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Clinical Advances in Orthopedic Trauma Surgery
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Clinical Advances in Orthopedic Trauma Surgery

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

Deadline for manuscript submissions: closed (30 November 2024) | Viewed by 7621

Special Issue Editors

Prof. Dr. Joseph Borrelli Jr.

E-Mail Website
Guest Editor
West Coast Musculoskeletal Institute and Department of Orthopedic and Sports Medicine, Morsani College of Medicine, University of South Florida, Tampa, FL 33602, USA
Interests: osteoarthritis; fractures; cartilage injury; joint reconstruction; orthopedic trauma
Special Issues, Collections and Topics in MDPI journals
Dr. Dolfi Herscovici

E-Mail Website
Guest Editor
Center for Bone and Joint Disease, 10221 Yale Ave, Brooksville, FL 34613, USA
Interests: foot and ankle; foot fractures; total ankle arthroplasty; joint reconstruction; orthopedic trauma

Special Issue Information

Dear Colleagues,

Orthopedic trauma, which often involves bone fractures, joint dislocations and associated soft tissue injury, is a public health issue around the world, and these injuries pose a serious economic burden on individuals and society in general. This is particularly true for people with osteoporosis and previous joint replacements. Fractures can lead to work absence, decreased productivity, disability, impaired quality of life, health loss and high healthcare costs. Advancements in orthopedic trauma surgery are being made in a multitude of areas to improve the care of trauma patients and therefore decrease the burden of disease. Advances are being made in musculoskeletal imaging and the management of soft tissue injuries, including the management of open fractures. New biologics have been developed to further promote bone healing and new methods are being developed to better manage trauma-associated blood loss. Additionally, newer techniques and implants are now available to improve the care and outcomes in patients who have suffered traumatic long-bone fractures (i.e., far cortical locking techniques), treatment of periprosthetic and inter-prosthetic fractures, fractures of the proximal femur including femoral neck fractures, as well as fractures of the pelvis and acetabulum. Advances are also being made for the treatment of high-energy foot and ankle trauma, as well as fractures of the scapula and glenoid neck. In this Special Issue, we welcome authors to submit papers that address recent clinical advances in orthopedic trauma surgery.

Prof. Dr. Joseph Borrelli Jr.
Dr. Dolfi Herscovici
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

  • orthopedic trauma
  • fractures
  • soft tissue injury
  • musculoskeletal imaging
  • bone healing

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Published Papers (4 papers)

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Research

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15 pages, 2084 KiB  
Article
Hemi-Versus Total Hip Arthroplasty in Femoral Neck Fractures? Predicting Failure on a 10-Year Data Analysis of the German Arthroplasty Registry (EPRD)
by Sven Hungerer, Florian Hinterwimmer, Iris Leister, Severin Langer, Alexander Gotzler and Claudio Glowalla
J. Clin. Med. 2025, 14(5), 1457; https://doi.org/10.3390/jcm14051457 - 21 Feb 2025
Cited by 1 | Viewed by 596
Abstract
Background/Objectives: The German Arthroplasty Registry (EPRD) recorded almost 100,000 femoral neck fractures between 2013 and 2023. The aim of this study was to identify survival rates and risk factors for failure in individuals with femoral neck fractures. Methods: A dataset of 97,410 cases [...] Read more.
Background/Objectives: The German Arthroplasty Registry (EPRD) recorded almost 100,000 femoral neck fractures between 2013 and 2023. The aim of this study was to identify survival rates and risk factors for failure in individuals with femoral neck fractures. Methods: A dataset of 97,410 cases from the EPRD was analyzed. We compared hemiarthroplasty (HA) and total hip arthroplasty (THA) using machine learning algorithms (MLAs) and statistical modeling approaches. For the MLA, the dataset was partitioned into training and test sets, with iterative feature selection and hyperparameter search. Predictive models were developed using XGBoost classifiers. Based on the feature importance, we performed LASSO regression to assess the odds ratios for key predictors of implant failure. Results: The failure rate was 3.7% for HAs and 5.6% for THAs, with a peak six weeks after surgery. LASSO regression revealed six risk factors for failure: non-cemented stem fixation (OR: 1.022, 95% CI: 1.019–1.026), treatment type (THA vs. HA; OR: 1.013, 95% CI: 1.010–1.016), time to discharge (OR: 1.006, 95% CI: 1.006–1.006), male sex (OR: 1.003, 95% CI: 1.000–1.005), age (OR: 0.999, 95% CI: 0.999–0.999), and day of surgery (weekday vs. weekend/holiday; OR: 1.004, 95% CI: 1.002–1.008). Conclusions: Longer hospital stays, male sex, and surgeries performed on weekends or holidays were associated with higher failure risks, while cemented fixation and hemiarthroplasty showed protective effects. Given that the overall failure rate was only 4.5%, even a 1–2% change in odds represents a very large clinical effect. Full article
(This article belongs to the Special Issue Clinical Advances in Orthopedic Trauma Surgery)
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12 pages, 3799 KiB  
Article
The Outcomes of Mini-Plate Fixation for Unstable Wagstaffe Tubercle Fracture, an Indirect Syndesmosis Injury in Rotational Ankle Fracture
by Byung-Ryul Lee, Ki-Jin Jung, Eui-Dong Yeo, Sung-Hun Won, Yong-Cheol Hong, Chang-Hwa Hong, Chang-Hyun Kim, Ho-Sung Kim, Jae-Young Ji, Je-Yeon Byeon, Dhong-Won Lee and Woo-Jong Kim
J. Clin. Med. 2024, 13(6), 1605; https://doi.org/10.3390/jcm13061605 - 11 Mar 2024
Cited by 1 | Viewed by 1705
Abstract
Background: Wagstaffe fracture constitutes an indirect injury to the AITFL and can precipitate syndesmotic instability. The prevailing fixation methods often involve the use of mini-screws or K-wires, with absorbable suture repair reserved for cases with small or comminuted fragments exhibiting instability. In this [...] Read more.
Background: Wagstaffe fracture constitutes an indirect injury to the AITFL and can precipitate syndesmotic instability. The prevailing fixation methods often involve the use of mini-screws or K-wires, with absorbable suture repair reserved for cases with small or comminuted fragments exhibiting instability. In this study, we devised a mini-plate fixation method capable of securing the fracture fragment irrespective of its size or condition. Methods: A retrospective chart review was conducted on patients who underwent surgery for ankle fractures between May 2022 and October 2023. The surgical technique involved direct fixation of the Wagstaffe fracture using mini-plate fixation. Radiologic evaluation was performed using postoperative CT images, and clinical outcomes were assessed using the OMAS and VAS. Results: Fourteen patients with an average age of 62.5 years were included. Most fractures were associated with the supination-external rotation type. The average preoperative OMAS significantly improved from 5.95 to 83.57 postoperatively. The average VAS score decreased from 7.95 preoperatively to 0.19 postoperatively. Conclusions: The mini-plate technique for Wagstaffe fractures exhibited dependable fixation strength, effective fracture reduction, a minimal complication rate, and judicious surgical procedure duration. Full article
(This article belongs to the Special Issue Clinical Advances in Orthopedic Trauma Surgery)
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Review

