Archives of Orthopaedic and Trauma Surgery最新文献

{"title":"Comparison of 20-year results of total hip arthroplasty using first-generation annealed highly cross-linked polyethylene and zirconia heads in patients aged ≤ 50 and > 50 years","authors":"Yohei Naito,&nbsp;Shine Tone,&nbsp;Gai Kobayashi,&nbsp;Masahiro Hasegawa","doi":"10.1007/s00402-026-06317-0","DOIUrl":"10.1007/s00402-026-06317-0","url":null,"abstract":"<div><h3>Introduction</h3><p>This study investigated 20-year outcomes of total hip arthroplasty (THA) using zirconia heads on annealed highly cross-linked polyethylene (HXLPE) liners, comparing patients aged ≤ 50 and &gt; 50.</p><h3>Methods</h3><p>We reviewed 117 hips (100 patients) who underwent cementless THA between 2001 and 2004. After excluding follow-up &lt; 15 years, 22 hips (≤ 50) and 61 hips (&gt; 50) were analyzed. Merle d’Aubigné and Postel score, University of California, Los Angeles activity score, Kaplan–Meier survivorship, femoral head penetration, and oxidative degradation in retrieved liners were evaluated.</p><h3>Results</h3><p>Patients ≤ 50 had higher activity. Three revisions for infection occurred in the &gt; 50 group; none due to wear. Survivorship was 93% overall, 100% in ≤ 50, and 91% in &gt; 50, with no difference. Steady-state wear rate was 0.01 mm/year in both groups. Retrieved liners showed oxidation.</p><h3>Conclusion</h3><p>Zirconia-on-annealed HXLPE THA showed excellent 20-year wear resistance and survivorship, with comparable outcomes between ≤ 50 and &gt; 50 groups.</p></div>","PeriodicalId":8326,"journal":{"name":"Archives of Orthopaedic and Trauma Surgery","volume":"146 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13090258/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147715757","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":"Effect of a one time guideline based educational video intervention on osteoporosis related knowledge","authors":"Anna-Lena Hauser,&nbsp;Javier-Fernando Noriega Urena,&nbsp;Levan Saatashvili,&nbsp;Firas Esmail,&nbsp;Tobias Lange,&nbsp;Tobias Ludger Schulte,&nbsp;Alexander von Glinski","doi":"10.1007/s00402-026-06293-5","DOIUrl":"10.1007/s00402-026-06293-5","url":null,"abstract":"<div><h3>Introduction</h3><p>Osteoporosis remains underdiagnosed and undertreated, partly due to insufficient patient knowledge. This study aimed to assess osteoporosis-related knowledge and to evaluate the immediate and short-term effects of a one-time educational intervention through a guideline-based video in an adult online population.</p><h3>Materials and methods</h3><p>In this prospective, randomized controlled trial, adults aged ≥ 18 years were recruited via an established online panel. Participants were randomized to an intervention group, which viewed a standardized educational video on osteoporosis, or a control group without intervention. Osteoporosis knowledge was assessed using the Facts on Osteoporosis Quiz (FOOQ) and the Osteoporosis Knowledge Assessment Tool (OKAT). Knowledge retention was evaluated in the intervention group after one week. Between-group comparisons were performed using Man-Whitney U tests, χ² tests, and odds ratios.</p><h3>Results</h3><p>A total of 513 participants were included (intervention group: <i>n</i> = 198; control group: <i>n</i> = 315), with no significant differences in baseline demographic or clinical characteristics. Immediately after the intervention, osteoporosis-related knowledge was significantly higher in the intervention group compared with controls, as measured by both OKAT (11.6 vs. 8.8 points, <i>p</i> &lt; 0.0001) and FOOQ (13.2 vs. 11.1 points, <i>p</i> &lt; 0.0001). The proportion of participants with poor knowledge (FOOQ ≤ 10 points) was lower in the intervention group (20.7% vs. 41.3%; OR 0.37, 95% CI 0.24–0.56), while good knowledge (FOOQ ≥ 15 points) was more frequent (37.9% vs. 17.5%; OR 2.88, 95% CI 1.92–4.30). At 1-week follow-up (<i>n</i> = 65), knowledge scores in the intervention group remained significantly higher than baseline control values for both FOOQ and OKAT (all <i>p</i> &lt; 0.005), indicating short-term knowledge retention.</p><h3>Conclusion</h3><p>A brief, guideline-based educational video significantly improves osteoporosis-related knowledge, with substantial retention after one week. Video-based education represents an effective, scalable tool to enhance patient understanding of osteoporosis and may support future prevention and management strategies.