Impact of ulnar fracture level on radial head dislocation: A Monteggia fracture study.

Background: Monteggia fracture is defined as a combination of a proximal ulnar fracture with radial head dislocation. Radial head dislocation may be misdiagnosed under an elbow radiograph, leading to further complications. This study aimed to compare the ulnar fracture pattern characteristics between Monteggia fracture and an isolated proximal ulnar fracture in terms of how close the fracture site is to the coronoid and what type of fracture pattern is more likely to result in radial head dislocation.

AI assisted diagnosis using DEANet to improve correct diagnosis of iliac wing fracture and ischial spine fracture.

Background: Hip fractures-particularly those involving the iliac wing and ischial spine-are complex injuries that often require CT or MRI scans for accurate diagnosis. However, these imaging modalities are costly, time-consuming, and involve exposure to radiation or contrast-related risks. This study aims to develop an AI-based classification model, the Dynamic Efficient Attention Network, capable of automatically distinguishing between iliac wing and ischial spine fractures using pelvic X-ray images.

Simultaneous Occurrence of Anterior Cruciate Ligament Avulsion and Adjacent Anterior Meniscal Root Tear Not Uncommon in Patients With Tibial Posterior Condyle Fracture, Particularly Those With a Long Vertical Split.

Background: Tibial posterior condyle fractures (PCFs) are caused by shearing injuries. This mechanism results in anterior cruciate ligament (ACL) avulsions, which may involve adjacent anterior meniscal roots. The simultaneous occurrence of ACL avulsion and anterior meniscal root tears (AMRTs) in patients with PCF remains unclear.

A New Postoperative Stability Score to Predict Loss of Reduction in Intertrochanteric Fractures in Elderly Patients.

The study aimed to validate a newly developed postoperative stability score for evaluating clinical follow-up in elderly patients with low-energy hip fractures. From 1 January 2020 to 31 December 2021, we enrolled patients aged over 65 who underwent cephalomedullary nail fixation using proximal femoral nail antirotation II (PFNAII) and had at least 6 months of follow-up; excluding multiple fractures, pathological fractures, and periprosthetic fractures. We collected general patient data.

Comparison of primary total hip arthroplasty with limited open reduction and internal fixation vs open reduction and internal fixation for geriatric acetabular fractures: a systematic review and meta-analysis.

Purpose: Comminuted fractures with poor bone quality in the elderly are associated with poor outcomes. An alternative to open reduction and internal fixation (ORIF) alone, primary or acute total hip arthroplasty (aTHA), allows early mobilization with full weight bearing. In this study, we aim to analyze whether treatment of aTHA with/withtout ORIF (limited ORIF) vs ORIF alone yields better intra-operative results, functional outcomes, and less complications.

Quantification of the Safe Zone of the First to Third Sacral Segments for Transiliac-Transsacral Screw Fixation in Normal and Dysmorphic Sacra.

Transiliac-transsacral screw fixation is widely used to stabilize unstable posterior pelvic ring injuries. Preoperative radiographic assessment of the safe osseous corridor is necessary because the safe space of sacrum is narrower for transiliac-transsacral screw placement than for traditional iliosacral screw placement. However, the radiographic assessment has rarely been studied in the Taiwanese population.

"Fragment Width Ratio" as a Predictor of Nonunion for Femoral Shaft Fracture With Third Fragments.

Previous studies have reported that large fracture fragment with displacement might cause nonunion of femoral shaft fractures. We therefore intended to delineate significant risk factors for developing a nonunion predisposed by a major fracture fragment. We analyzed 61 patients who were operated on using interlocking nails for femoral shaft fractures from 2009 to 2018.

Using Trident distal radial locking plate to fix the fracture of distal radius volar rim.

Background: The volar locking plates have been widely used in a variety of distal radius fractures, but they still have several limitations when dealing with small fragments located around the watershed line with widely reported complications. The volar rim fragments play a critical role in radiocarpal joint stability and failing to secure the volar rim fragment usually results in carpal instability, subluxation, or even dislocation. This study investigates clinical outcomes in the use of a novel implant, the Trident distal radial (TDR) locking plate to treat distal radius fracture with the intermedium column edge (lunate fossa volar rim) fragment involvement.

Combining a transosseous cerclage wire after patellar tendon reattachment to treat patella distal pole fracture did not improve functional outcome.

This study aims to investigate whether an augmented wire in the treatment of patella distal pole fracture could improve knee range of motion (ROM) and radiographic features. Thirty-five consecutive patients with patellar distal pole fracture were analyzed from January 2014 to July 2019. The treatment is divided into two groups according to the presence or absence of augmented wire.

[Analysis of the Effects of Femoral Nerve Block on Pain Level and Knee Mobility in Patients With Total Knee Replacement].

Background: Osteoarthritis is a common cause of inactivity and reduced quality of life in the elderly. Total knee replacement (TKR) surgery, a last-stage treatment option for osteoarthritis, often results in postoperative pain that influences knee flexion and the ability to perform prescribed rehabilitation exercises.

Purpose: This study was designed to examine the effectiveness of single femoral nerve block (FNB) on pain level and knee mobility in patients with TKR.

The radiographic outcome after plating for pubic symphysis diastasis: does it matter clinically?

Introduction: Open reduction and internal fixation with plates is the most widespread surgery in traumatic pubic symphysis diastasis. However, implant failure or recurrent diastasis was commonly observed during follow-up. The aim of our study was to evaluate the radiologic findings and clinical outcomes.