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13 pages, 287 KiB  
Review
Control of Haemorrhage in Orthopaedic Trauma
by Robert M. Kenyon and Jennifer L. Leighton
J. Clin. Med. 2024, 13(14), 4260; https://doi.org/10.3390/jcm13144260 - 22 Jul 2024
Viewed by 2342
Abstract
This paper aims to outline current practices and examine promising new advancements in the modern management of haemorrhage in orthopaedic trauma. Many prehospital and perioperative haemorrhage control strategies and techniques have been available to clinicians for multiple decades, yet our understanding and utilisation [...] Read more.
This paper aims to outline current practices and examine promising new advancements in the modern management of haemorrhage in orthopaedic trauma. Many prehospital and perioperative haemorrhage control strategies and techniques have been available to clinicians for multiple decades, yet our understanding and utilisation of these practices continues to be refined and optimised. There is a particular focus in this article on issues related to resuscitation and coagulation in trauma. We examine the complex mechanisms that lead to coagulopathy in trauma patients as well as the transformative effect tranexamic acid has had in limiting blood loss. We also explore some emerging technologies such as endovascular interventions and clot-stabilising dressings and devices that are likely to have a significant impact going forward. Full article
(This article belongs to the Special Issue Clinical Advances in Orthopedic Trauma Surgery)
12 pages, 6352 KiB  
Review
Advances in Dynamization of Plate Fixation to Promote Natural Bone Healing
by Michael Bottlang, Sunil S. Shetty, Connor Blankenau, Jennifer Wilk, Stanley Tsai, Daniel C. Fitzpatrick, Lawrence J. Marsh and Steven M. Madey
J. Clin. Med. 2024, 13(10), 2905; https://doi.org/10.3390/jcm13102905 - 14 May 2024
Cited by 5 | Viewed by 2216
Abstract
The controlled dynamization of fractures can promote natural fracture healing by callus formation, while overly rigid fixation can suppress healing. The advent of locked plating technology enabled new strategies for the controlled dynamization of fractures, such as far cortical locking (FCL) screws or [...] Read more.
The controlled dynamization of fractures can promote natural fracture healing by callus formation, while overly rigid fixation can suppress healing. The advent of locked plating technology enabled new strategies for the controlled dynamization of fractures, such as far cortical locking (FCL) screws or active plates with elastically suspended screw holes. However, these strategies did not allow for the use of non-locking screws, which are typically used to reduce bone fragments to the plate. This study documents the first in vivo study on the healing of ovine tibia osteotomies stabilized with an advanced active plate (AAP). This AAP allowed plate application using any combination of locking and non-locking screws to support a wide range of plate application techniques. At week 9 post-surgery, tibiae were harvested and tested in torsion to failure to assess the healing strength. The five tibiae stabilized with an AAP regained 54% of their native strength and failed by spiral fracture through a screw hole, which did not involve the healed osteotomy. In comparison, tibiae stabilized with a standard locking plate recovered 17% of their strength and sustained failure through the osteotomy. These results further support the stimulatory effect of controlled motion on fracture healing. As such, the controlled dynamization of locked plating constructs may hold the potential to reduce healing complications and may shorten the time to return to function. Integrating controlled dynamization into fracture plates that support a standard fixation technique may facilitate the clinical adoption of dynamic plating. Full article
(This article belongs to the Special Issue Clinical Advances in Orthopedic Trauma Surgery)
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