BMC Musculoskeletal Disorders最新文献

{"title":"Title of the study: finite element analysis of five internal fixation modalities for Schatzker type IV‒C tibial plateau fractures.","authors":"Zulong Zhou, Run Fang, Yulong Liu, Mingxiang Liu, Lingchao Kong, Rende Ning","doi":"10.1186/s12891-025-08770-1","DOIUrl":"10.1186/s12891-025-08770-1","url":null,"abstract":"<p><strong>Background: </strong>This study aims to evaluate the biomechanical performance of five different internal fixation strategies for Schatzker type IV-C tibial plateau fractures using three-dimensional finite element analysis. By analyzing stress distribution and displacement patterns under physiological load, we seek to identify optimal fixation modalities for clinical application.</p><p><strong>Methods: </strong>We established a three-dimensional finite element model of Schatzker IV-C tibial plateau fractures and evaluated five internal fixation modalities via finite element analysis. These modalities included a medial plate (Model 1), a medial plate with two posterior tension screws (Model 2), a medial plate with two lateral tension screws (Model 3), a posterior medial double plate (Model 4), and a medial lateral double plate (Model 5). To simulate the biomechanics of unilateral knee axial compression during normal adult gait, an axial force of 1,200 newtons (N) was applied, with 60% of the force distributed to the medial plate. We comprehensively analyzed equivalent von Mises stresses, displacements, and equivalent stress-displacement plots for each fixation.</p><p><strong>Results: </strong>Model 5 demonstrated the best overall performance in terms of internal fixation stress (91.46 MPa) and fracture block stress (10.826 MPa), suggesting optimal stress distribution and fracture block protection. Model 3 performed best in terms of internal fixation displacement (4.391 mm), suggesting an advantage in fracture block stability. While the models performed well in several areas, the double plate fixation scheme was superior in terms of stress distribution and fracture stability. It is ideal for managing complex fractures.</p><p><strong>Conclusions: </strong>A single medial plate (Model 1) provides adequate fixation and stability for fractures without the lateral intercondylar ridge. Lag screws with the medial plate (Models 2 and 3) effectively reduce stress and minimize trauma. Double plate on the posterior medial side (Model 4) significantly enhances fixation and prevents displacement for complex fractures. Medial-lateral double plate fixation (Model 5) provides the most favorable biomechanical stability for fractures with extensive lateral plateau comminution. However, balance the benefits against increased complexity, particularly in patients with compromised soft tissue or high functional demands. Selecting internal fixation based on the fracture line can optimize outcomes and speed recovery.</p>","PeriodicalId":9189,"journal":{"name":"BMC Musculoskeletal Disorders","volume":"26 1","pages":"509"},"PeriodicalIF":2.2,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12100812/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144131962","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":"The causal relationship between immune cells and knee osteoarthritis: Mendelian randomization study.","authors":"Chenghao Gao, Hongxu Pu, Yifan Zeng, Jun Xiao","doi":"10.1186/s12891-025-08735-4","DOIUrl":"10.1186/s12891-025-08735-4","url":null,"abstract":"<p><p>Knee osteoarthritis (OA) is a common degenerative joint disease that affects millions of people worldwide. Inflammation is one of the key pathogenic factors of knee OA. However, the causal relationship between immune cells and knee OA development remains unclear. Herein, we used Mendelian randomization (MR) analysis to evaluate causal relationship between 731 immune cells and knee OA. Several methods were applied to ensure the robustness of our results, including inverse-variance weighted (IVW), simple mode, weighted median, weighted mode, and MR-Egger. We found that 23 immune cell phenotypes were causally associated with knee OA (P < 0.05), including various subpopulations of B cells, T cells, TBNK (T cells, B cells, Natural Killer cells) and monocytes, which was confirmed by heterogeneity, sensitivity, and pleiotropy tests. B cells had dominant effects on OA development, and specifically, our findings suggest that BAFF-R in IgD + CD38- unswitched memory B cells may have a protective role, whereas CD25 in IgD + CD24 + B cells appears to be associated with increased risk, pending further validation. Moreover, a higher population of regulatory T (Treg) cells indicated a higher risk of OA and reversely, OA could induce Treg differentiation. Collectively, our study identified several immune cells that were closely related to OA development, which provided novel insights into the pathogenesis of OA and therapeutic targets for OA treatment.