Trauma -Pubmed Results

CONCLUSIONS: Complete thoracoscopic rib fracture fixation significantly reduces surgical trauma, improves recovery, and lowers the incidence of postoperative complications.

PURPOSE OF REVIEW: To elucidate the association between testosterone and skeletal health in men. In this review, i) we discuss the influence of testosterone on bone metabolism, ii) review population studies demonstrating the relationship between sex steroid concentrations and bone mineral density (BMD) and bone quality, and iii) summarize data from seminal trials of testosterone therapy and its effects on bone density and fracture risk.

BackgroundPercutaneous iliosacral screw fixation has become the gold standard for surgical stabilization of acute pelvic ring disruptions with unstable posterior pelvic injuries. Wound infection is uncommon owing to shorter operative time, reduced soft-tissue damage, less blood loss, and lower infection rates. Delayed sacroiliac joint infection after robot-assisted percutaneous iliosacral screw fixation is even rarer.Case presentation: We report a case of delayed sacroiliac joint infection after...

CONCLUSION: The modified Henry approach preserving the FCR tendon sheath significantly improves early postoperative pain relief and functional recovery, with sustained benefits in pain and grip strength up to 12 months. This technique does not increase surgical difficulty, reduces complication risk, and follows the ERAS principle, showing high clinical value.

CONCLUSIONS: The crutch-bend modification of retrograde ESIN was associated with improved postoperative radiographic alignment in this retrospective cohort. Whether this translates into clinically meaningful advantages remains uncertain and requires further investigation in larger prospective studies.

BACKGROUND: Ankle fracture fixation surgery may be performed with or without the use of a tourniquet. Surgeons who use a tourniquet report reduced intraoperative bleeding, which improves the visualisation of anatomical structures. This may facilitate more accurate fracture fixation and restoration of the anatomical configuration of the ankle joint, potentially leading to improved functional outcomes. An additional proposed benefit of tourniquet use is reduced operative time. In contrast,...

CONCLUSION: Fewer opioid pills effectively managed postoperative pain and aligned with high patient self-efficacy. Consistency between patient-reported outcome measures and medical records supported these findings. These observations are exploratory and should be interpreted in the context of a descriptive design.

CONCLUSIONS: The FNS provides rotational stability for Pauwels type III fractures comparable with multiple screw fixation and reduces stress at the fracture site. The DHS with an antirotation screw was less stable during hip rotation. Given its greater compressive strength than multiple screw fixation, the FNS is the preferred fixation option.

CONCLUSIONS: Avulsion fractures of the humeral lesser tuberosity in skeletally immature patients can remain undiagnosed for years due to subtle presentation. Persistent internal rotation weakness after trauma in adolescents should raise suspicion for this injury. Even in cases of markedly delayed diagnosis, appropriate surgical management can result in excellent functional recovery.

CONCLUSIONS: Low sodium and low GNRI levels were associated with increased risks of fragility fractures in patients with T2D. Clinicians should carefully monitor serum sodium levels and nutritional status, and consider early intervention to lower the incidence of fragility fractures in older patients with T2D.

CONCLUSIONS: This large, multicenter study with contemporary implants, instruments, and techniques for exchange nailing tibia nonunions demonstrates a nonunion repair success rate of 75%, consistent with the lower end of reported data in previous literature. No identifiable risk factors for failure of exchange nailing in tibia nonunions were found.

CONCLUSION: Following the introduction of working hour limitations, supervised teaching increased substantially. Although complication and mortality rates rose-likely reflecting an older and more complex patient population-hospital stays shortened. The proposed 42 + 4-hour model will require targeted compensatory measures to maintain surgical training quality and patient safety.

CONCLUSION: At short-term follow-up, Bankart repair using knotless all-suture anchors demonstrated favorable patient-reported outcomes and low redislocation rates. Patients who did not return to their preinjury level of sport exhibited significantly lower psychological readiness. The SI-RSI exhibited high discriminative performance in predicting return to preoperative level of sports, with an optimal cutoff value of 80.

