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Acute Trauma and Trauma Care in Orthopedics
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Acute Trauma and Trauma Care in Orthopedics

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

Deadline for manuscript submissions: 31 July 2024 | Viewed by 4150

Special Issue Editors

Prof. Dr. Pietro Maniscalco

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Guest Editor
Orthopedics and Traumatology Department, Guglielmo da Saliceto Hospital, 29121 Piacenza, Italy
Interests: orthopedics and traumatology; trauma; fractures; arthroplasty; arthroscopic; knee; hip; elbow
Special Issues, Collections and Topics in MDPI journals
Dr. Gianfilippo Caggiari

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Guest Editor
Orthopaedic and Traumatology Department, Università degli Studi di Sassari, 07100 Sassari, Italy
Interests: orthopedics and traumatology; trauma; fractures; arthroplasty; knee; hip; elbow

Special Issue Information

Dear Colleagues,

Orthopedics and trauma surgery are clinically challenging, and they deal with injuries and related diseases of the musculoskeletal system, which can be caused by trauma, accidents, sports injuries, degenerative diseases, infections, tumors, and congenital diseases. We have seen developments in all aspects of orthopedic surgery, using both invasive procedures and non-invasive and non-surgical methods to correct and treat disease. Common orthopedic problems include knee osteoarthritis, spinal deformities, and a variety of different sports injuries. Since these health conditions can greatly affect a person's quality of life, it is important for patients to receive a high level of treatment by an experienced physician. Consequently, there is also an increasing need for interdisciplinary treatment strategies, as these patients often present with underlying comorbidities that could have led to the injury itself, and thus require specific treatment.

This Special Issue combines original research and review papers with a focus on the recent advances in orthopedic and trauma surgery. We welcome the submissions of your best research.

Prof. Dr. Pietro Maniscalco
Dr. Gianfilippo Caggiari
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

  • orthopedics
  • trauma
  • injuries
  • musculoskeletal
  • surgery
  • knee osteoarthritis
  • spinal deformities
  • fracture
  • joint replacement
  • hip fractures
  • fragility fractures
  • minimally invasive surgery

Published Papers (6 papers)

