Injury-International Journal of the Care of the Injured最新文献

{"title":"Trends in geriatric ankle fractures in the United States: An 8-year analysis","authors":"José L. Ayala-Ortiz ,&nbsp;Doriann M. Alcaide ,&nbsp;Sean Taylor ,&nbsp;Gerald McGwin ,&nbsp;Joey P. Johnson","doi":"10.1016/j.injury.2026.113066","DOIUrl":"10.1016/j.injury.2026.113066","url":null,"abstract":"<div><h3>Introduction</h3><div>Ankle fractures are among the most common fractures in older adults, associated with substantial morbidity and healthcare burden. This study aimed to evaluate recent trends in incidence and injury characteristics of ankle fractures among adults aged ≥65 years presenting to United States emergency departments.</div></div><div><h3>Methods</h3><div>The National Electronic Injury Surveillance System (NEISS) database was queried for ankle fractures in adults aged ≥65 years from 2016 to 2023. Demographics, injury mechanisms, fracture types, and hospitalization rates were analyzed. Annual incidence rates per 100,000 persons were calculated. Trends over time, as well as age- and sex-specific differences, were analyzed.</div></div><div><h3>Results</h3><div>An estimated 241,449 ankle fractures occurred among adults aged ≥65 years between 2016 and 2023, with an overall incidence rate of 55.8 per 100,000 person-years. The incidence increased from 49.1 to 63.0 per 100,000 persons during the study period (<em>P</em> &lt; 0.0001). Incidence rates increased significantly in both males (from 25.7 to 34.7 per 100,000 persons; <em>P</em> &lt; 0.0001) and females (from 67.7 to 86.4 per 100,000 persons; <em>P</em> &lt; 0.0001). Most fractures occurred in women (76.2 %), resulted from low-energy trauma (92.8 %), and were closed fractures (96.9 %). Open fracture incidence rose from 0.64 to 2.40 per 100,000 persons, representing a 275 % increase (<em>P</em> &lt; 0.0001). Hospitalization rates increased from 20.3 to 29.7 per 100,000 persons (<em>P</em> &lt; 0.0001). Women aged ≥80 years accounted for the highest fracture burden. Women were more likely to sustain low-energy injuries (<em>P</em> &lt; 0.0001), while men had a higher proportion of open fractures (<em>P</em> = 0.011). Hospitalization rates increased with age, reaching 56.6 % among patients aged ≥80 years (<em>P</em> &lt; 0.0001).</div></div><div><h3>Conclusions</h3><div>Ankle fracture incidence among older adults in the U.S. increased significantly from 2016 to 2023, with rising rates in both males and females. Low-energy mechanisms remain the predominant cause in this population. Further studies are needed to identify optimal surgical treatments and rehabilitation strategies. Improving bone health and reducing morbidity and mortality remain key priorities in managing geriatric ankle fractures.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"57 3","pages":"Article 113066"},"PeriodicalIF":2.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146079376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robotic-assisted versus fluoroscopy-guided sacroiliac screw fixation: A retrospective comparative study","authors":"Maria Auron ,&nbsp;Gal Barkay ,&nbsp;Ohad Einav ,&nbsp;David Laniado ,&nbsp;Yoram Weil ,&nbsp;Josh E Schroeder","doi":"10.1016/j.injury.2026.113019","DOIUrl":"10.1016/j.injury.2026.113019","url":null,"abstract":"<div><h3>Background</h3><div>Percutaneous sacroiliac (SI) screw fixation is a widely used technique for stabilizing sacral fractures but is considered technically demanding due to complex pelvic anatomy and proximity to neurovascular structures. Conventional fluoroscopy-guided methods are associated with a relatively high risk of screw misplacement and considerable radiation exposure to patients and staff. Robotic-assisted navigation systems have been introduced to enhance screw accuracy and reduce radiation exposure. The aim of this study was to assess the efficiency, safety, and accuracy of sacroiliac screw fixation using a robot-assisted method compared with a conventional freehand technique.