Bone fractures in dogs are common orthopaedic conditions that require accurate diagnosis and rapid intervention. Traditional radiographic interpretation is often time consuming and is subject to variability, emphasizing the need for automated diagnostic tools. This paper represents a deep learning model based on classification of long bone fractures in dogs using medical conventional radiographic images. The proposed model uses a convolutional neural network (CNN), specifically ResNet50 to...

CONCLUSION: Our findings support MIPO as a valuable alternative to ORIF for proximal humerus fractures, offering reduced operative time without compromising reduction quality or complication rates. Patient selection, fracture complexity, and surgeon experience should guide technique choice. Appropriate training remains essential, and future prospective studies incorporating functional outcome measures are warranted.

Pauwels type III femoral neck fractures are biomechanically challenging because the steep fracture orientation produces dominant shear forces at the fracture interface. This study evaluated key finite element (FE) modeling parameters for simulating fracture fixation and validated numerical predictions against cadaveric experiments. Human femora were fractured at 70° and tested under physiological axial loading to measure construct stiffness and interfragmentary motion (IFM). Eight finite element...

Distal radius fractures (DRFs) account for 15% of all fractures in adults. Optimal treatment of DRFs depend on patient and fracture characteristics. Non- or minimally displaced DRFs can be treated nonoperatively with a cast. Although surgical treatment is becoming more popular, the majority of patients with a DRF are still treated nonoperatively. In addition, these considerations may be different for elderly patients. Conflicting evidence exists on the different aspects of treatment of DRFs....

For decades, vitamin D has been a cornerstone of preventive medicine. However, recent large-scale randomized controlled trials have failed to replicate the broad benefits previously observed in epidemiological studies, particularly with respect to fracture and fall prevention in vitamin D-replete populations. Moreover, growing evidence suggesting an increased fall risk associated with high-dose bolus administration has necessitated a re-evaluation of safety assumptions. This review synthesizes...

Three-dimensional (3D) assessment of tibial plateau fractures has traditionally relied on surface-based parameters such as gap area, which may not fully reflect the severity of articular injury. This study investigated whether volumetric quantification of articular depression provides independent prognostic information beyond conventional surface-based 3D measurements in Schatzker type III tibial plateau fractures. A retrospective analysis was performed on 38 patients with isolated Schatzker...

CONCLUSION: In this matched binational cohort, patients with operatively treated ankle fractures demonstrated comparable healing outcomes despite differences in postoperative care strategies across healthcare systems. These findings highlight the reliability of fracture healing in this injury pattern with low rate of complications despite cultural and system-level variation, supporting opioid-sparing strategies in appropriately selected patients.

CONCLUSION: Lateral infraclavicular block with ropivacaine 0.2% failed to demonstrate noninferiority for block success and was statistically inferior to ropivacaine 0.5%. Inferiority testing should be interpreted cautiously within the context of a noninferiority design, although the results suggest reduced effectiveness for distal radius fracture reduction. Lidocaine 1% with epinephrine yielded inconclusive results for noninferiority on block success, but provided a shorter block duration...

BACKGROUND: Artificial intelligence algorithms have been developed to support clinicians in diagnosing fractures, with the intention to improve the diagnostic accuracy of clinicians reviewing X-rays. The purpose of this rapid early value assessment was to identify the existing evidence base for the technology and to assess whether there was a prima facie case for the technology to represent positive outcomes for patients and a value-for-money investment for people in the National Health Service.

CONCLUSION: This nationwide study shows increased all-cause mortality among patients with DRF compared with sex and age-matched controls, with the highest mortality rate within the first 30 days after the fracture. The mortality rate ratio was consistently higher in the age-group 50-59 and among males.

CONCLUSIONS: Only half of patients with operative acetabular fractures received appropriate weight-based dosing of enoxaparin. Weight-based dosing was not associated with reduced VTE incidence, suggesting that receipt of prophylaxis itself may be the most important factor. Larger studies are warranted to verify these findings.

CONCLUSION: Patients with excessive MC bone loss may require a clavicular lengthening to approximate the MC to the manubrium. Restoring clavicular length through a DO in conjunction with a SC joint reconstruction using a tendon allograft is a salvage maneuver which can yield a successful outcome.

