Operative Orthopadie Und Traumatologie最新文献

{"title":"[Surgical treatment for chronic rupture of the quadriceps tendon].","authors":"Wolf Petersen, Yizhoe Ge, Johanna Schulze Borges, Martin Häner, Philipp von Roth","doi":"10.1007/s00064-026-00934-z","DOIUrl":"10.1007/s00064-026-00934-z","url":null,"abstract":"<p><strong>Objective: </strong>Reconstruction of the quadriceps tendon to restore extensor function in cases of chronic rupture.</p><p><strong>Indications: </strong>Rupture of the quadriceps tendon due to delayed diagnosis, failure of primary refixation or after implantation of a knee endoprosthesis.</p><p><strong>Contraindications: </strong>Infections.</p><p><strong>Surgical technique: </strong>Reopen the old incision and verify whether the quadriceps tendon can be reattached to the patella. If there is no dehiscence, refixation with bone anchors (no bone defects) or transosseously (bone defects). If the tissue quality is poor (e.g., previous surgery, knee prosthesis), augmentation with local VY turnover flap, tubular autologous or allogeneic tendon graft or with a synthetic mesh. If the dehiscence is < 5 cm, a VY lengthening flap is recommended. For defects > 5 cm, an allogeneic Achilles tendon graft is used; if the patella is absent an allogeneic extensor graft is used. In cases of significant patella infera (Caton Index < 0.5), either a needling, a Z-plasty to lengthen the patellar tendon (2-3 cm length) or proximalization of the tibial tubercle is performed.</p><p><strong>Rehabilitation: </strong>In cases of refixation with augmentation, 6 weeks of partial weight-bearing (10 kg body weight) in a straight removable splint. Range of motion: 4 weeks 0‑0-60, 5-6 weeks 0‑0-90. In cases of augmentation (total knee arthroplasty): Partial weight-bearing of 10 kg body weight is permitted for 6 weeks in a straight removable brace. Subsequently, the patient transitions to an articulated brace for another 6 weeks with progressive range of motion limitations as follows: weeks 7-8: 0‑0-30°, weeks 9-10: 0‑0-60°, weeks 11-12: 0‑0-90°. Thereafter, unrestricted motion is allowed, and the brace may be discontinued.</p><p><strong>Results: </strong>To date, only small case series have been published on all techniques for managing chronic quadriceps tendon injuries, which were summarized in three systematic reviews. In the native knee refixation with or without augmentation can achieve good clinical results with low rerupture rates. High revision rates and unsatisfactory functional outcomes have been reported after the use of larger allogeneic grafts (Achilles tendon or extensor tendon), therefore these procedures should only be used when large defects cannot be reconstructed using other techniques.</p>","PeriodicalId":54677,"journal":{"name":"Operative Orthopadie Und Traumatologie","volume":" ","pages":"144-160"},"PeriodicalIF":1.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147488443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical treatment of unstable and displaced medial clavicle fractures with a contoured biplanar low profile angle stable implant.","authors":"J Schmalzl, J Zimmermann, L Hufnagel, R Meffert","doi":"10.1007/s00064-025-00901-0","DOIUrl":"10.1007/s00064-025-00901-0","url":null,"abstract":"<p><strong>Objective: </strong>To achieve stable fixation to allow early mobilization by using a low profile contoured biplanar implant to avoid soft tissue problems and to minimize need for implant removal.</p><p><strong>Indications: </strong>Unstable and displaced medial clavicle fractures in young patients with high functional demands.</p><p><strong>Contraindications: </strong>Open/contaminated fractures. Fractures in geriatric patients with low functional demands.</p><p><strong>Surgical technique: </strong>Saber cut incision over the medial clavicle. Perpendicular incision to open the calvipectoral fascia. Fracture reduction and temporary retention. Contouring and attachment of the plate. Definitive plate fixation. Radiological documentation.</p><p><strong>Postoperative management: </strong>Cryotherapy, anti-inflammatory medication on demand. Shoulder sling for comfort for 1-2 weeks. Physical therapy with active flexion and abduction limited to 90° for 6 weeks. Clinical and radiological follow up for 6-12 months.