Annali italiani di chirurgia最新文献

{"title":"Identification of Risk Factors for Postoperative Delirium and Targeted Preventive Strategies in Elderly Patients in the Emergency Surgical ICU.","authors":"Xiaojiao Liu, Feng Pan, Liqin Hu, Jun Zhao","doi":"10.62713/aic.4591","DOIUrl":"https://doi.org/10.62713/aic.4591","url":null,"abstract":"<p><strong>Aim: </strong>Elderly patients admitted to the intensive care unit (ICU) after emergency surgery represent a uniquely high-risk population for postoperative delirium (POD). However, the key risk factors specific to this group have not been comprehensively integrated, and a corresponding clinical prediction tool is lacking. This study aimed to elucidate the clinical features, identify independent risk factors for POD, and develop and validate a prediction model tailored for elderly patients in the emergency surgical ICU.</p><p><strong>Methods: </strong>This retrospective study included 496 elderly patients (≥60 years) admitted post-emergency surgery. Delirium was assessed using the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU). Patients were randomly divided in a 7:3 ratio into training (n = 347) and validation (n = 149) sets. Logistic regression identified independent predictors, which were used to construct a nomogram. Model performance was evaluated via receiver operating characteristic (ROC) curves, calibration, and decision curve analysis (DCA).</p><p><strong>Results: </strong>POD incidence was 33.1%, predominantly the hypoactive subtype (64.6%), with peak onset on postoperative day 2 (57.9%). Five independent risk factors were identified: higher Sequential Organ Failure Assessment (SOFA) score (Odds Ratio [OR] = 3.818), elevated Procalcitonin (PCT) (OR = 1.594), longer mechanical ventilation (OR = 1.283), intraoperative hypotension (OR = 2.666), and physical restraint use (OR = 3.003). A nomogram was developed using these variables, which demonstrated excellent discriminative performance, with area under the curves (AUCs) of 0.937 and 0.913, in the training and validation datasets, respectively. DCA confirmed the clinical utility of our proposed model.</p><p><strong>Conclusions: </strong>This study identified five key and modifiable risk factors for POD in elderly emergency surgical ICU patients and successfully developed and validated a high-performance nomogram prediction tool. This model aids in the early identification of high-risk patients, providing a basis for implementing targeted bundled prevention strategies, which holds promise for improving clinical outcomes in this vulnerable population.</p>","PeriodicalId":8210,"journal":{"name":"Annali italiani di chirurgia","volume":"97 8","pages":"1517-1528"},"PeriodicalIF":0.8,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148787350","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":"Influence of Isokinetic Muscle Strength Training Combined With Early Functional Exercise on Joint Function After Knee Cruciate Ligament Reconstruction.","authors":"Yao Lin, Tianxiao Chen, Hong Lin, Wenjia Lv, Xiurong Ke, Xiangying Yang, Weiying Dai","doi":"10.62713/aic.4757","DOIUrl":"https://doi.org/10.62713/aic.4757","url":null,"abstract":"<p><strong>Aim: </strong>The purpose of this study was to evaluate and analyze the influence of isokinetic muscle strength training combined with early functional exercise on joint function after knee cruciate ligament reconstruction.</p><p><strong>Methods: </strong>A total of 294 patients undergoing knee cruciate ligament reconstruction from January 2023 to June 2025 were retrospectively selected. Based on different exercise methods, 155 patients who received early functional exercise for 24 weeks were included in a control group (CG), and the other 139 patients receiving isokinetic muscle strength training (starting from the 4th week after surgery) combined with early functional exercise were enrolled as an experimental group (EG). After propensity score matching (PSM), 252 patients were retained for analysis, including 126 cases in the EG and 126 cases in the CG. The primary clinical outcomes encompassed International Knee Documentation Committee Subjective Knee Form (IKDCSKF) and Knee Injury and Osteoarthritis Outcome Score (KOOS) before training (T0) and at 8 weeks (T1), 12 weeks (T2) and 24 weeks (T3) after surgery, and the secondary outcomes included joint range of motion (ROM) and isokinetic muscle strength test results involving extensor peak torque (EPT), flexor peak torque (FPT) and hamstrings/quadriceps (H/Q).