Trauma -Pubmed Results

The successful treatment of forearm non-unions, which occur as a complication in 2-10% of all forearm fractures, poses a significant challenge in reconstructive surgery. Current treatment often involves revision fixation with non-vascularized bone grafts for atrophic non-unions. Large bony defects in both forearm bones, however, necessitate advanced reconstructive techniques. In isolated reconstructions of the radius or ulna, the vascularized medial femoral condyle (MFC) flap has gained...

A 5-year-old female spayed ferret was presented with lameness of the left hind limb and dyspnea. Five months earlier, the animal had been diagnosed with dilated cardiomyopathy and an undifferentiated precardiac mass. Clinical, radiological, and laboratory examinations revealed a left femoral neck fracture, mild anemia, and hyperglobulinemia. Due to the poor general condition and unfavorable prognosis, the animal was euthanized. Pathological examination identified the precardiac mass as multiple...

CONCLUSION: Single-staged reconstruction of all indicated fractures in forequarter lateral implosion injuries is recommended.

CONCLUSION: AORIF provided rapid pain relief and increased mechanical resistance, allowing a successful secondary arthroplasty with standard implants, demonstrating its value as a minimally invasive option in periacetabular metastatic bone disease.

CONCLUSION: This case highlights operative considerations when using intravertebral stents in a young adult trauma patient, using cancellous allograft with posterior fixation for immediate stability.

CONCLUSIONS: Hip fractures among older adults in mainland China continued to rise in both number and incidence rate from 1990 to 2023, with women experiencing a consistently higher burden than men. The decrease in age-standardized YLDs suggests some improvement in post-fracture management, although the growing incidence highlights the need for strengthened prevention strategies, particularly fall prevention and osteoporosis management in older adults.

Distal radius fractures are common injuries that every orthopedic surgeon must be able to treat effectively. Achieving good outcomes without surgery is complex: it requires proper maneuvers in the emergency department, follow-up visits with cast adjustments or replacements, and follow-up radiographs, often resulting in discomfort for the patient. Additionally, some specialists, especially younger ones, are drawn to the perceived ease and convenience of surgical procedures, which contributes to...

CONCLUSIONS: Artificial intelligence demonstrated notable accuracy in the detection of tibial plateau fractures, outperforming both residents and attending physicians in this specific task. However, in the classification of fractures using the Schatzker system, attending physicians achieved higher accuracy. These findings suggest that AI may serve as a valuable support tool in the diagnostic process, particularly in its early stages, complementing - but not replacing - the clinical judgment and...

CONCLUSION: Bipolar hip arthroplasty with uncemented femoral stems appears to be a safe and effective option for treating extracapsular hip fractures in patients over 85 years old, allowing early rehabilitation and reducing complications associated with cementation and osteosynthesis.

Distal radius fractures are common injuries that every orthopaedic surgeon must be able to treat effectively. Achieving good outcomes without surgery is complex: it requires proper manoeuvres in the emergency department, follow-up visits with cast adjustments or replacements, and follow-up radiographs, often resulting in discomfort for the patient. Additionally, some specialists, especially younger ones, are drawn to the perceived ease and convenience of surgical procedures, which contributes to...

CONCLUSIONS: Lower nonaffected side muscle thickness is independently associated with functional status at discharge.

Osteoporosis (OP) and its related fragility fractures represent a significant global health burden, primarily characterized by reduced bone mass, deteriorated microarchitecture, and compromised self-repair capacity. While current mainstream therapies focusing on anti-resorption and anabolic pathways can slow bone loss, they often fall short in reversing established skeletal deficits and, particularly, in facilitating fracture healing. Growing evidence underscores that angiogenesis is...

We evaluated the clinical outcomes and limitations of anterior and posterior combined surgery with a mini-open corpectomy applying an expandable cage (Xcore®) and percutaneous pedicle screw (PPS) fixation using single-position surgery in the lateral decubitus position in patients aged > 75 years with thoracolumbar vertebral collapse. The cases of 30 consecutive patients who underwent this procedure and had ≥ 1-year follow-up were retrospectively analyzed. The mean operative time was 78.8 min and...