</div></div><div><h3>Methods</h3><div>Medical records of patients treated with sacroiliac screw fixation for sacral fractures at a single Level 1 trauma center between December 2014 and August 2025 were retrospectively analyzed. Patients were divided into robotic-assisted and freehand fluoroscopy-guided groups for comparative analysis. Primary outcomes were intraoperative radiation exposure and operative time; secondary outcomes included screw position accuracy and complications. Statistical analysis was performed with significance set at <em>p</em> &lt; 0.05.</div></div><div><h3>Results</h3><div>Twenty-five patients (mean age: 57.7 ± 22.4 years) were included; 15 in the robotic-assisted and 10 in the conventional fluoroscopy-guided groups. A total of 47 SI-screws were inserted: 29 in the robotic group and 18 in the conventional group. Operative times were comparable between groups (47.1 ± 16.3 min and. 45.1 ± 30.0 min, respectively; <em>p</em> = 0.85). Compared to conventional fluoroscopy, robotic assistance was associated with reduced fluoroscopy time (55.1 ± 23.1 vs. 181.1 ± 104.4 s, p=0.053) and higher screw placement accuracy (94 % vs. 62 %, <em>p</em> = 0.06), although these did not reach statistical significance. No major intraoperative complications occurred.</div></div><div><h3>Conclusion</h3><div>Robotic-assisted navigation in sacroiliac screw insertion can potentially lower radiation exposure and improve screw placement accuracy compared to conventional techniques, without prolonging surgical time. These findings support robotic guidance as a safe and potentially more precise alternative for sacral fracture fixation. Further prospective studies should be performed to evaluate the possible benefits of robotic assisted sacroiliac screw fixation.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"57 3","pages":"Article 113019"},"PeriodicalIF":2.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145981570","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of the effectiveness of platelet-rich plasma (PRP) injection and steroid injection in patients with bilateral moderate carpal tunnel syndrome: a prospective randomized controlled trial","authors":"Üzeyir Cansever ,&nbsp;Şebnem Koldaş Doğan ,&nbsp;İclal Erdem Toslak ,&nbsp;Meral Bilgilisoy Filiz ,&nbsp;Naciye Fusün Toraman","doi":"10.1016/j.injury.2026.113018","DOIUrl":"10.1016/j.injury.2026.113018","url":null,"abstract":"<div><h3>Background and objective</h3><div>To compare the effectiveness of platelet-rich plasma (PRP) injection, corticosteroid injection, and wrist splinting in patients with bilateral moderate carpal tunnel syndrome (CTS) using clinical, electrophysiological, and radiological parameters.</div></div><div><h3>Material and methods</h3><div>This randomized controlled study included 45 patients with bilateral moderate carpal tunnel syndrome, divided equally into three groups: PRP + splint, steroid + splint, and splint-only (control). Assessments were conducted pre-treatment and at 1 and 6 months post-treatment using VAS scores (pain and numbness), pinch and grip strength, QuickDASH questionnaire, EMG, and MRI.</div></div><div><h3>Results</h3><div>VAS scores significantly improved in all groups at both follow-ups, with greater reductions in night pain and numbness in the PRP and steroid groups versus control. All groups showed improved strength at month 1; by month 6, grip strength improved only in the PRP group, while pinch strength improved in both PRP and steroid groups. While A significant reduction in the Quick DASH symptom score was observed in the PRP and steroid groups, EMG findings improved significantly in all groups. MRI showed a significant decrease in palmar bowing in the PRP and steroid groups.</div></div><div><h3>Conclusion</h3><div>While both PRP and steroid injections were more effective than splinting alone in improving symptoms and function, PRP demonstrated some indications of more sustained benefits, particularly at the 6-month follow-up.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"57 3","pages":"Article 113018"},"PeriodicalIF":2.