Recent Advances in Trauma and Orthopaedic Surgery

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Orthopedics".

Deadline for manuscript submissions: 28 November 2024 | Viewed by 4788

Special Issue Editors


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Guest Editor
1. 404 Army General Hospital, Larisa, Greece
2. 1st Department of Pharmacology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
Interests: orthopaedic infections; lower limb orthopaedic surgery

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Guest Editor
1st Orthopaedic Department, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
Interests: upper limb orthopaedic surgery
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Special Issue Information

Dear Colleagues,

It is our pleasure to announce a Special Issue titled ‘Recent Advances in Trauma and Orthopaedic Surgery’. In this Special Issue, we welcome publications pertaining to all aspects of clinical orthopaedic surgery. Given the rapid evolution of techniques and clinical knowledge, we will prioritise novel findings that are likely to change orthopaedic clinical practice. In particular, submissions related to trauma, upper/lower extremity and tendon surgery, and infection orthopaedic research are welcome. Please note all study designs will be considered, except from case reports. Your contribution will be highly appreciated as we believe that this Special issue will lead to papers with clinically meaningful conclusions.

Dr. Konstantinos Tsikopoulos
Prof. Dr. Panagiotis Givissis
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • trauma
  • orthopaedic surgery
  • clinical research
  • orthopaedics
  • infection orthopaedic

Published Papers (6 papers)

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Research

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14 pages, 1454 KiB  
Article
Pediatric Diaphyseal Forearm Fracture Management with Biodegradable Poly-L-Lactide-Co-Glycolide (PLGA) Intramedullary Implants: A Longitudinal Study
by Aba Lőrincz, Ágnes Mária Lengyel, András Kedves, Hermann Nudelman and Gergő Józsa
J. Clin. Med. 2024, 13(14), 4036; https://doi.org/10.3390/jcm13144036 - 10 Jul 2024
Viewed by 358
Abstract
Background: Pediatric forearm fractures represent a substantial proportion of childhood injuries, requiring effective and minimally invasive treatments. Our study investigated the mid-term outcomes of biodegradable poly-L-lactide-co-glycolide (PLGA) intramedullary implants in managing diaphyseal forearm fractures in children. Methods: A follow-up cohort study was conducted [...] Read more.
Background: Pediatric forearm fractures represent a substantial proportion of childhood injuries, requiring effective and minimally invasive treatments. Our study investigated the mid-term outcomes of biodegradable poly-L-lactide-co-glycolide (PLGA) intramedullary implants in managing diaphyseal forearm fractures in children. Methods: A follow-up cohort study was conducted with 38 patients treated with PLGA implants. Control examinations were performed one year post-operation, assessing bone healing through radiographic evaluations and functional outcomes using injured and uninjured limb range of motion (ROM) comparisons. Scarring was evaluated employing the Vancouver Scar Scale (VSS), and satisfaction via a questionnaire. Results: Children were predominantly female (76.4%), with a mean age of 9.71 (SD: 2.69) years. Effective fracture stabilization and bone healing were found in all patients, with a minor reduction (mean difference of −1.5°, p = 0.282) in elbow flexion on the operated side (139.3°) compared to the intact (140.8°). Elbow extension presented negligible average changes (0.2°, p = 0.098). Forearm movements were slightly reduced on the operated side (mean pronation: 80.8° vs. 83.7°, p = 0.166; average supination: 83.5° vs. 85.7°, p = 0.141). Wrist palmar flexion and dorsiflexion showed no significant differences. VSS ratings indicated minimal scarring (mean guardian and doctor scores were 1.13 and 0.55, respectively, p = 0.020), and all patients reported satisfaction with the treatment outcomes. Conclusions: Biodegradable implants are effective for pediatric forearm fractures, providing stable bone healing while preserving functional ROM with minimal scarring and high patient satisfaction. PLGA proved to be a viable alternative to traditional metal implants, eliminating secondary removal surgeries. Full article
(This article belongs to the Special Issue Recent Advances in Trauma and Orthopaedic Surgery)
0 pages, 1985 KiB  
Article
Epidemiological Analysis of Traumatic Compartment Syndromes in Germany
by Philipp Herrmann, Annette Eidmann, Felix Hochberger, Tizian Heinz, Dominik Rak, Manuel Weißenberger, Maximilian Rudert and Ioannis Stratos
J. Clin. Med. 2024, 13(6), 1678; https://doi.org/10.3390/jcm13061678 - 14 Mar 2024
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Abstract
Background: Traumatic compartment syndrome is a critical condition that can lead to severe, lifelong disability. Methods: This retrospective study analyzed hospital billing data from 2015 to 2022, provided by the Federal Statistical Office of Germany, to examine the demographics and trends [...] Read more.
Background: Traumatic compartment syndrome is a critical condition that can lead to severe, lifelong disability. Methods: This retrospective study analyzed hospital billing data from 2015 to 2022, provided by the Federal Statistical Office of Germany, to examine the demographics and trends of traumatic compartment syndrome in Germany. The analysis included cases coded with ICD-10 codes T79.60 to T79.69 and any therapeutic OPS code starting with 5–79, focusing on diagnosis year, gender, ICD-10 code, and patient age. Results: The results showed that out of 13,305 cases, the majority were in the lower leg (44.4%), with males having a significantly higher incidence than females (2.3:1 ratio). A bimodal age distribution was observed, with peaks at 22–23 and 55 years. A notable annual decline of 43.87 cases in compartment syndrome was observed, with significant decreases across different genders and age groups, particularly in males under 40 (23.68 cases per year) and in the “foot” and “lower leg” categories (16.67 and 32.87 cases per year, respectively). Conclusions: The study highlights a declining trend in traumatic CS cases in Germany, with distinct demographic patterns. Through these findings, hospitals can adjust their therapeutic regimens, and it could increase awareness among healthcare professionals about this disease. Full article
(This article belongs to the Special Issue Recent Advances in Trauma and Orthopaedic Surgery)
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9 pages, 248 KiB  
Article
Demographics and Comorbidities of United States Service Members with Combat-Related Lower Extremity Limb Salvage
by Stephen M. Goldman, Susan L. Eskridge, Sarah R. Franco and Christopher L. Dearth
J. Clin. Med. 2023, 12(21), 6879; https://doi.org/10.3390/jcm12216879 - 31 Oct 2023
Viewed by 731
Abstract
Introduction: This retrospective study describes the demographics and injury characteristics of a recently identified cohort of US Service members with combat-related lower extremity limb salvage (LS). Methods: US Service members with combat trauma were identified from the Expeditionary Medical Encounter Database and Military [...] Read more.
Introduction: This retrospective study describes the demographics and injury characteristics of a recently identified cohort of US Service members with combat-related lower extremity limb salvage (LS). Methods: US Service members with combat trauma were identified from the Expeditionary Medical Encounter Database and Military Health System Data Repository and stratified into primary amputation (PA), LS, and non-threatened limb trauma (NTLT) cohorts based on ICD-9 codes. Disparities in demographic factors and injury characteristics were investigated across cohorts and within the LS cohort based on limb retention outcome. Results: Cohort demographics varied by age but not by sex, branch, or rank. The mechanism of injury and injury characteristics were found to be different between the cohorts, with the LS cohort exhibiting more blast injuries and greater injury burden than their peers with NTLT. A sub-analysis of the LS population revealed more blast injuries and fewer gunshot wounds in those that underwent secondary amputation. Neither demographic factors nor total injury burden varied with limb retention outcome, despite slight disparities in AIS distribution within the LS cohort. Conclusions: In accordance with historic dogma, the LS population presents high injury severity. Demographics and injury characteristics are largely invariant with respect to limb retention outcomes, despite secondary amputation being moderately more prevalent in LS patients with blast-induced injuries. Further study of this population is necessary to better understand the factors that impact the outcomes of LS in the Military Health System. Full article
(This article belongs to the Special Issue Recent Advances in Trauma and Orthopaedic Surgery)

