Injury-International Journal of the Care of the Injured最新文献

{"title":"Evaluating the physical examination and diagnostic workup for occult Neck Of Femur fractures in a district general hospital","authors":"Ahmed Maksoud,&nbsp;Mandla Nkala,&nbsp;Katie Henderson,&nbsp;Srinkanth Minijenahalli-Narayanaswamy","doi":"10.1016/j.injury.2026.113656","DOIUrl":"10.1016/j.injury.2026.113656","url":null,"abstract":"<div><h3>Background</h3><div>Occult Neck of Femur (NOF) fractures are radiographically elusive injuries. Undiagnosed, they lead to delayed treatment, displacement, and increased morbidity. While MRI is the gold standard for detection, CT is frequently used when MRI is unavailable. Physical examination manoeuvres, specifically the hip log-roll (HR) and straight leg raise (SLR), are often employed to guide decisions regarding cross-sectional imaging. This study explores the utility of these physical examinations in guiding the workup for occult NOF fractures.</div></div><div><h3>Methods</h3><div>A prospective service evaluation was performed at a 400-bed UK district general hospital (Jan 2023–Apr 2025). An electronic data-capture form integrated into CT/MRI requests identified 133 imaging requests ordered for suspected occult NOF fractures (120 CT and 14 MRI). Fifteen requests were cancelled (12 CT and 1 MRI out of a total 146 requests in 143 patients), and 14 CT Investigations related to suspected periprosthetic fracture were excluded from the primary native-hip analysis. Clinician-recorded results for HR, SLR, axial loading, and heel-percussion tests were compared against CT and MRI outcomes. Sensitivity, specificity, predictive values, and area under the ROC curve (AUC) were calculated for each test. A 4-point risk score (age &gt; 70, female gender, positive HR, positive SLR) was evaluated for its discriminatory power.</div></div><div><h3>Results</h3><div>CT confirmed 38 occult NOF fractures, with 4 further cases confirmed on MRI (including one initially missed on CT) and 3 on initial radiographic re-assessment. ). HR and SLR were performed in more than 95% of patients, demonstrating high sensitivities of 0.96 and 0.91, respectively, but low specificities (&lt;0.35). Axial loading and heel percussion showed lower sensitivities (0.68 and 0.64). Combined HR + SLR yielded a fair AUC (0.68), which improved to 0.72 when age and gender were incorporated into the risk score.</div></div><div><h3>Conclusions</h3><div>In this setting, CT detected 97% of occult NOF fractures, missing only one micro-trabecular injury subsequently detected on MRI. The hip log roll and straight leg raise tests demonstrated high sensitivity but limited specificity, with improved performance when combined with demographic factors. These findings suggest that clinical examination manoeuvres are most useful for ruling out, rather than confirming, occult NOF fractures. Importantly, they reinforce the role of careful bedside physical examination in guiding appropriate imaging, particularly in an era of increasing reliance on radiological investigations.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"57 10","pages":"Article 113656"},"PeriodicalIF":2.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148922368","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":"Anatomical fit of a precontoured suprapectineal plate in japanese patients with acetabular fractures: A three-dimensional morphometric study","authors":"Masahiro Yoshida,&nbsp;Mitsunaga Iwata,&nbsp;Nobunori Takahashi","doi":"10.1016/j.injury.2026.113709","DOIUrl":"10.1016/j.injury.2026.113709","url":null,"abstract":"<div><h3>Background</h3><div>Anatomically precontoured suprapectineal plates have been developed to reduce intraoperative contouring and facilitate anatomical fixation of acetabular fractures. However, their fit to the pelvic morphology of Japanese patients remains inadequately investigated. We aimed to evaluate the anatomical fit of a commercially available precontoured suprapectineal plate using mirrored three-dimensional (3D) pelvic models reconstructed from computed tomography (CT) images.</div></div><div><h3>Methods</h3><div>This retrospective morphometric study included 12 consecutive Japanese patients with acetabular fractures (nine men and three women; mean age, 73.5 years). Thin-slice CT images (1–2 mm) were reconstructed into patient-specific 3D pelvic models using ZedView software. The intact contralateral hemipelvis was mirrored to create an anatomical model. The mirrored models were exported as stereolithography (STL) files, processed using Z-SUITE software, and fabricated at full scale (1:1) using a Zortrax® fused deposition modeling 3D printer with acrylonitrile butadiene styrene (ABS) filament. A commercially available precontoured suprapectineal anatomical plate was placed on each mirrored pelvic model without additional contouring. Plate fit, iliopectineal line length, and pelvic curvature were evaluated. Poor fit was defined as a gap &gt; 5 mm between the plate and bone surface. Plate fit and morphometric measurements were performed by a single orthopedic surgeon according to predefined criteria. Correlations between anthropometric parameters and pelvic morphology were analyzed using Pearson's correlation coefficient. Statistical significance was set at p &lt; 0.05.