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146000086","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feasibility and discriminatory properties of a simple fitness-to-drive assessment using a driving simulator placed in an orthopaedic outpatient department: a feasibility study","authors":"Jonas A Ipsen ,&nbsp;Malene B Møhring ,&nbsp;Morten Hansen ,&nbsp;Christian Wong ,&nbsp;Jens Lauritsen","doi":"10.1016/j.injury.2026.113032","DOIUrl":"10.1016/j.injury.2026.113032","url":null,"abstract":"<div><h3>Introduction</h3><div>Safe return to driving after orthopaedic injury or surgery is important, but standardised and feasible in-hospital assessments are lacking. We evaluated the feasibility of a simple simulator-based fitness-to-drive assessment in an orthopaedic outpatient department and its ability to discriminate between orthopaedic patients and professional drivers.</div></div><div><h3>Methods</h3><div>In this prospective feasibility study (January 2024–January 2025), two identical driving simulators were installed in an orthopaedic outpatient department and a vocational training centre for professional drivers. Participants were ≥18 years, held a driving licence, and had no medical driving ban. All completed a 3-lap, 6-event scenario with predefined speed progression (50/60/70 km/h). Outcomes were completion, errors, speed progression, maximum reaction time and braking length (metres) at 50 km/h, simulator sickness, perceived realism, and subgroup test–retest reliability.</div></div><div><h3>Results</h3><div>We included 57 patients and 92 drivers. Overall completion was 96.6% (144/149); 31.2% achieved speed progression. Patients were older, more often female, and more functionally impaired than drivers. Drivers had a shorter braking distance (23.3 m; 95% CI 22.1–24.5) and faster reaction time (0.5 s; 95% CI 0.5–0.6) than patients (39.4 m; 95% CI 36.7–42.1 and 1.2 s; 95% CI 1.0–1.4). Simulator sickness leading to discontinuation occurred in 3.4%. Most patients (98.2%) and 64.0% of drivers perceived simulator driving as comparable to real driving. Repeat testing showed a shorter braking distance, particularly in patients.</div></div><div><h3>Conclusion</h3><div>The simulated assessment was feasible, well tolerated, and discriminated between patients and professional drivers. Variation indicates a need for individualised assessment. Validation against on-road driving is required before clinical implementation.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"57 3","pages":"Article 113032"},"PeriodicalIF":2.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146079375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does Soong grade predict radiological and functional outcomes after distal radius fracture plating?","authors":"Saphalya Pattnaik ,&nbsp;Mohamed Khalid ,&nbsp;Sangeetha Baskar ,&nbsp;Sagaya Joel Leo ,&nbsp;Gur Aziz Singh Sidhu ,&nbsp;Mothana Gawad ,&nbsp;Amr Mohammed ,&nbsp;Motaz Ahmed","doi":"10.1016/j.injury.2026.113061","DOIUrl":"10.1016/j.injury.2026.113061","url":null,"abstract":"<div><h3>Introduction</h3><div>Distal radius fractures (DRFs) are frequently managed with volar locking plates (VLP). The Soong classification, which grades plate prominence relative to the volar rim, is widely used because of its association with flexor tendon irritation, but its value in predicting postoperative radiographic restoration and patient-reported outcomes is less clear. This study examined whether Soong grade correlates with alignment (radial height and radial inclination) and patient-rated outcomes after VLP fixation of DRFs.</div></div><div><h3>Methods</h3><div>We conducted a retrospective review of consecutive patients undergoing surgical fixation for DRF, 44 met the inclusion criteria. Demographics, fracture characteristics, operator grade, time from injury to operation, radiation dose, postoperative imaging and clinic utilisation, antibiotic use, and a patient-rated outcome score were collected. Pre- and postoperative anteroposterior radiographs were used to measure radial height and radial inclination. Plate prominence was graded as Soong 0–2.