UNASSIGNED: This study aimed to report the complication rate associated with open reduction and internal fixation (ORIF) of mandibular condyle fractures in Oman.
UNASSIGNED: This retrospective cohort study was conducted among patients who underwent ORIF of mandibular condyle fractures at Al-Nahdha Hospital and the Sultan Qaboos University Hospital in Muscat, Oman, from January 2008 to December 2020. Data collected included patient demographics, fracture aetiology, fracture side and type, surgical approach and recorded complications and outcomes.
UNASSIGNED: A total of 68 patients (59 males and 9 females; mean age of 30.1 years) with 83 mandibular condyle fractures underwent ORIF during the study period. Subcondylar fractures were the most common type, occurring in 62.7% of patients, while bilateral fractures were observed in 21 (30.8%) patients. The most common surgical approach was retromandibular, used in 42.2% of patients. The overall complication rate was 42.6%, with the most frequently reported complications being transient facial nerve palsy (18.1%), malocclusion (14.7%) and restricted mouth opening (10.3%). Subsequent surgical interventions to correct malocclusion were performed in 6 cases. There was no statistically significant association between the overall complication rate and the patients\' clinical characteristics.
UNASSIGNED: Although ORIF of mandibular condyle fractures generally offers favourable outcomes, it carries a risk of complications.

UNASSIGNED: Pneumatic tourniquets are often used during the surgical treatment of unstable traumatic ankle fractures. The aim of this study was to assess the risk of reoperation after open reduction and internal fixation of ankle fractures with and without the use of pneumatic tourniquets.
UNASSIGNED: This was a population-based cohort study using data from the Danish Fracture Database with a follow-up period of 24 months. Data were linked to the Danish National Patient Registry to ensure complete information regarding reoperations due to complications, which were divided into major and minor. The relative risk of reoperations for the tourniquet group compared with the non-tourniquet group was estimated using Cox proportional hazards modelling.
UNASSIGNED: A total of 4,050 ankle fractures treated with open reduction and internal fixation between 15 March 2012 and 31 December 2016 were included, with 669 (16.5%) undergoing surgery with a tourniquet and 3,381 (83.5%) without a tourniquet. The overall reoperation risk was 28.2% with an adjusted relative risk of 1.46 (95% CI 0.91 to 2.32) for group comparison. The reoperation risk due to major complications was 3.1% with a tourniquet and 4.4% without a tourniquet, resulting in an adjusted relative risk of 1.45 (95% CI 0.91 to 2.32). For minor complications, there were 24.7% and 23.9% reoperations, resulting in an adjusted relative risk of 0.99 (95% CI 0.84 to 1.17).
UNASSIGNED: We found no significant difference in the reoperation rate when comparing ankle fractures treated surgically with and without the use of pneumatic tourniquets.

The aim of the study was to compare the efficacy and safety of robot-assisted (RA) percutaneous hollow screw fixation with traditional open reduction internal fixation (ORIF) for the treatment of calcaneal fractures through a systematic review and meta-analysis. An extensive search was conducted in the following databases-PubMed, CNKI, Embase, and the Cochrane Library-to gather research on patients with calcaneal fractures published up to July 2024. This search focuses on studies comparing the effectiveness of robot-assisted percutaneous cannulated screw fixation versus ORIF. We will include studies published in both English and Chinese. Our screening process adhered strictly to predefined inclusion and exclusion criteria, emphasizing randomized controlled trials (RCTs) and cohort studies. The ROBINS-I tool was utilized to evaluate the risk of bias in non-randomized studies. Meta-analysis was conducted using Review Manager 5.4.1. The final analysis incorporated six retrospective cohort studies comprising 247 patients-122 treated with robotic-assisted percutaneous cannulated screw fixation and 125 with conventional open reduction and internal fixation. The findings indicated that patients undergoing robotic-assisted percutaneous cannulated screw fixation experienced advantages over those receiving conventional treatment in terms of reduced hospital stay, lower estimated blood loss, and higher AOFAS scores at both 3 and 6 months. No statistically significant differences were observed between the two methods concerning operative time, fracture healing duration, or the frequency of intraoperative fluoroscopies. Robotic-assisted percutaneous cannulated screw fixation is a safe and viable treatment approach for patients with calcaneal fractures. When compared to ORIF methods, this robotic-assisted technique demonstrated significant benefits, including reduced hospital stay, lower estimated blood loss, and improved AOFAS scores at both 3 and 6 months.