</p><p><strong>Results: </strong>Repeated measures analysis of variance (ANOVA) revealed significant group × time interaction effects for both IKDCSKF and KOOS scores (both <i>p</i> < 0.001), indicating different improvement trajectories between the two groups. Significant time effects and group effects were also observed for both outcomes (both <i>p</i> < 0.001). Post hoc analysis with Bonferroni correction demonstrated that the EG group had significantly higher IKDCSKF and KOOS scores than the CG group at T1, T2, and T3 (<i>p</i> < 0.05 or <i>p</i> < 0.001), with more pronounced differences observed at T2 and T3 (all <i>p</i> < 0.001). At T3, EG had higher ROM, EPT, FPT and H/Q than CG (<i>p</i> < 0.001, <i>p</i> < 0.001, <i>p</i> < 0.001, <i>p</i> = 0.001). No significant difference was found in the proportion of patients with normal H/Q between the two groups (χ² = 0.06, <i>p</i> = 0.798). The β (95% CI) for EG on IKDCSKF score was 4.35 (2.82~5.87), and the β (95% CI) on KOOS score was 5.22 (3.91~6.53).</p><p><strong>Conclusions: </strong>Isokinetic muscle strength training combined with early functional exercise was associated with greater improvement in joint function and knee flexor and extensor muscle strength in patients undergoing knee cruciate ligament reconstruction. In addition, the intervention protocol may be independently associated with the patient's joint function.</p>","PeriodicalId":8210,"journal":{"name":"Annali italiani di chirurgia","volume":"97 8","pages":"1396-1404"},"PeriodicalIF":0.8,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148787490","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":"A Giant Ovarian Fibrothecoma Arising From Residual Ovarian Tissue Mimicking Advanced-Stage Ovarian Malignancy: A Short Report of Demons-Meigs Syndrome.","authors":"Muhammed Çağlar, Kadriye Dardağan, Öyküm Badur Gök, Derya Gümürdülü, İshak Aydın, Serdar Gümüş, Uğur Topal, Cem Kaan Parsak","doi":"10.62713/aic.4596","DOIUrl":"https://doi.org/10.62713/aic.4596","url":null,"abstract":"","PeriodicalId":8210,"journal":{"name":"Annali italiani di chirurgia","volume":"97 8","pages":"1337-1339"},"PeriodicalIF":0.8,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148787590","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":"Mesenteric Hyaline Vascular Castleman Disease Presenting as Acute Mechanical Intestinal Obstruction.","authors":"İsmail Ege Subaşı, Ahmet Topcu, Furkan Saydın, Safiye Figen, Pelin Aşkın","doi":"10.62713/aic.4789","DOIUrl":"https://doi.org/10.62713/aic.4789","url":null,"abstract":"","PeriodicalId":8210,"journal":{"name":"Annali italiani di chirurgia","volume":"97 8","pages":"1334-1336"},"PeriodicalIF":0.8,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148787630","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":"Recommendations for the Management of Symptomatic Hiatal Hernia in Saudi Arabia, With Regional Input From the Middle East: A Structured Expert Consensus Survey.","authors":"Ashraf Maghrabi, Mohammed Al Naami, Nizar Yamani, Emad Aljahdli, Moaz Abulfaraj","doi":"10.62713/aic.4699","DOIUrl":"10.62713/aic.4699","url":null,"abstract":"<p><strong>Aim: </strong>Gastroesophageal reflux disease (GERD) is prevalent in the Middle East, with hiatal hernia (HH) reported in nearly 30% of patients with GERD in Saudi Arabia. Management primarily involves lifestyle modifications and proton pump inhibitor therapy; however, patients with persistent symptoms may require surgical intervention. This study sought to establish expert-driven, best-practice recommendations to improve clinical outcomes in the management of HH through a Saudi-led structured expert consensus that also incorporated perspectives from the wider Middle East region.</p><p><strong>Methods: </strong>A structured expert consensus approach was conducted. A steering group of four experts collaboratively developed and ratified 32 Likert-scale statements encompassing five clinical domains: referral criteria, mesh utilization, risk mitigation, best practices, and guideline requirements. The ratified statements were subsequently distributed through a single-round online survey to surgeons performing HH repair across the Middle East, with a predefined consensus threshold of ≥75% agreement for each statement.