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Orthopedic Trauma Surgery: Current Challenges and Future Perspectives
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Orthopedic Trauma Surgery: Current Challenges and Future Perspectives

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 August 2025) | Viewed by 7216

Special Issue Editors

Dr. Paolo Schiavi

E-Mail Website
Guest Editor
Orthopaedic and Traumatology Clinic, Department of Medicine and Surgery, University Hospital of Parma, 43126 Parma, Italy
Interests: trauma surgery; hip surgery; polytrauma; osteosynthesys; arthroplasty
Special Issues, Collections and Topics in MDPI journals
Prof. Dr. Enrico Vaienti

E-Mail Website
Guest Editor
Orthopaedic and Traumatology Clinic, Department of Medicine and Surgery, University Hospital of Parma, 43126 Parma, Italy
Interests: trauma surgery; hip surgery; knee surgery; politrauma; osteosynthesys
Prof. Dr. Francesco Pogliacomi

E-Mail Website
Guest Editor
Orthopaedic and Traumatology Clinic, Department of Medicine and Surgery, University Hospital of Parma, 43126 Parma, Italy
Interests: trauma surgery; hand surgery; politrauma; osteosynthesys; microsurgery
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Orthopedic trauma surgery is a surgical branch which involves various surgeons with different levels of expertise, and its epidemiological weight is very consistent.

The surgical treatment results of most musculoskeletal post-traumatic lesions are satisfactory, but there are still significant acute and chronic post-traumatic problems which represent a great challenge for surgeons.

In some areas of orthopedic trauma surgery, there is no commonly accepted practice, and in other areas, there are differening opinions.

In specific acute and chronic post-traumatic pathologies of bone and muscles, different authoritative guidelines suggest entirely different treatments.

Therefore, there is a need to deepen our knowledge in this area.

A significant increase in available information about the treatments and outcomes of these lesions could reveal the future perspectives and the direction we have pursued to obtain better results.

This Special Issue aims to focus on the treatments and outcomes of particular post-traumatic lesions of the musculoskeletal system. Furthermore, we aim to include papers that perform a high-level analysis of available data in order to clarify possible future perspectives.

We welcome submissions of your best original papers, reviews, and meta analyses.

Dr. Paolo Schiavi
Prof. Dr. Enrico Vaienti
Prof. Dr. Francesco Pogliacomi
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 250 words) can be sent to the Editorial Office for assessment.

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 surgery
  • politrauma
  • osteosynthesis
  • arthroplasty
  • internal fixation
  • MIPO
  • outcome

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Published Papers (2 papers)

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Research

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13 pages, 1035 KB  
Article
Intramedullary Nailing for Humeral Shaft Fractures: Functional Outcome Assessment Within a Cohort of 202 Patients
by Alessandro Zanzi, Pietro Maniscalco, Edoardo Fantinato, Gianfilippo Caggiari, Giorgio Moretti, Michele Francesco Surace and Corrado Ciatti
J. Clin. Med. 2025, 14(21), 7782; https://doi.org/10.3390/jcm14217782 - 2 Nov 2025
Viewed by 1443
Abstract
Background: Humeral shaft fractures (HSFs) represent 13–25% of humeral fractures and are frequently complicated by radial nerve palsy and nonunion. While conservative management was historically preferred, surgical fixation with intramedullary nailing (IMN) has gained increasing popularity. The aim of this study was [...] Read more.
Background: Humeral shaft fractures (HSFs) represent 13–25% of humeral fractures and are frequently complicated by radial nerve palsy and nonunion. While conservative management was historically preferred, surgical fixation with intramedullary nailing (IMN) has gained increasing popularity. The aim of this study was to evaluate the effectiveness of IMN in the treatment of HSFs, focusing on postoperative complications and functional outcomes. Methods: A bicenter retrospective analysis was conducted on 202 patients who underwent antegrade IMN fixation for HSF between 2014 and 2019, with a minimum follow-up of four years. Demographic data, trauma characteristics, surgical details, and postoperative complications were recorded. Functional outcomes were assessed at one year using the Disabilities of the Arm, Shoulder and Hand (DASH), Oxford Shoulder Score (OSS), Constant Shoulder Score (CSS), and Visual Analogue Scale (VAS). Statistical analysis included ANOVA, Student’s t-test, Spearman’s correlation, and multivariate regression. Results: The mean follow-up was 57.7 ± 19.6 months. At one year, mean OSS, DASH, CSS, and VAS scores were 39.0, 16.6, 73.5, and 0.9, respectively. Excellent or good Constant outcomes were recorded in 89.6% of patients. Sixteen complications (7.9%) occurred, including nerve injuries (4.0%) and pseudoarthrosis (1.5%). Patients operated within 48 h had significantly better functional scores compared to those treated later (p < 0.01). No differences were found according to fracture pattern, sex, diabetes, or osteoporosis. Age showed a weak correlation with functional outcomes. Conclusions: IMN is a safe and effective option for the treatment of HSFs, with high rates of functional recovery and a low incidence of complications. Early surgical intervention appears to improve outcomes, supporting its role as a valuable strategy in HSF management. Full article
(This article belongs to the Special Issue Orthopedic Trauma Surgery: Current Challenges and Future Perspectives)
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Review