CONCLUSION: COVID-19 vaccination is associated with a reduction in the mortality risk among hip-fracture patients with recent infection. Shorter infection-to-surgery intervals are associated with increased mortality risk, and recent infection is associated with higher VTE risk.

CONCLUSIONS: Long-term trajectories and cumulative exposure of TyGFI were independently associated with hip fracture risk, suggesting that persistent metabolic-frailty imbalance contributes to skeletal fragility. TyGFI may serve as a practical integrative marker for early identification and prevention of high-risk individuals.

CONCLUSIONS: RNA analysis on capsular tissue harvested during implant removal in patients with PTSS could be reliably performed. Histology found mature fibrosis while molecular analysis could identify candidate genes as potential target for further research.

CONCLUSION: Acute bone shortening facilitates simultaneous tendon reconstruction and defect reduction, expanding limb-salvage options in complex distal forearm osteoarticular injuries.

CONCLUSIONS: Repurposing ACC fracture claims data for clinical trials has significant limitations and is likely to introduce false negative and false positive events. When tolerance for misclassification is higher (e.g., large non-randomised studies), ACC claims data may be useful because 60% of claims had a verified fracture, with higher proportions for major fracture types.

CONCLUSION: Second contralateral hip fractures are underrecognized events that significantly reduce long-term mobility, independence, and survival time post-fracture. Most occur within the first two years after the initial fracture, highlighting a critical window for targeted monitoring, fall prevention, and optimized osteoporosis management. Early identification of high-risk patients, especially those discharged to rehabilitation, is essential to mitigate functional decline and mortality.

CONCLUSION: Low-dose GCs, used for 2 years to treat RA, lead to bone loss at the lumbar spine but not at the femur.

Tibial plafond fractures pose a significant challenge to orthopedic surgeons. Operative treatment is necessary to achieve radiographic union and satisfactory functional outcomes. A common protocol involves a 2-stage approach, where open reduction and internal fixation is performed after allowing the soft tissues to rest for safe surgical exposure. Circular external fixators (CEF) offer an alternative, minimally invasive treatment strategy that provides fracture stabilization necessary for bone...

Distal third tibial nonunion is a challenging clinical scenario for orthopedic surgeons. Despite advancements in surgical techniques and implant designs, these patients continue to pose a significant burden on their quality of life and health care systems. This review aims to provide a short overview of the etiology, pathophysiology, diagnostic approaches, and classification systems, emphasizing the comprehensive treatment strategies. Focusing on clinical experience and practice, this article...

CONCLUSION: Fixation of parasymphyseal mandibular fractures using 3D-Interlocking or Twin-Fork miniplates yielded a slightly enhanced mental nerve conduction profile and integrity preservation when compared to the conventional miniplate configuration. Furthermore, the 3D-Interlocking plate demonstrated improved stability and healing of the fracture line. These findings support the use of 3D-Interlocking or Twin-Fork miniplates as preferable alternatives to conventional miniplates in the mental...

CONCLUSION: In the treatment of supracondylar fracture of humerus complicated with nerve injury, ultrasound provides a reference for the choice of treatment plan, reducing the probability of re-nerve injury, no radiation, good recovery of elbow joint function and other advantages, and the clinical effect is satisfactory.

CONCLUSION: TPF should be regarded as complex intra-articular injuries rather than simple bone fractures. This study provides a CT-based tool to identify fracture patterns associated with surgically relevant non-bony injuries. These findings may support indications for preoperative MRI, guide treatment strategies, and help prevent poor outcomes and post-traumatic osteoarthritis.

CONCLUSION: Preoperative navigation using volume-rendered virtual imaging could not guarantee a precise positioning of IS and TS screws. Although geometric deviations were observed between planned and placed screws, clinical outcomes were favourable, with a very low complication rate. The technique proved feasible and safe in clinical practice, achieving moderate overall accuracy, and may therefore be particularly valuable for less-experienced surgeons.