</p><p><strong>Results: </strong>A total of 61 responses were analyzed, including 54 (88.5%) from Saudi Arabia and 7 (11.5%) from other Middle Eastern countries (Jordan, Qatar, Kuwait, Egypt, and the United Arab Emirates). Respondents comprised general surgeons (n = 42), thoracic surgeons (n = 8), upper gastrointestinal/bariatric surgeons (n = 8), and other specialists (n = 3). Nearly 40% of respondents had more than 10 years of specialty experience. Of the 32 statements, 31 (96.9%) achieved consensus (≥75%), with only one statement-regarding mesh use for hernias 4-6 cm-not reaching consensus (67%). Based on these findings, nine recommendations were developed addressing referral pathways, diagnostic evaluation, surgical indications, and mesh utilization.</p><p><strong>Conclusions: </strong>Strong agreement across 31 of 32 statements among predominantly Saudi surgical experts reflects a shared recognition of challenges and areas for improvement in GERD and HH management. These findings provide a foundation for the future development of standardized care pathways for the diagnosis, referral, and surgical management of symptomatic HH, primarily within Saudi Arabia while also informing broader clinical practice across the Middle East.</p>","PeriodicalId":8210,"journal":{"name":"Annali italiani di chirurgia","volume":"97 9","pages":"1738-1747"},"PeriodicalIF":0.8,"publicationDate":"2026-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148987837","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":"Comparison of SuperPATH Approach and Moore Approach for Total Hip Arthroplasty in Patients With Femoral Neck Fractures: A Retrospective Study.","authors":"Yiming Wang, Ke Qi","doi":"10.62713/aic.4491","DOIUrl":"https://doi.org/10.62713/aic.4491","url":null,"abstract":"<p><strong>Aims: </strong>Femoral neck fractures require total hip arthroplasty for treatment; however, the efficacy comparison between the Moore approach and the SuperPATH approach remains unclear. This study aims to explore the clinical efficacy of the SuperPATH approach and the Moore approach in total hip arthroplasty for patients with femoral neck fractures.</p><p><strong>Methods: </strong>A retrospective analysis of the clinical data of 110 patients with femoral neck fractures treated at Changhai Hospital from September 2021 to September 2024. According to the different approaches used for total hip arthroplasty, patients were divided into a SuperPATH group (SuperPATH approach, n = 50) and a Moore group (Moore approach, n = 60). Baseline information, operative parameters, inflammatory response, visual analogue scale (VAS) scores, Harris scores, 10‑meter walking time, and complication rates were compared between the two groups.</p><p><strong>Results: </strong>Compared with the Moore group, the SuperPATH group had shorter operative time and incision length (<i>p</i> < 0.05), less intraoperative blood loss (<i>p</i> < 0.001), earlier time to first ambulation (<i>p</i> < 0.05), and shorter hospital stay (<i>p</i> < 0.001). On postoperative day 7, the inflammatory level in the Moore group was significantly higher than that in the SuperPATH group (<i>p</i> < 0.05). Compared with the Moore group, the VAS score of the SuperPATH group was lower on the first day, 7 days, and 1 month after the operation (<i>p</i> < 0.001). In the first week, one month, and three months after the operation, the Harris score of the SuperPATH group was significantly higher than that of the Moore group (<i>p</i> < 0.001). Two and three months after the operation, the 10-meter walking time of the SuperPATH group was shorter than that of the Moore group (<i>p</i> < 0.05). The total incidence of complications in the SuperPATH group was lower than that in the Moore group (χ² = 4.685, <i>p</i> = 0.030).</p><p><strong>Conclusions: </strong>Compared with the Moore approach, the SuperPATH approach for total hip arthroplasty in the treatment of femoral neck fractures has more advantages. It can shorten the operation time, reduce surgical trauma and inflammatory reactions, alleviate postoperative pain, improve joint function and walking ability, and reduce the incidence of complications.