Joint diseases and related surgery最新文献

{"title":"Validating Mini Nutritional Assessment-Short Form thresholds for postoperative mortality and complications in geriatric hip fracture patients with compromised nutritional status.","authors":"Yan Liu, Lili Sun, Zhiwei Liu, Yannan Ma, Chen Li, Menglin Liang, Qing Zhang, Han Yu, Cong Wang","doi":"10.52312/jdrs.2026.2417","DOIUrl":"10.52312/jdrs.2026.2417","url":null,"abstract":"<p><strong>Objectives: </strong>This study aims to establish evidence-based cut-off values of the Mini Nutritional Assessment-Short Form (MNA-SF) for predicting key postoperative outcomes including 60-day mortality, complications, and functional ambulation recovery in a broader cohort of elderly hip fracture patients.</p><p><strong>Patients and methods: </strong>Between January 2022 and July 2024, a total of 183 elderly hip fracture patients (57 males, 126 females; mean age: 82.7 ± 7.6 years; range, 65 to 101 years) who received surgical treatment were included. The patients encompassed the full spectrum of nutritional status (from well-nourished to malnourished). Logistic regression assessed the associations between preoperative MNA-SF scores (as a continuous variable) and 60-day mortality, complication rates, and gait status. Receiver operating characteristic (ROC) curves were used to identify optimal outcome-predictive cut-off values in the total cohort.</p><p><strong>Results: </strong>In the overall population, 78 of 183 (42.6%) patients developed postoperative complications, with 94 total complication events documented-34 orthopedic-specific complications (36.2%, including eight surgical site infections, four implant-related complications, and 22 affected limb function-related complications) and 60 systemic complications (63.8%, including 25 pulmonary infections, 26 urinary tract infections, 18 deep venous thromboses, 22 delirium cases, and three pressure sores). Lower MNA-SF scores were significantly correlated with increased risks of 60-day mortality and postoperative complications, but not with gait recovery. The optimal predictive cut-off for mortality was ≤ 7 (adjusted odds ratio [OR] = 0.72, 95% confidence interval [CI] 0.57-0.90; sensitivity 73.7%, specificity 64.0%; area under the curve [AUC] = 0.708). For complications, the optimal cut-off was ≤ 8 (adjusted OR = 0.82, 95% CI 0.72-0.93; sensitivity 74.4%, specificity 51.6%; AUC = 0.645).</p><p><strong>Conclusion: </strong>The MNA-SF is a valuable tool for preoperative risk stratification in geriatric hip fracture patients. We propose novel, evidence-based cut-off values (≤ 7 for mortality and ≤ 8 for complications) derived from a comprehensive cohort, which provide clinically actionable thresholds for identifying high-risk patients most likely to benefit from targeted nutritional and medical interventions.</p>","PeriodicalId":73560,"journal":{"name":"Joint diseases and related surgery","volume":"37 2","pages":"351-359"},"PeriodicalIF":2.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13392924/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147576777","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Irreducible metacarpophalangeal joint dislocations: Clinical characteristics, surgical approaches, and outcomes.","authors":"Mehmet Şah Sakçı, Ersen Türkmen, Mümin Karahan, Ekrem Özdemir","doi":"10.52312/jdrs.2026.2603","DOIUrl":"10.52312/jdrs.2026.2603","url":null,"abstract":"<p><strong>Objectives: </strong>This study aims to evaluate the clinical characteristics, surgical management, and outcomes of irreducible metacarpophalangeal (MCP) dislocations.</p><p><strong>Patients and methods: </strong>Between August 2020 and August 2024, a total of 13 patients (7 males, 6 females; mean age: 29.2 ± 23.7 years; range, 7 to 78 years) with MCP dislocations who were surgically treated were retrospectively analyzed. Demographics, dislocation patterns, obstructing elements, operative approach, and postoperative complications were documented. Functional outcomes included MCP range of motion (ROM), extension lag, grip strength recovery compared to the contralateral hand, and patient-reported disability using the Quick Disabilities of the Arm, Shoulder and Hand questionnaire (QuickDASH) questionnaire.