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Research

8 pages, 857 KiB  
Article
Periprosthetic Hip Fractures around the Stem: Can the Stem Design Affect Fracture Features?
by Luca Costanzo Comba, Luca Gagliardi, Francesco Onorato and Fabrizio Rivera
J. Clin. Med. 2024, 13(9), 2627; https://doi.org/10.3390/jcm13092627 - 29 Apr 2024
Viewed by 215
Abstract
Background: Total hip arthroplasty is one of the most successful orthopedic surgeries; nevertheless, many of these surgeries are the causes of failure, and among them, periprosthetic fractures are one of the major causes of revision. Our study focuses on periprosthetic hip fractures with [...] Read more.
Background: Total hip arthroplasty is one of the most successful orthopedic surgeries; nevertheless, many of these surgeries are the causes of failure, and among them, periprosthetic fractures are one of the major causes of revision. Our study focuses on periprosthetic hip fractures with two different stem designs. The aim of the study was to analyze the obtained results, focusing on the features of periprosthetic stem fractures observed. Methods: We retrospectively reviewed periprosthetic fractures occurring between 2010 and 2023, involving Alloclassic® or CLS® uncemented femoral stems. We analyzed demographic data, proximal femur morphology, and the fracture type. Results: We identified 97 patients. Considering the proximal femur morphology, we found that there was statistically significant prevalence of Dorr A proximal femur morphology in the CLS® group and of Dorr C in the Alloclassic® group. Considering the distribution of the fracture pattern, we reported a non-statistically significant prevalence of the fracture pattern with stable stems in the CLS® group. Conclusions: The choice of the prosthetic design of the femoral stem is a crucial element when planning total hip arthroplasty. However, we found a non-statistically significant difference between the two stems considered, raising questions about the real role of stem design as a primary determinant of periprosthetic hip fractures. Full article
(This article belongs to the Special Issue Acute Trauma and Trauma Care in Orthopedics)
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12 pages, 1088 KiB  
Article
Comparative Analysis of Complication Rates in Tibial Shaft Fractures: Intramedullary Nail vs. Ilizarov External Fixation Method
by Danilo Jeremic, Nikola Grubor, Zoran Bascarevic, Nemanja Slavkovic, Branislav Krivokapic, Boris Vukomanovic, Kristina Davidovic, Zelimir Jovanovic and Slavko Tomic
J. Clin. Med. 2024, 13(7), 2034; https://doi.org/10.3390/jcm13072034 - 31 Mar 2024
Viewed by 491
Abstract
Background: The external fixation (EF) Ilizarov method, shown to offer efficacy and relative safety, has unique biomechanical properties. Intramedullary nail fixation (IMN) is an advantageous alternative, offering biomechanical stability and a minimally invasive procedure. The aim of this study was to assess [...] Read more.
Background: The external fixation (EF) Ilizarov method, shown to offer efficacy and relative safety, has unique biomechanical properties. Intramedullary nail fixation (IMN) is an advantageous alternative, offering biomechanical stability and a minimally invasive procedure. The aim of this study was to assess outcomes in patients undergoing tibia fracture fixation, comparing the Ilizarov EF and IMN methods in an early phase of IMN implementation in Serbia. Methods: This was a retrospective study including patients with radiologically confirmed closed and open (Gustilo and Anderson type I) tibial diaphysis fractures treated at the Institute for Orthopedic Surgery “Banjica’’ from January 2013 to June 2017. The following demographic and clinical data were retrieved: age, sex, chronic disease diagnoses, length of hospital stay, surgical wait times, surgery length, type of anesthesia used, fracture, prophylaxis, mechanism of injury, postsurgical complications, time to recovery, and pain reduction. Pain intensity was measured by the Visual Analog Scale (VAS), a self-reported scale ranging from 0 to 100 mm. Results: A total of 58 IMN patients were compared to 74 patients who underwent Ilizarov EF. Study groups differed in time to recovery (p < 0.001), length of hospitalization (p = 0.007), pain intensity at the fracture site (p < 0.001), and frequency of general anesthesia in favor of intramedullary fixation (p < 0.001). A shorter surgery time (p < 0.001) and less antibiotic use (p < 0.001) were observed when EF was used. Additionally, we identified that the intramedullary fixation was a significant predictor of pain intensity. Conclusions: The IMN method offers faster recovery and reduced pain intensity in comparison to EF, while the length of surgery predicted the occurrence of any complication. Full article
(This article belongs to the Special Issue Acute Trauma and Trauma Care in Orthopedics)
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14 pages, 704 KiB  
Article