</p>","PeriodicalId":8210,"journal":{"name":"Annali italiani di chirurgia","volume":"97 7","pages":"1239-1246"},"PeriodicalIF":0.8,"publicationDate":"2026-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148468442","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":"Esophageal Duplication Cyst Presenting With Gastric Hemorrhage and Perforation in an Elderly Patient.","authors":"Ali Yildirim, Uğur Topal, Tuğba Toyran, İshak Aydin, Serdar Gümüş, Cem Kaan Parsak","doi":"10.62713/aic.4678","DOIUrl":"https://doi.org/10.62713/aic.4678","url":null,"abstract":"","PeriodicalId":8210,"journal":{"name":"Annali italiani di chirurgia","volume":"97 7","pages":"1127-1130"},"PeriodicalIF":0.8,"publicationDate":"2026-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148468605","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":"Self-Efficacy Intervention Combined With Staged Rehabilitation Training Improves Neurological Function, Motor Performance, and Prognosis in Patients After Traumatic Brain Injury Surgery: A Retrospective Cohort Study.","authors":"Run Luo, Xuwen Lin","doi":"10.62713/aic.4551","DOIUrl":"https://doi.org/10.62713/aic.4551","url":null,"abstract":"<p><strong>Aim: </strong>This study aimed to investigate the efficacy of self-efficacy intervention combined with staged rehabilitation training on neurological function, motor performance, psychological status, and mid-term prognosis in patients after traumatic brain injury (TBI) surgery.</p><p><strong>Methods: </strong>This retrospective cohort study recruited 162 TBI patients who underwent surgical treatment between January 2022 and January 2025. Patients were divided into the observation group (n = 75, routine care + self-efficacy intervention + staged rehabilitation training) and the control group (n = 87, routine care only). The primary outcome was a favourable prognosis (Glasgow Outcome Scale [GOS] scores 4-5) at 6-month follow-up. Secondary outcomes included changes in National Institutes of Health Stroke Scale (NIHSS), Fugl-Meyer Assessment (FMA), General Self-Efficacy Scale (GSES), Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS), Barthel Index (BI), 36-Item Short Form Health Survey (SF-36) scores, and postoperative complication rates.</p><p><strong>Results: </strong>Baseline characteristics were comparable between groups (<i>p</i> > 0.05). Post-intervention, the observation group showed significantly lower NIHSS scores (17.57 ± 4.19 vs. 20.14 ± 4.95, <i>p</i> < 0.001) and higher FMA scores for upper (49.84 ± 3.26 vs. 44.57 ± 3.55) and lower limbs (25.84 ± 2.74 vs. 22.68 ± 2.49) than the control group (<i>p</i> < 0.001). The observation group also had higher GSES (31.16 ± 2.83 vs. 26.57 ± 3.19) and BI scores (44.59 ± 4.81 vs. 39.94 ± 4.37), lower SAS (43.61 ± 7.17 vs. 46.34 ± 6.94) and SDS scores (42.17 ± 4.20 vs. 44.25 ± 4.74), and superior SF-36 subscale scores (<i>p</i> < 0.001). The incidence of postoperative complications was lower in the observation group (6.67% vs. 18.39%, <i>p</i> = 0.027). The proportion of favourable prognosis was higher in the observation group (74.67% vs. 56.32%, <i>p</i> = 0.015), and the combined intervention was an independent predictor of favourable outcome (adjusted odds ratio [aOR] = 2.09, 95% confidence interval [CI]: 1.05-4.16, <i>p</i> = 0.035).</p><p><strong>Conclusions: </strong>Self-efficacy intervention combined with staged rehabilitation training effectively improves neurological function, motor recovery, psychological well-being, daily living ability, and mid-term prognosis, while reducing complications in patients after TBI surgery, representing a valuable clinical rehabilitation strategy.</p>","PeriodicalId":8210,"journal":{"name":"Annali italiani di chirurgia","volume":"97 7","pages":"1199-1209"},"PeriodicalIF":0.8,"publicationDate":"2026-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148468621","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":"Gait Analysis Evaluation of Early Weight-Bearing After Surgical Fixation of Ankle Fractures: A Prospective Observational Study.","authors":"Belinda Trobec, Simone Strano, Giulia Sgubin, Alex Buoite Stella, Andrea Marchetti, Manuela Deodato, Luigi Murena, Gianluca Canton","doi":"10.62713/aic.4598","DOIUrl":"10.62713/aic.4598","url":null,"abstract":"<p><strong>Aim: </strong>Post-operative weight-bearing strategies after surgical fixation of ankle fractures remain controversial. This prospective observational pilot study aimed to evaluate whether an early weight-bearing (EWB) protocol influences weight-bearing symmetry during static stance and clinical and functional recovery compared with a restricted weight-bearing protocol.