Orthopedic Reviews最新文献

Background: Isolated radial head dislocation in children is a rare injury, often resulting from trauma or associated with complex elbow conditions like Monteggia fracture-dislocations. Its low incidence can lead to missed diagnoses, potentially causing long-term complications such as pain, stiffness, and functional impairment. Early recognition and intervention are essential.

Case presentation: A 7-year-old girl presented with persistent left elbow pain and limited motion three weeks after a fall on her outstretched hand. Initial treatment at a local facility misdiagnosed it as a soft-tissue injury. Radiographs revealed anterior radial head dislocation without fractures. Closed reduction failed, leading to open reduction and annular ligament reconstruction using a modified Bell-Tawse technique. Postoperative fixation and rehabilitation followed.

Conclusion: At 5-year follow-up, the patient achieved near-complete functional recovery with minimal pronation limitation. This case underscores the importance of thorough radiographic assessment in pediatric elbow trauma and demonstrates successful outcomes from surgical intervention in delayed presentations.

A comprehensive review of device-related complications from cylindrical lead spinal cord stimulator (SCS) implants was previously published. [1] Although SCS remains a minimally invasive treatment for neuropathic pain, hardware-related problems such as lead migration, lead fracture, lead disconnection, generator malfunction, loss of charge, generator flipping, pocket pain, and paresthesia intolerance are reported more often than biologic complications. [1,2] Understanding these issues, their clinical presentations, diagnostic evaluation, and management strategies is critical for long-term outcomes. This infographic was designed to present the key findings of the review in a clear and accessible visual format.

Background: Talus osteoarthritis (OA) is a disabling condition that negatively affects the lives of individuals in terms of pain, functional limitation. Hydrogels, due to their viscoelastic, bioactive, and biocompatible properties, have emerged as a promising therapeutic option in cartilage repair and OA management. Currently hydrogel applications in other joint OA such as knee are extensively studied, while their use in talocrural joint degeneration remains underexplored. This systematic review aims to analyze the uncertainty in the effectiveness and safety of hydrogel-based therapies in the treatment of talus OA.

Methods: Following PRISMA guidelines, a systematic search was conducted across PubMed, Embase, Scopus, Web of Science, and the Cochrane Library from 2015 up to 2025. Eligible studies included case series, cohort and randomized clinical trials investigating hydrogel implementation for talus OA. Data extraction and risk of bias assessments were independently performed by two reviewers. Thematic synthesis was applied due to heterogeneity in study designs.

Results: Preliminary screening identified 5 relevant studies. Hydrogel types included hyaluronic acid derivatives. Outcomes assessed included pain scores, joint function and imaging-based structural changes.

Conclusion: Hydrogel-based therapies represent a promising joint-preserving option for talus osteoarthritis, offering potential cartilage support and symptom relief. However, current evidence remains limited. Larger, well-designed clinical trials with standardized outcome measures are essential to validate efficacy and refine formulations tailored to the unique biomechanics of the ankle joint.

Shoulder injuries resulting from acute trauma are frequent. Minimally invasive (MIS) procedures such as arthroscopy are increasingly being used instead of traditional open approaches for several surgical purposes. When it comes to arthroscopy evaluations and treatments, the shoulder ranks second most often. Various shoulder pathologies, including rotator cuff pathology, subacromial impingement, acromioclavicular joint abnormalities, and more, may now be evaluated and treated with the use of shoulder arthroscopy. Shoulder arthroscopy has several benefits over open surgery, such as less comorbidity, faster recovery, and social and economic benefits. Shoulder arthroscopic treatments are more likely to be successful when meticulous care is taken with the patient's positioning, portal placement, fluid management, and other aspects.

Introduction: Intertrochanteric fractures are very common injuries in the elderly population and are typically managed with cephalomedullary nailing. Even though this approach generally has successful outcomes, complications like implant failure or peri-implant fractures could still occur, especially in osteoporotic patients.

Case presentation: An 87-year-old female with a previously operated intertrochanteric femoral fracture presented with a subcapital femoral neck fracture combined with breakage of the cephalic lag screw. Imaging showed no signs of non-union or malalignment in the pertrochanteric region.

Management: The patient underwent cemented dual mobility total hip arthroplasty after removal of the broken lag screw and cephalomedullary nail. Intraoperatively, a distal femoral spiral fracture occurred. This was stabilized with lag screws and a locking plate. The patient recovered uneventfully and returned to full weight-bearing 3 months postoperatively.

Conclusion: This case highlights a rare complication and presents a therapeutic approach in the context of contemporary literature.

This study leveraged the robust, multicenter ACS NSQIP database to evaluate risk factors associated with the development of pulmonary embolism (PE) following total knee arthroplasty (TKA). Our findings demonstrate that advanced age, elevated body mass index (BMI), chronic obstructive pulmonary disease (COPD), preoperative thrombocytosis or thrombocytopenia, congestive heart failure (CHF), and prolonged operative time are independently associated with increased odds of postoperative PE. These results underscore the importance of comprehensive preoperative risk stratification and individualized perioperative management strategies aimed at minimizing thromboembolic complications in this patient population.

