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Matched comparative study of 3D printed microporous tantalum prosthesis versus autologous bone graft in the final stage of Masquelet induced membrane surgery 3D打印微孔钽假体与自体骨移植在Masquelet诱导膜手术后期的匹配比较研究
IF 2 3区 医学 Q3 CRITICAL CARE MEDICINE Pub Date : 2026-02-06 DOI: 10.1016/j.injury.2026.113087
Yin Yang , Yongqing Xu , Jian Shi , Wei Yu , Xiaoqing He , Qixiong Guo , Xinyu Fan

Background

Masquelet induced membrane surgery is a viable option for the reconstruction of extensive bone defects. This study aimed to comprehensively compare the clinical efficacy of 3D printed microporous tantalum prosthesis and autologous bone graft in the final stage of Masquelet induced membrane surgery during the treatment of lower extremity fracture-related infections(FRI) with large segmental bone defect.

Methods

We retrospectively analyzed the clinical data of 43 patients with large segmental bone defect caused by lower extremity FRI treated with Masquelet induced membrane surgery. Among these, 21 patients were implanted 3D printed microporous tantalum prosthesis (Prosthesis group), while 22 patients were implanted autologous bone graft (Autologous bone group) in the final-stage surgery. Follow-up was conducted for 12 months postoperatively. Clinical efficacy was evaluated using the Paley grade for bone defect healing, Visual analog scale (VAS), Lower extremity functional scale (LEFS), Fernandez-Esteve eschar score, and time to full weight-bearing. The clinical outcomes between the two treatment groups were compared.

Results

Postoperatively, the scores of VAS and LEFS significantly improved compared to preoperative values in both groups (all P < 0.001). Compared to the Autologous bone group, the Prosthesis group demonstrated significantly higher LEFS scores and Fernandez-Esteve eschar scores, along with a significantly shorter time to full weight-bearing (all P < 0.05). The complication rate was 19.0% (4/21) in the Prosthesis group and 9.1% (2/22) in the Autologous bone group; there was no statistically significant difference between the two groups (P > 0.05). Patients experiencing complications received effective and targeted interventions.

Conclusion

Both implants show remarkable efficacy in the reconstruction of large segmental bone defect caused by lower limb FRI. However, 3D printed microporous tantalum prosthesis exhibits certain advantages over the autologous bone graft in terms of limb function recovery, bone callus growth, and early weight-bearing. However, when using this technique, one should be vigilant about the risk of complications.
面具小波诱导膜手术是广泛骨缺损重建的可行选择。本研究旨在综合比较3D打印微孔钽假体与自体骨移植在Masquelet诱导膜手术后期治疗下肢骨折相关感染(FRI)合并大节段骨缺损的临床疗效。方法回顾性分析43例下肢FRI所致大节段性骨缺损采用Masquelet诱导膜手术治疗的临床资料。其中21例患者植入3D打印微孔钽假体(假体组),22例患者植入自体骨移植(自体骨组)。术后随访12个月。采用Paley骨缺损愈合评分、视觉模拟评分(VAS)、下肢功能评分(LEFS)、Fernandez-Esteve eschar评分和完全负重时间评价临床疗效。比较两组患者的临床疗效。结果两组患者术后VAS、LEFS评分均较术前显著改善(P < 0.001)。与自体骨组相比,假体组的LEFS评分和Fernandez-Esteve eschar评分均显著高于自体骨组,达到完全负重所需时间显著缩短(P < 0.05)。假体组和自体骨组并发症发生率分别为19.0%(4/21)和9.1% (2/22);两组间差异无统计学意义(P > 0.05)。出现并发症的患者接受了有效和有针对性的干预。结论两种种植体对下肢FRI大节段骨缺损的修复效果显著,但3D打印微孔钽假体在肢体功能恢复、骨痂生长、早期负重等方面均优于自体骨移植。然而,当使用这种技术时,人们应该警惕并发症的风险。
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引用次数: 0
Mechanical and clinical performance of acellular allogeneic dermis combined with autologous split-thickness skin grafts for ankle soft tissue defect repair 脱细胞异体真皮联合自体厚裂皮移植修复踝关节软组织缺损的力学及临床效果
IF 2 3区 医学 Q3 CRITICAL CARE MEDICINE Pub Date : 2026-02-06 DOI: 10.1016/j.injury.2026.113088
Yixin Zhu , Qinghua Lai , Zhiyi Wei , Juntao Cheng

Objective

To evaluate the clinical efficacy, wound healing quality, and functional recovery of a composite grafting technique using acellular dermal matrix (ADM) and autologous split-thickness skin graft (ASTSG) for reconstructing complex ankle soft tissue defects.