</div></div><div><h3>Results</h3><div>The cohort was predominantly female (72.7%) with a mean age of 53.5 years (range 23–82, SD 16.3). Most fractures were intra-articular (88.6%) and dorsally angulated (79.5%). Mean time from injury to operation was 9.8 days (SD 5.8). Patient-rated outcome scores typically ranged 60–80 and did not appear to vary by sex, operator grade, or fracture configuration. By Soong grade, Grade 0 (<em>n</em> = 23) demonstrated the most favourable radiological restoration with mean postoperative radial height 13.6 mm and inclination 26.4°, alongside the highest mean patient-rated outcome score of 74.1. Grade 1 (<em>n</em> = 14) showed slightly lower restoration (radial height 12.1 mm, inclination 26.4°) and a mean outcome score of 65.3 with wider variability. Grade 2 (<em>n</em> = 7) had the least favourable radiology (radial height 11.7 mm, inclination 24.3°) and the lowest mean outcome score of 61.5; one patient in this group underwent plate removal for flexor tendon irritation.</div></div><div><h3>Conclusions</h3><div>In this single-centre retrospective series of VLP fixation for DRF, lower Soong grade—particularly Grade 0—was associated with better restoration of radial height and inclination and higher patient-rated outcome scores, whereas higher grades demonstrated a stepwise reduction in radiographic and functional results. These findings support meticulous plate positioning to minimise volar rim prominence and justify prospective, adequately powered studies to confirm the observed trends and evaluate longer-term tendon-related complications.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"57 3","pages":"Article 113061"},"PeriodicalIF":2.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146121373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preoperative malnutrition is associated with increased infectious, vascular, and wound complications after distal femur fracture fixation","authors":"Muaaz Wajahath ,&nbsp;Jawad Saad ,&nbsp;Noah Hodson ,&nbsp;Ameen Suhrawardy ,&nbsp;Ali Mehaidli ,&nbsp;Amir Ghafarian ,&nbsp;Tyler Forbes ,&nbsp;Stuart Guthrie","doi":"10.1016/j.injury.2026.113031","DOIUrl":"10.1016/j.injury.2026.113031","url":null,"abstract":"<div><h3>Objectives</h3><div>Distal femur fractures (DFF) are serious injuries that frequently affect older, medically complex patients. Malnutrition worsens outcomes in elective orthopaedic surgery, but its impact in urgent DFF fixation, where preoperative optimization time is limited, remains unclear. This study evaluated whether preoperative malnutrition predicts 90-day morbidity after DFF fixation and whether implant choice modifies risk among malnourished patients.</div></div><div><h3>Methods</h3><div>Adults undergoing operative DFF fixation from 2005 to 2025 were identified in the TriNetX US Collaborative Network. Malnutrition was defined as serum albumin ≤3.5 g/dL or leukocyte count ≤1.5 × 10³/µL within one year before surgery. After 1:1 propensity matching for demographics and comorbidities, outcomes were compared between 13,924 malnourished and 13,924 non-malnourished patients. A secondary matched analysis compared plate versus intramedullary nail fixation in malnourished patients (<em>n</em> = 662). Ninety-day postoperative complications, readmission, and opioid-related outcomes were assessed.</div></div><div><h3>Results</h3><div>Malnourished patients had significantly higher rates of nearly all 90-day complications, including sepsis (risk ratio [RR] 3.55), surgical site infection (RR 3.05), wound disruption (RR 3.38), pulmonary embolism (RR 2.09), pneumonia (RR 2.45), renal failure (RR 2.53), anemia (RR 1.97), and transfusion (RR 2.52) (all <em>p</em> &lt; 0.001). Ninety-day readmission and opioid-related outcomes were also substantially increased. Among malnourished patients, overall complication rates were similar between plate and nail fixation, with the exception of lower pneumonia rates in the plate cohort (<em>p</em> = 0.045).</div></div><div><h3>Conclusions</h3><div>Preoperative malnutrition is a strong, independent predictor of postoperative morbidity after DFF fixation, and complication risk remains high regardless of implant choice. Routine nutritional screening with simple laboratory markers and targeted perioperative optimization should be integrated into trauma workflows to improve outcomes in this vulnerable population.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"57 3","pages":"Article 113031"},"PeriodicalIF":2.