Archives of Orthopaedic and Trauma Surgery最新文献

{"title":"Finite element analysis of the treatment of supracondylar humerus fractures in children with kirschner’s pin and a new method of treatment","authors":"Bicheng Liu,&nbsp;Hanjie Liu,&nbsp;Xiangyu Lv,&nbsp;Yu Wang,&nbsp;Chenglei Zhao,&nbsp;Man He,&nbsp;Jingxin Zhao","doi":"10.1007/s00402-025-06074-6","DOIUrl":"10.1007/s00402-025-06074-6","url":null,"abstract":"<div>\u0000 \u0000 <span>AbstractSection</span>\u0000 Purpose\u0000 <p>Supracondylar humerus fractures in children are common elbow injuries. This finite element analysis (FEA) study investigates the biomechanical properties of five Kirschner pin fixation techniques for pediatric extension-type fractures, with a focus on proposing a novel posterolateral double-pin caudal fixation method (Group E).</p>\u0000 \u0000 <span>AbstractSection</span>\u0000 Method\u0000 <p>A three-dimensional finite element model was developed based on CT scans of a 5-year-old child’s humerus to simulate extension-type fractures. Five fixation configurations were compared: Group A: Mediolateral cross-pinning (3 pins); Group B: Cross-pinning (2 pins); Group C: Lateral fan-pinning (3 pins); Group D: Lateral fan-pinning (2 pins); Group E: Novel technique with two lateral pins connected extracorporeally (2 pins) Biomechanical testing includes tensile (30 N·mm), torsion (135 N·mm), and inversion (100 N·mm) load testing for all groups.</p>\u0000 \u0000 <span>AbstractSection</span>\u0000 Results\u0000 <p>Optimal stability: Group A (tensile: 167.15 MPa, torsion: 153.96 MPa, inversion: 146.98 MPa).Novel Group E performance: Tensile: 174.02 MPa (vs. 176.98 MPa in Group D), Torsion: 162.99 MPa (vs. 236.8 MPa in Group D), Inversion: 169.19 MPa (vs. 151.11 MPa in Group D), Group E significantly outperformed Group D and approached the stability of Groups B/C.</p>\u0000 \u0000 <span>AbstractSection</span>\u0000 Conclusion\u0000 <p>The novel extracorporeal-connected double-pin fixation (Group E) provides comparable biomechanical stability to conventional three-pin techniques while eliminating medial pinning-related ulnar nerve injury risks. It represents a viable optimized option for clinical practice.</p>\u0000 \u0000 <span>AbstractSection</span>\u0000 Level of evidence\u0000 <p>IV (Computational biomechanical study).</p>\u0000 \u0000 </div>","PeriodicalId":8326,"journal":{"name":"Archives of Orthopaedic and Trauma Surgery","volume":"145 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145210663","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":"Return to sexual activity after total hip arthroplasty: a comparative study of emergency or elective total hip arthroplasty patients","authors":"Sule Atalay Mert,&nbsp;Ali Can Çiçek","doi":"10.1007/s00402-025-06083-5","DOIUrl":"10.1007/s00402-025-06083-5","url":null,"abstract":"<div><h3>Introduction</h3><p>To evaluate changes in sexual function and return to sexual activity following total hip arthroplasty (THA), comparing patients who underwent emergency THA for femoral neck fractures with those who underwent elective THA for osteoarthritis, and to identify clinical and demographic predictors of postoperative sexual outcomes.</p><h3>Methods</h3><p>This retrospective study included 68 THA patients (37 Emergency THA after Fracture, 31 Elective THA for Osteoarthritis; 54.4% male and 45.6% female). Data included age, sex, BMI, pain during sex, time to resume sex, and postoperative UCLA (University of California–Los Angeles) and FJS-12 (Forgotten Joint Score) scores. Analyses involved t-tests, Chi-square, regression models, and Spearman correlation.</p><h3>Results</h3><p>Time to sexual activity resumption did not differ significantly between groups. However, the nature of change varied: patients undergoing elective THA for osteoarthritis more often reported improvement or no change, while patients undergoing emergency THA for femoral neck fractures more commonly reported reduced or ceased activity (<i>p</i> = 0.001). Female sex, older age, and higher BMI were associated with delayed sexual resumption (<i>p</i> &lt; 0.01). Patients who experienced hip pain interfering with sexual activity before surgery were significantly less likely to report improvements in sexual quality after total hip arthroplasty. Although FJS-12 and UCLA scores were strongly correlated (<i>r</i> = 0.869, <i>p</i> &lt; 0.01), they did not independently predict resumption. The multinomial logistic model explained 59.2% of the variance (Nagelkerke R² = 0.592).