</p><p><strong>Results: </strong>The index finger was most frequently involved (53.8%), with dorsal dislocations predominating (76.9%). A dorsal approach was performed in 76.9%. Dorsal reconstruction resulted in greater MCP ROM (flexion 85.8° ± 7.5° vs. 78.4° ± 6.7°), smaller extension lag (-1.8° ± 3.7° vs. -4.2° ± 5.3°), and lower disability scores (QuickDASH 4.0 ± 4.7 vs. 8.8 ± 5.5). Volar reconstruction provided superior grip strength (107.5 ± 8.7% vs. 90.9 ± 12.3%), exceeding baseline. Return-to-sport was earlier after the dorsal approach (11.5 ± 2.9 vs. 14.4 ± 3.0 weeks). Although differences did not reach statistical significance, large effect sizes (d ≥ 0.8) highlighted clinical relevance. Transient postoperative hypoesthesia occurred in two volar cases.</p><p><strong>Conclusion: </strong>Timely operative management, tailored to dislocation type and obstructing anatomy, is essential. The dorsal approach optimizes MCP mobility, disability reduction, and athletic recovery, whereas the volar approach enhances grip strength. These complementary outcomes underscore the importance of individualized surgical selection and structured rehabilitation.</p>","PeriodicalId":73560,"journal":{"name":"Joint diseases and related surgery","volume":"37 2","pages":"431-441"},"PeriodicalIF":2.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13386355/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147576943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Wire-stem fretting and galvanic corrosion as an underrecognized cause of metallosis after hip arthroplasty: A rare case report.","authors":"Wei-Cheng Chiu, Hui-Jung Yu, Wei-Zhi Liao","doi":"10.52312/jdrs.2026.2668","DOIUrl":"10.52312/jdrs.2026.2668","url":null,"abstract":"<p><p>Although metallosis after hip arthroplasty is most often attributed to bearing wear or trunnion corrosion, auxiliary fixation devices may also serve as a potential source. In this article, we report a rare case in which direct contact between a stainless-steel cerclage wire and a titanium femoral stem produced localized metallic debris and a peri-stem pseudotumor, consistent with fretting and galvanic corrosion. Ten years after index total hip arthroplasty complicated by an intraoperative femoral fracture treated with cerclage, the patient presented with groin pain and a cystic lesion with solid components adjacent to the femoral stem. Revision surgery revealed black-stained tissue concentrated at the wire-stem interface. Histological examination confirmed metallic debris with chronic inflammation. After extensive debridement and revision to a distally fixed stem, pain on the Visual Analog Scale (VAS) decreased from 5 to 1, and the Harris Hip Score (HHS) improved from 70 to 93 at six months. In conclusion, this case serves as a reminder that even auxiliary fixation devices, such as stainless-steel cerclage wires placed for intraoperative fracture stabilization, can generate metallic debris and lead to metallosis when they come into contact with titanium stems. Surgeons, therefore, should avoid direct contact between stainless-steel and titanium components, or otherwise interpose an insulating layer when cerclage fixation is required.</p>","PeriodicalId":73560,"journal":{"name":"Joint diseases and related surgery","volume":"37 2","pages":"572-578"},"PeriodicalIF":2.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13374054/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147576925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Osteogenic effect of platelet-rich fibrin on a bone defect model of long bone in rabbits.","authors":"In Park, Saerom Jeong, Jihoon Ryu","doi":"10.52312/jdrs.2026.2654","DOIUrl":"10.52312/jdrs.2026.2654","url":null,"abstract":"<p><strong>Objectives: </strong>This study aims to evaluate the osteogenic effect of platelet-rich fibrin (PRF) graft with periosteal repair on a bone defect of long bone in rabbits, compared to control group that underwent periosteal repair alone.</p><p><strong>Materials and methods: </strong>A total of 12 female New Zealand white rabbits were used in this study. Two rabbits were designated for PRP preparation, mixed with a human thrombin agent to produce PRF. A bone defect (5 mm in diameter and 7 mm in depth) was created in both proximal tibiae of 10 rabbits. The defect site of the right proximal tibia was filled with PRF, followed by periosteal repair (PRF group). In contrast, only periosteal repair was performed on the left proximal tibia (control group). For histological evaluation, hematoxylin and eosin (HE) and Masson's trichrome (MT) staining were performed at Weeks 4 and 8 after surgery. The bone healing ratio, defined as the proportion of newly formed bone area to surgically created defect area, was calculated to assess bone regeneration. For radiological examination, micro-computed tomography (micro-CT) was conducted at Week 8 after surgery.