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146038911","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Homelessness is associated with increased 90 day and 1 year complications after upper extremity fractures fixation","authors":"Zina Smadi ,&nbsp;Myles Moore ,&nbsp;Katie McBee ,&nbsp;Ahmad Quaddoura ,&nbsp;Fatima Mubarak ,&nbsp;Youssef M. Khalafallah ,&nbsp;Daniel E. Pereira ,&nbsp;Adam Z. Khan ,&nbsp;Joseph A. Abboud","doi":"10.1016/j.injury.2026.113083","DOIUrl":"10.1016/j.injury.2026.113083","url":null,"abstract":"<div><h3>Background</h3><div>This study examines 90-day outcomes and one-year outcomes following surgical fixation of upper extremity fractures in homeless patients.</div></div><div><h3>Methods</h3><div>A retrospective analysis was conducted using a nationwide database to identify patients who underwent open reduction and internal fixation of upper extremity fractures including (shoulder and upper arm, elbow and forearm, wrist and hand) and had documented homelessness status. Patients were 1:1 propensity score-matched to controls based on demographic factors, comorbidities (including chronic kidney disease, hypertension, heart failure, diabetes mellitus, liver diseases, substance abuse and opioid dependence) and BMI yielding 2,584 patients per group. Primary outcomes included fracture related outcomes while secondary outcomes were healthcare utilization, medical and substance related outcomes. Relative risks (RR), 95% confidence intervals (CI), and p-values were calculated.</div></div><div><h3>Results</h3><div>At 90 days, homeless patients had significantly higher risks of emergency department visits (RR: 5.18, p &lt; 0.001), sepsis (p = 0.002), opioid dependence (RR: 2.88, p = 0.002), substance abuse (RR: 5.87, p &lt; 0.001), renal failure (RR: 3.34, p &lt; 0.001), pneumonia (RR: 2.90, p &lt; 0.001), transfusion (RR: 2.61, p = 0.003), readmission (RR: 3.22, p &lt; 0.001), wound complications (RR: 1.97, p &lt; 0.001), and postoperative infection (RR: 2.70, p &lt; 0.001). At 1 year, homeless patients had elevated risks of opioid dependence (RR: 4.69, p &lt; 0.001), substance abuse (RR: 5.72, p &lt; 0.001), opioid use (RR: 1.58, p = 0.011), revision surgery (RR: 1.78, p = 0.017), and malunion (RR: 1.92, p = 0.013).</div></div><div><h3>Conclusion</h3><div>Homeless patients undergoing upper extremity fractures ORIF face significantly higher risks of 90 day and 1 year adverse outcomes compared to housed patients. These findings highlight the critical need for tailored interventions to improve care continuity, minimize risks and improve outcomes in homeless individuals.</div></div><div><h3>LEVEL OF EVIDENCE</h3><div>Level III, Retrospective Cohort</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"57 3","pages":"Article 113083"},"PeriodicalIF":2.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146138249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Occult contralateral sacroiliac joint injuries missed on single-energy CT of operative pelvis fractures","authors":"Joseph T. Patterson ,&nbsp;Michael Allen ,&nbsp;Vivek Satish ,&nbsp;Andrew M. Duong ,&nbsp;Reza Firoozabadi ,&nbsp;Joshua L. Gary","doi":"10.1016/j.injury.2025.112952","DOIUrl":"10.1016/j.injury.2025.112952","url":null,"abstract":"<div><h3>Objective</h3><div>To determine the diagnostic performance of single-energy CT (SECT) scan for detecting contralateral posterior pelvic ring injuries in patients with an operative pelvis fracture.</div></div><div><h3>Methods</h3><div>Retrospective cohort study.</div></div><div><h3>Setting</h3><div>Level I Trauma Center</div></div><div><h3>Patient selection criteria</h3><div>Consecutive adults with operatively-treated pelvic ring injuries and preoperative and postoperative pelvis CT scans. Exclusion criteria were incomplete or unreadable imaging, pelvis CT obtained on a spine board or with a pelvic binder in place, prior pelvic instrumentation, or sacroiliac joint fusion.