</p>","PeriodicalId":9189,"journal":{"name":"BMC Musculoskeletal Disorders","volume":"26 1","pages":"504"},"PeriodicalIF":2.2,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12096777/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144126684","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":"Does an additional attachment plate improve fixation in Vancouver type B1 and C periprosthetic femoral fractures? A retrospective comparative study.","authors":"Soo-Hwan Jung, Chul-Ho Kim, Jae Suk Chang, Ji Wan Kim","doi":"10.1186/s12891-025-08762-1","DOIUrl":"10.1186/s12891-025-08762-1","url":null,"abstract":"<p><strong>Introduction: </strong>This study compared the clinical and radiologic outcomes of well-fixed periprosthetic femoral fractures after hip arthroplasty according to the use of single plate fixation with additional attachment plate device (group 1) or not (group 2).</p><p><strong>Materials and methods: </strong>Retrospective data were obtained from a single center by reviewing medical records of patients who underwent reduction and internal fixation of Vancouver type B1 and C periprosthetic femoral fractures between June 2006 and June 2021. The study analyzed patient demographics, fracture characteristics, surgical details, functional outcomes (Harris hip score [HHS] and Koval score at 1-year follow-up), reoperation rates, and radiologic findings. In this study, nonunion and malunion were defined as indicators of \"healing problems.\"</p><p><strong>Results: </strong>Among the 32 included patients (group 1: 15; group 2: 17), fractures resulted from high-energy (six cases) and low-energy (26 cases) injuries, with no open fractures. The fractures included 21 cases of Vancouver type B1 and 11 cases of type C. One patient (6.7%) in group 1 required revision surgery. Excellent or good outcomes were observed in 100% of group 1 and 88.2% of group 2 patients according to Beals-Tower criteria (p = 0.031). Healing problems occurred in 6.7% and 41.2% of patients in groups 1 and 2, respectively (p = 0.03). HHS score, Koval score, union time, or femoral alignment did not differ significantly between the two groups (p > 0.05).</p><p><strong>Conclusions: </strong>Using an additional plate in the treatment of well-fixed periprosthetic femoral fractures yielded better clinical outcomes compared to cases without an additional plate. Lower rates of nonunion or delayed union and improved overall healing were observed in the augmented group.</p>","PeriodicalId":9189,"journal":{"name":"BMC Musculoskeletal Disorders","volume":"26 1","pages":"505"},"PeriodicalIF":2.2,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12096572/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144126682","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":"The impact of blood flow restriction training on tendon adaptation and tendon rehabilitation - a scoping review.","authors":"Samuel Öberg, Ludvig von Schewelov, Eva Tengman","doi":"10.1186/s12891-025-08734-5","DOIUrl":"10.1186/s12891-025-08734-5","url":null,"abstract":"<p><strong>Background: </strong>Tendon injuries are common in athletes and in the general population and require extensive rehabilitation. Current conservative treatment often includes different high-load resistance training (HLRT) modalities. However, certain populations may not tolerate HLRT well. Blood flow restriction training (BFRT) incorporates low load while achieving hypertrophy and strength adaptations comparable to HLRT. However, the effects of BFRT on healthy and pathological tendons are unknown. The aims of this scoping review were therefore to summarize the reported impact of BRFT: (1) on tendon adaptation in healthy individuals, and (2) in tendon rehabilitation after injury.</p><p><strong>Methods: </strong>A scoping review based on PRISMA guidelines was performed. A systematic literature search in the electronic databases PubMed, SPORTDiscus and CINAHL was performed in May 2024. This review includes peer-reviewed articles investigating the effects of BFRT on healthy tendons and in tendon rehabilitation. Methodological quality was assessed using the Downs and Black scale and JBI Critical Appraisal Checklist.</p><p><strong>Results: </strong>19 studies with varied design, population, investigated tendon, intervention design and outcome measures were eligible. Ten studies were randomized controlled trials (RCT), one study was a clinical controlled trial, three studies were feasibility studies and five were case reports. The reviewed studies included 351 healthy subjects and 122 individuals with tendon-related disorders (101 subjects with tendinopathy and 21 subjects with tendon ruptures). Tendons investigated were Achilles (n = 6), patellar (n = 6), hamstring (n = 1), gluteal (n = 1), biceps brachii distal (n = 1), tendons of the rotator cuff (n = 2) and lateral elbow extensors (n = 2). In the nine studies on healthy individuals, the effects of BFRT showed contradictory results regarding tendon-related outcomes. However, changes in outcome measures did not differ significantly from HLRT conditions or low-load resistance training (LLRT) conditions. The studies on tendon rehabilitation also showed contradictory results regarding tendon-related outcomes, although several studies do report decreased pain, increased strength, enhanced performance and improved self-reported diagnosis-specific function.