Evaluation of Outcome after Total Hip Arthroplasty for Femoral Neck Fracture: Which Factors Are Relevant for Better Results?
by Paolo Schiavi, Francesco Pogliacomi, Matteo Bergamaschi, Francesco Ceccarelli and Enrico Vaienti
J. Clin. Med. 2024, 13(7), 1849; https://doi.org/10.3390/jcm13071849 - 23 Mar 2024
Viewed by 518
Abstract
Background: Femoral neck fractures (FNFs) are frequent orthopedic injuries in elderly patients. Despite improvements in clinical monitoring and advances in surgical procedures, 1-year mortality remains between 15% and 30%. The aim of this study is to identify variables that lead to better outcomes [...] Read more.
Background: Femoral neck fractures (FNFs) are frequent orthopedic injuries in elderly patients. Despite improvements in clinical monitoring and advances in surgical procedures, 1-year mortality remains between 15% and 30%. The aim of this study is to identify variables that lead to better outcomes in patients treated with total hip arthroplasty (THA) for FNFs. Methods: All patients who underwent cementless THA for FNF from January 2018 to December 2022 were identified. Patients aged more than 80 years old and with other post-traumatic lesions were excluded. Patient data and demographic characteristics were collected. The following data were also registered: time trauma/surgery, surgical approach, operative time, intraoperative complications, surgeon arthroplasty-trained or not, and anesthesia type. In order to search for any predictive factors of better short- and long-term outcomes, we performed different logistic regression analyses. Results: A total of 92 patients were included. From multivariable logistic regression models, we derived that a direct anterior surgical approach and an American Society of Anesthesiologists (ASA) classification < 3 can predict improved short-term outcomes. Moreover, THAs performed by surgeons with specific training in arthroplasty have a lower probability of revision at 1 year. Mortality at 1 year was ultimately influenced by the ASA classification. Conclusions: A direct anterior approach and specific arthroplasty training of the surgeon appear to be able to improve the short- and long-term follow-up of THA after FNF. Full article
(This article belongs to the Special Issue Acute Trauma and Trauma Care in Orthopedics)
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12 pages, 1200 KiB  
Article
Angle-Adjustable Dynamic Hip Screw Plate for Unstable Trochanteric Fractures in Middle-Aged Patients: Mid-Term Outcomes and Return to Sport
by Luca Andriollo, Giorgio Fravolini, Rudy Sangaletti, Loris Perticarini, Francesco Benazzo and Stefano Marco Paolo Rossi
J. Clin. Med. 2024, 13(4), 988; https://doi.org/10.3390/jcm13040988 - 08 Feb 2024
Viewed by 537
Abstract
Background: There are conflicting results in the literature regarding the superiority of proximal femoral nails over dynamic hip screw (DHS) plates. The primary aim of this study is to evaluate mid-term post-injury patient-reported outcome measures (PROMs) and return to sport (RTS) in middle-aged [...] Read more.
Background: There are conflicting results in the literature regarding the superiority of proximal femoral nails over dynamic hip screw (DHS) plates. The primary aim of this study is to evaluate mid-term post-injury patient-reported outcome measures (PROMs) and return to sport (RTS) in middle-aged patients treated with the DHS plate for unstable trochanteric fractures. Methods: Fifty-seven middle-aged patients (35–64 years) treated for proximal femoral fractures of type 31-A2 and 31-A3 according to the AO/OTA classification with the DMS Dynamic Martin Screw (KLS Martin Group, Jacksonville, FL, USA) between January 2017 and December 2019 were enrolled. Results: Forty-nine patients were included in this retrospective study, and the average age was 54.1 years (SD 8.4). The average follow-up duration at final follow-up was 60.5 months (SD 8.6). Post-operative complications included only one case of aseptic loosening of the implant, with a complication rate of 2%. There were no infections, peri-implant fractures, or other complications reported. Two out of the forty-nine patients (4.1%) required treatment with a total hip arthroplasty due to post-traumatic arthritis. The Harris Hip Score at final follow-up was 77.1 (SD 20.1), and the Western Ontario and McMaster Universities Osteoarthritis Index was 21.6 (SD 13.7). The overall rate of RTS was 57.7%. Conclusions: Treatment with DHS for unstable trochanteric fractures is a safe option in middle-aged patients, ensuring a good functional recovery. Full article
(This article belongs to the Special Issue Acute Trauma and Trauma Care in Orthopedics)
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11 pages, 2996 KiB  
Article
Vertebral Fractures in Pediatric Suicidal Jumpers: A Retrospective Study with Epidemiological and Clinical Analysis before and after the COVID-19 Pandemic
by Marco Crostelli, Osvaldo Mazza, Francesca Manfroni, Federico Tundo, Valeria Calogero, Marianna Mazza, Roberto Averna and Stefano Vicari