</p><p><strong>Results: </strong>A total of nine rabbits survived until the planned euthanasia time points (four rabbits at Week 4 and five at Week 8). At Week 4 postoperatively, HE staining revealed a higher bone healing ratio in the PRF group compared to the control group; however, the difference was not statistically significant (PRF group: 71.0 ± 15.6, control group: 59.5 ± 18.1, p = 0.34). At Week 8 postoperatively, histological analysis showed no difference in the bone healing ratio between the two groups (PRF group: 79.3 ± 8.7, control group: 75.9 ± 13.2, p = 0.55). Micro-CT analysis demonstrated a superior LaneSandhu score in the PRF group compared to the control group, although this difference was not statistically significant (p = 0.15).</p><p><strong>Conclusion: </strong>The PRF graft with periosteal repair appears to promote improved early-stage new bone formation in bone defects of long bone in an animal model compared to periosteal repair alone, although it does not reach statistical significance.</p>","PeriodicalId":73560,"journal":{"name":"Joint diseases and related surgery","volume":"37 2","pages":"372-380"},"PeriodicalIF":2.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13386379/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147576538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cannulated screw tension band versus Kirschner wire tension band for patellar fractures: A systematic review and meta-analysis.","authors":"Zhong-Bo Deng, Duo Shan, Feng Pan, Yang-Jing Cao","doi":"10.52312/jdrs.2026.2558","DOIUrl":"10.52312/jdrs.2026.2558","url":null,"abstract":"<p><strong>Objectives: </strong>This meta-analysis aimed to systematically compare the clinical outcomes of cannulated screw tension band (CSTB) and Kirschner wire tension band (KWTB) fixation for patellar fractures.</p><p><strong>Materials and methods: </strong>Comprehensive searches were conducted in the Cochrane Library, Web of Science, PubMed, Embase, and SpringerLink databases for studies published through July 2025. Search terms included \"cannulated screw,\" \"Kirschner wire,\" \"tension band,\" and \"patellar fracture.\" Mean differences (MDs) and odds ratios (ORs) were utilized as pooled effect measures, with 95% confidence intervals (CIs).</p><p><strong>Results: </strong>Eleven studies involving 1,358 patients with patellar fractures met the inclusion criteria. Meta-analysis revealed no statistically significant differences between the groups in terms of operative time (MD = 4.00; 95% CI -1.82~9.82; p = 0.18), fracture healing time (MD = 0.08; 95% CI -0.07~0.22; p = 0.28), or postoperative Visual Analog Scale scores (MD = 0.21; 95% CI -0.74~1.15; p = 0.67). However, CSTB fixation demonstrated significantly superior postoperative knee range of motion (ROM) (MD = -7.16; 95% CI -9.34~-4.98; p < 0.00001), higher Lysholm scores (MD = -4.80; 95% CI -6.62~-2.99; p < 0.00001), and significantly lower rates of reoperation (OR = 5.14; 95% CI 2.66~9.93; p < 0.00001) and overall complications (OR = 14.19; 95% CI 4.85~41.56; p < 0.00001) compared to KWTB.</p><p><strong>Conclusion: </strong>For patellar fracture fixation, CSTB offers significant advantages over KWTB in terms of postoperative knee ROM, functional outcomes, reoperation rates, and overall complication rates.</p>","PeriodicalId":73560,"journal":{"name":"Joint diseases and related surgery","volume":"37 2","pages":"360-371"},"PeriodicalIF":2.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13402923/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147576920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health-related quality of life in patients undergoing surgery for upper extremity bone tumors: A cross-sectional study.","authors":"Mustafa Çeltik, Özlem Orhan, Gülsüm Öztürk Emiral, Kemal Yücel, Hayati Hürol Türkoğlu, Coşkun Ulucaköy, İsmail Burak Atalay","doi":"10.52312/jdrs.2026.2663","DOIUrl":"10.52312/jdrs.2026.2663","url":null,"abstract":"<p><strong>Objectives: </strong>This study aims to evaluate health-related quality of life (HRQoL) in patients who underwent surgical treatment for upper extremity bone tumors, using validated patient-reported outcome measures, and to explore clinical factors associated with better or worse outcomes.