</p><p><strong>Results: </strong>In total, 5 patients were treated with the described technique. All patients were very satisfied with the result. The mean Constant-Murley score was 91 points and the mean Quick DASH (disabilities of shoulder and hand) was 3% after an average follow-up of 74 months. In none of the cases implant removal was necessary.</p>","PeriodicalId":54677,"journal":{"name":"Operative Orthopadie Und Traumatologie","volume":" ","pages":"137-143"},"PeriodicalIF":1.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144121396","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Revision surgery after trapeziometacarpal joint arthroplasty].","authors":"Victoria Franziska Struckmann, Thomas Krohn, Ali Ayache, Benjamin Panzram","doi":"10.1007/s00064-026-00935-y","DOIUrl":"https://doi.org/10.1007/s00064-026-00935-y","url":null,"abstract":"<p><strong>Objective: </strong>Restoration of pain-free mobility of the trapeziometacarpal joint (TMJ) after a complicated course following arthoplasty through revision surgery with preservation of the prosthesis.</p><p><strong>Indications: </strong>Complications during or after implantation of a thumb carpometacarpal joint endoprosthesis, such as first metacarpal shaft fracture, cup malalignment, cup loosening, trapezium fracture, and impingement.</p><p><strong>Contraindications: </strong>Insufficient bone stock and/or the presence of infection may argue against revision surgery with preservation of the prosthesis.</p><p><strong>Surgical technique: </strong>Various techniques are employed depending on the indication for revision, as outlined below.</p><p><strong>Postoperative management: </strong>As with the primary operation, revision of the neck component usually requires only a short period of immobilization. Revision of the cup or stem may require a longer period of immobilization of up to 6 weeks, depending on the extent of the revision.</p><p><strong>Results: </strong>In our cohort, the postoperative outcome following the described revision procedures was comparable to that after primary thumb carpometacarpal arthroplasty without subsequent revision, with observed differences largely attributable to prolonged immobilization necessitated by revision of the components implanted in the bone.</p>","PeriodicalId":54677,"journal":{"name":"Operative Orthopadie Und Traumatologie","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2026-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147488464","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Supracondylar dome osteotomy with plate fixation via a posterior triceps-splitting approach].","authors":"A N Herzog, F Fernandez-Fernandez","doi":"10.1007/s00064-026-00932-1","DOIUrl":"https://doi.org/10.1007/s00064-026-00932-1","url":null,"abstract":"<p><strong>Objective: </strong>Supracondylar correction outside the joint block is performed to achieve a symmetrical cubital axis in the frontal plane and a balanced range of motion in the sagittal plane without interfering with joint congruence.</p><p><strong>Indications: </strong>Supracondylar correction is performed mainly in the frontal plane. A simultaneous correction in the sagittal plane is effortlessly possible as well. The condylar prominence can be balanced through additional medial translation.</p><p><strong>Contraindications: </strong>Dome osteotomy is not suitable for patients aged under 10 years. It is not the first-choice method for correction of rotational deformity. Moreover, dome osteotomy alone is insufficient for correction of deformities with joint incongruence.</p><p><strong>Surgical technique: </strong>The distal humerus is exposed through a posterior triceps-splitting approach. A series of drillings in the curve of a dome were made using a 2-mm K‑wire. Gear-formed osteotomy was further completed with a 4-mm osteotome, so that the distal fragment could be gradually rotated. After the required correction had been achieved, the osteotomy was temporarily fixed with a 2-mm K-wire. Final fixation was achieved with a 3.5-mm locking compression tibia plate.</p><p><strong>Postoperative management: </strong>Free range of motion and full weightbearing are possible immediately after surgery. However, weightbearing exceeding the weight of the arm and propping up the arm are prohibited in the first 6 weeks. Radiologic examinations are performed after 6 weeks and 3 months. Sports are prohibited during the first 3 months. Further clinical follow-ups are continued annually until bone maturity is attained.