</p></div>","PeriodicalId":8326,"journal":{"name":"Archives of Orthopaedic and Trauma Surgery","volume":"146 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13090292/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147715780","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":"Coordinated Return-to-Work model reduces sickness absences after hip or knee arthroplasty: a registry-based study","authors":"Pauliina Kangas,&nbsp;Konsta Pamilo,&nbsp;Satu Soini,&nbsp;Maria Hirvonen,&nbsp;Visa Kervinen,&nbsp;Marja-Liisa Kinnunen","doi":"10.1007/s00402-026-06312-5","DOIUrl":"10.1007/s00402-026-06312-5","url":null,"abstract":"<div><h3>Introduction</h3><p>Working-age adults increasingly undergo total hip (THA) and knee (KA) arthroplasties. We evaluated how post-arthroplasty referral to occupational health services (OHS) using the Coordinated Return-to-Work (CRTW) model, affects return to work (RTW).</p><h3>Materials and methods</h3><p>The CRTW model was evaluated through a benchmarking controlled trial. We used the electronic records of four hospitals in Finland to identify working-age THA and total/unicondylar KA patients before (control group, <i>N</i> = 668) and after (intervention group, <i>N</i> = 536) the CRTW model was implemented. We combined these data with sickness benefits registry data. The differences between the study groups’ RTW were analyzed using a Cox regression model, adjusting for age, sex, body mass index, number of special reimbursement entitlements for medicines, and earnings as covariates. Subgroup analyses included intervention participants whose sick leaves were prescribed by a surgeon according to the CRTW protocol.</p><h3>Results</h3><p>After THA, the control group’s mean RTW-duration was 87.8 days, compared to 74.9 days for the intervention group, with the mean difference being 12.9 days (95% CI 5.7–20.2). The intervention group was associated with earlier RTW; HR 1.35 (95% CI 1.13–1.61). After KA, the control group’s mean RTW-duration was 107.8 days, while the intervention group’s was 93.4 days, with the mean difference being 14.4 days (95% CI 5.9–22.9), HR 1.29 (95% CI 1.09–1.54). In the subgroup analyses, the mean RTW-duration in the specifically targeted intervention groups was 60.2 days after THA and 84.7 days after KA. The mean differences compared with the control groups were 27.6 days (95% CI 19.1–36.1), HR 2.96 (95% CI 2.22–3.95) and 23.1 days (95% CI 10.9–35.3), HR 1.51 (95% CI 1.18–1.95), respectively.</p><h3>Conclusions</h3><p>The CRTW model effectively shortens the RTW-duration after arthroplasty. Success depends on surgeons prescribing brief sick leaves and referring patients to OHS for work ability assessment.</p></div>","PeriodicalId":8326,"journal":{"name":"Archives of Orthopaedic and Trauma Surgery","volume":"146 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13090294/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147715741","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":"Persistent extensor strength deficit despite acceptable clinical outcomes after surgical treatment of patella fractures: a mid- to long-term follow-up study","authors":"Raşit Emin Dalaslan,&nbsp;Mücahid Osman Yücel,&nbsp;Sönmez Sağlam,&nbsp;Mehmet Arıcan,&nbsp;Zekeriya Okan Karaduman,&nbsp;İsmail Sav","doi":"10.1007/s00402-026-06307-2","DOIUrl":"10.1007/s00402-026-06307-2","url":null,"abstract":"<div><h3>Introduction</h3><p>To evaluate mid- to long-term clinical outcomes together with objective isokinetic measurements of knee flexor and extensor muscle strength in patients who underwent surgical treatment for AO/OTA type C patella fractures, and to investigate the relationship between fracture severity, clinical scores, and strength deficits. We hypothesized that significant quadriceps strength deficits would persist despite acceptable clinical outcomes and that these deficits would be associated with worse pain and functional scores.