Review

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16 pages, 13021 KiB  
Review
A Novel Surgical Treatment Management Algorithm for Elbow Posterolateral Rotatory Instability (PLRI) Based on the Common Extensor Origin Integrity
by Christos Koukos, Michail Kotsapas, Konstantinos Sidiropoulos, Aurélien Traverso, Kerem Bilsel, Fredy Montoya and Paolo Arrigoni
J. Clin. Med. 2024, 13(8), 2411; https://doi.org/10.3390/jcm13082411 - 20 Apr 2024
Viewed by 855
Abstract
Background: Here, we introduce a comprehensive treatment algorithm for posterolateral rotatory instability (PLRI) of the elbow, a condition affecting elbow mobility. We outline a diagnostic approach and a novel surgical management plan through the arthroscopic surgeon’s point of view. Methods: The [...] Read more.
Background: Here, we introduce a comprehensive treatment algorithm for posterolateral rotatory instability (PLRI) of the elbow, a condition affecting elbow mobility. We outline a diagnostic approach and a novel surgical management plan through the arthroscopic surgeon’s point of view. Methods: The central focus of this management approach is the integrity of common extensor origin (CEO). High clinical suspicion must be evident to diagnose PLRI. Special clinical and imaging tests can confirm PLRI but sometimes the final confirmation is established during the arthroscopic treatment. The most appropriate treatment is determined by the degree of CEO integrity. Results: The treatment strategy varies with the CEO’s condition: intact or minor tears require arthroscopic lateral collateral ligament imbrication, while extensive tears may need plication reinforced with imbrication or, in cases of retraction, a triceps tendon autograft reconstruction of the lateral ulnar collateral ligament alongside CEO repair. These approaches aim to manage residual instability and are complemented using a tailored rehabilitation protocol to optimize functional outcomes. Conclusion: PLRI is a unique clinical condition and should be treated likewise. This algorithm offers valuable insights for diagnosing and treating PLRI, enhancing therapeutic decision-making. Full article
(This article belongs to the Special Issue Recent Advances in Trauma and Orthopaedic Surgery)
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Other