Introduction: Ankle arthrodesis is a key surgical option for end-stage ankle arthritis when total ankle replacement is not feasible. Despite advancements, challenges like non-union and infection persist. While bibliometric analysis has been applied in other orthopaedic fields, no study has focused on ankle arthrodesis.

Methods: This study analysed the 50 most-cited articles to assess their impact and guide future research and clinical practice. A Web of Science search using the terms (("Ankle*" OR "Tibiotalar") AND ("Arthrodesis" OR "Fusion")) identified 533 articles published up to October 2024, including only English-language, peer-reviewed studies on human subjects, while excluding non-peer-reviewed, non-English, or unrelated studies. After screening and data extraction, bibliometric techniques assessed publication trends, citation impact, and key research contributors.

Results: The 50 analysed articles, published between 1948 and 2017, accumulated 12,674 citations (average 678.8 per year), with Ankle Arthrodesis: Long-Term Follow-Up with Gait Analysis by Mazur et al. (1979) as the most cited. The Journal of Bone and Joint Surgery published the most articles (N=26), with the USA leading in research output (N=31). Research activity increased in the 1990s and 2000s, with most studies being observational (92%) and Level IV evidence (34%) prevailing.

Conclusion: This analysis highlights influential studies and research gaps, emphasizing the need for high-quality clinical trials to refine surgical techniques and improve patient outcomes in ankle arthrodesis. Future research should focus on robust methodologies and long-term functional outcomes to advance ankle arthrodesis practice.

Background: Osteogenesis Imperfecta (OI) is a rare genetic bone disorder that has attracted increasing scientific attention. Bibliometric analysis offers insights into the intellectual structure and evolution of this field. This study aimed to identify and evaluate the most highly cited articles on OI to highlight influential contributors, leading journals, and major research trends.

Methods: A bibliometric search was conducted in the Web of Science Core Collection using the terms "Osteogenesis Imperfecta" and "Brittle Bone Disease." The search was restricted to English- language original and review articles published between 2000 and 2024. The 50 most cited articles were selected and analyzed based on citation metrics, journal impact factors, author contributions, institutional affiliations, and collaboration patterns. Statistical analyses were performed using SPSS version 25.0.

Results: The United States produced the highest number of publications, followed by the United Kingdom and Germany. The most cited article, published by Rauch et al. (2004), received 950 citations. The Journal of Bone and Mineral Research and The American Journal of Human Genetics were the most prolific journals in this domain. Observational studies and genetic investigations dominated the top-cited works. Collaboration networks revealed strong interconnections among North American and European institutions, while keyword analysis highlighted growing research interest in gene therapy, molecular diagnostics, and precision medicine.

Conclusion: This bibliometric analysis identified the most influential contributions in OI research, underscoring the role of key authors, journals, and international collaborations. It also revealed major trends in genetic and clinical studies while highlighting emerging areas such as gene therapy and precision medicine as promising directions for future research.

Background: Anterior cruciate ligament (ACL) injuries often require surgical intervention. The use of the peroneus longus tendon in ACL reconstruction has been reported to offer significant potential benefits, such as preserving the hamstring tendons. However, its effects on the ankle must be considered prior to surgery.

Methods: This was a cross-sectional study evaluating ankle morbidity using the American Orthopedic Foot and Ankle Society (AOFAS) score, plantarflexion and eversion strength, and Clarke's angle on both extremities. Data were collected from patients who underwent ACL reconstruction using the peroneus longus tendon as an autograft. Statistical analysis was performed using the Mann-Whitney test with SPSS v.26.

Results: A total of 64 patients were included, with the mean AOFAS scores of 58.88 (donor side) and 70.12 (contralateral side). Mann-Whitney test results showed no significant difference in AOFAS scores between the two sides (p=0.085). The mean plantarflexion strength values were 62.23 (donor) and 66.77 (contralateral), with no significant difference (p=0.489). Additionally, the mean Clarke's angle values were 59.10 (donor) and 69.90 (contralateral), with no significant difference (p=0.099).

Conclusion: There was no statistically significant difference in ankle function in patients who used the peroneus longus tendon as an autograft in ACL reconstruction.

Background/objectives: Femoral and tibial shaft fractures are among the most common long bone fractures. This study aims to assess and compare the economic impact of these two approaches by evaluating: direct costs (implant pricing, instrumentation and operating room expenses) and indirect costs (complication rates and reoperation expenses).

Methods: This study is a comparative cost-analysis study aimed at evaluating the financial burden of stocking an orthopaedic theatre with IM nails versus locking rods used for the treatment of femoral and tibial shaft fractures. The analysis will focus on the costs associated with the procurement; storage and utilization of these implant systems, using publicly available data, manufacturer pricing and relevant industry reports.

Results: In this comparison, IM nailing is slightly more expensive than treating the same fractures by universal locking rod systems with the cost difference ranging between $3,473and$ 5,846. The main contributors to the cost difference include the slightly higher surgical time for IM nailing, as well as higher staffing and operating room costs in addition to higher complication rates reported.

Conclusions: While universal locking rods may have a higher upfront cost, they can reduce hospital inventory needs through their innovative designs which can potentially lead to long term cost savings, as one system can accommodate a bigger range of fractures.