</p><h3>Conclusions</h3><p>Post-THA sexual outcomes are influenced by more than physical function. Preoperative pain, age, sex, and psychological readiness are key factors. Comprehensive counseling, especially for patients undergoing emergency THA for femoral neck fractures and for women, should address sexual health expectations during recovery.</p><h3>Level of evidence</h3><p>Level III, retrospective cohort study.</p></div>","PeriodicalId":8326,"journal":{"name":"Archives of Orthopaedic and Trauma Surgery","volume":"145 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145210665","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":"Gastrocnemius release procedures in the treatment of mechanical metatarsalgia: a systematic review","authors":"Laura Langone,&nbsp;Antonio Mazzotti,&nbsp;Simone Ottavio Zielli,&nbsp;Alberto Arceri,&nbsp;Federico Sgubbi,&nbsp;Gianmarco Di Paola,&nbsp;Elena Artioli,&nbsp;Cesare Faldini","doi":"10.1007/s00402-025-06043-z","DOIUrl":"10.1007/s00402-025-06043-z","url":null,"abstract":"<div><p>Mechanical metatarsalgia (MM) is a condition marked by forefoot overload, causing pain and functional limitations. While conservative treatments like insoles are often effective, surgery is considered when these fail. Traditional approaches focus on the midfoot or forefoot; however, gastrocnemius release (GR) has emerged as an alternative due to the link between equinus contractures and forefoot overload. This systematic review examines the role of GR in MM treatment, analyzing five studies that met the inclusion criteria. These studies evaluated outcomes following either minimally invasive proximal gastrocnemius release or ultrasound-guided needle-based lengthening. Results showed significant pain reduction, improved American Orthopedic Foot and Ankle Society (AOFAS) scores, and greater ankle dorsiflexion. Patient satisfaction was also high. Despite encouraging outcomes, limitations such as small sample sizes, short follow-ups, and methodological differences highlight the need for further research. Nevertheless, GR appears to be a promising option for MM, particularly in cases of isolated gastrocnemius contracture.</p></div>","PeriodicalId":8326,"journal":{"name":"Archives of Orthopaedic and Trauma Surgery","volume":"145 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145210664","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":"A systematic review and meta-analysis of tension band plating vs. intramedullary nailing for anterior tibial diaphyseal stress fractures in athletes","authors":"Zachary D Randall,&nbsp;Jacob W Mazzola,&nbsp;Aravinda Ganapathy,&nbsp;Bryant M Song,&nbsp;Marschall B Berkes","doi":"10.1007/s00402-025-06078-2","DOIUrl":"10.1007/s00402-025-06078-2","url":null,"abstract":"<div><h3>Background</h3><p>Return to sport (RTS) and optimal operative management for anterior tibial diaphyseal stress fractures (aTDSF) in athletes remain poorly defined.</p><h3>Methods</h3><p>A systematic review was performed following PRISMA guidelines. Included studies examined aTDSF treated with IM nailing or tension band plating and reported time to RTS. Exclusions included non-English studies, abstracts, reviews, or those published before 1990, acute tibial fractures, or lacking operative management data. Extracted data included RTS rates, time to RTS, complications, demographics, and total aTDSF cases. A mixed method meta-analysis compared RTS times between treatment modalities.</p><h3>Results</h3><p>Eight studies comprising 37 athletes met inclusion criteria. RTS was achieved in 100% (14/14) of IM nailing cases and 95% (19/20) of tension band plating cases. IM nailing had a mean RTS of 19.7 weeks, while tension band plating had a mean RTS of 11.4 weeks, showing a significant difference (<i>p</i> &lt; 0.01). Subgroup analysis revealed negligible heterogeneity for tension band plating (<i>I</i>^2 = 0%) and moderate heterogeneity for IM nailing (<i>I</i>^2 = 66.7%). Complications for IM nailing included chronic anterior knee pain (2/14, 14%), while tension band plating complications included symptomatic hardware removal (6/20, 30%) and one athlete unable to compete (1/20, 5%). The included studies were small case series or case reports and thus prone to bias.