</div></div><div><h3>Results</h3><div>Poor plate fit was identified in eight of 12 patients (66.7%). In four patients (33.3%), the anterior portion of the plate overhung the pubic symphysis despite appropriate positioning along the pelvic brim. Iliopectineal line length was positively correlated with body height (r = 0.628, p = 0.029) and body weight (r = 0.610, p = 0.035), but not pelvic curvature (r = 0.385, p = 0.216).</div></div><div><h3>Conclusions</h3><div>The precontoured suprapectineal anatomical plate frequently showed inadequate anterior conformity in Japanese patients with acetabular fractures. Preoperative patient-specific evaluation using mirrored 3D pelvic models may facilitate implant selection and surgical planning while providing valuable information for future anatomical plate design.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"57 10","pages":"Article 113709"},"PeriodicalIF":2.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149003162","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":"Mini-fragment applications for lower extremity long bone fractures: A narrative review","authors":"Robert P. Dunbar,&nbsp;Anthony T. Sorkin,&nbsp;Habib Mohammed Alismaily,&nbsp;Fransisco Chana-Rodriguez","doi":"10.1016/j.injury.2026.113351","DOIUrl":"10.1016/j.injury.2026.113351","url":null,"abstract":"<div><div>Mini-fragment systems (2.0, 2.4 and 2.7 mm) have evolved from fixation of just hand and foot fractures to have become an indispensable component of complex fracture fixation all over the appendicular skeleton. Surgeons currently use mini-fragment fixation in provisional fixation capacities, as adjunctive fixation to larger fixation constructs and in isolation in select situations. The versatility and popularity of these implants is far reaching, even in the lower extremity long bones, where their usage may be somewhat non-intuitive. In this narrative review we delineate the rationale for the use of these implants. We then illustrate several applications for these implants throughout the lower extremities that have proven useful.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"57 ","pages":"Article 113351"},"PeriodicalIF":2.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149257843","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patellar fractures: To plate them all? Results of a new treatment protocol","authors":"Amit Davidson,&nbsp;Elad Harats,&nbsp;Yadin Levy,&nbsp;Moshe Stavsky,&nbsp;Idan Lieberman,&nbsp;Abraham Altergot,&nbsp;Shlomo Bloom","doi":"10.1016/j.injury.2026.113652","DOIUrl":"10.1016/j.injury.2026.113652","url":null,"abstract":"<div><h3>Introduction</h3><div>In recent years, anatomically contoured locking plates have been introduced as an alternative fixation method for patellar fractures. Biomechanical studies have demonstrated superior mechanical stability and clinical studies further suggest that plating reduces complication and revision rates, especially in comminuted fracture patterns. However, there is uncertainty regarding the role of plating in less complex fracture types. Following an institutional shift to routine plating of all surgically treated patellar fractures, this study compares outcomes and costs of plate versus non-plate fixation for patellar fractures.</div></div><div><h3>Methods</h3><div>Retrospective cohort at a level-I trauma center (2016–2023). Patients undergoing fixation with ≥ 6-month follow-up were included. Major complications were fixation failure or deep infection; minor included superficial infection, ROM &lt; 110°, persistent knee pain, or stair-climbing difficulty. Hardware removal was analyzed separately.</div></div><div><h3>Results</h3><div>125 patients met criteria (48 plating; 77 non-plate); 70% had AO C1–C2 patterns. Major complications occurred in 4% after plating versus 15% with non-plate (p = 0.07). Hardware removal rate was 8.3% with plating versus 26.0% without. Minor complication rates were lower with plating (p &lt; 0.05). ROM was better after plating (0–136°) than non-plate fixation (1–126°). Cost analysis showed higher primary cost with plating, offset by fewer complications, yielding a net additional expenditure of $6413 overall.</div></div><div><h3>Conclusion</h3><div>Plating reduced complications and hardware removal and improved overall function, with modest additional cost.