Journal of Orthopedic and Spine Trauma

Enhancing Orthopedic Education: Integrating Brain-Dead Cadavers Post Organ Donation into Arthroscopy Training

2025-11-28T19:37:28+00:00

The Article Abstract is not available.

Current Concepts of Spine Robotic Assistance versus Freehand Techniques in Spine Surgery: A Systematic Review and Meta-Analysis

2025-11-28T19:37:27+00:00

Background: Robotic assistance in spinal surgery has completely changed the face of the practice over recent decades. The concept of pedicle screw fixation, introduced in the early 1950s, has grown to be one of the cornerstones of treatment for various spinal pathologies. The purpose of this study is to evaluate surgical outcomes and different treatment modalities in spinal pathologies by comparing robotic-assisted techniques with conventional freehand techniques.

Methods: A systematic review and meta-analysis were performed based on the PRISMA guidelines. A literature search was conducted using major databases such as ScienceDirect and PubMed/MEDLINE. Statistical analyses were performed using IBM SPSS software, R software, and Microsoft Excel. Peer-reviewed studies published in the English language up to January 2025 were included.

Results: Results were compiled from a total of 2,592 patients who underwent robotic neuronavigation-guided spinal surgery, reflecting the precision and efficacy of state-of-the-art robotic technologies in spinal surgery. Of these, 2,219 patients were treated with robotic- assisted pedicle screw placement, while 2,294 patients were treated with conventional freehand or fluoroscopy-guided techniques.

Conclusion: Our findings have shown that robotically assisted spine surgery is indeed more accurate, with reported rates of up to 90% precision in pedicle screw placement compared to freehand techniques

The Influential Factors in Determining the Efficiency of Bracing in Controlling Scoliotic Curves: A Narrative Review of Literature

2025-11-28T19:37:26+00:00

Background: Various treatment approaches can be used for individuals with scoliosis deformity, with bracing playing a significant role. The aim of this review was to assess the effectiveness of bracing in controlling scoliotic curves based on studies published between 2018 and 2025.

Methods: A search was conducted in databases such as PubMed, Google Scholar, ISI Web of Knowledge, and Scopus using keywords like brace, orthosis, and scoliosis between 2018 and 2025. Papers were selected based on the research question of interest (effectiveness of bracing in preventing scoliotic curve progression).

Results: This narrative review highlighted the importance of certain parameters in predicting the outcomes of brace treatment. Factors such as Risser sign, initial Cobb angle, in-brace correction (IBC), curve type, vertebral rotation, brace wearing time, type of brace, and poor compliance all influence the effectiveness of bracing treatment.

Conclusion: It appears that the outcomes of bracing treatment in individuals with scoliosis can be predicted based on certain parameters. The findings of this review assist clinicians in determining the effectiveness of bracing in individuals with scoliosis.

Functional Outcome of Radius Ulna Fracture Treated with Nailing in Adults

2025-11-28T19:37:25+00:00

Background: Intramedullary nailing (IMN) of radius and ulna has its own advantages and disadvantages. The chances of infection are significantly decreased, as it is usually a closed procedure and has less periosteal stripping. This study was undertaken to evaluate the results of radius ulna nailing and its radiological and functional outcomes using this method.

Methods: This study of forearm bones fracture treated by IMN was performed on 30 patients prospectively admitted at SVP Hospital Ahmedabad, India, from 2020 to 2022. Clinically, fracture was united when the patient was completely pain free. Patients were followed up at monthly intervals till union and were assessed clinically and radiographically, and details were recorded.

Results: The evaluation of the result was done using Anderson et al. criteria. 28 (93.33%) patients had good to excellent results. Twenty-nine (96.66%) patients had good radiological union. Of these, one patient had union at 22 weeks and one had union at 36 weeks. Twenty-one (70%) patients had union within 4 months.

