{"title":"Implants for fixation of intertrochanteric femoral fracture: a systematic review and network meta-analysis of randomized controlled trials.","authors":"Shanshan Zhang, Yihao Ge, Zhaodong Bi, Jiheng Xiao, Yuqing Li, Cici Bai, Miao Tian, Xiuting Li, Yanbin Zhu","doi":"10.1186/s12891-025-09032-w","DOIUrl":"https://doi.org/10.1186/s12891-025-09032-w","url":null,"abstract":"<p><strong>Background: </strong>A variety of implant devices have been used for treatment of intertrochanteric femoral fractures (IFF), but the optimal has long been disputed. We aim to summarize the latest evidence for the effectiveness and safety of implants for IFF.</p><p><strong>Methods: </strong>This systematic review and network meta-analysis included searches of PubMed, Embase, the Cochrane Library, and Web of Science from January 1, 2000 to August 31, 2024, for randomized controlled trials of implants in older adult patients with intertrochanteric femoral fracture. Non-English studies, pathological fractures, pathological reports, animal studies, conference abstracts, and incomplete primary were deemed ineligible. We performed frequentist random-effect network meta-analyses to summarize the evidence and applied the Confidence in Network Meta-Analysis frameworks to rate the certainty of evidence, calculate the treatment effects, categorize interventions, and present the findings. The study was registered with PROSPERO, CRD 42,024,562,020.</p><p><strong>Results: </strong>A total of 54 eligible trials were identified, involving 15 implants and enrolling 10,275 participants; all subsequent estimates refer to the comparison with sliding hip screw (SHS). InterTAN nail (ITN) resulted in the largest reduction in non-mechanical major post-surgery complications (OR, 0.55; 95% CI, 0.33 to 0.91; moderate confidence). No significant differences were found in terms of Harris hip score, reoperation rate, and overall mechanical complications with moderate to low-level evidence. In secondary findings, percutaneous compression plate (PCCP) resulted in the lowest occurrence of non-mechanical minor post-surgery complications (OR, 0.12; 95% CI, 0.05 to 0.30; high confidence), and proximal femoral nail anti-rotating (PFNA) (OR, 0.05; 95% CI, 0.02 to 0.11; high confidence) resulted in most reduced non-specific mechanical complications, respectively and. ITN demonstrated the highest risk of operative issues (OR, 3.41; 95% CI, 2.03 to 5.73; moderate confidence).</p><p><strong>Conclusions: </strong>In older patients with intertrochanteric fractures, ITN proved among the most effective in reducing non-mechanical major post-surgery complications, but had the highest risk of intraoperative complications. No implants demonstrated superior effectiveness over others.</p><p><strong>Registration of systematic reviews: </strong>CRD 42021245678, PROSPERO.</p>","PeriodicalId":9189,"journal":{"name":"BMC Musculoskeletal Disorders","volume":"26 1","pages":"818"},"PeriodicalIF":2.4,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12376464/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144943124","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":"Clinical, radiological outcomes, and plantar pressure distribution following isolated talonavicular arthrodesis: a retrospective analysis.","authors":"Chaoqun Wang, Chengfei Meng, Feifei Tong, Shengnan Dong, Serafeim Tsitsilonis, Frank Graef, Xugui Li, Zexi Ling, Tobias Gehlen","doi":"10.1186/s12891-025-09082-0","DOIUrl":"https://doi.org/10.1186/s12891-025-09082-0","url":null,"abstract":"<p><strong>Background: </strong>Isolated talonavicular arthritis is relatively uncommon and remains understudied. Furthermore, the alterations in plantar pressure distribution (PPD) following isolated talonavicular arthrodesis (TNA) have not been thoroughly investigated. This study aimed to evaluate PPD, clinical outcomes, and radiographic changes in patients undergoing unilateral isolated TNA. METHODS: Fifteen patients (63.2 ± 11.4 years) who underwent isolated unilateral TNA performed by a single surgeon were included. Postoperative PPD was evaluated across five foot regions at a mean follow-up of 33.3 ± 13.0 months, with comparisons made to the contralateral, unaffected foot. Clinical outcomes were assessed using the American Orthopaedic Foot and Ankle Society (AOFAS) score and the Foot Function Index (FFI). Radiographic evaluation included measurements of Meary's angle (MA), talonavicular coverage angle (TCA), and talus-first metatarsal angle (T1MA). Preoperative and postoperative data for these variables were compared to analyze surgical outcomes. RESULTS: Compared with the unaffected foot, pressure-time integrals (PTIs) in the forefoot, medial sole, and the entire plantar surface were lower on the affected side, while PTIs in the lateral sole, hindfoot, and midfoot were higher, though none reached statistical significance (P > 0.05). Clinically, AOFAS midfoot scores improved from 27.0 ± 21.3 to 78.9 ± 21.0 (P < 0.001), hindfoot scores from 25.1 ± 