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14 pages, 561 KB  
Review
Current Evidence and Surgical Strategies in the Management of Greater Tuberosity Fracture–Dislocations: A Narrative Review
by Gabriele Colò, Federico Fusini, Luca Faoro, Giacomo Popolizio, Sergio Ferraro, Giorgio Ippolito, Massimiliano Leigheb and Michele Francesco Surace
J. Clin. Med. 2025, 14(14), 5159; https://doi.org/10.3390/jcm14145159 - 21 Jul 2025
Cited by 2 | Viewed by 4905
Abstract
Background: Greater tuberosity fracture–dislocations (GTFDs) represent a distinct subset of proximal humerus fractures, occurring in up to 57% of anterior glenohumeral dislocations. Malreduction may result in impingement, instability, and functional limitation. Treatment is influenced by the displacement magnitude and direction, bone quality, [...] Read more.
Background: Greater tuberosity fracture–dislocations (GTFDs) represent a distinct subset of proximal humerus fractures, occurring in up to 57% of anterior glenohumeral dislocations. Malreduction may result in impingement, instability, and functional limitation. Treatment is influenced by the displacement magnitude and direction, bone quality, and patient activity level. Methods: This narrative review was based on a comprehensive search of PubMed, Scopus, and Web of Science for English-language articles published between January 2000 and March 2025. Studies on pathomechanics, classification, diagnosis, treatment, and outcomes of GTFDs in adult and pediatric populations were included. Data were analyzed to summarize the current evidence and identify clinical trends. Results: A displacement ≥ 5 mm is the standard surgical threshold, though superior or posterosuperior displacement ≥ 3 mm—and ≥2 mm in overhead athletes—may justify surgery. Conservative treatment remains appropriate for minimally displaced fractures but is associated with up to 48% subacromial impingement and 11% delayed surgery. Surgical options include arthroscopic repair for small or comminuted fragments and open reduction and internal fixation (ORIF) with screws or plates for larger, split-type fractures. Locking plates and double-row suture constructs demonstrate superior biomechanical performance compared with transosseous sutures. Reverse shoulder arthroplasty (RSA) is reserved for elderly patients with poor bone stock, cuff insufficiency, or severe comminution. Pediatric cases require physeal-sparing strategies. Conclusions: GTFDs management demands an individualized approach based on fragment displacement and direction, patient age and activity level, and bone quality. While 5 mm remains the common threshold, lower cutoffs are increasingly adopted in active patients. A tiered treatment algorithm integrating displacement thresholds, fracture morphology, and patient factors is proposed to support surgical decision making. The incorporation of fracture morphologic classifications further refines fixation strategy. Further prospective and pediatric-specific studies are needed to refine treatment algorithms and validate outcomes. Full article
(This article belongs to the Special Issue Orthopedic Trauma Surgery: Current Challenges and Future Perspectives)
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