</p><h3>Conclusion</h3><p>Both IM nailing and tension band plating yield high RTS rates, but tension band plating may offer faster RTS, albeit with higher hardware-related complication rates. The moderate heterogeneity observed in the IM nailing subgroup, coupled with a moderate risk of bias across all included studies, underscores the need for further high-quality research to validate these findings.</p></div>","PeriodicalId":8326,"journal":{"name":"Archives of Orthopaedic and Trauma Surgery","volume":"145 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145197890","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":"Component placement angles in total knee arthroplasty affect mid- to long-term clinical results: an average 8-year follow-up study","authors":"Koki Kawada,&nbsp;Yusuke Yokoyama,&nbsp;Tomonori Tetsunaga,&nbsp;Kazuki Yamada,&nbsp;Yuki Okazaki,&nbsp;Toshiki Kohara,&nbsp;Toshifumi Ozaki","doi":"10.1007/s00402-025-06080-8","DOIUrl":"10.1007/s00402-025-06080-8","url":null,"abstract":"<div><h3>Introduction</h3><p>Few studies have examined how the component placement angles in total knee arthroplasty (TKA) affect mid- to long-term clinical outcomes. This study investigated the influence of coronal and sagittal plane component placement angles on mid- to long-term outcomes in mechanical alignment TKA.</p><h3>Materials and Methods</h3><p>Forty-eight knees undergoing TKA using the FINE Total Knee System were evaluated for range of motion (ROM) preoperatively. Both ROM and clinical scores were evaluated at 3 and 5 years postoperatively and at the final follow-up (average 8-year). The valgus (alpha) and flexion (gamma) angles of the femoral component, and the varus (beta) and posterior tilt (sigma) angles of the tibial component were evaluated. Correlations between radiographic assessments, knee ROM, and clinical scores were assessed using Spearman's correlation coefficient.</p><h3>Results</h3><p>The alpha angle was negatively correlated with the knee flexion angle (r = − 0.323, p = 0.025) and ROM (r = − 0.352, p = 0.014), and the sigma angle was negatively correlated with the Knee Injury and Osteoarthritis Outcome Score (KOOS)-Symptoms at 3 years postoperatively (r = − 0.304, p = 0.036). The alpha angle was negatively correlated with the knee flexion angle (r = − 0.357, p = 0.013), ROM (r = − 0.337, p = 0.019), and KOOS-Sports and Recreation function (r = − 0.349, p = 0.015), and positively correlated with the Visual Analog Scare pain score (r = 0.307, p = 0.034) at the final follow-up. The beta angle was positively correlated with KOOS-Pain (r = 0.303, p = 0.036) and KOOS-Symptoms (r = 0.397, p = 0.005) at the final follow-up.</p><h3>Conclusions</h3><p>Valgus placement of the femoral component and varus placement of the tibial component in the FINE Total Knee System negatively impacted clinical scores at an average 8-year follow-up.</p></div>","PeriodicalId":8326,"journal":{"name":"Archives of Orthopaedic and Trauma Surgery","volume":"145 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00402-025-06080-8.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145197923","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":"Multimodal intraoperative neuromonitoring during total hip arthroplasty in severe hip deformities: how do we do it and when do the alerts occur?","authors":"Tim T. C. R. de Mees,&nbsp;Vincent J. J. F. Busch,&nbsp;Juerd Wijntjes,&nbsp;Petra J. C. Heesterbeek,&nbsp;Rian Grutters,&nbsp;Ilona Racz,&nbsp;Leon van Loon,&nbsp;Marc W. Nijhof","doi":"10.1007/s00402-025-06060-y","DOIUrl":"10.1007/s00402-025-06060-y","url":null,"abstract":"<div>\u0000 \u0000 <span>AbstractSection</span>\u0000 Introduction\u0000 <p>Total Hip Arthroplasty (THA) with leg lengthening can offer great outcome in patients with severe hip deformities but comes with higher risk of intra-operative nerve injury. The aim was to investigate the relationship between surgical steps and multimodal intraoperative neuromonitoring (IONM) events during THA in severe hip deformities.</p>\u0000 \u0000 <span>AbstractSection</span>\u0000 Methods\u0000 <p>This cohort study of 27 cases with symptomatic severe hip deformities, such as Crowe 3 and 4 developmental dysplasia of the hip (DDH). All cases received THA with IONM between September 2019 and December 2023. The goal of surgery in all cases was to reestablish the original center of rotation. Monitored modalities were Transcranial Motor Evoked Potentials (TcMEPs), Somatosensory Evoked Potentials (SSEPs) and free-running Electromyography (EMG). Alarm criteria were a TcMEP amplitude loss of 80%, neurotonic discharges on the free-running EMG and/or significant SSEP amplitude loss. Follow-up took place during hospital stay and at the follow-up visit 8 weeks postoperatively.