Methods

A retrospective cohort study included 108 patients with ankle soft tissue defects (≥3 cm²). Patients were divided into an observation group (n = 55, ADM+ASTSG) and a control group (n = 53, pedicled skin flap). Primary outcomes were graft survival, wound healing time, and scar quality (Vancouver Scar Scale). Secondary outcomes included ankle function (range of motion, gait analysis), operative parameters, cost, and histological assessment of neotissue.

Results

The ADM+ASTSG group demonstrated a significantly higher graft survival rate (96.80 % vs. 78.22 %, P < 0.05) and superior scar quality at 6 months (VSS total score: 2.3 ± 0.8 vs. 4.7 ± 1.1, P < 0.05). Functional recovery was better, evidenced by greater ankle range of motion and gait symmetry (68.3 ± 5.2 % vs. 59.6 ± 4.8 %, P < 0.05). The technique also resulted in shorter operative time (36.6 ± 6.3 vs. 118.6 ± 11.4 min, P < 0.05) and lower hospitalization costs. Histologically, the ADM group showed more organized collagen fibers and a higher collagen I/III ratio, indicating more mature tissue regeneration.

Conclusion

The ADM+ASTSG composite grafting technique promotes high-quality wound healing and functional recovery in ankle soft tissue defects, offering a clinically effective and cost-efficient alternative to traditional flaps. Its ability to support structured tissue regeneration translates into superior scar quality and mechanical adaptability for the dynamic ankle joint.
目的评价脱细胞真皮基质(ADM)与自体裂厚皮肤(ASTSG)复合移植技术修复踝关节复杂软组织缺损的临床疗效、创面愈合质量和功能恢复情况。方法回顾性队列研究纳入108例踝关节软组织缺损(≥3cm²)患者。将患者分为观察组(55例,ADM+ASTSG)和对照组(53例,带蒂皮瓣)。主要结局是移植物存活、伤口愈合时间和疤痕质量(温哥华疤痕量表)。次要结果包括踝关节功能(活动范围、步态分析)、手术参数、费用和新组织的组织学评估。结果ADM+ASTSG组移植成活率明显高于对照组(96.80% vs. 78.22%, P < 0.05), 6个月时瘢痕质量明显优于对照组(VSS总分:2.3±0.8 vs. 4.7±1.1,P < 0.05)。功能恢复更好,踝关节活动范围更大,步态对称(68.3±5.2%比59.6±4.8%,P < 0.05)。同时缩短手术时间(36.6±6.3 min vs. 118.6±11.4 min, P < 0.05),降低住院费用。组织学上,ADM组胶原纤维组织更整齐,胶原I/III比更高,表明组织再生更成熟。结论ADM+ASTSG复合移植技术可促进踝关节软组织缺损高质量的创面愈合和功能恢复,是一种临床有效且经济的替代传统皮瓣的方法。其支持结构化组织再生的能力转化为卓越的疤痕质量和动态踝关节的机械适应性。
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引用次数: 0
Advanced trauma life support 2025: A brief review of updates 2025年晚期创伤生命支持:简要回顾最新进展
IF 2 3区 医学 Q3 CRITICAL CARE MEDICINE Pub Date : 2026-02-03 DOI: 10.1016/j.injury.2026.113079
Akilesh Ramasamy
Guidelines and practices in trauma care constantly evolve based on evidence available, and every healthcare provider who treats trauma should be up-to-date in trauma-care concepts. The Eleventh Edition of Advanced Trauma Life Support, released in 2025, contains a complete revamp of the foundational principles of acute trauma care, content design, delivery, and training, based on medical and educational evidence. In this edition, a significant update is the emphasis on control of exsanguinating/major haemorrhage (ABCDE to x-ABCDE where x stands for control of exsanguinating haemorrhage in trauma resuscitation. In addition to damage control resuscitation, some of the significant changes include recommendations for permissive hypotension, limiting crystalloids, early transfusion, neuroprotective focus, and modifications in operational principles in spine motion restriction. Some of these conceptual changes with their rationale are briefly described in this review as an update for any healthcare provider involved in trauma resuscitation.