</p><p><strong>Conclusions: </strong>The present scoping review shows contradictory results regarding tendon-related outcomes although studies point to increasing tendon function after rehabilitation. BFRT may be a viable option to incorporate into training regimes aimed at inducing tendon adaptation. Further in-depth research is warranted.</p><p><strong>Clinical trial number: </strong>This is a review and therefore is Clinical trial number: Not applicable. However, the review has been preregistered at www.osf.io (DOI https://doi.org/10.17605/OSF.IO/PYV43 ) stated in the method section.</p>","PeriodicalId":9189,"journal":{"name":"BMC Musculoskeletal Disorders","volume":"26 1","pages":"503"},"PeriodicalIF":2.2,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12096532/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144126686","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":"Contextual and placebo effects of suboccipital myofascial release: evaluating its influence on pain threshold, cervical range of motion, and proprioception.","authors":"Ertuğrul Safran, Yaren Kaya","doi":"10.1186/s12891-025-08741-6","DOIUrl":"10.1186/s12891-025-08741-6","url":null,"abstract":"<p><strong>Background: </strong>Suboccipital myofascial release (MR) is widely used in manual therapy for addressing cervical dysfunction. However, its specific therapeutic effects remain unclear, especially when compared to sham interventions, raising questions about the roles of contextual and placebo influences.</p><p><strong>Objective: </strong>This study aimed to evaluate the immediate effects of suboccipital MR on pain pressure threshold(PPT), cervical range of motion (ROM), and proprioception, while considering the influence of non-specific effects such as placebo and contextual factors.</p><p><strong>Methods: </strong>A single-blind, sham-controlled randomized study was conducted with 30 asymptomatic participants (15 per group). The MR group received five minutes of suboccipital myofascial release, while the sham group received light touch without therapeutic pressure.Outcomes included PPT, cervical ROM (flexion, extension, and rotation), and proprioception, measured before and immediately after the intervention. A 2 × 2 mixed ANOVA was used to analyze group × time interaction and main effects. Paired t-tests were used as supportive within-group analyses.</p><p><strong>Results: </strong>The MR group showed within-group improvements in PPT (e.g., left-side PPT increased from 7.31 ± 2.58 to 8.67 ± 1.98 kg/cm², p = 0.028), cervical ROM (e.g., flexion improved from 57.00 ± 9.05° to 64.00 ± 9.60°, p = 0.0004), and proprioception (e.g., flexion reposition error decreased from 5.77 ± 2.24° to 3.70 ± 2.40°, p = 0.006). However, no significant group × time interactions were observed for any outcome, suggesting similar changes in both MR and sham groups.</p><p><strong>Conclusions: </strong>Suboccipital MR produced significant within-group improvements in PPT, cervical ROM, and proprioception. However, the absence of significant differences between the MR and sham interventions suggests that non-specific or contextual factors may account for the observed effects. Further studies are needed in symptomatic populations with longer follow-up and objective outcome measures to determine the specific efficacy of MR.</p><p><strong>Trial registration: </strong>This study was retrospectively registered with ClinicalTrials.gov under the identifier NCT06761391 on January 5, 2025.</p>","PeriodicalId":9189,"journal":{"name":"BMC Musculoskeletal Disorders","volume":"26 1","pages":"502"},"PeriodicalIF":2.2,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12093650/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144118912","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":"Mid-term comparison of highly porous versus hydroxyapatite-coated porous surface in the same cup system: a retrospective single-center study.","authors":"Tetsuya Tachibana, Hiroki Katagiri, Kazumasa Miyatake, Takahisa Ogawa, Masanobu Hirao, Ryohei Takada, Ryusuke Saito, Tetsuya Jinno","doi":"10.1186/s12891-025-08753-2","DOIUrl":"10.1186/s12891-025-08753-2","url":null,"abstract":"<p><strong>Background: </strong>In this study, we aimed to compare the mid-term clinical and radiographic outcomes of highly porous and hydroxyapatite (HA)-coated porous titanium cups using the same cementless cup system in patients undergoing total hip arthroplasty (THA). We investigated the differences in radiolucent line (RLL) formation, cup migration, and clinical outcomes between the two surface processing methods.