We investigated the associations between intake of sugar-sweetened, artificially sweetened, and naturally sweetened beverages (SSBs, ASBs, and NSBs) and osteoporosis and first incident fracture risks. We analyzed data from 171,694 to 168,366 United Kingdom Biobank participants (mean age: 55.8 ± 7.96 years; 53.9% and 52.9% women, respectively) for osteoporosis and fracture outcomes. Median follow-up durations were 13.5 and 13.4 years, respectively. Cox proportional hazards models were used to...

CONCLUSION: Bipolar hip arthroplasty with uncemented femoral stems appears to be a safe and effective option for treating extracapsular hip fractures in patients over 85 years old, allowing early rehabilitation and reducing complications associated with cementation and osteosynthesis.

CONCLUSIONS: Artificial intelligence demonstrated notable accuracy in the detection of tibial plateau fractures, outperforming both residents and attending physicians in this specific task. However, in the classification of fractures using the Schatzker system, attending physicians achieved higher accuracy. These findings suggest that AI may serve as a valuable support tool in the diagnostic process, particularly in its early stages, complementing-but not replacing-the clinical judgment and...

Although the performance of minimally invasive plate osteosynthesis (MIPO) via the anteroinferior approach is increasingly adopted for midshaft clavicle fractures, the influence of fracture morphology on clinical outcomes under a standardized protocol is unclear. We retrospectively analyzed the cases of 54 patients who underwent anteroinferior MIPO for an acute midshaft clavicle fracture (AO/OTA types B1, B2, B3) performed by a single surgeon across three affiliated institutions (2009-2022). We...

CONCLUSION: This MR study provides evidence that antidepressant use may directly influence bone metabolism and increase fracture susceptibility, particularly at the wrist. These findings highlight the importance of bone health monitoring in patients receiving antidepressant therapy, especially those at elevated fracture risk. Further mechanistic studies and longitudinal validation are warranted.

CONCLUSIONS: General practitioners should know the timing of antibiotic administration and debridement, should manage pain with medications and immobilization of the fracture, and prescribe tetanus prophylaxis as needed. The specialist should ensure surgical cleaning and wound closure, considering the use of local antibiotics such as VAC to improve the patient's prognosis. Up-to-date and protocol-based management of this condition is important for preventing morbidity and mortality.

CONCLUSION: FGF21 elevates the risk of OP and fractures that have occurred over the past five years, and a causal relationship exists. It serves as a potential risk factor for impaired bone health in T2DM.

CONCLUSION: Combined testing of FDP, TM, and MA holds clinical significance for clinicians to early predict the risk of VTE in post-traumatic fracture patients and implement preventive measures.

CONCLUSIONS: Our findings indicate that prior osteoporotic fractures and trabecular vBMD are significant predictors of cardiovascular event risk, independent of traditional risk factors.

CONCLUSION: While assuring consistency of clinical experience within orthopaedic resident training is an exceptionally difficult task, it seems that residents in this program received similar exposure to varying fracture trauma pathologies. However, there may exist regional differences or other variables that contribute to differences in fracture location and/or volume from one institution to another. It remains essential for residents to take an active role in ensuring that they gain sufficient...

CONCLUSION: Persistent opioid use is common after both THA and hemiarthroplasty for hip fracture. Patients with higher health care needs before fracture and higher comorbidity burden were more likely to persistently use postoperative opioids.

Although there have been improvements in surgical fixation techniques, the process of fracture healing continues to pose challenges, especially for patients with additional health issues. Low-intensity pulsed ultrasound (LIPUS) has been proposed as a non-invasive method to facilitate faster bone recovery; however, its effectiveness in clinical settings remains unclear. This study aimed to assess the impact of LIPUS on the healing of lower limb fractures. A double-blinded, prospective, randomised...

We have not identified any research in the literature that explores the severity of knee osteoarthritis in relation to the type of hip fracture. In our study, we examined the severity of knee osteoarthritis in patients with hip fractures affecting the intertrochanteric (Group 1) and femoral neck region (Group 2). In our study, patients over 50 years of age were analyzed and Kellgren-Lawrence classification was applied to bilateral knee radiographs. The correlation between the severity of knee...