创伤护理的指导方针和实践不断发展,基于现有的证据,每个治疗创伤的医疗保健提供者都应该掌握最新的创伤护理概念。《高级创伤生命支持》第11版于2025年发布,基于医学和教育证据,对急性创伤护理、内容设计、交付和培训的基本原则进行了全面修订。在这个版本中,一个重要的更新是强调对失血/大出血的控制(ABCDE)到x-ABCDE,其中x代表创伤复苏中对失血/大出血的控制。除了损害控制复苏,一些重要的变化包括建议允许性低血压,限制晶体,早期输血,神经保护焦点,以及修改脊柱运动限制的操作原则。在这篇综述中,简要描述了一些概念上的变化及其基本原理,作为任何涉及创伤复苏的医疗保健提供者的更新。
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引用次数: 0
Letter to the Editor: “Health behavior, health, and socioeconomic background in adolescence as risk factors for traumatic brain injuries: A longitudinal study” 致编辑的信:“青少年健康行为、健康和社会经济背景作为创伤性脑损伤的风险因素:一项纵向研究”。
IF 2 3区 医学 Q3 CRITICAL CARE MEDICINE Pub Date : 2026-02-01 DOI: 10.1016/j.injury.2025.112598
Shashank Dokania , Dr. Parth Aphale , Himanshu Shekhar
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引用次数: 0
Letter to the Editor: Association between acute pre-injury alcohol use and 12-month health outcomes for survivors of major trauma: A registry-based study 致编辑的信:急性损伤前酒精使用与重大创伤幸存者12个月健康结果之间的关系:一项基于登记的研究。
IF 2 3区 医学 Q3 CRITICAL CARE MEDICINE Pub Date : 2026-02-01 DOI: 10.1016/j.injury.2025.112603
Karthikeyan Kandaswamy , Ajay Guru
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引用次数: 0
Concern on “Efficacy of intranasal ketamine in controlling pain caused by bone fractures.” 关注“鼻内氯胺酮控制骨折引起的疼痛的疗效”。
IF 2 3区 医学 Q3 CRITICAL CARE MEDICINE Pub Date : 2026-02-01 DOI: 10.1016/j.injury.2025.112565
Chitta Ranjan Mohanty , Amiya Kumar Barik , Anju Gupta , Rakesh Vadakkethil Radhakrishnan , Subhasree Das
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引用次数: 0
Intranasal ketamine in controlling pain caused by bone fractures: Can we go? 鼻内氯胺酮控制骨折引起的疼痛:我们能走吗?
IF 2 3区 医学 Q3 CRITICAL CARE MEDICINE Pub Date : 2026-02-01 DOI: 10.1016/j.injury.2025.112766
Camille Martinet , Julien Galant , Nicolas Cazes
Not applicable
不适用。
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引用次数: 0
The road injury chain of survival: A framework for improving trauma outcomes 道路伤害生存链:改善创伤结果的框架。
IF 2 3区 医学 Q3 CRITICAL CARE MEDICINE Pub Date : 2026-02-01 DOI: 10.1016/j.injury.2025.112285
Tim Nutbeam , Willem Stassen
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引用次数: 0
Comment on “Inter-hospital variation in transfusion practices for severe trauma” 对“严重创伤输血做法的医院间差异”的评论。
IF 2 3区 医学 Q3 CRITICAL CARE MEDICINE Pub Date : 2026-02-01 DOI: 10.1016/j.injury.2025.112851
Ranjana Sah , Rachana Mehta
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引用次数: 0
Concern on “Ultrasound-guided percutaneous cryoneurolysis of intercostal nerves in traumatic rib fractures” 对“外伤性肋骨骨折超声引导下经皮肋间神经冷冻神经松解术”的关注。
IF 2 3区 医学 Q3 CRITICAL CARE MEDICINE Pub Date : 2026-02-01 DOI: 10.1016/j.injury.2025.112564
Amiya Kumar Barik , Anju Gupta , Chitta Ranjan Mohanty , Rakesh Vadakkethil Radhakrishnan , Aditya Vikram Prusty
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Injury-International Journal of the Care of the Injured
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