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"57 10","pages":"Article 113652"},"PeriodicalIF":2.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148932133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Change associated with enoxaparin prophylactic anti-Xa levels during prolonged hospitalization in trauma patients","authors":"Lauren E. Mangan,&nbsp;Jerime Gendron,&nbsp;Mark J. Seamon,&nbsp;Niels D. Martin,&nbsp;Raymond F. Lamore","doi":"10.1016/j.injury.2026.113675","DOIUrl":"10.1016/j.injury.2026.113675","url":null,"abstract":"<div><h3>Background</h3><div>The administration of optimized venous thromboembolism (VTE) prophylaxis is critical in trauma patients. Guidance thus far has focused on initial enoxaparin dose selection and anti-factor Xa (anti-Xa) level monitoring. The need for monitoring and titrating prophylaxis in high-risk patients requiring prolonged hospitalization remains unknown.</div></div><div><h3>Methods</h3><div>This was a retrospective, single-center, cohort study including patients admitted with traumatic injury between January 1, 2021, and November 1, 2025, receiving enoxaparin for chemoprophylaxis and requiring prolonged hospitalization (<u>&gt;</u>14 days). The primary outcome characterized clinically significant change in enoxaparin anti-Xa levels between the first level resulting within prophylactic target range and a repeat level obtained at least 6 days later resulting outside of prophylactic target range. Secondary outcomes evaluated the incidence of thrombus and clinically significant bleeding during the index hospitalization.</div></div><div><h3>Results</h3><div>Of 272 consecutive patients screened, 43 patients were included within the study period. The patient cohort exhibited a median Injury Severity Score (ISS) of 21 [13.5–27] on admission. A total of 46 repeat anti-Xa levels were obtained at least 6 days following the first anti-Xa level within prophylactic target range. Clinically significant change in repeat anti-Xa levels was observed in 12/46 (26%) instances. The majority of repeat anti-Xa levels resulted in subtherapeutic range (10/12, 83.3%). The incidence of thrombus occurred in 7/43 (16.3%) patients and clinically significant bleeding in 1/43 (2.3%) patients during the index hospitalization.</div></div><div><h3>Conclusions</h3><div>Approximately one-quarter of patients exhibited clinically significant change between the first anti-Xa level within prophylactic target range and repeat anti-Xa levels obtained at least 6 days later in this evaluation. Subsequent larger studies are necessary to validate these hypothesis generating findings.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"57 10","pages":"Article 113675"},"PeriodicalIF":2.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148946374","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":"Epidemiology, functional outcomes, and socioeconomic burden of hand tendon injuries: A five-year retrospective cohort study in southern Italy","authors":"Gabriele Delia,&nbsp;Michele Rosario Colonna,&nbsp;Fabio Di Blasi,&nbsp;Michele Maruccia,&nbsp;Pasqualina Laganà,&nbsp;Cristina Genovese,&nbsp;Giovanni Genovese,&nbsp;Fabiana Battaglia","doi":"10.1016/j.injury.2026.113691","DOIUrl":"10.1016/j.injury.2026.113691","url":null,"abstract":"<div><h3>Background</h3><div>Hand tendon injuries represent a major challenge in reconstructive surgery, with profound consequences on function, quality of life, and socioeconomic costs. Despite advances in surgical techniques and rehabilitation protocols, functional recovery often remains suboptimal, and comprehensive analyses addressing both clinical and economic outcomes are limited, particularly in Southern Europe.</div></div><div><h3>Methods</h3><div>We conducted a five-year retrospective cohort study including 206 patients who underwent surgical repair of hand tendon injuries at the Plastic Surgery Unit of university hospital (2020–2024). Data collected comprised demographics, injury characteristics, occupation, type of trauma, rehabilitation pathway, and functional outcomes. Functional recovery was assessed through grip strength (digital dynamometer) and range of motion (goniometer). Socioeconomic impact was evaluated based on work absenteeism.</div></div><div><h3>Results</h3><div>Extensor tendon injuries were more common than flexor lesions (66% vs. 34%), with the index finger being the most affected digit. The majority of patients were male (83.5%), and patients aged 21–60 years represented the largest proportion of the cohort. Functional recovery was favorable overall, with mean grip strength reaching 87% and mobility 76% of expected values; however, the ring finger demonstrated the poorest outcomes. In descriptive analyses, patients who underwent postoperative rehabilitation showed higher functional-recovery values than those who did not undergo rehabilitation. The mean absence from work was 69.5 days; employees reported a mean absence of approximately 80.7 days, whereas self-employed participants reported 42.3 days.