Conclusion: Use of IMN has resulted in, and continues to result in, predictable and good outcomes. Complication rates are lower compared to plate osteosynthesis, although application of above-elbow (AE) slab is a downside of the procedure. The IMN has a future in repair of forearm fractures considering its low complication rates, low cost, and good results

A Comparative Study of Braided versus Standard Preparation of Autologous Hamstring Graft in Anterior Cruciate Ligament Reconstruction

2025-11-28T19:37:24+00:00

Background: Anterior cruciate ligament (ACL) reconstruction commonly employs autologous hamstring grafts, with varioustechniques used for graft preparation. Standard 4-strand grafts are widely accepted; however, braided grafts have been proposed tooffer improved biomechanical properties and graft fixation. This study aims to compare the clinical and functional outcomes ofbraided versus standard hamstring graft preparations in ACL reconstruction.

Methods: In this prospective randomized study, 171 patients undergoing primary ACL reconstruction were assigned to two groups:group A (standard graft, n = 92) and group B (braided graft, n = 79). Intraoperative data such as graft length and diameter wererecorded. Clinical and functional outcomes were evaluated using International Knee Documentation Committee (IKDC) andLysholm scores and knee range of motion (ROM) at 2 weeks, 6 weeks, 3 months, and 6 months postoperatively.

Results: The braided graft group demonstrated a larger mean graft diameter (P = 0.492) but decreased graft length (P = 0.028).During follow-ups till 6 months, both groups showed progressive improvement but no significant difference between the twogroups with respect to knee ROM, IKDC, or Lysholm scores. Difference in complications was statistically insignificant.

Conclusion: The study suggests that both standard and braided hamstring grafts are effective options for ACL reconstruction,yielding comparable short-term clinical outcomes. However, the braided technique demonstrates potential advantages in terms ofincreased graft thickness and uniform fixation. While these findings are promising, further in vivo studies and long-term clinicaltrials are necessary to validate the superiority of the braided graft technique in ACL reconstruction

Comparison of Dynamic Compression Plating vs. Flexible Intramedullary Nailing in Diaphyseal Humerus Fractures: A Study of 50 Cases

2025-11-28T19:37:23+00:00

Background: Diaphyseal humerus fractures are frequent orthopaedic injuries requiring effective management for optimal recovery. This study aims to evaluate and compare the outcomes of open reduction with dynamic compression plating (DCP) and closed reduction with flexible intramedullary nailing (IMN) for treating humeral shaft fractures.

Methods: This prospective, randomized study included 50 patients with diaphyseal humeral fractures, randomized to either DCP (group P) or IMN (group N). Primary outcomes assessed were radiological union, functional recovery through Disabilities of the Arm, Shoulder, and Hand (DASH) scores, and range of motion (ROM). Secondary outcomes included surgical duration, exposure to radiation, and postoperative complications.

Results: The union rate was comparable between the two groups, with 100% in group P and 96% in group N (P = 0.99). Similarly, the DASH scores showed no significant difference (group P: 21.80 ± 6.98, group N: 24.56 ± 9.48, P = 0.24). Group P required longer surgical time and showed higher chances of surgical site infection (SSI), while group N experienced higher exposure to radiation and increased implant-related complications.

Conclusion: Both DCP and flexible IMN are viable options for diaphyseal humerus fractures, with no significant difference in functional outcomes. The choice between these methods should consider patient-specific needs and fracture characteristics.

The Impact of Spinopelvic Parameters on the Femoroacetabular Anteversion Angle

2025-11-28T19:37:22+00:00

Background: We aimed to investigate the relationship between spinopelvic parameters, spinal deformities, and femoral and acetabular anteversion in patients who were candidates for total hip arthroplasty (THA).

Methods: The femoral and acetabular anteversion angles were measured using computed tomography (CT) scans. Additionally, spinopelvic parameters were assessed with the appropriate graphs. We utilized SPSS software to analyze the relationship between different types of spinopelvic deformities, spinopelvic parameters, and femoroacetabular anteversion angles.

Results: A one-way analysis of variance (ANOVA) showed a significant effect of deformity type on femoral and acetabular version (P < 0.001). Post hoc analysis using Tukey’s honestly significant difference test (HSD) revealed that patients with stuck sitting deformity had significantly higher femoral and acetabular anteversion compared to others (P < 0.001). The anterior pelvic plane (APP) significantly predicted both femoral and acetabular anteversion in the regression model.