</p>\u0000 \u0000 <span>AbstractSection</span>\u0000 Results\u0000 <p>In 16 of 27 cases we found IONM signal alerts that correlated with several surgical events (in total 22 events): surgical exposure/hip dislocation (12 events), acetabular reconstruction/cementing (4 events) and trial reduction (6 events). Actions taken were removal or replacement of instruments, neutralization of the leg, screw replacement of the massive autograft (2 events) and extensive subtrochanteric osteotomy (4 events). In 7 cases the IONM alerts concerned solely sciatic innervated muscles, in 2 cases solely femoral and in 7 cases both sciatic and femoral innervated muscles. In 14 cases normalization of IONM signals occurred spontaneously or after corrective maneuvers, in 2 cases no normalization occurred during surgery. No case showed a postoperative neurological deficit at follow up.</p>\u0000 \u0000 <span>AbstractSection</span>\u0000 Conclusion\u0000 <p>Multimodal IONM in THA for severe hip deformities revealed numerous specific surgical steps leading to IONM signal alerts. In a majority of cases adjustment of the surgical procedure could normalize the IONM signals. None of our patients experienced a postoperative neurological deficit.</p>\u0000 \u0000 </div>","PeriodicalId":8326,"journal":{"name":"Archives of Orthopaedic and Trauma Surgery","volume":"145 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12479666/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145184613","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":"Correction: Diagnostic wrist arthroscopy: findings in patients suspected of TFCC lesions","authors":"Lyse van Wijk,&nbsp;Sandesh Kasie,&nbsp;Claire Koeyvoets,&nbsp;Sebastiaan Souer,&nbsp;Hand-Wrist Study Group,&nbsp;Steven Hovius,&nbsp;Brigitte van der Heijden","doi":"10.1007/s00402-025-06069-3","DOIUrl":"10.1007/s00402-025-06069-3","url":null,"abstract":"","PeriodicalId":8326,"journal":{"name":"Archives of Orthopaedic and Trauma Surgery","volume":"145 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12479595/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145184577","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":"Demographic and clinical features of extremity crush injuries resulting from entrapment under the rubble: an orthopedic perspective","authors":"Ender Gümüşoğlu,&nbsp;Zeynel Mert Asfuroğlu,&nbsp;Metin Manouchehr Eskandari","doi":"10.1007/s00402-025-06077-3","DOIUrl":"10.1007/s00402-025-06077-3","url":null,"abstract":"<div><h3>Introduction</h3><p>We aimed to contribute to the literature by reporting the demographic and clinical characteristics of patients who suffered extremity crush injuries as a result of being trapped under rubble following the earthquake that occurred in Turkey on February 6, 2023.</p><h3>Materials and methods</h3><p>In total, 65 patients, including 33 females and 32 males, were enrolled. The mean age of the patients was 32.2 ± 20.45 years. Patients were categorized into four treatment groups, including nonoperative (<i>n</i> = 13), fasciotomy/debridement (<i>n</i> = 20), fracture fixation (<i>n</i> = 5), and amputation (<i>n</i> = 27) groups. Demographic and clinical information were analyzed.</p><h3>Results</h3><p>The lower extremities were the most frequently affected anatomical regions. Upon hospital admission, all patients exhibited significant elevations in serum potassium and creatinine kinase levels; however, these levels decreased significantly within 24 h of the initiation of operative or nonoperative treatment (<i>p</i> &lt; 0.05). The rate of crush syndrome development was 54%, 60%, and 59% in the nonoperative, fasciotomy/debridement, and amputation groups, respectively. Similarly, the rate of hemodialysis was 15%, 35%, and 22% in the nonoperative, fasciotomy/debridement, and amputation groups, respectively. The reoperation rate was 75% and 30% in the fasciotomy/debridement and amputation groups, respectively. Furthermore, the incidence of infection was 40% in fracture fixation group, 40% in the fasciotomy/debridement group, and 33% in the amputation group. The mortality rate was 5% in the fasciotomy/debridement group and 7% in the amputation group. The mean duration of hospitalization for all treatment groups was 10.9 ± 10.41 days, with the fasciotomy/debridement group having the longest duration of hospitalization (14.5 ± 9.8 days).