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Clinical Advances in Trauma and Orthopaedic Surgery
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Clinical 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: 20 December 2025 | Viewed by 2936

Special Issue Editors

Dr. Valerio Pace

E-Mail Website
Guest Editor
"Trauma & Orthopaedics" Department, "Media Valle del Tevere - Pantalla" Hospital, USL Umbria 1, 06059 Perugia, Italy
Interests: trauma and orthopaedics surgery; hand and wrist surgery; hip-knee replacement; peripheral nerve disorders; chronic back pain management
Dr. Pierluigi Antinolfi

E-Mail Website
Guest Editor
Head of Trauma and Orthopaedic Surgery Department, Azienda Ospedaliera Santa Maria Terni, 05100 Terni, Italy
Interests: knee surgery; hip surgery; joint replacement; knee arthroscopy; hip arthroscopy; osteoarthritis; ligament injury

Special Issue Information

Dear Colleagues, 

The recent progress in orthopaedic surgery and its subspecialty areas is remarkable. Various common orthopaedic diseases have been under great scrutiny in recent years. Moreover, several innovative diagnostic and therapeutic algorithms have been studied, especially those related to hand/wrist surgery, tendon/ligament injuries, nerve injury and joint disorders. Additionally, significant advances and innovations related to robotic surgery, artificial intelligence (AI) and orthopaedic injections have been proposed. New indications and surgical techniques are also available, with debated and controversial results. Modern trends and directions are focused on minimally invasive surgery, AI-assisted surgery and the utilization of new therapeutic agents. In this Special Issue, we welcome authors to submit papers based on clinical advances and innovations of orthopaedic diseases in terms of both diagnosis and treatment.

Dr. Valerio Pace
Dr. Pierluigi Antinolfi
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

  • orthopaedic surgery
  • hand/wrist surgery
  • tendon injury
  • ligament injury
  • artificial intelligence (AI)
  • robotic surgery
  • orthopaedic injections
  • nerve injury

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Published Papers (3 papers)