</p><h3>Materials and methods</h3><p>This retrospective cohort study included 58 patients treated surgically for patella fractures between 2015 and 2024, with a median follow-up duration of 60 months (IQR: 32–94; range: 13.1–132.0 months). The primary outcome was extensor muscle strength deficit measured by isokinetic dynamometry. Secondary outcomes included flexor strength deficit, Lysholm score, visual analog scale (VAS), and knee range of motion. Isokinetic dynamometry at 60°/s was used to measure concentric flexor and extensor peak torque values, and strength deficits were calculated by comparison with the contralateral limb. Outcomes were compared among fracture subtypes (C1, C2, C3), and correlations between strength deficits and clinical scores were analyzed. Non-parametric tests (Kruskal–Wallis) and partial correlation analysis (Pearson, adjusted for age) were used for statistical analysis.</p><h3>Results</h3><p>At final follow-up, patients demonstrated generally acceptable clinical outcomes (mean Lysholm: 80.12 ± 16.88; mean VAS: 2.19 ± 1.79) with minimal extension deficits. However, the primary outcome, extensor muscle strength deficit, remained substantial a mean extensor strength deficit of 36.31 ± 17.27%, and 84.5% of patients exhibited marked extensor asymmetry (≥ 20%). Flexor strength deficits were less pronounced (19.09 ± 10.75%) but remained clinically relevant. No statistically significant differences were detected in clinical scores, range of motion, or strength deficits were observed among fracture subtypes (<i>p</i> &gt; 0.05). Greater extensor and flexor strength deficits were significantly associated with higher VAS scores and lower Lysholm scores (all <i>p</i> &lt; 0.05). Revision surgery was required in 12% of patients, and implant removal in 38%, indicating a considerable secondary surgical burden.</p><h3>Conclusions</h3><p>Despite satisfactory clinical scores and radiographic healing, substantial and persistent quadriceps weakness appears to be common after surgically treated patella fractures. Objective strength deficits are strongly associated with pain and functional outcomes and may not be fully captured by conventional clinical assessments. Long-term management should therefore incorporate objective muscle strength evaluation and targeted rehabilitation strategies to address persistent extensor weakness.</p></div>","PeriodicalId":8326,"journal":{"name":"Archives of Orthopaedic and Trauma Surgery","volume":"146 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13090276/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147715732","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":"Tendon gel using the film model method promotes ligament healing in rabbits","authors":"Rikuto Yoshimizu,&nbsp;Junsuke Nakase,&nbsp;Kazuaki Yoshioka,&nbsp;Toru Kuzumaki,&nbsp;Kojun Torigoe,&nbsp;Satoru Demura","doi":"10.1007/s00402-026-06280-w","DOIUrl":"10.1007/s00402-026-06280-w","url":null,"abstract":"<div><h3>Introduction</h3><p>Tendon gel is a translucent gel-like material secreted from the ends of a severed tendon. When mechanical stress is applied to a 3-day in vivo-preserved tendon gel, it matures into type I collagen–dominant tissue similar to normal tendon. This study aimed to evaluate the effects of transplanting a 3-day in vivo-preserved tendon gel into a knee medial collateral ligament (MCL) injury site in rabbits to promote intrinsic ligament regeneration.</p><h3>Materials and methods</h3><p>Tendon gel was prepared from rabbit Achilles tendons using the film model method and harvested after 3 days of in vivo preservation. The 3-day tendon gel was transplanted into the knee MCL injury sites in another set of rabbits (<i>n</i> = 48). Additionally, the healing process was assessed at 1, 2, and 4 weeks postoperatively using mechanical and histological analyses. Ultimate load, peak stress, and elastic modulus were measured. Histological maturity was semi-quantitatively scored, and collagen type I and III expressions were examined by immunofluorescence staining.</p><h3>Results</h3><p>At 2 weeks, the tendon gel group demonstrated significantly higher ultimate load than the control group (12.25 ± 4.90 vs. 5.25 ± 2.40 N; <i>p</i> = 0.02). The tendon gel group had greater peak stress than the control group (3.54 ± 1.44 vs. 1.69 ± 0.78 MPa; <i>p</i> = 0.02). Histological scores were higher in the tendon gel group than in the control group (7.25 ± 0.43 vs. 5.50 ± 1.73; <i>p</i> = 0.03). Cells in the tendon gel group were aligned parallel to collagen fibers with elongated nuclei, while type I collagen expression was stronger than that observed in controls.</p><h3>Conclusions</h3><p>Transplanting a 3-day in vivo-preserved tendon gel into an injured ligament enhanced mechanical strength and histological maturation at 2 weeks postoperatively. These findings suggest that this tendon gel serves as a promising biomaterial for accelerating ligament healing.