OBJECTIVE: The aim of this study was to investigate the efficacy of three-dimensional (3D) printing-assisted treatment for acetabular fractures (AFs) and to compare with conventional surgical methods.
METHODS: Between May 2019 and May 2022, a total of 44 patients (33 males, 11 females; mean age: 40.6±11.8 years; range, 20 to 68 years) who were diagnosed with AFs based on clinical symptoms, X-ray and computed tomography (CT) and underwent open reduction and internal fixation in Hospital of Xinjiang Production and Construction Corps were retrospectively analyzed. The patients were divided into two groups based on whether 3D printing was applied as the experimental group (n=24) and control group (n=20). In the experimental group, pelvic and acetabular data were imported into a 3D printer, and an equal-scale highly simulated model was printed using photosensitive resin as the 3D printing material. The model was used to develop more specific personalized surgical plans, to determine the optimal sequence of surgical procedures for fracture reduction, and simulate surgery in vitro.
RESULTS: In the experimental group, the mean surgical duration was shorter (123.57±22.05 vs. 163.57±26.20 min, p<0.001), the mean intraoperative bleeding loss was lower (557.14±174.15 vs. 885.71±203.27 mL, p<0.001), and the frequency of intraoperative fluoroscopy was lower (8.64±1.65 vs. 12.07±2.76, p<0.001) than in the control group. No statistically significant differences were found between the two groups in the Visual Analog Scale scores after surgery or the hip function score after treatment (p>0.05). No major postoperative complications were observed in any of the patients.
CONCLUSIONS: Compared to conventional surgical treatment, preoperative 3D printing-assisted treatment for adult patients with AFs can significantly reduce surgical duration, intraoperative bleeding loss and frequency of intraoperative C-arm fluoroscopy, reducing surgical difficulty and improving surgical safety.

OBJECTIVE: This study aimed to compare reoperation rate and clinical outcomes between revision open reduction and internal fixation and hip arthroplasty following failed subtrochanteric fracture fixation.
METHODS: A retrospective review was conducted of patients > 50 years old treated for failed fixation of subtrochanteric fractures with revision ORIF or hip arthroplasty from 2003 to 2023. Primary outcomes included rate of fracture union and reoperations after initial salvage therapy. Secondary outcomes included complications (infection, dislocation, bursitis, implant prominence, implant failure, nonunion), pain, and gait-aid requirements by final follow-up.
RESULTS: Forty-four patients were identified: 34 treated with revision ORIF and 10 with hip arthroplasty. The arthroplasty cohort was older (75.4 vs. 66.0 years, p = 0.016) but did not differ from the ORIF cohort in sex, type of initial fixation, or reason for fixation failure. Patients treated with revision ORIF and patients treated with arthroplasty had similar rates of fracture union (85.3% vs. 80.0%, p = 0.772) and reoperation (35.3% vs. 30.0%, p = 0.710). There was no significant difference in rate of additional complications not requiring reoperation (0.0% vs. 40.0%, p = 0.071). The arthroplasty cohort achieved full weightbearing in significantly shorter time than the revision ORIF cohort (3.8 vs. 6.8 weeks, p = 0.005).
CONCLUSIONS: Both revision ORIF and hip arthroplasty are acceptable options for salvage of failed subtrochanteric fracture fixation in patients greater than 50 years old, but patients should be counseled that although the rate of fracture union is high whether revision ORIF or hip arthroplasty is selected, the rate of reoperation can exceed 1-in-4 patients.
METHODS:  : Level III, Retrospective Comparative Study.