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12 pages, 3906 KiB  
Brief Report
Case Studies of a Simulation Workflow to Improve Bone Healing Assessment in Impending Non-Unions
by Tanja C. Maisenbacher, Saskia Libicher, Felix Erne, Maximilian M. Menger, Marie K. Reumann, Yannick Schindler, Frank Niemeyer, Lucas Engelhardt, Tina Histing and Benedikt J. Braun
J. Clin. Med. 2024, 13(13), 3922; https://doi.org/10.3390/jcm13133922 - 4 Jul 2024
Viewed by 395
Abstract
Background: The healing potential of a fracture is determined by mechanical and biological factors. Simulation-based workflows can help assess these factors to assist in predicting non-unions. The aim of this study was the introduction of two use cases for a novel patient-specific simulation [...] Read more.
Background: The healing potential of a fracture is determined by mechanical and biological factors. Simulation-based workflows can help assess these factors to assist in predicting non-unions. The aim of this study was the introduction of two use cases for a novel patient-specific simulation workflow based on clinically available information. Methods: The used software is an extension of the “Ulm Bone Healing model” and was applied in two cases with non-union development after fracture fixation to show its principal feasibility. The clinical and radiographic information, starting from initial treatment, were used to feed the simulation process. Results: The simulation predicted non-union development and axial deviation in a mechanically driven non-union. In the case of a biological non-union, a slow, incomplete healing course was correctly identified. However, the time offset in callus bridging was discordant between the simulation and the distinctly slower healing response in the clinical case. Conclusions: The simulation workflow presented in the two clinical use cases allowed for the identification of fractures at risk for impending non-union immediately after the initial fixation based on available clinical and radiographic information. Further validation in a large non-union cohort is needed to increase the model’s precision, especially in biologically challenging cases, and show its validity as a screening instrument. Full article
(This article belongs to the Special Issue Recent Advances in Trauma and Orthopaedic Surgery)
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14 pages, 944 KiB  
Systematic Review
Percutaneous Fixation for Traumatic Symphysis Pubis Disruption—Are the Results Superior Compared to Open Techniques? A Systematic Review and Meta-Analysis of Clinical and Biomechanical Outcomes
by Dimitrios Kitridis, Konstantinos Tsikopoulos, Panagiotis Givissis and Byron Chalidis
J. Clin. Med. 2023, 12(15), 4988; https://doi.org/10.3390/jcm12154988 - 28 Jul 2023
Cited by 1 | Viewed by 1119
Abstract
Introduction: Open reduction and reconstruction plate and screws fixation (RPSF) is considered the gold standard for the treatment of traumatic symphysis pubis diastasis (SPD). Percutaneous cannulated screw fixation (PCSF) has recently gained popularity as it may reduce operative time and morbidity. The current [...] Read more.
Introduction: Open reduction and reconstruction plate and screws fixation (RPSF) is considered the gold standard for the treatment of traumatic symphysis pubis diastasis (SPD). Percutaneous cannulated screw fixation (PCSF) has recently gained popularity as it may reduce operative time and morbidity. The current systematic review aims to compare the clinical and radiological outcomes of PCSF and RPSF in traumatic SPD and analyze the biomechanical effectiveness of PCSF. Material and Methods: The Medline, Scopus, and Cochrane databases were searched until February 2023. The primary outcomes were the incidence of implant failure and revision surgery and the amount of displacement of symphysis pubis. Secondary outcomes were the intraoperative blood loss, the scar length, the operative time, the wound infection, and the patients’ functional improvement. Results: Six clinical trial studies with a total of 184 patients and nine biomechanical studies were included. There was no significant difference between the two groups regarding the incidence of implant failure, the prevalence of revision surgery, and the amount of postoperative loss of reduction (p > 0.05 for all outcomes). The intraoperative blood loss (14.9 ± 4.2 mL for PCSF versus 162.7 ± 47.6 mL for PCSF, p < 0.001) and the incision length (1.7 ± 0.9 mL for PCSF versus 8 ± 1.4 mL for PCSF, p < 0.001) were significantly lower after PCSF. The mean operative time was 37 ± 19.1 min for PCSF and 68.9 ± 13.6 min for RPSF (p < 0.001). The infection rate was less frequent in the PCSF group (3% for PCSF versus 14.3% for RPSF, p = 0.01). One clinical trial reported better functional recovery after PCSF. In all biomechanical studies, the threshold for implant failure was beyond the applied forces corresponding to daily activities. Conclusions: PCSF for traumatic SPD is associated with less operative time, less blood loss, and a lower infection rate when compared to conventional plate techniques without increasing the incidence of postoperative fixation failure and revision surgery. Moreover, PCSF has been proven to be biomechanically sufficient for stabilization. Therefore, it should be considered an efficient and viable alternative for the reconstruction of SPD when closed reduction can be adequately achieved. Full article
(This article belongs to the Special Issue Recent Advances in Trauma and Orthopaedic Surgery)
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