</p></div>","PeriodicalId":8326,"journal":{"name":"Archives of Orthopaedic and Trauma Surgery","volume":"146 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13090201/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147715756","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":"Minimum 10-year outcomes of cementless total hip arthroplasty using a 32-mm femoral head with CT-based navigation: a comparative study with manual technique","authors":"Shine Tone,&nbsp;Yohei Naito,&nbsp;Gai Kobayashi,&nbsp;Akihiro Sudo,&nbsp;Masahiro Hasegawa","doi":"10.1007/s00402-026-06294-4","DOIUrl":"10.1007/s00402-026-06294-4","url":null,"abstract":"<div><h3>Introduction</h3><p>Computed tomography <b>(</b>CT)-based navigation improves the accuracy of component placement in total hip arthroplasty (THA). To date, evidence of its long-term clinical impact is limited. This study aimed to compare minimum 10-year outcomes of cementless THA performed using CT-based navigation and a manual technique with a 32-mm femoral head.</p><h3>Materials and methods</h3><p>This study included a minimum follow-up of 10 years. The CT-based group included 58 hips and the manual group included 53 hips. Postoperative cup orientation was assessed using CT. Clinical outcomes were evaluated using the Merle d’Aubigné and Postel score, Harris Hip Score (HHS), and Forgotten Joint Score-12 (FJS-12). Kaplan–Meier analysis was used to estimate the 10-year implant survival with revision for any reason as the endpoint.</p><h3>Results</h3><p>The CT-based group achieved a significantly higher cup placement accuracy (100% within Lewinnek’s safe zone versus 49% in the manual group, <i>p</i> &lt; 0.001). At the final follow-up, the CT-based group showed higher Merle d’Aubigné and Postel total score (16.8 vs. 16.1, <i>p</i> = 0.035) and HHS (90.3 vs. 85.0, <i>p</i> = 0.015), although the difference in HHS did not exceed the minimal clinically important difference. The FJS-12 scores did not differ significantly (71.1 vs. 62.2, <i>p</i> = 0.051). Ten-year survival rates were 98.2% in the CT-based group and 100% in the manual group (n.s.).</p><h3>Conclusions</h3><p>CT-based navigation improved cup placement accuracy and produced modest improvements in some clinical scores; however, long-term implant survival and clinically meaningful benefits were not superior to those of manual THA.</p></div>","PeriodicalId":8326,"journal":{"name":"Archives of Orthopaedic and Trauma Surgery","volume":"146 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13090190/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147715805","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":"Time-zero stability of uncemented standard versus intermediate revision stems after extended trochanteric osteotomy (ETO): a biomechanical study","authors":"Jakob Hax,&nbsp;Ivan Zderic,&nbsp;Boyko Gueorguiev,&nbsp;Yannik Kalbas,&nbsp;Michael Leunig,&nbsp;Hans-Christoph Pape,&nbsp;Hannes A. Rüdiger","doi":"10.1007/s00402-026-06308-1","DOIUrl":"10.1007/s00402-026-06308-1","url":null,"abstract":"<div><h3>Introduction</h3><p>This time-zero biomechanical study investigates femoral stem stability after extended trochanteric osteotomy (ETO) without fragment refixation, representing a worst-case scenario. ETO is used in complex femoral revisions to improve exposure while preserving soft tissue and neurovascular structures. In the setting of a short ETO, surgeons may choose between standard (STD) and intermediate revision (REV) stems, although their primary stability remains unclear. Clinically, STD are still used after short ETO with low rates of aseptic loosening, aiming for proximal bone loading to reduce stress shielding. We therefore hypothesized that STD would demonstrate non-inferior axial and torsional stability compared with REV in a short open ETO model.</p><h3>Materials and methods</h3><p>A biomechanical model using SYNBONE^® femurs and uncemented, collared, fully coated triple-tapered STD and REV 135° CCD was established. A standardized 60 mm ETO (vastus ridge to distal end of ETO) was performed and left unrepaired to simulate a worst-case scenario. Four groups (<i>n</i> = 6 each) were tested: (1) STD and (2) REV under axial loading (500 cycles at 20° adduction up to 500 N at 1 Hz, then static loading to failure), and (3) STD and (4) REV under torsional loading (500 cycles up to 10Nm internal rotation at 1 Hz, then failure testing). Axial stiffness (N/mm), torsional stiffness (Nm/deg), and failure load/torque were assessed.