</p><p><strong>Patients and methods: </strong>Between January 2015 and January 2024, a total of 55 patients (26 males, 29 females; mean age: 42.4 ± 19.0 years; range, 16 to 81 years) who were treated surgically for upper extremity bone tumors and evaluated at least six months postoperatively were included. The patients completed the EuroQol EQ-5D-5L and the Short Form-12 (SF-12) questionnaires. Clinical variables included age, sex, tumor site, pathology, treatment modality, and adjuvant or neoadjuvant therapies.</p><p><strong>Results: </strong>The humerus was the most frequent tumor site (60%), and joint involvement was present in 80% of cases. Benign tumors accounted for two-thirds of patients, while malignant tumors represented one-third. Curettage-based procedures predominated, and only two patients required amputation. Postoperative complications and recurrences were both observed in 7.3% of patients. On the EQ-5D-5L, 65.5% of patients reported no difficulty with mobility or self-care, but half experienced limitations in usual activities. Pain and discomfort were reported by 74.5%, and anxiety or depression by 67.3%. The mean EQ-5D-5L index was 0.55 ± 0.49 and the mean EQ-VAS was 70.9 ± 20.1. The mean SF-12 physical component score (PCS) and mental component score (MCS) were 42.6 ± 11.3 and 47.0 ± 11.2, respectively, indicating that physical functioning was more impaired than mental well-being. Correlation analyses demonstrated strong associations between EQ-5D-5L, EQ-VAS, and SF-12 scores, supporting convergent validity. Subgroup analyses revealed that younger patients (< 50 years), those with benign pathology, and individuals without adjuvant or neoadjuvant therapies reported significantly higher HRQoL scores.</p><p><strong>Conclusion: </strong>Patients undergoing surgery for upper extremity bone tumors frequently experience pain and psychological distress despite preserved independence in mobility and self-care. Age, pathology, treatment intensity and tumor location were associated with HRQoL. These findings highlight the importance of rehabilitation and psychosocial support in postoperative care, alongside oncological and surgical management.</p>","PeriodicalId":73560,"journal":{"name":"Joint diseases and related surgery","volume":"37 2","pages":"501-509"},"PeriodicalIF":2.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13386357/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147576933","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reconstruction of traumatic forefoot defects with free lateral arm flap.","authors":"Kubilay Erol, Can Yener, Erdem Er, Özgün Barış Güntürk, Tulgar Toros","doi":"10.52312/jdrs.2026.2513","DOIUrl":"10.52312/jdrs.2026.2513","url":null,"abstract":"<p><strong>Objectives: </strong>This study aims to evaluate the results of traumatic soft tissue defects of the forefoot reconstructed using the lateral arm flap and to examine the advantages and disadvantages of this flap.</p><p><strong>Patients and methods: </strong>Between January 2007 and December 2023, a total of 25 patients (23 males, 2 females; median age: 35 years; range, 8 to 57 years) who underwent lateral arm free flap reconstruction for forefoot soft tissue defects were retrospectively analyzed. Age, sex, injury mechanism, flap size, anastomosis site, vascular complications, associated injuries, functional results, donor site coverage, and aesthetic results of the operation rated by the patient and surgeons were noted. The recovery of sensation at the reconstructed site was also evaluated.</p><p><strong>Results: </strong>The median follow-up was 24.8 (range, 15 to 44) months. Only one total flap loss was encountered in this study, with an overall flap survival rate of 96%. Debulking of the flap was necessitated in four patients for comfortable shoe wear; those flaps were used to cover sizeable dorsal defects of the foot. The median European Foot and Ankle Society (EFAS) daily living score at the final evaluation was 18.2 (range, 17 to 21). All patients were able to wear regular shoes without modifications. All flaps regained protective sensation, although in none of them a neurography was performed. In the Semmes-Weinstein monofilament (SWM) testing, 18 patients could feel 4.56, four patients 6.65, and three patients 4.31. The patient-rated satisfaction score for reconstruction averaged 3,7 on a five-point scale.