</div></div><div><h3>Conclusions</h3><div>Hand tendon injuries impose a significant clinical and socioeconomic burden. Extensor tendons and the index finger were most commonly involved, and the ring finger exhibited the lowest functional recovery. Postoperative rehabilitation was descriptively associated with better functional outcomes; however, the observational study design does not allow causal inferences to be made. These findings support the need for preventive strategies in both occupational and domestic settings and for further prospective studies of the factors associated with functional recovery.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"57 10","pages":"Article 113691"},"PeriodicalIF":2.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148946383","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":"Overview and new developments in intramedullary and cephalomedullary nailing","authors":"Simon Hackl,&nbsp;Ferdinand Weisemann,&nbsp;Oliver Trapp,&nbsp;Christian von Rüden","doi":"10.1016/j.injury.2026.113718","DOIUrl":"10.1016/j.injury.2026.113718","url":null,"abstract":"<div><div>The primary objectives of osteosynthetic fracture stabilization are accurate fracture reduction, restoration of the anatomical axis and rotational alignment, and the provision of adequate biomechanical and biological conditions to support bone healing. In fractures of long tubular bones, these goals can be optimally achieved by intramedullary nailing, which provides long-segment internal splinting along the anatomical axis of the bone combined with locking screws to ensure axial and rotational stability. In addition, intramedullary nailing is a tissue-preserving technique, as nail insertion is performed remote from the fracture site, thereby minimizing soft tissue trauma within the fracture zone. The indications for intramedullary nailing include epiphyseal and diaphyseal fractures of long bones, selected metaphyseal fractures that can be stabilized using anatomically contoured nails, as well as reconstructive procedures such as the treatment of nonunions, corrective osteotomies, and arthrodeses of the lower extremity. A major advantage of intramedullary nailing is the high primary stability of the implant, which generally allows early functional rehabilitation. The resulting biomechanical benefits permit early full weight bearing and, in the treatment of fracture healing disorders, are associated with high rates of osseous union. Continuous improvements in implant design and instrumentation, together with the introduction of anatomically contoured reconstruction nails, are expected to further expand the indications and effectiveness of intramedullary nailing. This narrative review summarizes historical milestones, biomechanical principles, technical aspects, and recent implant developments in intramedullary nailing, with a particular focus on cephalomedullary nailing for unstable trochanteric and subtrochanteric femoral fractures. Special emphasis is placed on fracture reduction quality, implant selection, and screw positioning, as these factors remain the strongest determinants of fixation stability and clinical outcome.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"57 ","pages":"Article 113718"},"PeriodicalIF":2.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149257846","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic value of baseline RDW-CV in critically ill patients with pelvic fractures: A retrospective cohort study","authors":"He Huang,&nbsp;Lulu Gu,&nbsp;Weihua Lu","doi":"10.1016/j.injury.2026.113701","DOIUrl":"10.1016/j.injury.2026.113701","url":null,"abstract":"<div><h3>Background</h3><div>Red blood cell distribution width coefficient of variation (RDW-CV) is a potential prognostic biomarker, but its prognostic significance in critically ill patients with pelvic fractures remains unclear. This study evaluated the association between baseline RDW-CV and mortality and developed a nomogram for predicting 365-day mortality.</div></div><div><h3>Methods</h3><div>This retrospective cohort study included adult patients with pelvic fractures admitted to the intensive care unit (ICU) in the MIMIC-IV database. Baseline RDW-CV was defined as the first measurement after ICU admission. Associations with 30-, 90-, and 365-day mortality were evaluated using Kaplan–Meier analysis, Cox regression, restricted cubic splines (RCS), and subgroup analyses. A nomogram incorporating RDW-CV, age, and Acute Physiology Score III (APSIII) was internally validated.