Functional outcomes following fixation of a marginal distal radius fracture with two commonly used volar locking plates: a retrospective cohort study.

Introduction: The volar locking plate has been widely used for unstable distal radius fractures to provide early recovery of wrist function. Volar plate prominence to the watershed line has been reported to be related to flexor tendon irritation, and avoid implant prominence in this area was suggested. On the other hand, marginal distal radius fracture patterns required the plate to cross the watershed line, making conflict over plate positioning on marginal distal radius fractures.

Immediate application of negative pressure wound therapy following lower extremity flap reconstruction in sixteen patients.

Negative pressure wound therapy (NPWT) is usually applied in wound management and soft-tissue salvage after the development of complications. However, immediate postoperative application of NPWT over the flap coverage is seldom reported. We evaluate the effectiveness of immediate postoperative application of NPWT following fasciocutaneous or muscle flap coverage for lower leg reconstruction.

Single pulley double-strand anchor suture fixation of the coronoid process in terrible triad of the elbow injury.

Background: Terrible triad of the elbow injury is difficult to manage, and the role of the coronoid process in instability is very important. We describe a simple, modified suture technique to fix a coronoid process fragment using suture anchor fixation.

Methods: Eight patients (three female and five male) with coronoid process injuries with the fragment involving <50% of the total height (Regan-Morrey type I/II) in terrible triad of elbow injury were included.

Concomitant Acromioclavicular and Coracoclavicular Ligament Reconstruction with a Duo-Figure-8 Autogenic Graft Wrapping Technique for Treating Chronic Acromioclavicular Separation.

Backgroud: Coracoacromial ligament transfer is the traditional procedure for treating chronic acromioclavicular separation, but it is significantly inferior to ligament reconstruction according to biomechanical and clinical studies. However, ligament reconstruction carries the risk of complications of graft loosening and peri-tunnel fractures. Currently, there is no ligament reconstruction procedure optimal for preventing such complications.

Dual-construct fixation is recommended in ipsilateral femoral neck fractures with infra-isthmus shaft fracture: A STROBE compliant study.

The aim of this study was to evaluate the risk factors related to osteosynthesis failure in patients with concomitant ipsilateral femoral neck and shaft fractures, including old age; smoking habit; comminuted fragments; infra-isthmus fracture; angular malreduction; unsatisfactory reduction (fracture gap >5 mm); and treatment with single construct.Patients over the age of 20 with concomitant ipsilateral femoral neck and shaft fractures diagnosed at a level one medical center between 2003 and 2019 were included. Treatment modalities included single construct with/without an antirotational screw for the neck and dual constructs.

The elastic stable intramedullary nails as an alternative treatment for adult humeral shaft fractures.

Background: Plate and locked intramedullary nailing for humeral fractures are golden standard procedure, but the humerus is a nonweight-bearing bone and can tolerate a larger range of acceptable alignment. We believe the elastic stable intramedullary nails (ESINs) can provide enough relative stability for humeral shaft fractures in certain adult patients.

Methods: There are four new indications for using ESINs: (1) patient could not tolerate a sugar-tong splint but was a high risk for general anesthesia, (2) intramedullary canal narrowing (<7 mm), (3) long spiral or oblique fracture over the metadiaphyseal junction, and (4) obesity.

A novel low-profile external skeletal fixator for type IIIB open tibial fractures: A biomechanical and clinical pilot study.

Background: Although external fixator is standard for managing staged treatment of open tibial fracture, the main disadvantage of this device is too bulky to be tolerated by most patients for longtime use. The purposes of this pilot study were to compare the biomechanical properties of a novel low-profile external fixator (LP-ESF) with a traditional ESF and also to evaluate its performance in patients with Gustilo type IIIb tibial open fractures.

Methods: A prospective clinical pilot study started from January 2015 to December 2017, and 18 patients with Gustilo type IIIb open tibial fractures underwent the fixation with a novel LP-ESF system.

A strategy to prevent complications of hyperextension type tibial plateau fracture.

Background: Tibial plateau fractures (TPFs) are the most common among periarticular fractures. Mechanism of injuries is most from varus/valgus and flexion injury. Hyperextension type injuries are rare and easily to be overlooked.

Peri-implant Fractures Following Hook Plate Fixation for Unstable Distal Clavicle Fractures.

Clavicle hook plate is a common implant for treating distal clavicle fracture. Although high bone union rate and good functional outcome have been reported, so have several complications, such as osteolysis and fracture of the acromion, loss reduction, hook impingement, and rotator cuff tear. Peri-implant fracture over the medial side of the hook plate is a rare complication.

Safety and Efficacy of Prophylactic Closed Incision Negative Pressure Therapy after Acute Fracture Surgery.

Introduction: Soft tissue swelling after acute fracture surgery is a challenge which may increase wound dehiscence, delay early range of motion, and increase infection rate postoperatively. This study investigates closed incision negative pressure therapy (ciNPT) using wide-range cover over the incision site and the peripheral swelling trauma zone to promote early active motion and to mitigate joint stiffness, bulla formation, and tendon adhesion.

Methods: Twenty-nine patients were enrolled between January 2018 and December 2018.

A combined prone and supine approaches for complex three column tibial plateau fracture with posterolateral articular injury.

Introduction: Updated three column fixation of tibial plateau fractures (TPFs) arouse the importance of posterior column articular reduction. Complex TPFs with posterolateral (PL) articular injury is difficult to manage. We presented a strategy of combined positions and approaches to treat these injuries.