</p><p><strong>Conclusion: </strong>Reconstruction of forefoot soft tissue defects using the lateral arm flap provided satisfactory results in terms of successful soft tissue coverage, function, and patient satisfaction, with good cosmetic appearance and unrestricted shoe wear. Based on these findings, this flap is a good alternative for forefoot reconstruction owing to its ease of dissection, constant vascular anatomy, rich blood supply, and limited thickness. In addition, it does not sacrifice a major artery, does not limit the function of the arm, and the donor site can be closed primarily in most cases. The main disadvantage of the flap seems to be the conspicuous scar it leaves on the lateral aspect of the arm.</p>","PeriodicalId":73560,"journal":{"name":"Joint diseases and related surgery","volume":"37 2","pages":"422-430"},"PeriodicalIF":2.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13386388/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147576799","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Time-dependent effects of topical mucopolysaccharide polysulfate and silver sulfadiazine on wound healing in a rat excisional wound model.","authors":"Raşit Emin Dalaslan, Mücahid Osman Yücel, Sönmez Sağlam, Mehmet Arıcan, Zekeriya Okan Karaduman, Fatih Demir, Yunus Emre Bulum, Mustafa Toker","doi":"10.52312/jdrs.2026.2769","DOIUrl":"10.52312/jdrs.2026.2769","url":null,"abstract":"<p><strong>Objectives: </strong>This study aims to evaluate the effects of topical creams containing mucopolysaccharide polysulfate (MPS) on wound healing using an experimental wound model.</p><p><strong>Materials and methods: </strong>Standard full-thickness skin defects were created in 32 Wistar rats and monitored for 14 days under four different topical treatment protocols: Control (Group 1, n = 8), Hirudoid (Group 2, n = 8), Silverdin (Group 3, n = 8), and Hirudoid + Silverdin (Group 4, n = 8). Wound closure rates were quantified through photographic analysis, while histological and immunohistochemical healing characteristics were assessed using the Structure, Presence of Cells, Organization, and Tissue Integration (SPOT) score, additional histological indices, and the transforming growth factor-beta 1 (TGF-β1) H-score. Intergroup differences were analyzed using appropriate non-parametric statistical tests.</p><p><strong>Results: </strong>On Day 3, wound closure rates were higher in the Hirudoid, Silverdin, and Hirudoid + Silverdin groups compared to the control group (p < 0.01). By Day 14, this difference sustained only in the Silverdin and Hirudoid + Silverdin groups, indicating that the early advantage observed with Hirudoid alone was not maintained over time (p < 0.01). No significant differences in the general histological parameters were observed among the groups (p > 0.05). However, the TGF-β1 H-score was lower in the Silverdin group than in the control and Hirudoid groups (p < 0.01).</p><p><strong>Conclusion: </strong>Our study results suggest that MPS may accelerate early wound closure, but does not significantly improve wound closure in later stages, and its combination with silver sulfadiazine offers no additional benefit compared to silver sulfadiazine alone.</p>","PeriodicalId":73560,"journal":{"name":"Joint diseases and related surgery","volume":"37 2","pages":"552-562"},"PeriodicalIF":2.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13403003/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147576772","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of radiological and clinical follow-up strategies for intrathoracic osteochondromas in hereditary multiple osteochondromas patients.","authors":"Niyazi İğde, Osman Emre Aycan, Berkay Doğan, Berksu Polat, Serhat Gürbüz","doi":"10.52312/jdrs.2026.2522","DOIUrl":"10.52312/jdrs.2026.2522","url":null,"abstract":"<p><strong>Objectives: </strong>This study aims to evaluate the incidence, distribution, clinical implications, and surgical criteria for intrathoracic osteochondromas in hereditary multiple osteochondroma (HMO) patients.