</p><p><strong>Methods: </strong>This retrospective study included 209 hips (116 in the highly porous group and 93 in the HA porous group) with a minimum follow-up period of over 4 years. Using standardized anteroposterior pelvic radiographs, we conducted radiographic evaluations to assess cup orientation, initial gaps, and RLLs. Migration was analyzed using Einzel-Bild-Rontgen Analysis (EBRA), focusing on a subset of 28 randomly selected cups from each group as determined by power analysis. Clinical outcomes were measured using the Japanese Orthopedic Association (JOA) hip score. The primary outcome was the incidence of cup revision, and the secondary outcomes were postoperative JOA scores and the incidence of initial gaps and RLLs.</p><p><strong>Results: </strong>No cup revisions were made in either group. Both groups had significant postoperative improvements in the JOA scores, with no differences observed during the follow-up period. At baseline, the initial gaps were observed at similar rates (highly porous vs. HA porous [51% vs. 52%]; p = 0.97). However, at the 5-year follow-up, the initial gaps were resolved in nearly all cases. In the highly porous group, RLLs were significantly more frequent during the first-year follow-up (23% vs. 2%; p < 0.0001). However, they decreased in all cases, and none of them exhibited RLL expansion. EBRA migration analysis revealed no significant differences between the groups.</p><p><strong>Conclusion: </strong>Both groups demonstrated comparable mid-term clinical and radiographic outcomes. The highly porous group exhibited higher initial RLL incidences. However, RLL diminished over time without compromising the migration or clinical results. Both designs are reliable options for cementless THA.</p>","PeriodicalId":9189,"journal":{"name":"BMC Musculoskeletal Disorders","volume":"26 1","pages":"500"},"PeriodicalIF":2.2,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090497/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144109607","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":"Advanced feature fusion of radiomics and deep learning for accurate detection of wrist fractures on X-ray images.","authors":"Mohamed J Saadh, Qusay Mohammed Hussain, Rafid Jihad Albadr, Hardik Doshi, M M Rekha, Mayank Kundlas, Amrita Pal, Jasur Rizaev, Waam Mohammed Taher, Mariem Alwan, Mahmod Jasem Jawad, Ali M Ali Al-Nuaimi, Bagher Farhood","doi":"10.1186/s12891-025-08733-6","DOIUrl":"10.1186/s12891-025-08733-6","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to develop a hybrid diagnostic framework integrating radiomic and deep features for accurate and reproducible detection and classification of wrist fractures using X-ray images.</p><p><strong>Materials and methods: </strong>A total of 3,537 X-ray images, including 1,871 fracture and 1,666 non-fracture cases, were collected from three healthcare centers. Radiomic features were extracted using the PyRadiomics library, and deep features were derived from the bottleneck layer of an autoencoder. Both feature modalities underwent reliability assessment via Intraclass Correlation Coefficient (ICC) and cosine similarity. Feature selection methods, including ANOVA, Mutual Information (MI), Principal Component Analysis (PCA), and Recursive Feature Elimination (RFE), were applied to optimize the feature set. Classifiers such as XGBoost, CatBoost, Random Forest, and a Voting Classifier were used to evaluate diagnostic performance. The dataset was divided into training (70%) and testing (30%) sets, and metrics such as accuracy, sensitivity, and AUC-ROC were used for evaluation.</p><p><strong>Results: </strong>The combined radiomic and deep feature approach consistently outperformed standalone methods. The Voting Classifier paired with MI achieved the highest performance, with a test accuracy of 95%, sensitivity of 94%, and AUC-ROC of 96%. The end-to-end model achieved competitive results with an accuracy of 93% and AUC-ROC of 94%. SHAP analysis and t-SNE visualizations confirmed the interpretability and robustness of the selected features.</p><p><strong>Conclusions: </strong>This hybrid framework demonstrates the potential for integrating radiomic and deep features to enhance diagnostic performance for wrist and forearm fractures, providing a reliable and interpretable solution suitable for clinical applications.</p>","PeriodicalId":9189,"journal":{"name":"BMC Musculoskeletal Disorders","volume":"26 1","pages":"498"},"PeriodicalIF":2.2,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090392/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144109515","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: Osseointegration potential of boron-coated titanium alloy pedicle screw in rabbit spine model.","authors":"Hidir Ozer, Mehdi Hekimoğlu, Ibrahim Kulac, Ozgur Can Eren, Yeliz Kasko Arici, Haydar Çelik, Ali Fahir Ozer","doi":"10.1186/s12891-025-08702-z","DOIUrl":"10.1186/s12891-025-08702-z","url":null,"abstract":"","PeriodicalId":9189,"journal":{"name":"BMC Musculoskeletal Disorders","volume":"26 1","pages":"501"},"PeriodicalIF":2.2,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090513/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144109452","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":"FGA can be used as a promising therapeutic target in osteoarthritis.","authors":"Guanhong Chen, Han Zhang, Xizhuang Bai","doi":"10.1186/s12891-025-08738-1","DOIUrl":"10.1186/s12891-025-08738-1","url":null,"abstract":"<p><strong>Background: </strong>This study aims to identify critical signaling pathways and pathogenic genes involved in osteoarthritis (OA) to provide a foundation for identifying targeted therapeutic strategies.