INTRODUCTION: Recovery after extremity fracture is influenced by injury-related impairments, functional capacity, symptom severity and psychosocial well-being, emphasising the need for patient-reported outcome measures (PROMs). Despite increasing adoption of Patient-Reported Outcomes Measurement Information System (PROMIS) and legacy PROMs in orthopaedic research, substantial knowledge gaps remain regarding their measurement properties, comparability and clinical utility, particularly in...

CONCLUSION: These results revealed a high prevalence of latent osteoporosis, regardless of age, sex, or injury mechanism. DXA testing should be recommended to prevent secondary fragility fractures for all DRF patients aged 50 and older, including males.

CONCLUSION: Compared with plate fixation combined with bone grafting, the technique of intramedullary augmentation with bone cement combined with plate-screw fixation yields better shoulder joint function and less loss of humeral neck-shaft angle in the treatment of osteoporotic proximal humeral fractures in elderly patients.

CONCLUSIONS: This study helped establish a 'point- baseline' method which can be readily and easily used to identify the severity of radial translation, which was a significant predictor of DRUJ instability. On the other hand, whether or not severe radial translation, treatment of DRUJ instability by the three major ways: (1) the ulnar styloid fracture fixation; (2) the dorsal ulnar corner fragment fixation; and (3) traumatic TFCC injuries repairing.

CONCLUSION: Concomitant TBI was associated with enhanced radiographic fracture healing and showed a non-significant trend toward more advanced osseous callus formation. The observed decline in serum β-catenin mRNA relative expression in the fracture groups suggests phase-dependent regulation of Wnt/β-catenin-related activity during repair. However, serum β-catenin mRNA represents an indirect systemic marker and does not establish a mechanistic, TBI-specific pathway. These findings highlight the...

CONCLUSION: Compared with traction-table positioning, lateral decubitus cephalomedullary nailing was associated with better functional outcome, shorter operative and fluoroscopy times, and lower estimated blood loss, while union and complication rates were similar between groups. These findings suggest that lateral decubitus positioning is a viable alternative for subtrochanteric fracture fixation, particularly when traction-table setup may compromise operating-room efficiency. Given the...

CONCLUSION: In Schatzker type II-III TPFs with articular depression, autologous iliac crest bone grafting demonstrated better radiological maintenance of reduction and higher final RRS compared to TCP grafting, although midterm functional scores were similar. These level III data suggest that autograft remains a reliable option for structural support in metaphyseal defects; however, prospective randomized comparative studies are needed to confirm any potential advantage over tricalcium phosphate...

CONCLUSION: Higher ADHD symptom scores were significantly associated with the occurrence of extremity fractures in children. These findings suggest that assessing ADHD-related symptoms may provide useful insights during pediatric trauma evaluations. However, due to the cross-sectional design, temporality and causality cannot be established. Longitudinal studies are needed to confirm these associations.

CONCLUSION: A callus-preserving fixation approach may offer a biological advantage in the management of high-energy distal humerus gunshot fractures by promoting earlier bone healing without compromising functional outcomes. When extra-articular callus does not interfere with anatomical reduction, preserving it in situ may be considered as part of a staged damage-control-to-definitive fixation strategy.

Effective pain management is a cornerstone in the treatment of patients with multiple rib fractures, as inadequate analgesia can impair ventilation and increase the risk of pulmonary complications. Bilateral rib fractures, in particular, can significantly compromise respira-tory mechanics, leading to hypoventilation, atelectasis, and hypoxemia. Regional analgesic techniques play a crucial role in improving respiratory function while reducing reliance on opioids and their associated adverse...

PURPOSE OF REVIEW: Osteoporosis affects more than 53 million Americans and contributes to nearly 2 million fragility fractures each year, yet most patients who sustain fractures never receive guideline-recommended pharmacotherapy. Traditional step-therapy typically begins with bisphosphonates and reserves anabolic agents for later-line use, whereas sequential therapy prioritizes anabolic treatment followed by antiresorptive consolidation. This review synthesizes the evidence comparing these...

CONCLUSIONS: In this comparison of surgical and non-surgical treatment for distal radius fractures across hospitals with varying surgical rates, comminuted intra-articular distal radius fractures (AO 23-C2/C3) treated surgically were associated with better one-year patient-reported outcomes than those treated non-surgically.