23.8 to 77.9 ± 14.9 (P < 0.001), and FFI decreased from 54.0% ± 19.8-16.5% ± 15.9% (P < 0.001). Radiographically, the TCA decreased significantly from 12.3° ± 6.3° to 4.7° ± 5.2° (P = 0.002), while changes in MA and T1MA were not significant (P = 0.078 and P = 0.123, respectively). Pedobarographic results on affected sides showed no significant correlation with either preoperative or postoperative AOFAS scores or FFI. However, these scores showed significant correlations with changes in T1MA between preoperative and postoperative assessments. Preoperative T1MA and postoperative MA were significantly associated with PTIs in specific regions of the plantar surface on the affected side. Additionally, BMI was correlated not only with PTIs in certain plantar areas but also with postoperative FFI. CONCLUSIONS: Isolated TNA was associated with improved functional outcomes and trends toward symmetrical PPD during walking on both sides, though larger studies are needed to confirm these observations.</p><p><strong>Clinical trial number: </strong>Not applicable.</p><p><strong>Level of evidence: </strong>Level IV.</p>","PeriodicalId":9189,"journal":{"name":"BMC Musculoskeletal Disorders","volume":"26 1","pages":"817"},"PeriodicalIF":2.4,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12376354/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144943201","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":"Clinical efficacy of modified laminoplasty in the treatment of cervical spondylotic myelopathy.","authors":"Zhiyu Huang, Tianzuo Zhan, Shaodong Zhang","doi":"10.1186/s12891-025-08989-y","DOIUrl":"https://doi.org/10.1186/s12891-025-08989-y","url":null,"abstract":"<p><strong>Background: </strong>Laminoplasty complications, particularly axial symptoms and C5 nerve root palsy, significantly impair patients' quality of life. To address these challenges, we used a modified surgical technique that preserves muscular attachments to the C3 and C7 spinous processes while incorporating C4/C5 foraminotomy, aiming to reduce the incidence of these complications.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 93 patients who underwent laminoplasty for cervical spondylotic myelopathy (CSM) at our institution between January 2016 and June 2022. The cohort comprised 42 patients receiving modified laminoplasty (modified group) and 51 patients undergoing traditional laminoplasty (traditional group). Demographic and surgical parameters, including gender, age, operative duration, intraoperative blood loss, postoperative hospital stay, and complications, were systematically collected. Radiographic parameters including C0-C2 Cobb angle, C2-C7 Cobb angle, T1 slope (T1S), and C2-C7 sagittal vertical axis (SVA) were measured preoperatively and at follow-up on X-ray films. Functional outcomes were evaluated using Japanese Orthopaedic Association (JOA) and Neck Disability Index (NDI) scores.</p><p><strong>Results: </strong>The mean follow-up duration was 55.2 months. No significant differences were observed in terms of gender, age, or operation time between the two groups. Modified group exhibited significantly lower intraoperative blood loss and shorter postoperative hospital stays compared to traditional group (p = 0.013 and p = 0.024, respectively). At follow-up, the C2-C7 Cobb angle and C2-C7 SVA in the modified group, as well as the C2-C7 Cobb angle in the traditional group, demonstrated significant reductions (17.02 ± 10.49° vs. 20.76 ± 10.55°; 24.00 ± 9.18 mm vs. 26.81 ± 9.22 mm; 14.94 ± 12.31° vs. 23.04 ± 10.58°, p < 0.05). Furthermore, the decrease in the C2-C7 Cobb Angle was more pronounced in the traditional group compared to the modified group (-8.10 ± 9.24° vs. -3.74 ± 8.52°, p < 0.05). The NDI score improved more significantly in the modified group than in the traditional group (-13.90 ± 7.59 vs. -10.16 ± 8.74, P = 0.032), whereas the improvement in the JOA score was similar between the two groups (p = 0.344). Additionally, the increase in the postoperative NDI score was positively correlated with increases in T1S and C2-C7 SVA (r = 0.181, p < 0.05; r = 0.208, p < 0.01).</p><p><strong>Conclusion: </strong>Compared with traditional laminoplasty, the modified laminoplasty provided equivalent neurological decompression efficacy while demonstrating superior clinical advantages, including reduced surgical invasiveness, preserved cervical stability, and a lower incidence of postoperative axial symptoms, though it showed no significant difference in preventing postoperative C5 palsy.