Conclusion: Our observations indicate that spinopelvic deformities significantly impact femoral and acetabular anteversion, with the “stuck sitting” group exhibiting the highest values.

Arthroscopic Single-Row Repair in Full-Thickness Rotator Cuff Tear: A 60-Case Study of Functional Outcomes and Structural Integration at 2-Year Follow-Up

2025-11-28T19:37:21+00:00

Background: The aim of this study was to assess practical results and tendon healing in individuals experiencing full-thickness rotator cuff tears handled using single-row arthroscopic rotator cuff repair (SR-ARCR), emphasizing its cost-effectiveness in resource-limited settings. Furthermore, the analysis includes evaluation of fatty muscle degeneration, glenohumeral joint arthritis, the significance of subscapularis tendon repair, and the impact of biceps tenotomy.

Methods: 60 rotator cuff reconstructions with a minimum of 24-month follow-up and all treated by SR-ARCR were evaluated. Functional assessment was done by Constant-Murley Score (CMS) and University of California and Los Angeles (UCLA) Score for shoulder, and structural assessment was performed by Sugaya grading. While CMS and UCLA scores are expressed as unitless numerical scales derived from components involving pain, function, range of motion (ROM) (in degrees), and strength (in kilograms), the Sugaya grading system is a qualitative magnetic resonance imaging (MRI)-based classification without numerical units.

Results: Mean follow-up was 35.93 ± 26.24 months with a minimum of 24 months. We noted a significant increase in post-operative mean CMS (range: 0-100) to 94.83 ± 7.78 (P < 0.001) and mean UCLA Score (range: 0-35) to 33.82 ± 6.70 (P < 0.001). Active forward flexion increased to 166.50 ± 11.62º (P < 0.001), external rotation (in degrees) increased to 79.17 ± 10.13º (P < 0.001), muscle strength (in kilograms) (0-25 kg) increased to 22.78 ± 3.32 (P < 0.001), and visual analogue scale (VAS) (0-10) decreased to 1.20 ± 0.75 (P < 0.001) post- operatively. Patients with Sugaya 1 grading (85% of patients) had CMS of 97.06 ± 5.21 (P < 0.001), Sugaya 2 (10%) had score of 82.67 ± 9.42 (P < 0.001), and Sugaya 3 or higher (5%) had score of 81.33 ± 6.35 (P < 0.001).

Conclusion: SR-ARCR offered excellent outcomes cost-effectively with structural integration of rotator cuff at 24 months when tension-free repair of cuff was done

Intramedullary Nailing in Proximal Humerus Fractures: Outcomes Beyond the Simple Two-Part

2025-11-28T19:37:20+00:00

Background: Proximal humerus fractures (PHFs) are common injuries, particularly in the elderly. While intramedullary nailing (IMN) has gained popularity for treating these fractures, its efficacy in complex cases, especially those with comminuted calcar, remains a topic of debate. This study aimed to evaluate the outcomes of IMN in PHFs with and without calcar comminution.

Methods: A prospective observational study was conducted on 40 patients with displaced PHFs treated with IMN. Patients were divided into two groups based on the integrity of the calcar: intact (group A) and comminuted (group B). Radiographic and clinical outcomes were assessed at 3, 6, and 12 months postoperatively.

Results: All fractures achieved union. Minimal loss of reduction was observed in both groups, with no significant difference between them. Functional outcomes, including pain, range of motion (ROM), and patient -reported scores, improved over time in both groups. Patients with intact calcar showed significantly better outcomes in terms of Simple Shoulder Test (SST) score and forward elevation at all follow-up points. The complication rate was low (2.5%), with one case of osteonecrosis in group A.

Conclusion: IMN is a safe and effective treatment for displaced PHFs, even with comminuted calcar. Although calcar comminution may lead to slightly worse outcomes in specific functional parameters, the overall impact is minimal. IMN offers a viable alternative to plate fixation, particularly in complex fractures, with favorable outcomes and a low complication rate.