</p><h3>Conclusions</h3><p>During the acute treatment phase, a significant increase in crush syndrome and wound infection rates, accompanied by a greater need for hemodialysis and prolonged hospitalization, were frequently observed. We hypothesize that the findings of studies on earthquake-related experience could provide a reference for future investigations.</p></div>","PeriodicalId":8326,"journal":{"name":"Archives of Orthopaedic and Trauma Surgery","volume":"145 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145147521","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":"Correction: A retrospective radiographic comparative study of 113 feet undergoing joystick-assisted minimally invasive surgery (MIS) vs. minimally invasive Chevron–Akin (MICA) for hallux valgus correction","authors":"Songbai Wang,&nbsp;Gansheng He,&nbsp;Guofan Zheng,&nbsp;Yuanbin Zhu,&nbsp;Ruirui Shang,&nbsp;Yong Zhang,&nbsp;Yunbo Bai,&nbsp;Jian Liu","doi":"10.1007/s00402-025-06070-w","DOIUrl":"10.1007/s00402-025-06070-w","url":null,"abstract":"","PeriodicalId":8326,"journal":{"name":"Archives of Orthopaedic and Trauma Surgery","volume":"145 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145129903","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":"Arthroscopically assisted (AORIF) ankle fracture treatment seems to lead to superior results when compared to open reduction and internal fixation (ORIF) only: results of a systematic review","authors":"Rainer Christoph Miksch,&nbsp;Fabian Tobias Spindler,&nbsp;Wolfgang Böcker,&nbsp;Hans Polzer,&nbsp;Sebastian Felix Baumbach","doi":"10.1007/s00402-025-06030-4","DOIUrl":"10.1007/s00402-025-06030-4","url":null,"abstract":"<div>\u0000 \u0000 <span>AbstractSection</span>\u0000 Introduction\u0000 <p>Ankle fractures often involve intra-articular pathologies, which can only be addressed by additional arthroscopy. This systematic review aims to compare the outcomes of arthroscopically assisted open reduction and internal fixation (AORIF) with traditional open reduction and internal fixation (ORIF) for ankle fractures.</p>\u0000 \u0000 <span>AbstractSection</span>\u0000 Materials and methods\u0000 <p>A systematic literature search adhering to PICOS and PRISMA guidelines was conducted across the following databases: MEDLINE (PubMed), Scopus, Central and EMBASE. Studies that compared AORIF and ORIF of ankle fractures and focused on patient-reported outcome measures (PROMs) as the primary outcome were included. Excluded were studies on non-acute or non-isolated fractures, pilon fractures, concomitant injuries outside the ankle, biomechanical or computational studies, and those lacking objective outcome data.</p>\u0000 \u0000 <span>AbstractSection</span>\u0000 Results\u0000 <p>A total of 7089 studies were screened, 12 of which met the inclusion criteria for qualitative synthesis. The level of evidence was I-III with a mean MINORS Tool score of 19.17. Among the included studies, six studies focused on unimalleolar fractures, with four demonstrating significantly better PROMs for the AORIF group. Five studies addressed bimalleolar and/or trimalleolar fractures, with one showing significantly better PROMs for AORIF. Seven studies reported on intra-articular pathologies, with a detection rate of up to 88.89%. Two out of three studies on posttraumatic arthritis indicated lower grades of osteoarthritis in the AORIF group.</p>\u0000 \u0000 <span>AbstractSection</span>\u0000 Conclusion\u0000 <p>The review suggests that AORIF may lead to improved scores as obtained through various PROMs compared to ORIF, particularly for unimalleolar fractures. However, the heterogeneity among the underlying studies indicates the need for further research to identify specific patient populations and fracture types that would benefit the most from AORIF.</p>\u0000 \u0000 </div>","PeriodicalId":8326,"journal":{"name":"Archives of Orthopaedic and Trauma Surgery","volume":"145 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00402-025-06030-4.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145073839","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}