</p><p><strong>Methods: </strong>Twenty-six patients who underwent knee joint surgery in the Department of Orthopedics between January and December 2023 were enrolled. Cartilage samples in the experimental group (OA group) were harvested from the articular surfaces of the knee joints of OA patients undergoing total knee arthroplasty (TKA). In contrast, control samples were obtained from non-load-bearing regions of irreparable cartilage fragments excised during surgical management of tibial plateau fractures. Proteomic profiling was conducted using label-free quantitative mass spectrometry-based proteomics. Subsequent bioinformatics analysis was performed using R version 4.3.3 to identify differentially expressed proteins and key pathogenic genes. Quantitative real-time polymerase chain reaction (qPCR) and western blots were employed to validate the expression levels of candidate genes.</p><p><strong>Results: </strong>The proteomic analysis revealed that regulatory signaling pathway of insulin-like growth factor-binding protein (IGFBP) for IGF transport and uptake and the platelet degranulation signaling pathway were significantly implicated in OA pathogenesis. Among the differentially expressed proteins, fibrinogen alpha chain (FGA) was identified as a central gene associated with OA. The qPCR and western blots validation confirmed significantly elevated expression of FGA in OA articular chondrocytes samples compared to controls.</p><p><strong>Conclusions: </strong>FGA plays a pivotal role in the molecular pathology of OA and may represent a promising therapeutic target for the development of precision treatments for OA.</p>","PeriodicalId":9189,"journal":{"name":"BMC Musculoskeletal Disorders","volume":"26 1","pages":"499"},"PeriodicalIF":2.2,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090478/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144109600","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":"Intra-thoracic displacement of scapular lateral margin: a case report and literature review.","authors":"Lin Zhang, Jiaze Peng, Yang Yu, Xianpeng Huang, Fuyin Yang, Chengbing Yang, Caopei Guo, Jiachen Peng","doi":"10.1186/s12891-025-08750-5","DOIUrl":"10.1186/s12891-025-08750-5","url":null,"abstract":"<p><strong>Background: </strong>Cases of scapular fractures with fragments displacing into the thoracic cavity via intercostal spaces are exceedingly rare in clinical practice. According to the literature, there have been no prior reports of distal lateral margin fractures of the scapula that displace into the thoracic cavity.</p><p><strong>Case presentation: </strong>We reported a case of a patient who presented with right shoulder pain and limited mobility after a fall. Examination revealed fractures of the medial and lateral margins of the right scapula, with the distal end of the lateral margin having detached from the inferior angle of the scapula and penetrating the thoracic cavity through the second intercostal space. Therefore, there existed the possibility of a pleural breach. We opted to perform an operation of open reduction and internal fixation via the Judet approach, during which it was confirmed that the fracture fragments were in contact but didn't perforate the pleura, thereby avoiding complications such as pneumothorax. The use of plates on both the medial and lateral columns, together with the sturdy scapular spine, formed a triangular structure that stabilized the fracture. At the six-month postoperative follow-up, the patient demonstrated favorable clinical outcomes.</p><p><strong>Conclusion: </strong>Surgical approaches are increasingly becoming minimally invasive. In this complex case of scapular fracture, we chose a sufficiently exposed large incision surgical approach to provide a clear view of the fracture fragment that was directed toward the pleura. The non-thoracotomy approach, avoiding the complication of pneumothorax and ensuring rigid fracture fixation, represented an alternative form of \"minimally invasive\" surgery.</p>","PeriodicalId":9189,"journal":{"name":"BMC Musculoskeletal Disorders","volume":"26 1","pages":"495"},"PeriodicalIF":2.2,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12087183/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144101251","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}