</p><p><strong>Results: </strong>The correction that was aimed for was achieved in all concluded cases. None of the complications mentioned in the literature occurred in our cases. Moreover, elbow function and stability were significantly improved. Although dome osteotomy is technically demanding, standardized surgical execution contributes to excellent reproducible results.</p>","PeriodicalId":54677,"journal":{"name":"Operative Orthopadie Und Traumatologie","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2026-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147482206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Internal hemipelvectomy: periacetabular resection with hip transposition].","authors":"Dimosthenis Andreou, Arne Streitbürger, Wiebke Guder, Markus Nottrott, Nina Myline Engel, Lars Erik Podleska, Jendrik Hardes","doi":"10.1007/s00064-025-00922-9","DOIUrl":"10.1007/s00064-025-00922-9","url":null,"abstract":"<p><strong>Objective: </strong>Long-term stable fixation of the leg to the remaining ilium or sacrum following internal hemipelvectomy including resection of the acetabulum.</p><p><strong>Indications: </strong>Bone sarcomas, soft tissue sarcomas infiltrating the bone, solitary late metastases, acetabular reconstruction failure.</p><p><strong>Contraindications: </strong>Palliative treatment goal, mutilating resection (especially when the tumor extends beyond the midline of the sacrum).</p><p><strong>Surgical technique: </strong>Facilitation of stable fixation of the femoral head or proximal femur replacement to the remaining bone (ilium or sacrum,) following periacetabular pelvic resection. Insertion of 2-3 bone anchors in the ilium or sacrum, depending on the extent of tumor resection, alternatively transosseous sutures and attachment of a partially resorbable mesh, closed at the proximal end. Depending on the muscular coverage, repositioning of the hip or bipolar cup proximally. Attachment of the mesh to the remaining hip capsule or the megaprosthesis and the muscles. The reconstruction length must not compromise sufficient muscle coverage.</p><p><strong>Postoperative management: </strong>Elastic hip spica. Bed rest for 1-2 weeks, depending on the weight of the leg. Mobilization with a walker or 2 crutches with 20 kg weight bearing for the following 4-6 weeks. Lymphatic drainage/venous foot pump as required. Adjuvant chemo- or radiotherapy as per multidisciplinary tumor board recommendation.</p><p><strong>Results: </strong>The goal is the development of a stable scar around the neo-joint with minimal dead space. Young patients can often walk for several kilometers, typically using a walking stick on the contralateral side. Sole lift, lengthening of the femur at a later point if desired. There is a risk of wound-healing disorders or deep infections postoperatively in approximately 30% of cases. In case of infection, removal of the mesh and possibly of the proximal femoral replacement, as well as vacuum-assisted closure therapy may be necessary.</p>","PeriodicalId":54677,"journal":{"name":"Operative Orthopadie Und Traumatologie","volume":" ","pages":"33-43"},"PeriodicalIF":1.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145402765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Autologous fibular transplantation for reconstruction of segmental bone defects].","authors":"Burkhard Lehner, Jakob Bollmann, Axel Horsch, Andreas Geisbüsch, André Lunz, Julian Maximilian Deisenhofer","doi":"10.1007/s00064-025-00927-4","DOIUrl":"10.1007/s00064-025-00927-4","url":null,"abstract":"<p><strong>Objective: </strong>Biological reconstruction of extensive meta-/diaphyseal bone defects using autologous fibular graft. Aim is stable defect bridging with preservation of the limb and restoration of function.</p><p><strong>Indications: </strong>Intercalary bone defects caused by joint-preserving tumor resection of bone tumors, failed osteosyntheses with pseudarthrosis, chronic osteomyelitis after debridement, posttraumatic or congenital bone loss. Vascularized grafts are particularly indicated in cases of compromised soft tissue, previous radiotherapy, defects > 10-12 cm, or anticipated delayed healing.</p><p><strong>Contraindications: </strong>Severe peripheral arterial occlusive disease (donor or recipient site); active infections. Relative contraindications for vascularized grafts include short, biologically active defects with intact perfusion.