</div></div><div><h3>Outcome</h3><div><em>Measures and Comparisons</em>: An “occult” contralateral sacroiliac joint injury was defined as either (A) a positive change of ≥2.0 mm between preoperative and postoperative CT measurements at this level on the “uninjured” side or (B) an intraoperatively fluoroscopic finding of ≥2.0 mm of sacroiliac joint widening on either static or dynamic stress fluoroscopic imaging on the “uninjured” side not present on the initial, preoperative CT</div></div><div><h3>Results</h3><div>One hundred forty-six adults, 62 % male sex, with a mean age of 42.5 years were included. A unilateral posterior pelvic ring injury was identified on the initial pelvis CT in ninety patients. An occult contralateral sacroiliac joint injury was identified in 11 patients (12.2 %), 5 by intraoperative fluoroscopic examination, none during instrumentation, and 6 by postoperative pelvis CT. One U-type sacral fracture was identified on postoperative CT. The diagnostic performance of pelvis SECT in the initial trauma evaluation for correctly classifying bilateral pelvic ring injuries was 84 % sensitivity with a 16 % false negative rate, 100 % specificity, 88 % negative predictive value, and 92 % accuracy.</div></div><div><h3>Conclusions</h3><div>In this cohort, 16 % of bilateral posterior ring injuries were incorrectly classified as unilateral from the initial pelvis CT. A complete unilateral posterior ring injury should raise suspicion for an occult contralateral injury and may warrant additional radiographic or fluoroscopic stress examination if clinically appropriate.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"57 2","pages":"Article 112952"},"PeriodicalIF":2.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145829295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the Editor: “Health behavior, health, and socioeconomic background in adolescence as risk factors for traumatic brain injuries: A longitudinal study”","authors":"Shashank Dokania ,&nbsp;Dr. Parth Aphale ,&nbsp;Himanshu Shekhar","doi":"10.1016/j.injury.2025.112598","DOIUrl":"10.1016/j.injury.2025.112598","url":null,"abstract":"","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"57 2","pages":"Article 112598"},"PeriodicalIF":2.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144621556","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Isolated acetabular anterior wall fractures: fracture patterns, fixation methods and a new proposed classification system for a rare injury","authors":"Michela Saracco ,&nbsp;Vincenzo Ciriello ,&nbsp;Nikolaos K. Kanakaris ,&nbsp;Peter V. Giannoudis","doi":"10.1016/j.injury.2025.112958","DOIUrl":"10.1016/j.injury.2025.112958","url":null,"abstract":"<div><h3>Background</h3><div>Isolated anterior wall acetabulum fracture (AWF) represents a rare injury. There is a paucity of information available about this fracture and no classification has been proposed so far. The aim of this study was to analyse the various possible fracture patterns, related treatment approaches and to develop a new classification system.</div></div><div><h3>Methods</h3><div>Common search engines were systematically searched, according to the PRISMA guidelines. Data relating to the studies that reported surgical approaches and results about isolated AW fractures were included. Data quality was also assessed. We topographically subdivided the fractures, according to the percentage of the anterior wall involved, location of the fracture, and the degree of comminution. The mean follow-up was 38.8 months (6–240).</div></div><div><h3>Results</h3><div>17 papers were eligible for this study. The ilio-inguinal (ILI) approach was the most used one (58.2 %). Different reconstruction techniques were deployed. Anatomical reduction was obtained in 46.6 % of the cases. 3 patients required hip prosthesis within 18 months. Based on the evidence gathered the anterior wall was divided into 3 segments (proximal, (P) middle (M) and distal (D)1/3 segment. Based on the area of involvement in each zone was also divided into Type <em>I</em> &lt; 25 %; Type II 25–50 % and Type III &gt;50 %. Comminution (C) was also assigned if present in any of the 3 zones.</div></div><div><h3>Conclusion</h3><div>Isolated anterior wall acetabulum fracture is an uncommon injury. The IIL approach was the most used for fixation. A new classification system was developed to guide surgical approach and fixation techniques.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"57 2","pages":"Article 112958"},"PeriodicalIF":2.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145914269","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}