</p>","PeriodicalId":9189,"journal":{"name":"BMC Musculoskeletal Disorders","volume":"26 1","pages":"816"},"PeriodicalIF":2.4,"publicationDate":"2025-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12375267/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144943242","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":"Randomized, controlled trial to analyze the effect of using a traction-bed-device on patients suffering from osteoarthritis/spondylosis of the lumbar spine.","authors":"Jörn Bengt Seeger, Friedemann Müller","doi":"10.1186/s12891-025-08961-w","DOIUrl":"https://doi.org/10.1186/s12891-025-08961-w","url":null,"abstract":"<p><strong>Background: </strong>Treatment methods for low back pain (LBP) can be divided into conservative, invasive and surgical treatment approaches with traction therapy as a non-surgical therapeutic option. A clinical study analysed the effect of using a traction-bed-device (Movento) on 35 patients suffering from osteoarthritis/spondylosis of the lumbar spine.</p><p><strong>Methods: </strong>The study was performed as a multicentric, double-blind, randomised, controlled interventional study. The patients were treated over three weeks while staying in rehabilitation clinics. All patients were assessed initially at study entry, weekly and after 3 weeks as well as 12 weeks after discharge. The following outcome measures were used: Numerical Rating Scale (NRS), Roland-Morris Disability Questionnaire (RMDQ), (12) Progressive Isoinertial Lifting Evaluation (PILE-Tests) and the 36-Item Short Form Health Survey (SF36). One hundred ten patients between 40 and 75 years of age with a diagnosed osteochondrosis/spondylarthrosis with chronification stadium 1 and 2 according to Gerbershagen were enrolled in the study. Both study groups received conventional rehabilitation therapy. The intervention group additionally received additional therapy with a minimum of five hours with the Movento traction device per night with seven sessions per week and a duration of 21 days. The therapy is based on the unloading and loading of spinal tissueThe duration of the treatment was limited to a minimum of 5 h and a maximum of 8 h.</p><p><strong>Results: </strong>The intervention group was able to show significantly better results in pain reduction (NRS) (p < 0.05), the Roland-Morris Questionnaire (p < 0.05), the PILE-Test (p < 0.05), the morning start-up time and the Finger-Floor-Distance measurement (p < 0.05) as well as the improvements in quality of life (SF-36).</p><p><strong>Conclusions: </strong>The presented results show that an additional traction device can improve pain score, function, clinical scores as well as improvements in quality of life in patients with spondylosis.</p>","PeriodicalId":9189,"journal":{"name":"BMC Musculoskeletal Disorders","volume":"26 1","pages":"812"},"PeriodicalIF":2.4,"publicationDate":"2025-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12374264/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144943267","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}
Wen-Bin Zhang, Fei-Long Lu, Yu-Lin Ma, Xiao-Ming Du, Hao Song, Zhao-Xi Yang, Yi-Mei Hu
{"title":"The role of scapular morphological structure in degenerative rotator cuff injury: a digital reconstruction radiograph study.","authors":"Wen-Bin Zhang, Fei-Long Lu, Yu-Lin Ma, Xiao-Ming Du, Hao Song, Zhao-Xi Yang, Yi-Mei Hu","doi":"10.1186/s12891-025-09086-w","DOIUrl":"https://doi.org/10.1186/s12891-025-09086-w","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the relationships among the acromial tilt (AT), the glenoid inclination angle (GIA), the critical shoulder angle (CSA), the acromioglenoid angle (AGA), and degenerative rotator cuff injury via digital reconstruction radiographs (DRRs).</p><p><strong>Methods: </strong>A retrospective cohort of 63 patients who met the inclusion criteria were enrolled from the Affiliated Hospital of Chengdu University of Traditional Chinese Medicine between April 2023 and April 2024, 33 patients with rotator cuff injury and 30 controls were included. Clinical data and scapular computed tomography (CT) scans were collected, and three-dimensional reconstructions were generated via Amira software (Thermo Fisher Scientific, USA). Digital reconstruction radiograph (DRR) images were simulated at the Grashey and Y positions of the scapula, and the parameters were measured via Digimizer software (MedCalc Software, Belgium). The diagnostic and predictive validity of each parameter for DRR for rotator cuff injury was assessed through statistical analysis of the measured data, including inter-observer consistency, correlation analysis among parameters, and receiver operating characteristic (ROC) curve analysis.</p><p><strong>Results: </strong>(1) Inter-observer reliability was excellent for all the parameters (intra-class correlation coefficient (ICC) > 0.8). (2) CSA and AGA were significantly greater in the rotator cuff injury group (P<sub>CSA</sub>= 0.003;P<sub>AGA</sub> < 0.001), whereas GIA was significantly lower (P < 0.001); no difference was detected in AT (P > 0.05). (3) Binary logistic regression analysis revealed that GIA, CSA, and AGA were risk factors for rotator cuff injury (P<sub>CSA</sub>=0.008; P<sub>AGA</sub> = 0.001; P<sub>GIA</sub> = 0.001). (4) ROC analysis yielded area under the curve (AUC) values of 0.755 (GIA), 0.700 (CSA), and 0.796 (AGA), with cutoff thresholds of 83.98°, 30.67°, and 42.04°, respectively. (5) Strong correlations were observed between the CSA and AGA (r = 0.939), whereas the GIA was inversely correlated with both the CSA (r = -0.423) and the AGA (r = -0.471).