</p><p><strong>Surgical technique: </strong>Harvesting of the fibula as a vascularized or nonvascularized segment, adaptation to the defect, fixation using plates. In tumor resections possible combination with allografts or extracorporeally irradiated autografts (using Capanna technique)-especially in the lower leg to improve mechanical stability. Microsurgical vascular anastomoses are required for vascularized fibula.</p><p><strong>Postoperative management: </strong>Early mobilization under unloading conditions, regular radiographic monitoring, and gradual weight-bearing based on consolidation. Physiotherapy to prevent joint stiffness; clinical monitoring of the donor site.</p><p><strong>Results: </strong>Consolidation rates of 85-95% under appropriate fixation and soft tissue coverage. Fibula grafts show high biological integration, potential for hypertrophy under load, and long-term load capacity. Typical complications include nonunion, graft fracture, infection, vascular complications, and donor-site morbidity.</p>","PeriodicalId":54677,"journal":{"name":"Operative Orthopadie Und Traumatologie","volume":" ","pages":"55-67"},"PeriodicalIF":1.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145985149","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[General principles of biopsy technique and approaches in soft tissue and bone sarcomas].","authors":"M M Ploeger, S V Hattem, D Alex, R Placzek, D C Wirtz, S Koob","doi":"10.1007/s00064-025-00926-5","DOIUrl":"10.1007/s00064-025-00926-5","url":null,"abstract":"<p><strong>Surgical objective: </strong>Removal of sufficient representative tumor material for tumor classification and initiation of adequate therapy, ensuring complete subsequent sarcoma resection without contamination of other compartments.</p><p><strong>Indications: </strong>Histological confirmation of musculoskeletal findings suspected to be malignant or of unclear status and adjustment of existing systemic therapies.</p><p><strong>Contraindications: </strong>Lack of therapeutic use of the biopsy for decision-making or treatment as well as highly palliative situations with greatly reduced prognosis.</p><p><strong>Surgical technique: </strong>Skin incision, subcutaneous preparation with fasciotomy and sharp severing of the musculature directly on the bone without 'spreading' the scissors. Avoidance of soft tissue barriers, 'direct access' to the tumor, meticulous hemostasis to avoid hematomas. In case of an intraosseous tumor, opening of the bone with an awl or bone marrow biopsy needle. The surgical aim is to collect approximately 1 cm³ sample.</p><p><strong>Further management: </strong>Immobilization of the affected limb if necessary. Partial weight-bearing/no weight-bearing in case of intraosseous findings to avoid pathological fracture if necessary. Presentation to the interdisciplinary tumor board before planning further therapy.</p><p><strong>Results: </strong>In the context of a systematic literature review, all primary studies published between January 2014 and December 2024 that compared biopsy techniques (open incisional biopsy and core needle biopsy) were considered. Of the 76 initially identified studies, five met the predefined inclusion criteria. Recent years has shown an increasing trend toward the use of image-guided core needle biopsy.</p>","PeriodicalId":54677,"journal":{"name":"Operative Orthopadie Und Traumatologie","volume":" ","pages":"3-10"},"PeriodicalIF":1.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146031593","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Surgical management of juvenile and aneurysmal bone cysts in children and adolescents : Curettage, ceramic bone graft substitution and adjuvants].","authors":"Sven-Oliver Dietz, Beatrice Jung, Michael Nienhaus, Frank Traub, Erol Gercek","doi":"10.1007/s00064-025-00928-3","DOIUrl":"10.1007/s00064-025-00928-3","url":null,"abstract":"<p><strong>Objective: </strong>The aim of treating juvenile (UBC) and aneurysmal bone cysts (ABC) is complete defect filling with subsequent bony consolidation, restoration of stability, pain reduction, and minimization of recurrence risk.</p><p><strong>Indications: </strong>Symptomatic or pathologic fractures due to confirmed UBC or ABC based on imaging and/or histology.</p><p><strong>Contraindications: </strong>Suspected malignancy based on clinical or radiologic findings.