</p><p><strong>Patients and methods: </strong>Between January 2010 and January 2024, a total of 246 patients (146 males, 100 females; mean age: 8.2 ± 4.5 years; range, 1 to 18 years) who were diagnosed with HMO and had thoracic imaging using computed tomography (CT) with at least one year of clinical follow-up were retrospectively analyzed. Lesion characteristics (type, size, number, and location), symptoms, and surgical data were recorded. The receiver operating characteristic (ROC) curve analysis was performed to identify the size threshold associated with surgical indication.</p><p><strong>Results: </strong>Intrathoracic osteochondromas were detected in 35% of chest X-rays and in 81.8% of CT scans. Among 45 CT-confirmed cases, 68.9% had multiple lesions and 77.8% were pedunculated. Surgical excision was performed in 12 patients (4.9%), most commonly due to chest pain or paracardiac location. Tumor size was significantly higher in excised cases (median: 26 mm vs. 12 mm, p < 0.001). A lesion size > 15 mm predicted surgical need with 91.67% sensitivity and 72.73% specificity (area under the curve [AUC] = 0.883, p < 0.001).</p><p><strong>Conclusion: </strong>Routine chest radiography, reinforced by selective thoracic CT in symptomatic or suspicious cases, should be integrated into the follow-up of HMO patients to detect intrathoracic osteochondromas early. A lesion size of > 15 mm, chest pain, and paracardiac localization are strong predictors of surgical intervention and should guide clinical decision-making.</p>","PeriodicalId":73560,"journal":{"name":"Joint diseases and related surgery","volume":"37 2","pages":"402-412"},"PeriodicalIF":2.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13386358/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147576939","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medial plating versus newly designed intramedullary nail with distal interlocking system for distal tibia fractures: A biomechanical study with finite element analysis.","authors":"Omer Kays Unal, Mirza Zafer Dagtas, Turan Najafov, Cihan Demir, Ender Ugutmen, Fuat Akpinar","doi":"10.52312/jdrs.2026.2459","DOIUrl":"10.52312/jdrs.2026.2459","url":null,"abstract":"<p><strong>Objectives: </strong>The aim of this study was to compare the biomechanical properties of a newly designed Tibial Intramedullary Nail-Distal Supportive Bolt Locking Screw (TIN-DSBLS) and medial anatomical plate in distal tibia fracture models using finite element analysis (FEA).</p><p><strong>Materials and methods: </strong>Twelve medium-size, fourth-generation composite tibia models were used for testing. Models were divided into two groups as plate and nail group. A standardized osteotomy was made through each model. In the plate group, osteotomized models were fixed with distal tibia medial anatomic plate. Models in nail group were fixed with new design intramedullary nail with distal Bolt screw locking. All bone models were tested by an axial loading test machine to measure the force, maximum force, fracture site displacement and Stiffness. The second step of this study was FEA of the two models.</p><p><strong>Results: </strong>The results of axial loading test results of two groups revealed that for distal tibia fracture, tibia nail which was locked with newly designed bolt screw showed superiority against plate-screw fixation about force (1597.76 ± 85.54 vs. 830.74 ± 146.7 N), maximum force (3617.6 vs. 1512.42 N), fracture site displacement (4.89 ± 1 vs. 7.85 ± 0.5 mm) and stiffness (357.88 ± 52.6 vs. 109.67 ± 13.6 N/mm). In FEA, maximum stress levels in implants were 1.7 time higher in nail group, bones were not exposed to higher levels of stress or deformation as in plate group. Maximum stress levels in bones of the nail group were 2.75 times lower than plate group. Total displacement in the plate group was more than two-fold compared to the nail group.</p><p><strong>Conclusion: </strong>Our study results showed that the TIN-DSBLS provides more load transfer from the nail to the cortex in tibia distal metaphyseal fractures compared to traditional nails. Taken together, it is biomechanically superior to plate-screw fixation in fractures extending up to 2.5 cm proximal to the ankle joint.</p>","PeriodicalId":73560,"journal":{"name":"Joint diseases and related surgery","volume":"37 2","pages":"477-488"},"PeriodicalIF":2.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13386377/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147576170","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}