暂无摘要。

UNASSIGNED: To compare the effectiveness of open reduction and hook plate fixation versus closed indirect reduction and dorsal extension blocking Kirschner wire fixation for bony mallet fingers.
UNASSIGNED: The clinical data of 68 patients with bony mallet finger who admitted between May 2019 and June 2022 were retrospectively analyzed. Among them, 33 cases were in the open group (treated with open reduction and hook plate fixation) and 35 cases were in the closed group (treated with closed indirect reduction and dorsal extension blocking Kirschner wire fixation). There was no significant difference between the two groups in terms of gender, age, the affected side, the affected finger, cause of injury, time from injury to operation, and Wehbé-Schneider classification ( P>0.05). The operation time, intraoperative fluoroscopy frequency, fracture healing time, time of returning to work, and postoperative complications were recorded and compared between the two groups. At 12 months after operation, visual analogue scale (VAS) score was used to assess the pain of the injured finger, active flexion range of motion and extension deficit of the distal interphalangeal joint (DIP) were measured by goniometer, and the effectiveness was assessed by Crawford criteria.
UNASSIGNED: All patients in the two groups were followed up 12-26 months, with an average of 15 months. There was no significant difference in the follow-up time between the closed group and the open group ( P>0.05). The operation time in the closed group was shorter than that in the open group, and the intraoperative fluoroscopy times, the fracture healing time, and the time of returning to work in the closed group were more than those in the open group, and the differences were significant ( P<0.05). In the closed group, there were 5 cases of pinning tract infection and 3 cases of small area pressure ulcer skin necrosis on the dorsal side of the finger, which were cured after intensive nursing and dressing change. Local nail depression deformity occurred in 7 cases in the open group, and the deformity disappeared after removal of plate. The incisions of the other patients healed uneventfully without complications such as infection, skin necrosis, exposure of the internal fixation, or nail deformity. There was no significant difference in the incidence of skin necrosis between the two groups ( P>0.05), but the differences in the incidence of infection and nail deformity between the two groups were significant ( P<0.05). There was no significant difference in VAS score, DIP active flexion range of motion, DIP extension deficiency, or Crawford criteria evaluation between the two groups at 12 months after operation ( P>0.05). At last follow-up, there was no DIP osteoarthritis and joint degeneration in both groups.
UNASSIGNED: Open reduction and hook plate fixation versus closed indirect reduction and dorsal extension blocking Kirschner wire fixation have their own advantages and disadvantages, but both of them have good results in the treatment of bony mallet fingers. Open reduction and hook plate fixation is recommended for young patients with bony mallet fingers who are eager to return to work.
UNASSIGNED: 比较切开复位钩状钢板固定与闭合间接复位背侧伸直阻挡克氏针固定治疗骨性锤状指的临床疗效。.
UNASSIGNED: 回顾分析 2019年5月—2022年6月收治且符合选择标准的68例骨性锤状指患者临床资料。其中切开组33例（采用切开复位钩状钢板固定），闭合组35例（采用闭合间接复位背侧伸直阻挡克氏针固定治疗）。两组患者性别、年龄、患侧侧别、伤指指别、致伤原因、受伤至手术时间及Wehbé-Schneider分型比较差异均无统计学意义（ P>0.05）。记录并比较两组患者手术时间、术中透视次数、骨折愈合时间、返岗工作时间及并发症发生情况；术后12个月采用疼痛视觉模拟评分（VAS）评定伤指疼痛情况，量角器测量手指远侧指间关节（distal interphalangeal joint，DIP）主动屈曲活动度及伸直欠缺度，采用Crawford标准评定临床疗效。.
UNASSIGNED: 两组患者均获随访，随访时间12～26个月，平均15个月；闭合组和切开组随访时间比较差异无统计学意义（ P>0.05）。闭合组手术时间短于切开组，术中透视次数、骨折愈合时间及返岗工作时间均多于切开组，差异均有统计学意义（ P<0.05）。闭合组发生针道感染5例、末节指背侧皮肤小面积压疮坏死3例，经加强护理换药后痊愈；切开组发生7例指甲局部凹陷畸形，拆除内固定钢板后畸形消失；其余患者切口均顺利愈合，无感染、皮肤坏死、内固定物外露、指甲畸形等并发症发生。两组患者皮肤坏死发生率比较差异无统计学意义（ P>0.05），感染和指甲畸形发生率比较差异有统计学意义（ P<0.05）。术后12个月，两组VAS评分、DIP主动屈曲活动度、DIP伸直欠缺度及Crawford标准评价比较差异均无统计学意义（ P>0.05）。 末次随访时两组患者均无DIP骨关节炎及关节退行性改变发生。.
UNASSIGNED: 切开复位钩状钢板固定与闭合间接复位背侧伸直阻挡克氏针固定治疗骨性锤状指虽各有利弊，但均取得了较好治疗效果；对于急于重返工作岗位的年轻骨性锤状指患者建议采用切开复位钩状钢板固定。.