</p><p><strong>Surgical technique: </strong>After fluoroscopic localization, the lesion is exposed via a tissue-sparing approach. The cyst wall is opened, and complete curettage is performed. The defect is filled with ceramic bone substitute and/or allogeneic cancellous bone soaked in methylprednisolone (UBC) or polidocanol (ABC). In ABC, the cyst lining is completely removed. In UBC, curettage combined with elastic-stable intramedullary nailing (ESIN) for stabilization is frequently sufficient.</p><p><strong>Postoperative management: </strong>Fractures are managed like nonpathologic fractures. Radiographic follow-up is performed at 4, 12, 26, and 52 weeks. If ABCs fail to respond, repeated percutaneous polidocanol injections are administered.</p><p><strong>Results: </strong>In a cohort of 44 patients (22 UBC, 23 ABC), after a follow-up of up to 6 years, 82% achieved a favorable radiological outcome (Capanna 1-2). Recurrence with refracture occurred in 4 patients after ESIN removal. The overall complication rate was low.</p>","PeriodicalId":54677,"journal":{"name":"Operative Orthopadie Und Traumatologie","volume":" ","pages":"76-87"},"PeriodicalIF":1.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146068659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Hyperthermic isolated limb perfusion with TNF-alpha and melphalan for the treatment of locally advanced soft-tissue sarcoma].","authors":"Lars Erik Podleska, Jendrik Hardes, Arne Streitbürger, Georg Täger","doi":"10.1007/s00064-025-00925-6","DOIUrl":"10.1007/s00064-025-00925-6","url":null,"abstract":"<p><strong>Objective: </strong>Regional neoadjuvant isolated limb perfusion (ILP) with TNF-alpha and melphalan (TM-ILP) for the treatment of primarily unresectable highly malignant soft tissue sarcomas. The goal is to reduce the size and devitalize the tumor in order to convert a primarily unresectable tumor into a resectable state.</p><p><strong>Indications: </strong>Primarily nonresectable (indication for amputation or higher-grade mutilating resection), highly malignant soft tissue sarcomas of the extremities.</p><p><strong>Contraindications: </strong>Vascular occlusions, thromboses, acute infections, especially of the affected extremity.</p><p><strong>Surgical technique: </strong>Vascular access to the artery and vein proximal to the affected limb. Arterial and venous cannulation of the vessels supplying the limb and tumor. Connection to a heart-lung machine. Application of a tourniquet or elastic bandage proximal to the catheter tips. Nuclear medicine leak rate measurement (technetium 99m) to rule out a systemic leak. Perfusion of the limb with 1-2 mg recombinant TNF-alpha (Tasonermin/Beromun, Belpharma SA, Luxembourg) for 15 min, followed by the addition of 11-13 mg melphalan per liter of limb volume and subsequent perfusion for an additional 60 min. Washing out with 2-5 l of crystalloid solution while wrapping the limb several times with elastic Esmarch bandages. Removal of the tourniquet and catheters, reconstruction of the vessels, wound closure.</p><p><strong>Postoperative management: </strong>Elevate and cool the limb (especially the forearm and lower leg). Close cardiovascular and clinical monitoring for existing risk of TNF-alpha-induced Septic Inflammatory Response Syndrome (SIRS) and compartment syndrome (occurring within the first 24 h after ILP). Full weight-bearing on the limb is possible. Continue elevated positioning therapy depending on the degree of swelling. The hospital stay is approximately 1 week.</p><p><strong>Results: </strong>Overall treatment response to TM-ILP: 60-70%. Complete remissions observed in just under 20% of cases. Limb preservation is possible in over 80% of cases.</p>","PeriodicalId":54677,"journal":{"name":"Operative Orthopadie Und Traumatologie","volume":" ","pages":"23-32"},"PeriodicalIF":1.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146031608","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sarkomchirurgie.","authors":"Dieter C Wirtz, Sebastian Koob","doi":"10.1007/s00064-026-00930-3","DOIUrl":"https://doi.org/10.1007/s00064-026-00930-3","url":null,"abstract":"","PeriodicalId":54677,"journal":{"name":"Operative Orthopadie Und Traumatologie","volume":"38 1","pages":"1-2"},"PeriodicalIF":1.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146108499","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}