</div></div><div><h3>Results</h3><div>Among 270 patients, 37 (13.7%) had elevated RDW-CV (&gt;15.5%). Patients with elevated RDW-CV had higher 30-day (32.4% vs. 7.3%), 90-day (35.1% vs. 9.4%), and 365-day mortality (40.5% vs. 12.0%) than those with RDW-CV ≤ 15.5% (all <em>P</em> &lt; 0.001), with significantly lower survival probabilities (log-rank <em>P</em> &lt; 0.0001). In fully adjusted Cox models, elevated RDW-CV remained independently associated with 30-day (HR 2.68, 95% CI 1.20–5.99; <em>P</em> = 0.016), 90-day (HR 2.33, 95% CI 1.12–4.84; <em>P</em> = 0.024), and 365-day mortality (HR 2.21, 95% CI 1.14–4.26; <em>P</em> = 0.018). RCS analysis showed a significant overall association with 365-day mortality (<em>P</em> = 0.007), without significant nonlinearity (<em>P</em> = 0.079). Findings were consistent across prespecified subgroup and sensitivity analyses. The nomogram showed good calibration and discrimination for 365-day mortality (AUC 0.878). Exploratory analyses of dynamic RDW-CV changes during ICU stay showed no significant association with survival.</div></div><div><h3>Conclusions</h3><div>Elevated baseline RDW-CV was independently associated with increased short- and long-term mortality in critically ill patients with pelvic fractures. Baseline RDW-CV may provide a practical marker for early risk stratification, while serial RDW-CV measurements offered limited additional prognostic value.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"57 10","pages":"Article 113701"},"PeriodicalIF":2.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148946405","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":"Predictors of long-term quality of life following operative treatment of unstable pelvic ring injuries: A retrospective cohort study","authors":"Perumal Ramesh,&nbsp;Asif Imran,&nbsp;Mukund S. Nair,&nbsp;Agraharam Devendra,&nbsp;Arunkamal Chandramohan,&nbsp;Jayaramaraju Dheenadhayalan,&nbsp;Shanmuganathan Rajasekaran","doi":"10.1016/j.injury.2026.113698","DOIUrl":"10.1016/j.injury.2026.113698","url":null,"abstract":"<div><h3>Objectives</h3><div>To evaluate long-term health-related quality of life after operative treatment of unstable pelvic ring injuries and determine factors independently associated with outcome.</div></div><div><h3>Methods</h3><div>A retrospective cohort study was conducted at a single Level I trauma center. Adult patients with AO/OTA 61B and 61 C pelvic ring injuries treated operatively between 2014 and 2018 with a minimum follow-up of five years were included. Health-related quality of life was assessed using the EQ-5D-5L (Indian value set). Associations between patient, injury, and treatment characteristics and EQ-5D index scores were evaluated using univariable and multivariable linear regression.</div></div><div><h3>Results</h3><div>Ninety-eight patients were included (74% male; mean age, 41 ± 15 years) with a mean follow-up of 6.7 years. The mean EQ-5D index score was 0.87 ± 0.13. On univariable analysis, poor reduction, polytrauma, concomitant injuries, and postoperative complications were associated with lower EQ-5D scores, whereas combined and posterior fixation were associated with higher scores. On multivariable analysis, poor reduction (&gt;10 mm; β = −0.22, 95% CI −0.29 to −0.15; p &lt; 0.001) and polytrauma (β = −0.05, 95% CI −0.09–0.00; p = 0.044) remained independently associated with worse quality of life. Fixation method and AO/OTA fracture classification were not independently associated with outcome.</div></div><div><h3>Conclusions</h3><div>Poor reduction and polytrauma were independently associated with worse long-term quality of life after operative treatment of unstable pelvic ring injuries. Reduction quality was the only potentially modifiable factor independently associated with long-term outcome, supporting careful attention to fracture reduction during operative management.</div></div><div><h3>Level Of evidence</h3><div>Prognostic Level IV.</div></div><div><h3>Level of evidence</h3><div>IV.</div></div><div><h3>Level of clinical care</h3><div>Level I Tertiary trauma centre.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"57 10","pages":"Article 113698"},"PeriodicalIF":2.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148946440","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":"Editorial: Innovative fixation technology","authors":"Volker Alt,&nbsp;Theodore Miclau,&nbsp;Esther M.M. Van Lieshout","doi":"10.1016/j.injury.2026.113741","DOIUrl":"10.1016/j.injury.2026.113741","url":null,"abstract":"","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"57 ","pages":"Article 113741"},"PeriodicalIF":2.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149257851","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}