances and levels the accuracy of glenoid preparation pin positioning in shoulder arthroplasty between experienced and junior surgeons.","authors":"Chloe Imbert, Ramy Samargandi, Amaury Facque, Damien Cariou, Julien Berhouet","doi":"10.1016/j.otsr.2025.104350","DOIUrl":"10.1016/j.otsr.2025.104350","url":null,"abstract":"<p><strong>Purpose: </strong>The potential of mixed reality to improve the accuracy of glenoid preparation pin positioning in shoulder arthroplasty has been previously reported. Another benefit of mixed reality may be its ability to assist junior surgeons in enhancing their precision during prosthetic procedures. The aim of this study was to evaluate and compare the accuracy of glenoid preparation pin positioning between a senior surgeon and a junior surgeon utilizing mixed reality guidance. The hypothesis of this study was that mixed reality would equalize surgical accuracy between operators of different experience levels.</p><p><strong>Methods: </strong>An experienced senior surgeon and a novice junior surgeon each aimed to position a glenoid preparation pin, first freehand and then using a mixed reality guidance solution (Blue Mixed Reality Guidance™, Stryker), on 15 and 30 3D-printed scapula specimens, respectively (10 Type A and 10 Type B according to Walch, and 10 Type E according to Favard), which were pre-planned with dedicated software (Blueprint Planning™, Stryker). The accuracy of the entry point and orientation of the glenoid pin post-surgery, without and with mixed reality guidance, was evaluated and compared between the two operators.</p><p><strong>Results: </strong>Without mixed reality, there was no significant difference between the two surgeons regarding entry point accuracy (p = 0.8) and pin orientation (p > 0.05). However, there was an important median positional discrepancy for version and inclination, measuring 17 ± 12° and 20 ± 13° for the junior surgeon, compared to 9 ± 8° for version and inclination for the senior surgeon. With mixed reality guidance, no significant differences were observed in inclination, version, or positioning along the antero-posterior and supero-inferior axes of the pin between the two surgeons. Nevertheless, the junior surgeon demonstrated greater accuracy for the overall entry point of the pin, with a median positional discrepancy of 1.39 ± 1.04 mm versus 2.10 ± 0.86 mm (p = 0.02). There were no significant differences in accuracy between the two surgeons based on glenoid type, except for the overall entry point of Type A glenoids, where the junior surgeon was more precise (p = 0.02), as well as for the antero-superior axis (p = 0.01).</p><p><strong>Conclusion: </strong>The use of mixed reality improves and levels the accuracy of positioning and orientation of a glenoid guide pin in arthritic glenoids between two surgeons of different experience levels.</p><p><strong>Level of evidence: </strong>III; experimental non-randomized comparative study.</p>","PeriodicalId":54664,"journal":{"name":"Orthopaedics & Traumatology-Surgery & Research","volume":" ","pages":"104350"},"PeriodicalIF":2.2,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145006829","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":"Post-traumatic lower-limb amputation: Indications, techniques and results.","authors":"Sylvain Rigal, Alexia Milaire, Laurent Mathieu, Nicolas de l'Escalopier","doi":"10.1016/j.otsr.2025.104389","DOIUrl":"10.1016/j.otsr.2025.104389","url":null,"abstract":"<p><p>This study presents a review of traumatic lower-limb amputation, addressing 6 questions. (1) In what circumstances is amputation necessary in traumatology? (2) Are scores and results analyses contributive to decision-making for emergency amputation? Amputation can be primary, when directly caused by the trauma, salvage if limb conservation would be life-threatening, a necessity if functional prognosis is poor, or else necessitated by a mass-casualty context. Score systems and results analysis can help identify patients who would benefit from amputation or salvage, but applications are controversial, and the surgeon's expertise is a determining factor for treatment option in emergency settings. (3) What are the technical principles of amputation in traumatology? These principles must take account of the limitations imposed by emergency settings, in which the stump cannot always be optimized. In the acute phase, non-closure is the rule, and delayed stump shaping is preferable, to limit complications. (4) What quality of life can the amputee expect? Quality of life is a major issue in traumatic amputation. Prosthetics can restore walking capacity and promote social, occupational and familial autonomy. (5) How can complications be prevented and treated after traumatic amputation? Frequent complications include infection, cover defect, heterotopic ossification and chronic pain. These often require adaptation of the prosthesis or surgery by a specialized team. (6) Apart from surgery, what considerations guide management? Other aspects have to be integrated in the care pathway: regulatory considerations, shared decision-making, multidisciplinary teamwork, and psychological and social factors.</p>","PeriodicalId":54664,"journal":{"name":"Orthopaedics & Traumatology-Surgery & Research","volume":" ","pages":"104389"},"PeriodicalIF":2.2,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144979178","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}