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Research

13 pages, 2417 KB  
Article
Cement Augmentation of the Blade in Proximal Femoral Nailing for Trochanteric Fractures in Elderly Patients: A Retrospective Comparison of Mechanical Stability and Complications
by Zoltan Cibula, Marian Grendar, Diaa Sammoudi, Milan Cipkala, Marian Melisik and Maros Hrubina
J. Clin. Med. 2025, 14(21), 7469; https://doi.org/10.3390/jcm14217469 - 22 Oct 2025
Viewed by 144
Abstract
Background: Cephalomedullary nails are the standard treatment of trochanteric fractures, and some implants with a perforated blade allow augmentation with bone cement to increase mechanical stability. The study compares the results of PFNA and TFNA implants (DePuy Synthes) with or without cement [...] Read more.
Background: Cephalomedullary nails are the standard treatment of trochanteric fractures, and some implants with a perforated blade allow augmentation with bone cement to increase mechanical stability. The study compares the results of PFNA and TFNA implants (DePuy Synthes) with or without cement augmentation of the blade. Methods: A retrospective study evaluated 219 trochanteric fractures. The study included 59 men (27%) and 160 women (73%), with a mean patient age of 82 years. The most common fractures were type 31A2 (56%), followed by type 31A1 (25%) and type 31A3 (19%). The monitored parameters were evaluated from anteroposterior and axial images of the proximal femur and pelvis. TAD, blade position, lateral blade prominence, fracture varus, and cut-out were evaluated. Results: Cement-augmented blade implants (CABs) in 68 patients (31%) and cement-free implants (NCABs) in 151 patients (69%) were used. The average age difference between the groups was 7 years (CAB 86.07 ± 5.85 and NCAB 79.13 ± 8.48). CABs were used more frequently in women (60 cases) than in men (8 cases). Blade position was optimal in 68% of cases and suboptimal in 32%. The risk of varus deformities was not statistically significantly affected by the blade position. The statistical significance of CABs for reducing the risk of varus deformities in stable fractures (p = 0.396) or unstable fractures (p = 0.101) was not confirmed. The average varus angulation during treatment was 2.57° (CAB 2.53° and NCAB 2.67°). A varus deformity greater than 10° was confirmed in 8 eight patients (3.7%) and cut-out in three patients (1.4%). All patients with cut-out were in the NCAB group. Cement leakage occurred in two cases and was asymptomatic. One case of deep infection, lateral blade prominence, and avascular necrosis (AVN) were recorded. Conclusions: Cement augmentation of the blade did not significantly reduce varus deformity in this cohort, regardless of blade position of fracture stability. CABs may prevent cut-out in specific subgroups, but this requires further investigation. Full article
(This article belongs to the Special Issue Clinical Advances in Trauma and Orthopaedic Surgery)
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10 pages, 729 KB  
Article
Have New Plate Designs Reduced the Rate of Hardware Removal Following Midshaft Clavicle Fracture Fixation?
by Maria Oulianski, Yoram Weil, Omer Ben Yehuda, Rami Mosheiff and Mahmoud Jammal
J. Clin. Med. 2025, 14(18), 6351; https://doi.org/10.3390/jcm14186351 - 9 Sep 2025
Viewed by 982
Abstract
Objectives: Operative fixation of displaced midshaft clavicle fractures has become increasingly the more acceptable choice of care in recent years, based on evidence supporting its effectiveness. However, this practice presents challenges due to the complex S-shaped morphology of the clavicle and its [...] Read more.
Objectives: Operative fixation of displaced midshaft clavicle fractures has become increasingly the more acceptable choice of care in recent years, based on evidence supporting its effectiveness. However, this practice presents challenges due to the complex S-shaped morphology of the clavicle and its subcutaneous location. Despite the introduction of anatomically pre-contoured plates, achieving optimal implant-to-bone fit remains difficult, prompting the development of newer plate generations. The aim of this study was to compare the hardware removal rates of second-generation 2.7 mm thinner plates (SGPs) with those of first-generation 3.5 mm plates (FGPs). Methods: A retrospective comparative cohort study was conducted at a level one trauma center. A total of 187 patients received FGPs, and 67 received SGPs, both positioned on the superior bone surface. All surgeries were performed by fellowship-trained surgeons, and patients were followed for at least one year. Data were extracted from medical records and the PACS system. Results: The patients’ demographics (age: 32.86 vs. 33.14 years; gender: 16.85% vs. 14.92% female) and fracture type (AO/OTA) were similar between the two groups. The rate of implant removal (20.1% vs. 20.9%) did not differ significantly between groups. Complications included nonunion (1.6% vs. 1.7%, statistically not significant) and infection (three cases in the FGP group, none in the SGP group). Conclusions: Despite the high success rate of clavicle fixation procedures, the superior clavicular plate removal rate remains significant, regardless of the implant design. Full article
(This article belongs to the Special Issue Clinical Advances in Trauma and Orthopaedic Surgery)
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10 pages, 2516 KB  
Article
Free Flap Reconstruction of Traumatic Skin Defects of the Entire Hand Dorsum
by Soyeon Jung, Seungjun Lee and Seokchan Eun
J. Clin. Med. 2025, 14(4), 1308; https://doi.org/10.3390/jcm14041308 - 16 Feb 2025
Viewed by 1234
Abstract
Background/Objectives: The reconstruction of hand defects, especially involving the dorsal region of the hand, has remained a challenge for surgeons because of its anatomical features and complex functions. The goal of reconstruction should include functional restoration as well as being esthetically pleasing. [...] Read more.
Background/Objectives: The reconstruction of hand defects, especially involving the dorsal region of the hand, has remained a challenge for surgeons because of its anatomical features and complex functions. The goal of reconstruction should include functional restoration as well as being esthetically pleasing. The flap transfer reconstruction strategy is essential for satisfying these requirements. Methods: Free flaps were used to cover traumatic defects of the hand dorsum in eleven patients from 2016 to 2022. Eight males and three females with a mean age of 41 years were enrolled. The size of the flaps ranged from 6 × 5 cm to 20 × 9 cm, and the selected flaps included five anterolateral thigh flaps, three lateral arm flaps, and three superficial circumflex iliac artery flaps. Results: All flaps survived, with one case of partial necrosis. One patient experienced joint stiffness during recovery. The donor sites were closed primarily, and there was no need for skin grafting. Secondary debulking or thinning was also not required. The majority of cases recovered excellent function of the hand (mean Q_DASH: 2.5) with satisfactory esthetic outcomes. The postoperative observations were followed by more than six months. Conclusions: Small defects can be treated using local, pedicled, and island-type flaps. However, larger defects involving the exposure of tendons, nerves, and other critical structures commonly require free tissue transfers. The flap reconstruction for hand dorsum in the study is feasible to produce acceptable outcomes in large sized defects. Full article
(This article belongs to the Special Issue Clinical Advances in Trauma and Orthopaedic Surgery)
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