</p><h3>Results</h3><p>REV showed higher axial stiffness (297.5 ± 39.7 N/mm) than STD (245.9 ± 33.2 N/mm, <i>p</i> = 0.035) and greater axial failure load (1228.1 ± 86.8 vs. 1002.5 ± 114.1 N, <i>p</i> = 0.003). Torsional stiffness and peak torque were comparable between groups. Axial failure with REV occurred at the distal stem tip, while STD fractured through the ETO. Torsional failure produced spiral fractures from the distal ETO in both groups.</p><h3>Conclusions</h3><p>Under time-zero worst-case conditions without ETO refixation, the REV demonstrated higher axial stability, while torsional stability was comparable. The STD provided sufficient primary stability after short open ETO, supporting its potential use when revision stem implantation is not required.</p></div>","PeriodicalId":8326,"journal":{"name":"Archives of Orthopaedic and Trauma Surgery","volume":"146 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13090256/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147715771","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":"Outcomes and associated factors of revision procedures after failed total ankle arthroplasty: a comparative cohort analysis","authors":"Kathrin Pfahl,&nbsp;Julia Eder,&nbsp;Dominic Simon,&nbsp;Gautier Beckers,&nbsp;Boris Michael Holzapfel,&nbsp;Markus Walther","doi":"10.1007/s00402-026-06305-4","DOIUrl":"10.1007/s00402-026-06305-4","url":null,"abstract":"<div><h3>Introduction</h3><p>After failed total ankle arthroplasty (TAA), revision arthrodesis (RAA) and revision arthroplasty (RTAA) are treatment options, but comparative outcome data remain limited. The aim of this study was to compare mid-term survival of RAA and RTAA after failed primary TAA and to explore clinical and radiographic factors associated with failure.</p><h3>Materials and methods</h3><p>In this retrospective cohort study, 124 patients (RAA = 72, RTAA = 52) were reviewed after failed TAA between 2006 and 2020, with a minimum follow-up of 12 months. Kaplan-Meier analysis and Cox regression were used to assess survival, and decision tree models were used as exploratory tools to identify factors associated with failure.</p><h3>Results</h3><p> Mean follow-up was 71.6 ± 42.7 months. Surgical failure occurred in 6.45% of patients, with no significant difference (RAA 6.9%, RTAA 5.8%). Five-year survival was slightly higher for RTAA (97% vs. 93%), although durability decreased beyond 87 months. Female sex, higher BMI, and younger age were associated with failure after RAA, whereas large periprosthetic cysts and elevated BMI were related to failure after RTAA.</p><h3>Conclusions</h3><p>RAA and RTAA demonstrate comparable mid-term survival after failed TAA. Revision strategy selection should be individualized, considering bone stock, patient characteristics, and failure patterns.</p><h3>Levels of evidence</h3><p>III</p></div>","PeriodicalId":8326,"journal":{"name":"Archives of Orthopaedic and Trauma Surgery","volume":"146 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13090239/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147715794","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":"Intramedullary headless compression screw fixation for metacarpal fractures: a retrospective clinical and radiological study","authors":"Burak Kuşcu,&nbsp;Mustafa Kınaş","doi":"10.1007/s00402-026-06316-1","DOIUrl":"10.1007/s00402-026-06316-1","url":null,"abstract":"<div><h3>Background</h3><p>Intramedullary headless compression screw fixation has gained increasing popularity for the surgical treatment of metacarpal fractures owing to its minimally invasive nature and potential for early mobilisation without prolonged postoperative immobilisation. However, comprehensive data on clinical and radiological outcomes remain limited.</p><h3>Methods</h3><p>This retrospective study included patients with metacarpal shaft or neck fractures treated with retrograde intramedullary headless screw fixation. No postoperative immobilisation was applied, and early active mobilisation was initiated in all patients on the day of surgery. Demographic data, fracture characteristics, operative details, pre- and postoperative angulation, radiological union time, functional outcomes, QuickDASH score, and complications were recorded. Preoperative and postoperative angulation values were compared using a paired Student’s t-test.