A Two-Pin Method for Improved Exposure in Shotgun Hemi-Hamate Arthroplasty

2025-11-28T19:37:19+00:00

This technical note introduces a two-pin technique designed to improve exposure during the shotgun approach for hemi-hamate arthroplasty, a surgical procedure commonly used to treat comminuted intra-articular and chronic proximal interphalangeal (PIP) joint fractures. A 1.0 mm Kirschner wire (K-wire) is inserted into the middle phalanx (P2) distal to the fracture, and a second K-wire is placed into the head of the proximal phalanx (P1). These pins stabilize the joint, facilitate soft tissue retraction, and improve visualization of the fracture site. The graft is harvested from the dorsal distal hamate and shaped to fit the PIP joint before fixation. This method addresses key challenges in visualization and stabilization associated with the shotgun approach. Early feedback suggests improved surgical efficiency, increased accuracy of reduction, and potentially better functional outcomes. The described two-pin technique is simple and reproducible, significantly enhancing exposure and stability during hemi-hamate arthroplasty. Further studies are needed to confirm its long-term effects

Anatomic Acromioclavicular Joint Reconstruction with Semitendinosus Allograft and 8-Plate: A Case Report on Surgical Techniques

2025-11-28T19:37:17+00:00

Background: Acromioclavicular (AC) joint dislocation is a quite common shoulder injury, especially among young, athletic people. Despite various treatment approaches, AC joint injuries still pose significant treatment challenges. Common concerns include postoperative pain, limited shoulder mobility, and hardware-related complications. In recent years, a number of surgical methods have been developed with the goal of improving functional outcomes while reducing complications. In this study, we report a surgical technique using semitendinosus allograft and an 8-plate for a patient with type III AC joint dislocation.

Case Report: A 33-year-old man sustained a type III AC joint dislocation following a motorcycle accident. Initial non-surgical management failed to relieve pain or restore full shoulder mobility. As a result, the patient underwent surgical intervention using semitendinosus allograft in combination with an 8-plate device. At the three-month follow-up, the patient had complete shoulder range of motion (ROM) and showed no symptoms of discomfort, dislocation, or joint prominence.

Conclusion: AC joint dislocation treatment remains debated, but recent advancements in surgical methods have made it more effective. Reconstruction using semitendinosus allograft and 8-plate device offers improved clinical outcomes with fewer complications

Unusual Association of Osteochondral Fracture of Patella with Adjacent Osteochondral Defect of Lateral Femoral Condyle: A Case Report and Review of Literature

2025-11-28T19:37:16+00:00

Background: Incidence of osteochondral fractures with osteochondral bone defects without significant anterior cruciate ligament (ACL) injuries is rather uncommon with minimal literature available about the incidence rates of such lesions. Osteochondral injuries of the knee have different mechanisms of injuries like those following ACL rupture and patellar dislocation, which comprise direct and indirect modes of injuries. Various treatment modalities have been described for osteochondral defect depending upon the size of defect, such as debridement, lavage, microfracture technique, and osteochondral autograft transfer system (OATS) therapy. In case of osteochondral fractures, the main mode of management is surgical wherein osteochondral fractures are managed with headless compression screws and bioabsorbable implants. Robust management of the osteochondral fractures and osteochondral defects helps in achieving good prognosis for the patient.

Case Report: An 18-year-old young man presented with complaints of pain and inability to move his right knee following alleged history of twisting of right knee while playing football. On examination, the patient had moderate effusion in the knee with tenderness over the medial patellofemoral joint line. Radiological investigation revealed traumatic osteochondral fracture of the patella and incidental finding of osteochondral defect in the lateral femoral condyle which was managed surgically with Herbert headless screw fixation for fracture and debridement with microfracturing for osteochondral defect. Post-operatively, patient had good rehabilitation and regained his normal range of motion (ROM) at the end of 12 weeks.

Conclusion: The coincidental existence of both osteochondral fracture and osteochondral defect is a rare entity and warrants the need for surgical management to have better prognosis