</p><p><strong>Conclusion: </strong>Measurements of GIA, CSA, and AGA derived from DRRs demonstrate high diagnostic value for degenerative rotator cuff injury. DRR represents a reliable alternative to conventional radiography in clinical practice. In the future, DRR holds promise as a tool for assessing the impact of degenerative rotator cuff injury. However, due to radiation exposure concerns, the current application of DRR is recommended primarily for retrospective studies utilizing existing computed tomography (CT) data.</p>","PeriodicalId":9189,"journal":{"name":"BMC Musculoskeletal Disorders","volume":"26 1","pages":"815"},"PeriodicalIF":2.4,"publicationDate":"2025-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12374477/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144943234","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}
Maria Augusta de Araújo Mota, Tarson Brito Landolfi, Marina Cardoso de Melo Silva, Bruna de Melo Santana, Ângela Jornada Ben, Johanna M van Dongen, Judith E Bosmans, Raymond Ostelo, Thomaz Nogueira Burke, Fernanda Pasinato, Caroline R Tottoli, Rodrigo Luiz Carregaro
{"title":"A multicenter trial-based economic evaluation of a mobile health intervention for individuals with chronic non-specific low back pain: randomized controlled trial protocol.","authors":"Maria Augusta de Araújo Mota, Tarson Brito Landolfi, Marina Cardoso de Melo Silva, Bruna de Melo Santana, Ângela Jornada Ben, Johanna M van Dongen, Judith E Bosmans, Raymond Ostelo, Thomaz Nogueira Burke, Fernanda Pasinato, Caroline R Tottoli, Rodrigo Luiz Carregaro","doi":"10.1186/s12891-025-09118-5","DOIUrl":"https://doi.org/10.1186/s12891-025-09118-5","url":null,"abstract":"<p><strong>Background: </strong>Chronic non-specific low back pain (CNLBP) is a prevalent and costly condition that encourages research into self-management strategies. Mobile health (mhealth) applications are promising interventions, but current evidence on their effectiveness is still conflicting. The aim is to investigate the (cost-)effectiveness of a supervised and personalized mhealth intervention, compared with conventional exercise therapy in individuals with CNLBP.</p><p><strong>Methods: </strong>A multicentre trial-based economic evaluation was designed to compare a mhealth intervention with conventional exercise. Participants will be recruited from two physical therapy rehabilitation clinics located within the participating centres. Adults aged between 18 and 59 years and with self-reported LBP > 12 weeks will be included. Following the collection of baseline data, participants will be randomly assigned to one of two groups using a permuted block randomization: (1) mhealth; (2) Conventional exercise delivered through a booklet. Outcome assessments will be conducted following randomisation at five distinct time points, resulting in a total follow-up period of 12 months. The primary clinical outcome is disability (Roland-Morris Disability Questionnaire), while secondary outcomes include pain (NRS), utility (Eq. 5D5L), fears and beliefs (FABQ), self-efficacy (PSEQ), and global perceived effect. A sample size of 146 participants was estimated (73 allocated to each group) to detect a 2-point between-groups difference on disability. A cost-effectiveness study will be conducted alongside the trial, comparing the two interventions in terms of costs and clinical outcomes.</p><p><strong>Discussion: </strong>While mhealth applications show promise as interventions for people with LBP, there is still a gap regarding the type of delivery and personalisation strategies. This study investigates whether the implementation of stratified and tailored care within a mobile application, based on patient-reported outcome measures and supervised by a physiotherapist, is (cost-)effective.</p><p><strong>Trial registration: </strong>NCT06651099 (registration date 21/10/2024).</p>","PeriodicalId":9189,"journal":{"name":"BMC Musculoskeletal Disorders","volume":"26 1","pages":"814"},"PeriodicalIF":2.4,"publicationDate":"2025-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12374270/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144943185","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":"Anatomical and histological analysis of the scalene triangle in a Japanese population: implications for thoracic outlet syndrome diagnosis and management.","authors":"Toshiya Nito, Hiroshi Satake, Masahiro Tsuchiya, Naomi Hanaka, Michiaki Takagi","doi":"10.1186/s12891-025-09048-2","DOIUrl":"https://doi.org/10.1186/s12891-025-09048-2","url":null,"abstract":"","PeriodicalId":9189,"journal":{"name":"BMC Musculoskeletal Disorders","volume":"26 1","pages":"811"},"PeriodicalIF":2.4,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12372329/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144943221","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}