</p><h3>Results</h3><p>A total of 37 patients were included, with a mean age of 37.5 ± 15.4 years. The majority of fractures involved the fifth metacarpal (70.3%). The most common mechanisms were direct impact/blunt trauma and falls. Mean operative time was 12.8 ± 3.9 min (range, 7–21 min). Mean preoperative angulation of 41.2° ± 12.2 improved significantly to 0.2° ± 0.71 postoperatively (<i>p</i> &lt; 0.001). Mean radiological union time was 5.6 ± 0.8 weeks (range, 4–7 weeks). At final follow-up, all evaluable patients had achieved full functional recovery, with a mean QuickDASH score of 10.3 ± 7.8 (range, 0.0–27.3). Minor complications occurred in two patients (5.4%), both of whom required implant removal following radiological union.</p><h3>Conclusion</h3><p>Retrograde intramedullary headless compression screw fixation provides reliable clinical and radiological outcomes for metacarpal fractures, enabling splint-free early mobilisation with effective deformity correction, a low complication rate, and favourable functional recovery. This technique represents a safe and effective surgical option in appropriately selected patients.</p></div>","PeriodicalId":8326,"journal":{"name":"Archives of Orthopaedic and Trauma Surgery","volume":"146 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13090266/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147715778","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":"Managing Vancouver B2 periprosthetic femoral fractures: is open reduction and internal fixation superior to stem revision?","authors":"Tihui Wang,&nbsp;Hongwei Xu,&nbsp;Jinqing Wu,&nbsp;Xu Wang","doi":"10.1007/s00402-026-06297-1","DOIUrl":"10.1007/s00402-026-06297-1","url":null,"abstract":"<div><h3>Purpose</h3><p>The aim of this study was to compare the long-term outcomes of stem revision (SR) and open reduction and internal fixation (ORIF) for the treatment of Vancouver B2 periprosthetic fractures of the femur.</p><h3>Methods</h3><p>From June 2013 to May 2023, 56 consecutive patients were studied at our institution. Four patients were lost to follow-up, four had incomplete data. Thus, 48 cases were included in the analysis. The patients were divided into a stem revision group (SR group with 25 patients) and an open reduction and internal fixation group (ORIF group with 23 patients). The surgical complications, perioperative parameters, and 1-year mortality rates were assessed, the functional outcomes were assessed with the Harris Hip Score (HHS), and the radiographic outcomes were assessed in accordance with the Beals and Tower criteria.</p><h3>Results</h3><p>In SR group, the mean follow-up time was 61.2 months, 36% of patients experienced complications, the mean HHS was 75.27, and 92% of the patients had “excellent–good” radiographic outcomes. In ORIF group, the mean follow-up time was 63.7 months, 21.7% of patients experienced complications, the mean HHS was 73.56, and 91.3% of the patients had “excellent–good” radiographic outcomes. The total number of postoperative complications, dislocation rate, blood loss volume, operation time and transfusion rate were lower in ORIF group, and two patients in SR group experienced hip dislocation. There were no significant differences in the 1-year mortality rate, bone healing time and reoperation rate between the two groups. However, while the fracture pattern was considerd, the one zone fracture demonstrated lower radiographic subsidence comparing with two zones fracture (1.18 ± 1.36 mm vs 1.87 ± 1.61 mm). Most of these patients in both groups did not return to their preoperative mobility status.</p><h3>Conclusions</h3><p>Although SR is the golden standard for Vancouver B2 periprosthetic fractures of the femur, ORIF can be a viable alternative for frail and low-demand patients on account of signifcantly less perioperative blood loss, shorter operating time and lower medical or total complication rates; expecially for the isolated medial or lateral zone fracture with primary long stem and “happy hips”.</p></div>","PeriodicalId":8326,"journal":{"name":"Archives of Orthopaedic and Trauma Surgery","volume":"146 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13090224/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147715802","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}