J. Clin. Med. 2023, 12(23), 7412; https://doi.org/10.3390/jcm12237412 - 29 Nov 2023
Viewed by 866
Abstract
Background: From the beginning of the COVID-19 pandemic, reports in the literature confirm a significant increase in suicide attempts in children and adolescents. At the Bambino Gesù Pediatric Hospital Emergency Department (Rome, Italy), there was a dramatic increase in suicidal jumpers. Many of [...] Read more.
Background: From the beginning of the COVID-19 pandemic, reports in the literature confirm a significant increase in suicide attempts in children and adolescents. At the Bambino Gesù Pediatric Hospital Emergency Department (Rome, Italy), there was a dramatic increase in suicidal jumpers. Many of these presented vertebral fractures. Methods: This retrospective study includes all suicidal jumpers with vertebral fractures treated from April 2017 to March 2023. We collected and compared data from three years before to three years after the pandemic, analyzing vertebral fractures. Results: From April 2019 to March 2020, 141 cases of suicide attempt arrived at the emergency department. Five of these were suicidal jumpers without vertebral fractures. From April 2020 to March 2023, 362 cases of suicide were hospitalized and 19 were suicidal jumpers; 12 reported vertebral fractures (mean age 14 years). Seven patients were treated by percutaneous pedicle fixation. Three patients needed an open spinal surgery by posterior approach. One case with cervical fractures was treated by Halo-Vest. Conclusions: This is the first report that shows a sharp increase in vertebral body fractures due to suicide jumping attempts in children and adolescents. This could be a new epidemiological phenomenon persisting or even increasing over time in the pediatric population as a consequence of the COVID-19 pandemic. Full article
(This article belongs to the Special Issue Acute Trauma and Trauma Care in Orthopedics)
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10 pages, 974 KiB  
Article
Functional Postoperative Outcome for 92 Cases of Radial Head Fractures: A PROM-Based Retrospective Study
by Michael Müller, Verena Mann, Julian Zapf, Konstantin Kirchhoff, Michael Zyskowski, Peter Biberthaler, Chlodwig Kirchhoff and Markus Wurm
J. Clin. Med. 2023, 12(18), 5870; https://doi.org/10.3390/jcm12185870 - 09 Sep 2023
Viewed by 849
Abstract
Background: Fractures of the radial head are common injuries, whereas, in the case of displaced fractures, surgical treatment using screw or plate osteosynthesis, excision, or replacement of the radial head is required. However, data about patient-related outcomes (PROM) for different types of [...] Read more.
Background: Fractures of the radial head are common injuries, whereas, in the case of displaced fractures, surgical treatment using screw or plate osteosynthesis, excision, or replacement of the radial head is required. However, data about patient-related outcomes (PROM) for different types of radial head fractures is limited in the current literature. Therefore, this study was conducted to evaluate the functional outcome after operatively treated radial head fractures and to further correlate these results with the initial modified Mason classification. Methods: In this retrospective study, all suitable patients with surgical treatment of a radial head fracture were identified. Only patients with Mason II-IV fractures were included. All patients completed the Elbow Self-Assessment Score (ESAS) questionnaire. Data on fracture classification, type of surgery, and revision operations (if needed) were assessed. Results: A total of 92 patients suffering from fractures of the radial head (57 Mason II, 35 Mason III-fractures) who were operatively treated at our institution were enrolled. There were 42 (47.7%) female and 50 (54.3%) male patients with an average age of 47.5 ± 14.1 years. Screw osteosynthesis was performed in 67 patients, plate osteosynthesis in 20 patients, and five patients received radial head arthroplasty. The average ESAS score accounted for 89.7 ± 16.7. Mason II fractures showed significantly better functional results with higher ESAS scores (92.3 ± 13.9 vs. 85.4 ± 20.1) as well as significantly lower rates of necessary implant removal (0 vs. 5 (14.3%) than Mason III fractures. Screw osteosynthesis showed significantly better functional ESAS scores, 91.0 ± 16.5, than plate osteosynthesis, with 85.3 ± 17.6 (p = 0.041), but was predominantly used in Mason II fractures. Conclusions: Surgical treatment using screw- and plate osteosynthesis of radial head fractures provides a good overall outcome. The postoperative function is associated with the initial Mason classification as the patients’ reported outcome was worse in Mason III fractures compared to Mason type II fractures. In this context, the ESAS score can be considered a useful tool for the assessment of the patient-based functional outcome. Full article
(This article belongs to the Special Issue Acute Trauma and Trauma Care in Orthopedics)
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