</p><p><strong>Methods: </strong>Thirty-three patients undergoing surgical fixation for ankle fractures were allocated to either EWB (n = 17) or restricted weight-bearing (RWB) (n = 16) according to surgeon preference and fracture characteristics. Clinical, radiographic, and gait analysis outcomes were assessed at 6 weeks, 3 months, and 6 months postoperatively. The primary outcome was weight-bearing symmetry during bipodalic static stance. Secondary outcomes included subjective return to balance, independence in activities of daily living (ADL), and return to work. Data were analyzed using nonparametric tests.</p><p><strong>Results: </strong>At 6 weeks, the EWB group demonstrated significantly greater weight-bearing symmetry during static stance compared to the RWB group (eyes open, <i>p</i> = 0.048; eyes closed, <i>p</i> = 0.044). Patients in the EWB group also showed higher rates of subjective return to balance (76% vs 31%, <i>p</i> = 0.009) and ADL independence (82% vs 50%, <i>p</i> = 0.049). No significant differences were observed in return to work (<i>p</i> = 0.805). No complications were observed in either group.</p><p><strong>Conclusions: </strong>In this small observational cohort, early weight-bearing was associated with improved early weight-bearing symmetry and functional recovery without observed complications. These findings should be interpreted cautiously, due to the study design and sample size and require confirmation in larger controlled studies.</p>","PeriodicalId":8210,"journal":{"name":"Annali italiani di chirurgia","volume":"97 7","pages":"1192-1198"},"PeriodicalIF":0.8,"publicationDate":"2026-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148468562","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":"Comparative Assessment of Elastic Intramedullary Nailing Versus Conventional Plate Fixation for Pediatric Femoral Shaft Fractures in the Emergency Setting.","authors":"Li Zhang, Chaokui Sun, Yirong Guo, Chengyuan Bao, Gang Ma","doi":"10.62713/aic.4546","DOIUrl":"https://doi.org/10.62713/aic.4546","url":null,"abstract":"<p><strong>Aim: </strong>This study aims to compare the clinical outcomes between elastic intramedullary nailing and traditional open reduction and plate fixation for pediatric femoral shaft fractures in the emergency setting.</p><p><strong>Methods: </strong>This retrospective study enrolled 313 pediatric patients with femoral shaft fractures who underwent emergency surgical treatment at Qinghai Provincial Women and Children's Hospital between January 2023 and February 2024. After propensity score matching (PSM), patients who received elastic stable intramedullary nailing were assigned to the observation group (n = 120), whereas those who were treated with traditional open reduction and plate fixation were included in the control group (n = 120). Perioperative data, postoperative knee function, range of motion, and incidence of complications were compared between the two groups.</p><p><strong>Results: </strong>Patients in the observation group demonstrated shorter operative times and smaller incision lengths than those in the control group. They also experienced reduced intraoperative blood loss and minimal fluoroscopic exposures, and achieved full weight-bearing earlier than those in the control group (<i>p</i> < 0.001). At both 3 and 6 months after surgery, knee function scores, knee range-of-motion scores, and total Hospital for Special Surgery (HSS) scores were higher in the observation group, along with improved knee stability score (<i>p</i> < 0.05). At 3 months postoperatively, the hip function score, hip range-of-motion score, and total Harris Hip score were also higher in the observation group (<i>p</i> < 0.01). Successful fracture union was achieved in all children, with no serious postoperative complications observed in either group. In the control group, two cases developed incision-site infections, which were cured after debridement and anti-infective treatment.</p><p><strong>Conclusions: </strong>In the emergency setting, both elastic intramedullary nailing and conventional open reduction with plate fixation can achieve favorable clinical outcomes in children with femoral shaft fractures. Elastic intramedullary nailing offers distinct advantages, such as minimal surgical trauma, earlier postoperative weight-bearing, and better early recovery, rendering it a suitable option in this clinical setting.</p>","PeriodicalId":8210,"journal":{"name":"Annali italiani di chirurgia","volume":"97 7","pages":"1182-1191"},"PeriodicalIF":0.8,"publicationDate":"2026-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148468507","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}