Postoperative delirium (POD) is a common and serious complication in elderly hip fracture patients, including those undergoing surgery for femoral neck fractures and intertrochanteric fractures, and is associated with poor clinical outcomes. Early identification of at-risk individuals remains challenging with conventional methods. To develop and validate machine learning models for predicting POD using preoperative variables, and to identify key risk factors, we conducted a retrospective study...

While the relationship between radial head fractures (RHF) and coronoid process fractures (CPF) is biomechanically established, the exact frequency of CPF in RHF patients without focus on elbow dislocations is underexplored. To better estimate the likelihood of CPF, the analysis of typical fracture constellations is useful. The aim of this study was therefore to analyze the correlation between RHF severity and the presence and type of CPF. This retrospective study analyzed 356 RHF patients,...

This study aimed to evaluate the feasibility of proximal femoral nailing (PFN) in the lateral decubitus position using a standardized, limb-based approach without a traction table and to report early postoperative (24-72 hours) radiographic and technical outcomes, focusing on lag screw position and tip- apex distance (TAD). This single-center retrospective study included 52 adult patients (>18 years) who underwent PFN in the lateral decubitus position according to a standardized algorithm...

CONCLUSION: The use of an antibiotic-impregnated cement nail as part of a staged protocol is a highly effective and reliable strategy for managing septic shaft non-union. This technique successfully addresses the dual challenges of infection and instability, leading to high rates of limb salvage and bone union. Patient-specific factors, particularly age and smoking, remain important predictors of the final outcome.

Calcaneal fractures present challenges due to the complex anatomy and difficulty in achieving precise screw placement. Traditional methods often rely on empirical screw insertion, leading to complications like joint penetration or nerve damage. We selected 66 adult calcaneus specimens and conducted analyses using micro-CT scanning and anatomical measurement techniques, dividing the calcaneus into the anterior, middle, posterior, and ST regions. The calcaneus was divided into anterior, middle,...

Gustilo-Anderson type III fractures, characterized by extensive soft-tissue damage, require urgent debridement and external fixation to minimize infection risk. Despite these measures, deep infections and osteomyelitis may still develop, sometimes leading to amputation. The Masquelet and Ilizarov techniques have emerged as effective approaches for reconstructing infected bone defects by promoting bone regeneration and soft-tissue healing. A 57-year-old male sustained a Gustilo-Anderson type IIIB...

CONCLUSION: A combination of PKP and PVB can significantly improve the pain relief rate and the quality of life in the early postoperative period of patients with thoracic vertebral fractures and costal pain.

CONCLUSION: This meta-analysis provides reassuring evidence that adjunctive SGLT2 inhibitor use is not associated with increased fracture risk in insulin-treated patients with T1DM patients. Nonetheless, the substantially elevated risks of diabetic ketoacidosis and genital tract infections necessitate vigilant clinical monitoring and risk mitigation strategies to ensure safe use of these agents.

CONCLUSIONS: TUBC fracture-dislocations represent a high-risk subgroup of trans-ulnar elbow injuries. Stable fixation of the coronoid base appears critical for achieving favorable outcomes. The Mayo classification provides clinically relevant stratification and prognostic insight for these complex injuries.

A school-aged child presented to the department with a history of a fall while playing. Facial swelling with restricted mouth opening was evident, suspecting a bilateral mandibular body fracture. CT showed bilateral fracture of the body of the mandible. The case report illustrates the management of bilateral mandibular body fractures through a non-invasive approach.

This study evaluated the effectiveness of a combination technique for managing severe composite tibial and soft-tissue defects, without requiring complex soft-tissue procedures. A retrospective analysis was conducted on 33 patients with tibial and soft-tissue defects and Gustilo type IIIB open fractures treated between April 2017 and December 2023. The management protocol for all patients consisted of two stages. The first stage involved thorough debridement in the emergency department, removal...