The objective of this descriptive cross-sectional study was to assess the functional outcomes of adolescents who had undergone internal fixation for patellar post-traumatic OCD fracture from 2019-2021. The injury mechanism was divided into two categories: a) torsional mechanism and b) direct contact injury. All candidates underwent X-ray and MRI/CT scan prior to the surgery to confirm the diagnosis. Operative treatment was open reduction and internal fixation (ORIF) of osteochondral fragment using headless screws. All patients were assessed pre-operatively with knee-ROM/IKDC (International Knee Documentation committee) score and satisfaction score, and postoperatively at one year follow-up. Fourteen patients were selected, with the mean age of 16.1±3.2 years. On one-year follow-up, no difference was noted in ROM when compared to the unaffected limb. The mean satisfaction score was 86±6.3 %. The mean pre-operative-IKDC score was 47.6±5.8 out of 100, whereas on one-year follow-up it was 88.6±2.2 which was statistically significant (p<0.05). Excellent outcomes can be achieved with headless screws for urgent ORIF (next elective list) of the osteochondral fragment.

OBJECTIVE: This study evaluated the relationship between obesity and postoperative complications in patients undergoing ankle open reduction internal fixation (ORIF).
METHODS:
METHODS: Retrospective cohort study.
METHODS: PearlDiver-Mariner All-Payor Database.
UNASSIGNED: Patients who underwent ankle ORIF from 2010 to 2021 and had a minimum of 2 years of follow-up were identified using Current Procedural Terminology, ICD-9, and ICD-10 codes.
UNASSIGNED: Patients were stratified by body mass index into nonobese, obese, morbidly obese, and super-obese groups. Complication rates, including 90-day readmissions, infection, and post-traumatic osteoarthritis, were compared between obesity groups. Patients were additionally compared with a 1:1 matched analysis that controlled for demographics and comorbidities.
RESULTS: A total of 160,415 patients undergoing ankle ORIF from 2010 to 2021 were identified. The cohort consisted mostly of females (64.8%) and the average age was 52.5 (SD 18.4) years. There were higher rates of 90-day readmissions, UTIs, DVT/PE, pneumonia, superficial infections, and acute kidney injuries in patients with increasing levels of obesity (P < 0.001). There were increased odds of nonunion and post-traumatic arthritis in the matched analysis at 2 years in the obesity group [OR: 2.36, 95% confidence interval (CI): 1.68-3.31, P < 0.001; OR: 2.18, 95% CI: 1.77-2.68, P < 0.001, respectively].
CONCLUSIONS: Postoperative medical complication rates in patients undergoing ankle ORIF, including infection, are higher in obese patients, even in the 1:1 matched analysis that controlled for demographic and comorbidity factors. Rates of nonunion and post-traumatic arthritis were higher in obese patients, as well. As such, it is important for surgeons to provide appropriate education regarding the risks after ankle ORIF in patients with obesity.
METHODS: Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.

OBJECTIVE: The 5-item modified frailty index (mFI-5) has been established as a reliable indicator of poor postoperative outcomes following a variety of orthopaedic procedures. This study aims to determine whether the mFI-5 can be used by surgeons to predict the likelihood of postoperative complications in patients undergoing open reduction internal fixation (ORIF) for tibial plateau fractures.
METHODS: From 2006 to 2019, patients aged 50 years or older undergoing ORIF for tibial plateau fracture were identified in the National Surgical Quality Improvement Program database. The mFI-5 was calculated based on the sum of the presence of 5 conditions: diabetes, congestive heart failure, hypertension, chronic obstructive pulmonary disease, and dependent functional status. Chi-squared tests and multivariable regression analysis were used to evaluate the association of different mFI-5 scores with postoperative complications.
RESULTS: The study analyzed 2213 patients with an average age of 63 years. Multivariable regression analysis demonstrated that in comparison to patients with a mFI-5 score of 0, those with a score of 1 had an increased risk of prolonged hospital stay (OR 1.31) and discharge to a non-home location (OR 1.50) while those with a score of 2 or greater were at an increased risk of readmission (OR 2.30), wound complication (OR 5.37), pulmonary complication (OR 4.56), urinary tract infection (OR 4.79), prolonged hospital stay (OR 1.89), and discharge to a non-home location (OR 3.01).
CONCLUSIONS: The mFI-5 is a reliable instrument for determining the likelihood of postoperative complications following ORIF for tibial plateau fracture repair.
METHODS: III.