CONCLUSION: Romosozumab demonstrated efficacy and safety similar to teriparatide. However, this overview revealed substantial overlap among primary studies, with most outcomes assessed through indirect comparisons and poor methodological quality. Future research should confirm these findings.

CONCLUSION: Functional outcomes were largely comparable between Tight-Rope and screw fixation techniques. These findings align with emerging evidence questioning the routine necessity of coronoid fixation and underscore the importance of individualized surgical decision-making.

CONCLUSION: These cases emphasize the importance of a thorough genital examination in female trauma patients, the necessity of a multidisciplinary approach, and the potential for timely surgical intervention to be life-saving. This report contributes to the limited body of literature on pelvic and genitourinary injuries in women caused by motorcycle accidents and highlights the need for further clinical research and documentation.

CONCLUSION: TTCP demonstrated promising biomechanical and biophysiological properties for vertebral augmentation. However, its use in infected sites and in the presence of metabolic bone disorders may be limited. Further clinical studies are required to validate its long-term efficacy.

CONCLUSION: Short-arm circular casting and volar splinting provide equivalent clinical and functional outcomes in the management of stable distal radius fractures. Given its ease of application and greater patient comfort, volar splinting can be considered a practical alternative in emergency department settings, particularly for selected patient populations.

CONCLUSION: Deficiencies in vitamin D and calcium were associated with an increased risk of hip fractures but did not appear to influence fracture pattern. These findings suggest that systemic biochemical parameters should be emphasized in comprehensive fracture risk assessment, underscoring the importance of preoperative evaluation and postoperative correction of metabolic deficiencies in patients with hip fractures.

CONCLUSION: Posterior buttress plate fixation was associated with a significantly lower risk of long-term post-traumatic ankle osteoarthritis and superior functional outcomes compared with screw fixation. These findings were especially evident in complex posterior malleolar fracture patterns, highlighting the importance of fracture morphology and fixation strategy in long-term joint preservation.

CONCLUSION: Given the vast size and sparse population of WA, rural and remote patients with open fractures face delays to crucial interventions when compared to similar patients presenting to a metropolitan trauma hospital. Enhancing early antibiotic administration protocols and education within the aeromedical retrieval service and rural/remote sites could improve the timeliness and consistency of care for patients requiring long-distance retrieval to tertiary care.

The incidence of posttraumatic knee osteoarthritis occurs in nearly one-third of patients sustaining intra-articular fracture and/or ligamentous knee injury. As a result, complex total knee arthroplasty may become the best treatment option for these patients. Several challenges must be considered when planning and executing the surgery, including exposure with prior incisions, implant retention or removal, angular deformity, bone defects, stability, and the use of enabling technologies. Although...

CONCLUSIONS: Despite satisfactory clinical scores and radiographic healing, substantial and persistent quadriceps weakness appears to be common after surgically treated patella fractures. Objective strength deficits are strongly associated with pain and functional outcomes and may not be fully captured by conventional clinical assessments. Long-term management should therefore incorporate objective muscle strength evaluation and targeted rehabilitation strategies to address persistent extensor...

» Pregnancy alters calcium balance, hormone regulation, and mechanical loading, which together lowers bone mineral density and increases risk of fractures. » Trauma during pregnancy carries significant maternal and fetal risk as low-mechanism injuries can trigger placental abruption, preterm labor, and fetal loss. » Imaging, anesthesia, and surgery require coordinated teams to provide care safely and optimize maternal and fetal outcomes. » Providers must verify pregnancy safety stratifications...

» Distal clavicle fractures are less common, accounting for 10% to 30% of all clavicle fractures. » The presence of radiographic nonunion does not correlate with symptomatic nonunion, with a variable percentage of patients necessitating subsequent surgical intervention (20%). » Fracture displacement is associated with a higher risk of nonunion (31%-37%), particularly in Neer type II and V fracture patterns. » Nondisplaced distal clavicle fractures can be treated with nonoperative management...

CONCLUSION: For people with ID aged ≥40 years, a proactive approach to risk assessment for MOF is not only clinically beneficial, but also cost-effective.